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Öğe Anaesthetic and Haemodynamic Effects of Continuous Spinal Versus Continuous Epidural Anaesthesia With Prilocaine(Greenwich Medical Media Ltd, 2003) Reisli, Ruhiye; Çelik, J.; Tuncer, S.; Yosunkaya, Alper; Otelcioğlu, S.Background and objective: To compare, using prilocaine, the effects of continuous spinal anaesthesia (CSA) and continuous epidural anaesthesia (CEA) on haemodynamic stability as well as the quality of anaesthesia and recovery in patients undergoing transurethral resection of the prostate gland. Methods: Thirty patients (>60 yr) were randomized into two groups. Prilocaine, 2% 40 mg, was given to patients in the CSA group, and prilocaine 1% 150 mg was given to patients in the CEA group. Incremental doses were given if the level of sensory block was lower than T-10 or if needed during surgery. Results: There was a significant decrease in mean arterial pressure in Group CEA compared with Group CSA (P < 0.01). The decrease in heart rate in Group CSA occurred 10 min after the first local anaesthetic administration and continued through the operation (P < 0.05). The level of sensory anaesthesia was similar in both groups. The times to reach the level of T-10 and the upper level of sensory blockade (T-max) were 18.0 +/- 4.7 and 25.3 +/- 7.0 min in Groups CSA and CEA, respectively, and were significantly longer in Group CEA. The duration of anaesthesia was 76.8 +/- 4 min and was shorter in Group CSA (P < 0.01). Conclusions: Spinal or epidural anaesthesia administered continuously was reliable in elderly patients undergoing transurethral resection of the prostate. Continuous spinal anaesthesia had a more rapid onset of action, produced more effective sensory and motor blockade and had a shorter recovery period. Prilocaine appeared to be a safe local anaesthetic for use with either continuous spinal anaesthesia or continuous epidural anaesthesia.Öğe A Comparison of Ropivacaine With Bupivacaine for Pediatric Caudal Block [çocuklarda Kaudal Blok Uygulanmasinda Bupivakain I?le Ropivakainin Karşilaştirilmasi](2001) Tuncer, S.; Orhan, R.; Çelik, J.; Reisli, Ruhiye; Tavlan, A.; Ökesli, SelminCaudal anaesthesia is a widely used method for lower abdominal, penoscrotal and lower extremity surgery in children. The aim of this study was to evaluate the quality of anaesthesia, the effects on hemodynamic parameters, postoperative pain and side effects of ropivacaine and bupivakaine in caudal anaesthesia. All patients received rectal midazolam 0.4 mg/kg for premedication 30 minutes before surgery. After routine monitorization, patients were randomized into two groups. All patients received 2-2.5 mg/kg bolus propofol intravenously and then propofol infusion was continued through the operation. Immediately after propofol bolus Group I (n=20) received 2 mg/kg 0.25% bupivacaine and Group II (n=20) received 2 mg/kg 0.2% ropivacaine for caudal anaesthesia. Heart rate, arterial blood pressure, SpO2 was measured 5 and 15 minutes after caudal blockade and every 15 minutes until discharged from the operating room. Postoperative pain was assessed according to Modified Pediatric Objective Pain Scale (MPOPS). The level of anaesthesia was satisfactory in both groups. No further analgesia was required. Heart rate, arterial blood pressure, SpO2 and the values of MPOPS were similar in both groups. 45% of Group I and 40% of Group II didn't need postoperative analgesia. As a result, we concluded that ropivacaine (2 mg/kg 0.2%) is as efficacious as bupivacaine (2 mg/kg 0.25%) anaesthesia and postoperative analgesia for caudal anesthesia in children.Öğe The Effects of Halothane and Sevoflurane on Qtc Interval(2000) Reisli, Ruhiye; Çelik, J.; Özdemir, K.; Tavlan, A.; Apillioğlu, S.; Ökeşli, S.Prolongation of the QT interval may cause hazardous arrhythmias. The effects of halothane and sevoflurane on the Q T interval (QTc) have been investigated during induction of anaesthesia in 30 ASA I-II class patients. No premedication was used to avoid the effects of other anaesthetic agents. Anaesthesia was induced with either halothane (n=15) or sevoflurane (n=15), and inspired concentration was increased gradually to achieve a constant initial end-tidal concentration of 2 MAC. After pupils came to midline 0.05 mg/kg atracurium was administered and end-tidal concentration was reduced to 1 MAC. Recordings of ECG, heart rate, systolic and diastolic arterial blood pressure were obtained at the following times: prior to induction of anaesthesia, after the lost of eye slash reflex, 3 min following atracurium administration, 1 and 3 min after tracheal intubation. QT interval was corrected for the heart rate (QTc). Both halothane and sevoflurane prolonged QTc one minute after the tracheal intubation, but it was statistically significant only in sevoflurane group (p<0.05). The heart rate increased 1 and 3 rain after tracheal intubation with sevoflurane (p<0.05). In both groups, systolic and diastolic arterial blood pressures decreased after induction of anaesthesia (p<0.05). In conclusion the prolongation of the QTc interval by halothane and sevoflurane suggests that caution should be used during administration of these agents to patients with long QTc syndrome.Öğe Intraperitoneal Versus Interpleural Analgesia on Post-Operative Pain to Laparoscopic Cholecystectomy(2000) Çelik, J.; Tuncer, S.; Reisli, R.; Ökeşli, S.; Otelcioğlu, S.In our study, we aimed to compare the quality and duration of analgesia intrapleural bupivacaine, bupivacaine+morphine, only morphine and intraperitoneal bupivacaine, bupivacaine+morphine and only morphine administration for relieving pain after laparoscopic cholecystectomy. 90 cases of ASA I-II class were included in the study. Cases were randomly allocated in six groups. At the end of surgery, Group I (n=15) intraperitoneal 3 mg morphine in 30 mL saline; Group II (n=15) intraperitoneal 30 mL % 0.25 bupivacaine; Group III (n=15) intraperitoneal 30 mL % 0.25 bupivacaine+3 mg morphine; Group IV (n=15) interpleural 3 mg morphine in 30 mL saline; Group V (n=15) interpleural 30 mL % 0.25 bupivacaine; Group VI (n=15) interpleural 30 mL % 0.25 bupivacaine+3 mg morphine were administered. Postoperatif pain was assesed by a visual analog scale, numeric rating scale in 1,2,4,6,12, 24 hours and side effect were recorded for 24 hours. Interpleural bupivacaine was effective for postoperative pain relief and adding morphine to bupivacaine does not increase the quality and duration of analgesia. There were no differences in intraoperative fentanyl consumption and postoperative pain scores (NRS, VAS) were less in groups V and VI than groups I,II,III,IV.Öğe The Maternal and Neonatal Effects of Intrathecal Sufentanil and Fentanyl Added to Hyperbaric Bupivacaine for Cesarean Section [Sezaryenlerde Bupivakaine Eklenen Sufentanil ve Fentanilin Maternal ve Neonatal Etkileri](2003) Reisli, Ruhiye; Tuncer, Sema; Çelik, J.; Yosunkaya, Alper; Uzun, S.; Sarkılar, Gamze; Ökesli, S.We aimed to evaluate the maternal and neonatal effects of intrathecal sufentanil, fentanyl and plasebo added to hyperbaric bupivacaine for cesarean section. After etthical committee approval, 45 healty, full-term parturients allocated into three groups. Group K (control group) received 10 mg bupivacaine heavy and 2 cc % 0.9 NaCl, Group F received 10 mg bupivacaine heavy and 25 ?g fentanyl and Group S received 10 mg bupivacaine heavy and 10 pg sufentanil intrathecally, Total volume of 4 mL was used in both groups. Haemodynamic values, sensory and motor blocs, the first requirement time for analgesia and Intrapostoperative side effects were recorded. Blood samples were collected from the umblical artery for blood gas analyses. Apgar score at 1 and 5 min. and Neurologic and Adaptive Capacity Score (NACS) of newborns at 2 evaluated. There were no significant differences in patients characteristics, time to reach L1-2, T10 and maximal sensory level, degree and resolution of motor block, blood gas analyses, Apgar and NACS scores. Nausea was more in group K than in group S and F (p<0.05). Pruritus was a frequent side effect both in group S and F (p<0.05), but it was more remarkable in group S (p<0.05). Complete analgesia was prolong in group F and S than in group K. The first requirement time for analgesia was longer in group S compared to group F (p<0.05). In summary, intrathecal fentanyl 25 pg or sufentanil 10 ?g added to hyperbaric bupivacaine for cesarean section reduced nausea and increased the duration of analgesia in the early postoperative period. Because this combinations had no adverse effects oil neonatals we concluded that they can be used safely in cesarean sections.Öğe Prevention of Postoperative Nausea-Vomiting in Children: Comparison of Granisetron and Droperidol Plus Metoclopramide(2001) Çelik, J.; Reisli, R.; Tuncer, S.; Duman, A.; Ökeşli, S.This study was performed to compare the efficacy of a droperidol-metoclopramide combination with granisetron to prevent postoperative nausea and vomiting after tonsillectomy with or without adenoidectomy in children. Ninety pediatric patients, ASA class I, aged 4-10 years, were enrolled in a prospective, randomized, double-blind investigation and assigned to one of two treatment regimens; granisetron 40 mg/kg (Group G, n=45), droperidol 50 mg/kg plus metoclopramide 0.25 mg/kg (Group DM, n=45). Antiemetic drugs were administered intravenaously (IV) after inhaled induction of general anaesthesia. The same standard general anesthetic technique was used. Tracheal extubation was performed while patients were still deeply anaesthetized. Acetaminophen (10-25 mg/kg PR) was applied for postoperative analgesia to all children. The rate of complete response, defined as no emesis and no need for rescue antiemetics, 0-3 h after anaesthesia were 85% in group G, 87% in group DM (p>0.05). No clinically important adverse events were observed in any of the groups.
