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    The Comparison of Postoperative Analgesic Effects of Preemptive Ketamine and Fentanyl Use in Mastectomy Operations
    (2001) Öğün, C. Ö.; Duman, A.; Ökeşli, S.
    The aim of this study was to compare the efficacy of preemptive analgesia with fentanyl or ketamine in women undergoing mastectomy for breast cancer. ASA I-II, 47 women scheduled for mastectomy were included in the study. For all patients, anesthesia was induced with thiopentale, vecuronium and maintained with O 2:N 2O (30:70) + isoflurane. Heart rate (HR), mean arterial pressure (MAP), peripheral O 2 saturation (SpO 2) were monitored. After the induction of anesthesia, the patients were randomly divided in three groups: Group K (n=16) received 1 mg/kg ketamine, while group F (n=16) received 1 ?g/kg fentanyl before the skin incisions and after excision of the specimens. Group P received isotonic saline at sametimes. No other analgesic drugs were used intraoperatively. HR, MAP, extubation times, emergency times, respiration rate, SpO 2, side effects were recorded and postoperative pain was evaluated by visual analogue scale (VAS; 0-10) and verbal rating scale (VRS) in the recovery room at full emergence (0), 1st, 2nd, 4th, 12th and 24th hours. Postoperative analgesic requirements (meperidine) were recorded. The comments of anaesthesiologist and patients about postoperative period were also evaluated. There were no differences in weight, age, emergence times, extubation times. Hemodynamic and respiratory parameters, VAS and VRS scores and meperidine requirements were similar at all times between the group K and F. The increase of postoperative nausea and vomiting in group F was significantly higher than group P but was similar between group K and P and group K and F (p<0.05). As a conclusion, both ketamine and fentanyl have premptive effects in patients undergoing mastectomy but we think that analgesic effects are probably due to administirating ketamine and fentanyl both before surgical incision and before wound closure.
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    Effects of Nimodipine on Tissue Lactate and Malondialdehyde Levels in Experimental Head Trauma
    (2001) Ak, A.; Üstün, M. E.; Öğün, C. Ö.; Duman, A.; Bor, M. A.
    We studied the effects of nimodipine on brain tissue lactate and malondialdehyde (MDA) levels one hour after experimental head trauma in 25 New Zealand rabbits. Group 1 (n=5) was the sham operated group. Group 2 (n = 10) received head trauma without treatment and in group 3 (n=10) nimodipine was administered for 30 minutes intravenously (2 ?g/kg/min) immediately after head trauma. In groups 2 and 3, tissue samples from the non-traumatized side was named as "a" and traumatized side as "b". The lactate and malondialdehyde contents were significantly higher in groups 2a, 2b, 3a and 3b when compared with to group 1 (P<0.05). The differences between non-treated groups (2a, 2b) and nimodipine treated groups (3a, 3b) were not significant (P>0.05). The differences between the traumatized sides (2b, 3b) and non-traumatized sides (2a, 3a) were significant (P<0.05). These results demonstrated that nimodipine is ineffective in suppressing the increase of tissue lactate and malondialdehyde levels in the early period of experimental head trauma.
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    Pain Following Spinal Cord Injury [spinal Kord Yaralanmalarinda Ağrı
    (2002) Levendoğlu, Funda; Öğün, C. Ö.; Öğün, T. C.
    Chronic pain is an important problem following spinal cord injury (SCI) with a prevelance around 65 %. One third of these people rate their pain as severe. A number of pain syndromes such as the transitional zone and central dysesthesia syndromes are associated with spinal injury based on the nature of the lesion, neurological structures damaged, and secondary pathophysiological changes. Accurate identification of pain types will help in selecting appropriate treatment approaches. Current pain treatment includes pharmacological approaches, surgical approaches, psychosocial modalities, electrical stimulation procedures, neurolytic injections, and physical modalities. But, results of these treatments are still controversial, Increased understanding of the pathogenesis of nociceptive, and neurogenic pain syndromes will enable clinicians develop effective therapies for these pain states that will improve the quality of life of patients with SCI.