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Öğe Comparison of Intrathecal Isobaric Bupivacaine-Morphine and Ropivacaine-Morphine for Caesarean Delivery(Elsevier Sci Ltd, 2003) Öğün, Cemile Öztin; Kırgız, E. N.; Duman, Ateş; Ökeşli, Selmin; Akyürek, CemalettinBackground. This study was designed to evaluate the effects of intrathecal isobaric bupivacaine 0.5% plus morphine and isobaric ropivacaine 0.5% plus morphine combinations in women undergoing Caesarean deliveries. Method. Twenty-five parturients received ropivacaine 15 mg and morphine 150 mug (RM group) and twenty-five parturients received bupivacaine 15 mg and morphine 150 mug (BM group) for spinal anaesthesia. Sensory and motor block, haemodynamics, postoperative analgesia, fetal outcomes, and side-effects were evaluated. Results. Intrathecal bupivacaine-morphine and ropivacaine-morphine provided effective sensory anaesthesia and motor block. Time to reach complete motor block was shorter and time to complete recovery from motor block was longer in the BM group than the RM group (P<0.05). The time to regression of two dermatomes and time for the block to recede to the S2 dermatome were similar in both groups (P>0.05). Time to first complaint of pain and the mean total consumption of tenoxicam were similar in both groups (P>0.05). APGAR scores at 1 and 5 min were similar in the two groups, as were mean umbilical blood pH values (P>0.05). Hypotension and pruritus were the most common side-effects in both groups during the operation. Conclusion. Intrathecal isobaric ropivacaine 0.5% 15 mg plus morphine 150 mug provides sufficient anaesthesia for Caesarean delivery. The ropivacaine-morphine combination resulted in shorter motor block, similar sensory and postoperative analgesia.Öğe Correlation Between Tissue Lactate Levels and Electroencephalogram In Evaluating the Severity of Experimental Head Trauma(Lippincott Williams & Wilkins, 2002) Öğün, Cemile Öztin; Üstün, Mehmet Erkan; Duman, Ateş; Gürbilek, Mehmet; Genç, Bülent OğuzObjective: The objective of this study was to develop an electroencephalographic grading scale for evaluating the severity of head trauma and assessing the correlation of this scale with brain tissue lactate concentrations. Design: Animal experiment. Setting: Animal research laboratory in a university hospital. Subjects: Thirty New Zealand rabbits were divided into three groups. Interventions: Rabbits were anesthetized, and bilateral frontoparietal craniectomy was performed. An electroencephalogram was recorded over the dura from both sides. After electroencephalographic recording, unilateral trauma was produced by using the weight drop method with a calculated force of 401) g(.)cm(-1) and 800 g(.)cm(-1) in group 2 (n = 10) and group 3 (n = 10), whereas in group I (n = 10) only craniectomy was performed. Electroencephalographic recording was repeated 60 mins after trauma or craniectomy, and cortical tissue samples were resected from both sides to evaluate tissue lactate concentrations in all three groups. Measurements and Main Results: Electroencephalographic recordings from both sides of the brain were evaluated together by using a 6-point scale (1 = best to 6 = worst) that was based on the presence or absence of electroencephalographic activity and the decrease in amplitude or frequency band of the electroencephalogram. Lactate was measured in resected tissue by using spectrophotometric enzymatic methods. One-way analysis of variance for repeated measures, Bonferroni-adjusted paired Student's t-test, Kruskal Wallis analysis of variance, Bonferroni-adjusted Mann-Whitney-U, and Spearman's correlation tests were used as appropriate for statistical analysis. We considered p < .05 to be significant. The difference in lactate concentrations was significant between the three groups (p < .05). Electroencephalographic grades were significantly different between the pretraumatic and posttraumatic recordings (p < .05) and between the three groups after craniectomy or trauma (p < .001). There was a positive high correlation between lactate concentrations and electroencephalographic grades. Conclusions. Tissue lactate concentrations and electroencephalograhic grades change with the severity of the trauma, and there is a strong positive correlation between tissue lactate concentrations and electroencephalographic grades.Öğe The Effect on Intraocular Pressure of Tracheal Intubation or Laryngeal Mask (Tm) Insertion During Sevoflurane Anaesthesia in Children Without the Use of Muscle Relaxants(BLACKWELL SCIENCE LTD, 2001) Duman, Ateş; Öğün, Cemile Öztin; Ökeşli, SelminBackground: We studied the effects of sevoflurane on intraocular pressure after induction in children undergoing either tracheal tube (TT) or laryngeal mask airway (LMA(TM)) insertion without a muscle relaxant Methods: The study included 38 children. Anaesthesia was induced (8%) and maintained (3-4%) with sevoflurane in 100% O-2. NO muscle relaxant was used. A TT was inserted in group I (n = 20), and an LMA in group II (n = 18). IOPs were measured after induction, insertion of TT or LMA and at 1, 2 and 3 min thereafter. The heart rate, mean arterial pressures were also recorded. Results: Intraocular pressures increased significantly in group I after TT (P < 0.01) and remained high until after 3 min. The pressures were similar in the LMA group at all measurements. Conclusions: Sevoflurane does not prevent the increase in IOP after intubation without muscle relaxants. LMA does not increase IOP in children after sevoflurane induction.Öğe Effects of Deferoxamine on Tissue Superoxide Dismutase and Glutathione Peroxidase Levels in Experimental Head Trauma(LIPPINCOTT WILLIAMS & WILKINS, 2001) Üstün, Mehmet Erkan; Duman, Ateş; Öğün, Cemile Öztin; Sümer, Fatih; Gürbilek, MehmetBackground: This study aims to evaluate the effects of deferoxamine on tissue superoxide dismutase (SOD) and glutathione peroxidase (GPx) brain levels after head trauma. Methods: Thirty rabbits were divided equally into three groups: group 1 was the sham-operated group, group 2 suffered head trauma (no treatment was given), and group 3 received deferoxamine 50 mg/kg after the trauma. Head trauma was applied unilaterally. One hour after trauma, brain cortices were resected and SOD and GPx levels were determined. One-way analysis of variance and Tukey-HSD tests were used for analysis. Significance was defined asp < 0.05. Results: Baseline SOD levels are preserved in the traumatized side of the deferoxamine-treated group. Although GPx level of the traumatized side of the deferoxamine-treated group decreased significantly, the decrease was significantly less than the nontreated group. Conclusion: Trauma leads to a decrease in brain tissue SOD and GPx levels, Deferoxamine suppresses this decrease completely in SOD level and partially in GPx level when given after trauma.Öğe Effects of Nimodipine and Magnesium Sulfate on Endogenous Antioxidant Levels in Brain Tissue After Experimental Head Trauma(LIPPINCOTT WILLIAMS & WILKINS, 2001) Üstün, Mehmet Erkan; Duman, Ateş; Öğün, Cemile Öztin; Vatansev, Hüsamettin; Ak, AhmetTo examine the effects of calcium antagonists nimodipine and magnesium sulfate (MgSO4) on tissue endogenous antioxidant levels, the authors studied superoxide dismutase (SOD) and glutathione peroxidase (GPx) levels in rabbit brain 1 hour after experimental head trauma. Forty New Zealand rabbits were anesthetized and randomly divided into four groups. Group 1 (n = 10) was the sham operated group. Group 2 (n = 10), the control group, received head trauma and no treatment. Group 3 (n = 10) received head trauma and intravenous (IV) 2 mu gr/kg nimodipine. Group 4 (n = 10) received head trauma and IV 100 mg/kg MgSO4. Head trauma was delivered by performing a craniectomy over the right hemisphere and dropping a weight of 20 g from a height of 40 cm. In the right (traumatized) hemisphere, SOD and GPx decreased by 57.60% +/- 9.60% and 72.93% +/- 5.51% respectively from sham values. Magnesium sulfate, but not nimodipine, reduced the magnitude of decrease of SOD and GPx to 19.43% +/- 7.15% and 39.01% +/- 7.92% respectively from sham values. In the left (nontraumatized) hemisphere, MgSO4 increased SOD to 42.43% +/- 24.76% above sham values. The authors conclude that MgSO4 treatment inhibited the decrease in SOD and GPx levels in experimental brain injury.Öğe Sakral düzeyde bir spinal blok seviyesi sürekli irrigasyon rezektoskopuyla yapılan transüretral prostat rezeksiyonları için yeterli anestezi sağlar mı?(2011) Apilioğulları, Seza; Sakallı, Melike; Duman, Ateş; Balasar, Mehmet; Öğün, Cemile ÖztinGiriş: Mesane basıncı düşük tutulduğunda L1 seviyesinde ki spinal bloğun transüretral prostat rezeksiyonu (TURP) için yeterli olduğu bildirilmiştir. Bu çalışmada sürekli irrigasyon rezektoskopu kullanılarak uygulanan TURP operasyonlarında spinal düşük doz (5 mg) bupivakain ile bupivakain fentanil kombinasyonunun spinal anestezi yeterliliği ve özellikleri açısından karşılaştırılması amaçlandı. Gereç ve Yöntem: Etik kurul onayı ve yazılı onamları alınan 50 hasta randomize yöntemle çalışmaya alındı. Oturur pozisyonda Grup B'de (n25) 5 mg hiperbarik bupivakain 0,4 ml %0,9 NaCl, Grup BF' de (n25) 5 mg hiperbarik bupivakain 0,4 ml (20?g) fentanil ile spinal anestezi yapıldı. Duyusal blok seviyeleri, motor blok değerleri, intraoperatif anestezi kalitesi, cerrahi çalışma koşulları ve yan etkiler kayıt edildi. Bulgular: Her iki grupta hemodinamik değişiklikler, maksimum duyusal blok seviyesi (L2) ve motor blok özellikleri açısından farklılık gözlenmedi. Duyusal blok seviyeleri S1'den yüksek olan 50 olgunun 46'sında yeterli cerrahi analjezi koşulları ek analjezi uygulanmaksızın sağlandı. Anestezi kalitesi ve cerrahın çalışma koşulları açısından gruplar benzerdi ve yan etkiler açısından fark yoktu. Sonuç: Fentanilli ya da fentanilsiz 5mg bupivakain ile S1 düzeyinin üzerinde bir duyusal blok, sürekli irrigasyon rezektoskopu kullanılarak yapılan TURP operasyonları için güvenli ve yeterli anestezi sağlamaktadır.
