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Öğe The Comparison of Bupivacaine-Tramadol Combination With Bupivacaine-Fentanyl and Plain Bupivacaine in Epidural Anesthesia(2002) Kesriklioğlu, A.; Duman, A.; Öztin, Öğün C.; Reisli, R.; Ökeşli, S.In this study, the properties of epidural anesthesia with 0.5% bupivacaine and tramadol was compared with epidural anesthesia using bupivacaine-fentanyl or plain bupivacaine. For this purpose, 63 patients undergoing transuretral prostate resection were divided into three groups. Group BT(n = 22) received 70mg 0.5% bupivacaine + 50 mg tramadol HCl, Group BF(n = 21) received 70mg 0.5% bupivacaine + 50 ?g fentanyl and Group B(n = 20) received only 70mg 0.5% bupivacaine epidurally. Heart rate (HR), mean arterial pressure (MAP), breath rate (BR), oxygen saturation (SpO2), levels of sensorial block, maximum sensorial block level and motor block level were recorded. Time to need for an analgesic supplement (effective analgesia) (time to reach VAS 4) was recorded. One way analysis of variance, Tukey HSD, Kruskall Wallis, Bonferroni corrected Mann-Whitney-U tests were used. No significant change in HR was seen in between the three groups after the epidural block. A significant decrease of MAP was seen in Group BF beginning at the 40th minute lasted up to the 60th minute. Time to reach T10 sensory block level and time to reach maximum sensory block level was shorter in Group BF than Groups BT and B while Group BT and Groups B were similar. Time to complete motor block was similar in Group BT and BF. The number of patients with complete motor block was similar in Group BT and BF while there was no patient with complete motor block in Group B. The time to reach VAS 4 was 17.57 ± 7.82 hours in Group BT, 11.79 ± 8.48 hours in Group BF and 5.40 ± 2.67 hours in Group B (p < 0.05). Side effects were similar and no treatment was needed. In conclusion, tramadol-bupivacaine combination increases postoperative analgesia time significantly compared with fentanyl-bupivacaine combination and plain bupivacaine while providing stabile hemodynamic responses and similar side effects.Öğe 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.Öğe A Comperative Study on Allergic Reactions Related to Various Anaesthetic Agents(1997) Altındiş, M.; Tuncer, S.; Özmen, S.; Ökeşli, S.; Sütçü, A.; Baysal, B.This study was designed to determine and compare allergic reactions due to IV anaesthetic agents used during surgical operations. From the Departments of general surgery, urology and orthopaedics 60 adults patients (27 male and 33 female with 35.9±12.5 mean age) having no tumoral-endocrine pathology or allergy/athopy history and being classified as ASA I and II were included to the study. They were divided into four groups as equal in number. The groups were similar demographically. After permission of the hospital's ethic comittee, the 4 groups were respectively infused with propofol (2.5 mg/kg) thiopentone (5 mg/kg), etomidate (0.3 mg/kg) and midazolam (0.3 mg/kg) for induction. Serum IgE levels (by ELISA using EIA-Bioclone, Australia) and eosinophil and basophil counts (by using autoanalyser) were measured in blood samples drawn both just before, after induction and 24 hrs later. As a result, we detected thiopentone to cause significant increase in serum IgE levels and eosinophil and basophil counts more than those of the other 3 agents (p<0.05). We concluded that, instead of using thiopentone, propofol, etomidate or midazolam may be a safer alternative for patients with an allergy/athopy history.Öğe EEG Findings in Etomidate Anaesthesia(1992) Özmen, S.; Ökeşli, S.; İlhan, N.; Akhan, G.; Otelcioğlu, S.; Ünal, F.This study included 30 volunteer cases (19 male, 11 female) in ASA-I group with normal electroancephalographic findings. All cases divided in 3 groups randomly and 45 minutessd prior to administration of etomidate, first group was premedicated with 0.5 mg Atropine, second group with 0.5 mg Atropine and 10 mg Diazepam and third group with 0.5 mg Atropine and 01. mg Fentanyl. Induction has been succeeded by IV 0.4 mg/kg etomidate. In order to maintain anaesthesia 0.1 mg/kg etomidate was administered intravenously at 5th minute and EEG was obtained for 15 mintures after first dosage of etomidate. The EEG findings of etomidate anaesthesia and the relation of myoclonia (the main side effect) with CNS was evaluated by EEG records. EEG findings were not affected with premedication methods and no correlation between myoclonia and EEG signs was established. However, myoclonia was decreased significantly in patients who received Fentanyl as premedication. Instead of the irregular alpha and fast activities were observed on control EEG recordings in patients anaesthetised with etomidate. The sharp waves and the suppression burst activities appeared in some cases. In conclusion attention must be paid during etomidate anaesthesia in epileptic patients or it should be avoided using etomidate in patients who has a history of epilepsy because of the possibility of provocating the seizures.Öğe Effect of Dexmedetomidine on Pain Caused by Injection of Propofol(2012) Şarkılar, G.; Kara, I.; Duman, A.; Aygın, F.; Ökeşli, S.Objective: This study was designed to assess the local and systemic effects of two different pre-anesthetic infusion dose of dexmedetomidine in preventing propofol injection pain. Material and Method: Two hundred fifty adults were assigned into five groups. Before injection of propofol, group 1 (placebo n=50) received an infusion of saline solution, group 2 (n=50) received 0.5 ?g kg -1 of dexmedetomidine and group 3 (n=50) received 1 ?g kg -1 of dexmedetomidine from the same vein. Group 4 (n=50) received 0.5 ?g kg -1 of dexmedetomidine and group 5 (n=50) received 1 ?g kg -1 dexmedetomidine followed by an injection of propofol from a vein located in the opposite hand. Pain assessment was made immediately after propofol injection. Results: Two hundred twenty five patients completed the study. The number of patients who suffered from any degree of pain was significantly high when compared to dexmedetomidine group (p=0.05). When compared with placebo and opposite hand, administering dexmedetomidine from the same vein was more efficient to prevent propofol pain (p=0.003). 1 ?g kg -1 of dexmedetomidine was similar to 0.5 ?g kg -1 of dexmedetomidine in preventing propofol pain.Conclusion: Dexmedetomidine infusions in pre-anesthetic sedative doses of 0.5 ?g kg -1 and 1 ?g kg -1 decrease the incidence of propofol injection pain compared to placebo.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 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.
