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  • Küçük Resim
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    The effect of environmental tobacco smoke on the dose requirements of rocuronium in children
    (BLACKWELL PUBLISHING LTD, 2004) Reisli, R; Apilliogullari, S; Reisli, I; Tuncer, S; Erol, A; Okesli, S
    Background: Smoking affects the pharmacodynamic and pharmacokinetic behaviour of several drugs. The aim of this study was to evaluate the effects of environmental tobacco smoke on onset and recovery time after single dose rocuronium in children. Methods: Forty children between 4 and 10 years were enrolled into the study. Children who have no familial smoking history were included in the first group whereas passive smokers included in the second group. Sevoflurane in 50% O-2 and 50% N2O was used for induction of anaesthesia. Evoked adductor pollicis electromyography was used to monitor neuromuscular block. The T-95 and T-25 values were recorded. Results: The T-95 values (+/-SD) for rocuronium were 110.1 +/- 39.3 s and 79.3 +/- 35.6 s for group 1 and group 2, respectively (P < 0.05). The T-25 value of group 2 was 40.1 +/- 10.6 min and compared with group 1 values (30.85 +/- 7.02 min) it was significantly longer (P < 0.01). Conclusion: This study shows that passive smoking children consume less rocuronium than nonsmokers during similar anaesthesia. We think that a history of passive smoking must also be taken into consideration during preoperative evaluation of paediatric patients.
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    The effects of adding diphenhydramine hydrochloride to lidocaine in intravenous regional anaesthesia
    (VSP BV, 2003) Reisli, R; Celik, J; Tuncer, S; Apilliogullari, S; Duman, A; Yosunkaya, A; Okesli, S
    This study aimed to evaluate whether diphenhydramine hydrochloride (DPH) could be used to reduce the dose of lidocaine for intravenous regional anaesthesia (IVRA). Sixty patients undergoing upper limb operations were divided into three groups (20 each). All patients received IVRA as follows: group 1 received 3 mg/kg lidocaine, group 2 received 40 mg DPH and 1.5 mg/kg lidocaine, and group 3 received 1.5 mg/kg lidocaine diluted to 40 ml with 0.9% saline solution. The onset of sensory block was tested by a pinprick. The duration of anaesthesia time was also recorded. Intraoperative pain was assessed using a five point pain score system. Side effects during surgery and after release of the tourniquet were recorded. Only 4 patients in group 3 had sufficient analgesia. Therefore, the patients in group 3 were excluded from the study. Data from 40 patients (group I and 2) were analysed. The onset time of sensory block was significantly shorter in group I than group 2 (2.4 +/- 1.54 min and 6.85 +/- 1.46 min, respectively). The tourniquet pain time was also significantly longer in group I than in group 2 (57.15 +/- 10.90 min and 42.65 +/- 9.67 min, respectively). One patient from each group experienced tinnitus for 30-60 s, and 4 patients in group 2 had minimal sedation after tourniquet release. According to our results, DPH is a safe and useful adjunct to IVRA in minor procedures of short duration. Decreasing the dose of lidocaine also decreases the risk of local anaesthetic toxicity in the event of accidental release of tourniquet pressure.