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Öğe Determining the Effect of Sufentanil on Propofol Injection Pain(KUWAIT MEDICAL ASSOC, 2012) Saritas, Tuba Berra; Borazan, Hale; Kara, Inci; Tuncer, Sema; Otelcioglu, SerefObjectives: Propofol is a general anesthetic. Its most important disadvantage is pain on injection. Our aim was to evaluate the effectiveness of sufentanil on propofol injection pain (PIP). Design: Case control randomized double-blind study Setting: Anesthesia department of Selcuk University Meram Medical School, Turkey Subjects: A total of 160 adults, 18 to 65 years, ASA I-II patients, scheduled for operations under general anesthesia, were enrolled in this study. A 22-gauge intravenous (IV) catheter was inserted into a vein on the dorsum of the hand. Patients were randomly allocated to one of four groups to receive either saline or 0.5, 1, 2 mcg sufentartil in 2 ml volume. Thirty seconds after the intravenous (IV) injection of the pretreatment drug, 5 ml of 1% propofol at room temperature (Fresenius Kabi, Hamburg, Germany) was injected IV at rate of 0.5 ml/sec. Pain was assesed verbally and scored as none (0), mild (1), moderate (2), severe (3). Interventions: Prior injection of sufentanil or placebo Main Outcome Measures: Severity of PIP Results: Demographic data were comparable among four groups. Sufentanil at 1 and 2 mcg doses significantly decreased pain incidence when compared to the saline group (p < 0.05). Sufentanil 0.5 mcg had no effect.(p > 0.05). Although 2 mcg sufentanil decreased the incidence of PIP more than 1 mcg, there was no significant difference between these groups (p > 0.05). Conclusion: Sufentanil at one and 2 mcg doses reduced the incidence and severity of PIPÖğe Effects of Preoperative Oral Melatonin Medication on Postoperative Analgesia, Sleep Quality, and Sedation in Patients Undergoing Elective Prostatectomy: A Randomized Clinical Trial(Springer Tokyo, 2010) Borazan, Hale; Tuncer, Sema; Yalçın, Naime; Erol, Atilla; Otelcioğlu, ŞerefPurpose Our intention was to assess the effectiveness of preoperative oral melatonin medication on sedation, sleep quality, and postoperative analgesia in patients undergoing elective prostatectomy. Fifty-two ASA I-II patients undergoing elective prostatectomy were included in this study, randomly divided into two groups. Patients received an oral placebo (n = 26) or 6 mg melatonin (n = 26) the night before and 1 h before surgery. All patients received a standard anesthetic protocol. At the end of surgery, all patients received tramadol i.v. via a PCA device. Extubation time, intraoperative fentanyl consumption, and recovery time were assessed at the end of the operation. Pain scores, tramadol consumption, and sedation scores were assessed at 1, 2, 4, 6, 12, 18, and 24 h postoperatively, and sleep quality and subjective analgesic efficacy were assessed at 24 h after surgery. There were no significant differences in demographic data between the groups. Extubation time and recovery time from anesthesia were significantly longer in the melatonin group (P < 0.05). Intraoperative fentanyl usage, pain scores, and tramadol consumption were significantly lower in the melatonin group (P < 0.05). The postoperative sleep quality of patients was significantly better in the melatonin group than in the control group (P < 0.05). Postoperative VAS of pain was significantly lower in the melatonin group compared with the control group at 1, 2, 4, 6, 12, 18, and 24 h postoperatively (P < 0.05). Subjective analgesic efficacy of patients was significantly different between groups (P < 0.05). The sedation scores were significantly higher in the melatonin group than in the control group at 1 h and 2 h after surgery (P < 0.05). Preoperative oral melatonin administration decreased pain scores and tramadol consumption and enhanced sleep quality, sedation scores, and subjective analgesic efficacy during the postoperative period.Öğe Gebelik ve Yıldırım Çarpması (Olgu Sunumu)(2006) Borazan, Hale; Gedik, Ender; Çiçek, Müslüm; Ülger, Hacer; Ersoy, ÖzcanYıldırım çarpmasına bağlı yaralanmalarda dünyada her yıl yaklaşık olarak 1000 kişinin öldüğü tahmin edilmektedir. Ancak yaralanmaların ortalama %70i öldürücü değildir. Yıldırım çarpması üç mekanizma ile etki gösterir. Bunlar; en öldürücü ve ciddi yaralanmalara sebep olanı direkt etkilenme, ağaç ya da uzun bir nesneden yansıma ve etkilenmiş zeminde duran kişiye alt ekstremiteden geçiş yoluyla olmaktadır. Bu olgu sunumunda, 29 yaşında 28 haftalık gebeliği olan kadın hastanın açık alanda çalışırken yıldırım çarpmasına maruz kalması, klinik bulguları ve tedavisi anlatıldı.Öğe A novel modified PAIR technique using a trocar catheter for percutaneous treatment of liver hydatid cysts: a six-year experience(AVES, 2016) Nayman, Alaaddin; Guler, Ibrahim; Keskin, Suat; Erdem, Tuba Berra; Borazan, Hale; Kucukapan, Ahmet; Ozbiner, HuseyinPURPOSE We aimed to demonstrate the success and reliability of a novel puncture, aspiration, injection, and reaspiration (PAIR) technique in liver hydatid cysts. METHODS Percutaneous treatment with ultrasonographic guidance was performed in 493 hepatic hydatid cysts in 374 patients. Patients were treated with a new PAIR technique by single puncture method using a 6F trocar catheter. The results of this novel technique were evaluated with regards to efficacy and safety of the procedure and complication rates. RESULTS Out of 493 cysts, 317 were Gharbi type I (WHO CE 1) and 176 were Gharbi type II (WHO CE 3A). Of all cysts, 13 were referred to surgery because of cystobiliary fistulization. Recurrence was observed in 11 cysts one month later. Therefore, the success rate of the PAIR technique was 97.7% (469/480). Minor complications (fever, urticaria-like reactions, biliary fistula) were seen in 44 treated patients (12%, 44/374); the only major complication was reversible anaphylactic shock which was observed in two patients (0.5%, 2/374). CONCLUSION This novel modified PAIR technique may be superior to catheterization by Seldinger technique due to its efficiency, easier application, lower severe complication rate, and lower cost. Further comparative studies are required to confirm our observations.Öğe Prevention of Pain on Injection of Propofol: A Comparison of Lidocaine with Different Doses of Paracetamol(Lippincott Williams & Wilkins, 2010) Borazan, Hale; Erdem, Tuba B.; Keçecioğlu, Melahat; Otelcioğlu, ŞerefBackground and objective The aim of this study was to compare the efficacy of pretreatment with paracetamol 0.5 mg kg(-1), 1 mg kg(-1), 2 mg kg(-1) and lidocaine 0.5 mg kg(-1) for prevention of propofol induced pain. Methods In this double-blind, placebo-controlled study, 250 adult patients ASA I or II, scheduled to undergo elective surgery, were randomly assigned into five groups of 50 each. Group P-0.5, group P-1 and group P-2 received 0.5, 1 and 2 mg kg(-1) paracetamol respectively; group L received 0.5 mg kg(-1) lidocaine; and the control group, group C, received isotonic saline pretreatment in the dorsum of the hand, followed by propofol 1 min later. A blinded researcher assessed the patient's pain level via a four-point scale. Results There were no significant differences in patient characteristics among the groups. The incidence of propofol injection pain in all treatment groups was significantly lower than in the control group (P < 0.001). When the paracetamol 0.5 mg kg(-1) group was compared with both the paracetamol 1 mg kg(-1) group (P < 0.01) and the paracetamol 2 mg kg(-1) group (P < 0.001), significant differences were observed. In the lidocaine 0.5 mg kg(-1) group propofol injection pain was significantly reduced compared with the paracetamol 0.5 mg kg(-1) group (P < 0.01). However, in the paracetamol 2 mg kg(-1) group pain was more significantly reduced than in the lidocaine 0.5 mg kg(-1) group (P < 0.001). In the paracetamol 2 mg kg(-1) group the incidence of pain was significantly less than in paracetamol 1 mg kg(-1) group (P < 0.001). Conclusion When given as venous retention pretreatments 1 min before propofol, paracetamol 1 mg kg(-1) and lidocaine 0.5 mg kg(-1) were equally effective in attenuating pain during intravenous (i.v.) injection of propofol whereas pretreatment with paracetamol 2 mg kg(-1) was shown to be the most effective treatment.Öğe Regional anesthesia with a single spinal anesthesia using hyperbaric bupivacaine in a child with arthroglyposis multiplex congenita(SPRINGER TOKYO, 2012) Borazan, Hale; Uluer, M. Selcuk; Sahin, Osman; Okesli, SelminArthrogryposis multiplex congenita (AMC) consists of complex congenital anomalies characterized by multiple contractures. Anesthetic management of these patients requires special care: as this disease often progresses until dysfunction of multiple organ systems occur, it may have an impact on the anesthetic management. Here, we report a case of AMC undergoing urgent surgery for open tibia fracture who had difficult airway management because of limited mouth opening. The anesthetic management of this patient is represented in light of the literature.Öğe Transfusion Related Acute Lung Injury: A Severe Case Triggered with Anti-HLA Class II Antibodies in the Recipient(PHARMAMED MADO LTD, 2012) Borazan, Hale; Yosunkaya, Şebnem; Yosunkaya, AlperTransfusion-related acute lung injury (TRALI) is a serious clinical syndrome associated with the transfusion of plasma-containing blood components. The classic TRALI syndrome is characterized by the suddenly onset of respiratory failure within 2-6 hrs of the transfusion of a blood product, generally transient, resolves within 48-96 hrs spontaneously, and has a better prognosis. Nonetheless there is an expanded definition of TRALI syndrome up to 72 hrs, which is called delayed TRALI. The potential causes of TRALI can be explained by two distinct mechanism including the anti-leukocyte antibodies in donor plasma or in recipient plasma with the reverse mechanism, and biological response modifiers in susceptible individuals. This report highlights the succesful management of a classic TRALI case that was seen approximately two hours after the transfusion of a packed red blood cell and triggered with anti-HLA class II antibodies in the recipient with reverse mechanism accompanied by neutropenia together.Öğe Transüretral prostat rezeksiyonunda intratekal düşük doz levobupivakain ve bupivakainin etkilerinin karşılaştırılması(2008) Borazan, Hale; Erdem, Tuba B.; Davarcı, Işıl; Otelcioğlu, ŞerefAmaç: Transüretral prostat rezeksiyonu (TURP) operasyonu geçirecek yaşlı hastalarda düşük dozda uygulanan levobupivakain ve izobarik bupivakainin etkilerinin karşılaştırılması amaçlanmıştır. Gereç ve yöntem: Benign prostat hiperplazisi (BPH) nedeniyle opere edilecek ASA II-III grubu 60 hasta rastgele iki gruba ayrılıp, birinci gruba (Grup L)10 mg (2 mL) % 0.5 levobupivakain (Chirocaine % 0.5, Abbott), ikinci gruba (Grup B) 10 mg (2 mL) % 0.5 izobarik bupivakain (Marcaine % 0.5,Astra-Zeneca) 22 G spinal iğne ile L3-4 aralığından intratekal aralığa verildi. Hastaların kalp atım hızı, noninvaziv kan basınçları, duyusal blok seviyesi ve motor blok seviyesi kaydedildi. Duyusal blok seviyesi T10 olduğunda operasyona izin verildi. Sonuçlar: Hastaların demografik verileri, cerrahi süreleri ve ASA fiziksel durumlarında, kalp atım hızı, sistolik arter basıncı, diastolik arter basıncı ve ortalama arter basıncı ölçümlerinde gruplar arasında istatistiksel olarak anlamlı fark bulunmadı (p 0.05). Duyusal blok özellikleri karşılaştırıldığında, duyusal blok başlama zamanı levobupivakain grubunda, bupivakain grubundan anlamlı olarak kısa bulundu (p 0.05). Motor blok başlama zamanı, komple motor blok kalkma zamanı ve cerrahi sonunda Bromage skorlarında levobupivakain grubu ile bupivakain grubu arasında istatistiksel olarak anlamlı fark bulunmadı (p 0.05). Yan etkiler açısından iki grup arasında anlamlı farklılık yoktu (p 0.05). Tartışma: BPH nedeniyle opere edilecek hastalarda spinal anestezide levobupivakain ve bupivakainin, bu dozlarda yan etkilerinin az olduğu ve hemodinamiyi bozmadan yeterli anestezi sağladıkları sonucuna ulaştık. Yaşlı hastalarda her ikisinin de bu dozlarda güvenle kullanılabileceğini düşünüyoruz.
