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Öğe Combination of ultra-low dose bupivacaine and fentanyl for spinal anaesthesia in out-patient anorectal surgery.(FIELD HOUSE PUBLISHING LLP, 2009) Apiliogullari, Seza; Duman, Ates; Tekin, Ahmet[Abstract not Available]Öğe COMPARISON OF SELECTIVE SPINAL ANESTHESIA AND LOCAL INFILTRATION ANESTHESIA UNDER MONITORED ANESTHESIA CARE TECHNIQUES IN PATIENTS UNDERGOING ANORECTAL DAY SURGERY(NOBEL ILAC, 2011) Duman, Ates; Apiliogullari, Seza; Tekin, Ahmet; Bodur, SaidObjective: In this prospective, randomized study, we aimed to compare the two techniques that we employ routinely in our clinic; selective spinal anesthesia (SSA) and local infiltration anesthesia under monitored anesthesia care (MAC) in terms of patient and surgeon satisfaction, time for ambulation (AT), time to be ready for discharge (RD). Material and Method: In group I (n=30), spinal anesthesia was achieved with 2.5 mg 0.5% hyperbaric bupivacaine in the sitting position. In group II (n=30), 0.25 mg.kg-1 of hetamine followed by 1-2mg. kg-1 of propofol were administered intravenously for sedation. Local infiltration anesthesia consisting of 5ml of 0.5% isobaric bupivacaine and 5ml of 2% prilocaine. Patient and surgeon satisfaction, AT, RD and side effects were compared. Results: The mean AT and RD were 38 min and 45 min respectively in group land, 43 mm and 57 min respectively in group II (p<0.05). While the groups were similar in terms of surgeon satisfaction, patient satisfaction was better in group I (p<0.05). Conclusion: When compared to local infiltration anesthesia under MCA, SSA technique provides better patient satisfaction together with shorter AT and RD times.Öğe Do infants need higher intrathecal fentanyl doses than older children? - reply(WILEY-BLACKWELL, 2008) Apiliogullari, Seza; Duman, Ates; Gok, Funda[Abstract not Available]Öğe DOES A SPINAL BLOCK AT SACRAL LEVEL PROVIDE ADEQUATE ANESTHESIA FOR TRANSURETHRAL RESECTION OF THE PROSTATE CONDUCTED WITH CONTINUOUS IRRIGATION RESECTOSCOPE?(GUNES KITABEVI LTD STI, 2011) Apiliogullari, Seza; Sakalli, Melike; Duman, Ates; Balasar, Mehmet; Ogun, Cemile OztinIntroduction: It has been previously reported that a spinal block at L1 level is adequate for transurethral resection of prostate (TURP) if low bladder pressure is provided. This study aims to compare adequacy and the characteristics of spinal anesthesia with low dose bupivacaine and bupivacaine + fentanyl combinations for TURP conducted with continuous irrigation resectoscope. Materials and Method: After Ethical Committee approval and informed consent, 50 patients were included with randomization. Spinal anesthesia was conducted in the sitting position with 5 mg of hyperbaric bupivacaine + 0.4 ml 0.9% NaCl in group B (n=25) and 5 mg of hyperbaric bupivacaine + 0.4 ml (20 mu g) fentanyl in group BF (n=25). Sensory block levels, motor block properties, quality of intraoperative anesthesia, surgical convenience and side effects were recorded. Results: The groups were similar regarding maximum block levels (L2), motor block and hemodynamic, properties. Sufficient analgesia was provided without additional analgesics in 46 of 50 patients with a sensory block higher than S1. Two groups were similar in terms of the quality of anesthesia, convenience for the surgeon and side effects. Conclusion: Bupivacaine (5mg) with or without fentanyl provides safe and adequate anesthesia, with a sensory block higher than S1, when continuous irrigation resectoscope is used for TURP.Öğe The effect of 45-degree head up tilt on bloody tap during lumbar puncture in children(WILEY-BLACKWELL PUBLISHING, INC, 2009) Duman, Ates; Apiliogullari, Seza; Ogun, Cemile Oztin[Abstract not Available]Öğe EFFECT OF DEXMEDETOMIDINE ON PAIN CAUSED BY INJECTION OF PROPOFOL(NOBEL ILAC, 2012) Sarkilar, Gamze; Kara, Inci; Duman, Ates; Aygin, Feride; Okesli, SelminObjective: 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 mu g kg(-1) of dexmedetomidine and group 3 (n=50) received 1 mu g kg(-1) of dexmedetomidine from the same vein. Group 4 (n=50) received 0.5 mu g kg(-1) of dexmedetomidine and group 5 (n=50) received 1 mu 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 mu g kg(-1) of dexmedetomidine was similar to 0.5 mu g kg(-1) of dexmedetomidine in preventing propofol pain. Conclusion: Dexmedetomidine infusions in p re-anesthetic sedative doses of 0.5 mu g kg(-1) and 1 mu g kg(-1) decrease the incidence of propofol injection pain compared to placebo.Öğe The effects of intrathecal morphine on patient-controlled analgesia morphine consumption, postoperative pain scores and satisfaction in patients undergoing gynecologic oncologic surgery under general anesthesia(OXFORD UNIV PRESS, 2012) Kara, Inci; Apiliogullari, Seza; Oc, Bahar; Celik, Jale Bengi; Duman, Ates[Abstract not Available]Öğe The effects of spinal anesthesia on auditory patients(ELSEVIER IRELAND LTD, 2016) Colpan, Bahar; Apiliogullari, Seza; Erdur, Omer; Celik, Jale Bengi; Duman, Ates; Senaran, Hakan; Ozturk, KayhanObjectives: Persistent or transient hearing loss (HL) is a less-recognized complication of spinal anesthesia (SA) in the pediatric population, although it has been previously reported in adults. The primary aim of this study was to investigate the effects of SA on auditory function in the pediatric population. Methods: After gaining institutional approval and parental consent, 30 American Society of Anesthesiologists physical status I-II children between 4 and 15 years undergoing lower extremity orthopedic surgery were enrolled in this prospective study. Spinal blocks were performed in the midline with a 25G Quincke needle using 0.5% hyperbaric bupivacaine. Transient evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) tests were administered before surgery and one-day postoperative. Children with detected HL were retested on postoperative day seven. Preoperative and postoperative results were compared. A Wilcoxin Signed-Ranks test (with Bonferroni correction) was used for statistical analyses. Results: There was no statistically significant HL in the postoperative period compared to the preoperative period. In 29 of 30 patients, no difference was detected at any frequency tested. In one patient, TEOAE and DPOAE tests were found to be decreased on postoperative day one. In this patient, control tests were found to be improved on postoperative day seven. Conclusions: Administration of SA may results in a low probability of transient hearing loss with no clinical significance in children 4-15 years of age. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Öğe Endovenous Laser Ablation under General Anesthesia for Day Surgery: Feasibility and Outcomes of the 300 Patients(MEDICAL TRIBUNE INC, 2014) Arun, Oguzhan; Oc, Bahar; Duman, Ates; Yildirim, Serkan; Simsek, Murat; Farsak, Bora; Oc, MehmetPurpose: Endovenous laser ablation (EVLA) for superficial venous insufficiency is traditionally performed under tumescent local anesthesia as day case surgery. The aim of this study is to evaluate the feasibility of general anesthesia in addition to tumescent anesthesia in patients undergoing EVLA. Methods: The anesthesia and clinical registration records of 341 extremities of 300 adult patients were reviewed and analyzed retrospectively. Demographic and clinical data, preoperative anesthetic evaluation data (ASA physical status, preoperative airway assessment, Mallampati score), type of supraglottic device, duration of anesthesia and surgery, any surgical and/or anesthetic complication, timing of mobilization and discharge, and postoperative course were evaluated. Results: Mean duration of operation and anesthesia was 28 (12-55) and 40 (20-65) minutes, respectively. Mobilization and discharge timing was 25 (11-45) and 139 (110-200) minutes, respectively. All patients were discharged the same day of surgery. Conclusion: The combination technique of administering general anesthesia with supraglottic device and tumescent anesthesia is a safe and effective method to reduce the patients' pain and discomfort during the EVLT procedure within the scope of day case surgery.Öğe Is neutrophil gelatinase associated lipocalin enough valuable in the diagnosis of acute kidney injury?(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2014) Arun, Oguzhan; Oc, Bahar; Duman, Ates; Oc, Mehmet[Abstract not Available]Öğe Is nimodipine really effective in head trauma?(ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD, 2009) Duman, Ates; Duman, Ipek; Ogun, Cemile Oztin[Abstract not Available]Öğe Is spinal anesthesia not enough for major abdominal procedures of neonates?(WILEY-BLACKWELL, 2008) Apiliogullari, Seza; Duman, Ates[Abstract not Available]Öğe Left femoral vein is a better choice for cannulation in children: a computed tomography study(WILEY-BLACKWELL, 2013) Ozbek, Seda; Aydin, Bahattin K.; Apiliogullari, Seza; Kara, Inci; Erol, Cengiz; Ciftci, Ilhan; Duman, AtesBackground Central venous catheters are often required in emergency rooms and intensive care and/or those undergoing major surgical procedures. In this study, we aimed to gain a better understanding of the anatomy of the femoral vessel in relation to central venous cannulation. Methods The right and left (total of 180) femoral veins (FVs) of 90 consecutive pediatric patients were retrospectively evaluated using computed tomography images. Patients were divided into two groups according to their age: group 1, patients up to 9years of age; and group 2, patients between 9 and 16years of age. Results The position and overlap of femoral artery (FA) to FV are significantly different between the left and right sides in both groups (P=0.001). The left FV was most commonly located medial to the FA. However, the right FV was most commonly located posterior-medial to the FA. The incidence of overlap of the FA over the FV was significantly lower at the left side in both groups. Conclusion The incidence of overlap of the FA over the FV was significantly lower at the left side in pediatric patients. This finding was similar between the patients aged 28years and those aged 916years and may have significant clinical implications. Guiding clinicians to select the left FV of children for cannulation may result in lower arterial puncture rates while accessing the central vein.Öğe Midazolam Can Decrease Salivation During Bronchoscopy(ELSEVIER, 2010) Apiliogullari, Seza; Celik, Jale Bengi; Duman, Ates[Abstract not Available]Öğe Neostigmine treatment protocols applied in acute colonic pseudo-obstruction disease: A retrospective comparative study(AVES, 2019) Ilban, Omur; Cicekci, Faruk; Celik, Jale Bengi; Bas, Mehmet Ali; Duman, AtesBackground/Aims: When conservative methods fail, neostigmine is recommended in the pharmacological treatment of acute colonic pseudo-obstruction (ACPO). The objective of this study was to analyze the response of patients to different neostigmine protocols. Materials and Methods: Patients diagnosed with ACPO in the intensive care unit between January 2015 and September 2017 were retrospectively studied. Either of the two neostigmine protocols, the bolus dose (BD) or continuous infusion (CI), was applied to the ACPO patients who were unresponsive to conservative treatments, and the results were analyzed. Results: In 79 of 122 (64%) patients, the resolution of symptoms was observed with conservative treatments. Of 43 patients who did not respond to conservative treatments, 20 were applied neostigmine as BD, and 23 were applied by CI. A total of 55% of patients in the BD group and 60.9% patients in the CI group responded to neostigmine therapy after the first dose. The group-specific protocols were reapplied in patients unresponsive to the first dose. A total of 25% in the BD group and 8.7% in the CI group responded to the second dose treatment. As a result, 80% of patients from the BD group and 69.6% from the CI group responded to neostigmine therapy. Although an overall response rate was higher in the BD group, there was no significant difference between groups (P=0.322). Colonic complications were observed in 2 patients, 1 from each group. There were no major side effects requiring treatment cessation. Conclusion: The safety and effectiveness of both neostigmine protocols applied to ACPO patients were similar. Clinical and radiological responses were obtained without serious side effects with CI.Öğe Patients Undergoing Transurethral Resection of the Prostate Should Receive the Same Amount of Intravenous Fluids(LIPPINCOTT WILLIAMS & WILKINS, 2009) Duman, Ates; Apiliogullari, Seza[Abstract not Available]Öğe Pediatric low-dose intrathecal morphine may be different for each type of surgery(LIPPINCOTT WILLIAMS & WILKINS, 2007) Duman, Ates; Apiliogullari, Seza[Abstract not Available]Öğe Preconditioning with levosimendan prevents contractile dysfunction due to H2O2-induced oxidative stress in human myocardium(LIPPINCOTT WILLIAMS & WILKINS, 2007) Sahin, Ayse Saide; Goemues, Niyazi; Duman, AtesWe studied the inotropic and possible antioxidant effects of levosimendan in human atrial strips, before and after induction of oxidative stress induced by H2O2. Levosimendan (10(-9) to 10(-6) M) increased contractions induced by electrical stimulation (ES) in human atrial strips. The maximal positive inotropic effect of levosimendan was 145.6 +/- 4.6% of predrug values. H2O2 (10-6 to 10(-3) M) significantly reduced contractions induced by ES. The maximum inhibition by H2O2 on the ES induced contraction was 47.2 +/- 3.5%. Levosimendan significantly increased the isometric contractions induced by ES when compared with the values obtained in the presence of 10(-5) M H2O2 by 89.0 +/- 4.7%, 98.9 +/- 3.4%, and 111.2 +/- 3.7% at 10(-8), 10(-7), and 10(-6) M concentrations, respectively. In concentrations of 10(-7) and 10(-6) M levosimendan, the maximum responses to ES increased when compared with the values obtained in the presence of 10(-3) M H2O2 by 87.1 +/- 3.6% and 95.1 +/- 5.3%, respectively. The cumulatively applied H2O2 (10(-6)-10(-3) M) did not change the positive inotropic response to levosimendan. In conclusion, levosimendan reverses the myocardial dysfunction induced by oxidative stress in human right atrial strips. Levosimendan prevents myocardial dysfunction if administered before oxidative stress.Öğe Renal Effects of Coronary Artery Bypass Graft Surgery in Diabetic and Non-Diabetic Patients: A Study with Urinary Neutrophil Gelatinase-Associated Lipocalin and Serum Cystatin C(KARGER, 2015) Arun, Oguzhan; Celik, Gulperi; Oc, Bahar; Unlu, Ali; Celik, Jale Bengi; Oc, Mehmet; Duman, AtesBackground/Aims: Cardiac surgery and diabetes are major causes of acute kidney injury (AKI). We aimed to investigate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) and serum cystatin C, as early biomarkers for prediction of AKI in diabetic and nondiabetic adult patients undergoing cardiac surgery. Methods: 15 non-diabetic and 15 diabetic adult patients undergoing cardiac surgery were enrolled. Peri-operative clinical and laboratory variables were recorded. Urinary NGAL, serum cystatin C, serum creatinine (Cre) and blood urea nitrogen (BUN) were evaluated. Results: AKI was detected in 4 patients in non-diabetic group and 12 patients in diabetic group. Urinary NGAL levels of diabetic and non-diabetic patients and serum cystatin C levels of diabetic patients exceed upper normal limits or cut off values much earlier than BUN and Cre. cystatin C levels of non-diabetic patients remain unchanged. Cystatin C and NGAL levels of patients meeting AKI criteria and NGAL levels of patients not meeting AKI criteria exceeded upper normal limits or cut off values much earlier in than BUN and Cre. Conclusions: Measurement of cystatin C level in both diabetic and nondiabetic patients may reveal AKI earlier than NGAL and BUN. In diabetic patients, measurement of urinary NGAL and serum cystatin C levels may indicate AKI signs earlier than BUN and Cre. Copyright (C) 2015 S. Karger AG, BaselÖğe Repair of duodenal atresia under spinal anesthesia in a low-birth-weight preterm neonate: case report(W B SAUNDERS CO-ELSEVIER INC, 2012) Ciftci, Ilhan; Apiliogullari, Seza; Kara, Inci; Gunduz, Ergun; Duman, AtesDuodenal atresia is a well-recognized cause of neonatal bowel obstruction. General anesthesia with tracheal intubation is the traditional anesthetic technique for surgical correction of this condition. Metabolic abnormalities and fluid deficits coupled with residual anesthetics are known to increase the risk of postoperative apnea, prolonging the operating room time and delaying extubation. Spinal anesthesia (SA) is an accepted alternative to general anesthesia in formerly preterm infants. In the current literature, there are reports of successful use of SA for simple infraumbilical surgery and, occasionally, for upper abdominal surgery, but there is no information on the use of SA in neonates for duodenal atresia repair. We present a case of duodenal atresia in a preterm infant at a gestational age of 30 weeks with coexisting bronchopulmonary dysplasia successfully repaired under SA. Further studies that compare the adverse effects with the potential advantages of SA are warranted before future recommendations are made for neonates who are undergoing upper abdominal surgery. Crown Copyright (C) 2012 Published by Elsevier Inc. All rights reserved.
