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    Anesthetic management of a newborn with trisomy 18 undergoing closure of patent ductus arteriosus and pulmonary artery banding
    (Clinics Cardive Publishing (PTY)Ltd, 2014) Arun O.; Oc B.; Oc M.; Duman A.
    Background: Peri-operative management of infants with trisomy 18 syndrome is challenging due to various congenital cardiac and facial anomalies. Case report: We report the anaesthetic management of a 13-day-old neonate with 1 540 g body weight, undergoing closure of patent ductus arteriosus and pulmonary artery banding. Anaesthesia was induced with sevoflurane, fentanyl and rocuronium. Despite dysmorphic facial features, ventilation and endotracheal intubation were achieved uneventfully. Anaesthesia was maintained with sevoflurane and fentanyl and was uneventful. The patient was transferred to the neonatal ICU intubated and with ventilatory support. The baby was extubated on the second day postoperatively. Conclusion: Our knowledge of the proper anaesthetic technique for children undergoing palliative or corrective surgery is limited. Further case reports will increase our experience in peri-operative management of children with trisomy 18.
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    Anesthetic management of a patient with myasthenia gravis during cardiac surgery (case report) [Kardiyak cerrahide miyastenia gravisli hastada anestezik yaklaşim]
    (2008) Sarkilar G.; Narin C.; Duman A.; Ökesli S.
    Myasthenia gravis (MG) is an autoimmune disorder mainly caused by antibodies against the muscle acetylcholine receptors at the neuromuscular junction. Loss of these receptors lead to a defect in neuromuscular transmission resulting with muscle weakness and fatigue. The use of muscle relaxants has remained controversial because patients with myasthenia gravis are known to be sensitive to their effects. The unpredictable susceptibility to muscle relaxants in patients with MG requires special considerations for anesthetic management. Experiences related to induction and maintenance of cardiac anesthesia without the use of muscle relaxant in patients with myasthena gravis are limited. In this report; induction and maintanence of anesthesia with sufentanil and propofol without neuromuscular block has been represented in a patient with MG undergoing cardiac surgery.
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    The combination of sevoflurane and thoracic epidural anesthesia without using muscle relaxant in patients with myasthenis gravis Undergoing thymectomy [Timektomi Uygulanacak Miyestenia Gravis Olgularinda Nöromüsküler Bloker Kullanilmaksizin Sevogluran ve Torasik Epidural Anestezi Kombinasyonu]
    (2003) Öztin Ö?ün C.; Duman A.; Sarkilar G.; Çelik J.B.; Ökesli S.; Aribaş O.
    In this prospective study, we combined induction with sevoflurane inhalation without neuromuscular blocking drugs, with thoracic epidural anesthesia for myasthenia gravis (MG) patients planed for transsternal thymectomy. We aimed to assess and present the procedure, respiratory and hemodynamic effects of this combination and our experiences during the intraopertative and postoperative periods. Inhalation induction with sevoflurane was performed in 7 MG patients with previous pulmonary function testing, following insertion of thoracic epidural catheters. Intubation was performed without neuromuscular blocker drugs. Sevoflurane and thoracic epidural analgesia were used together for maintenance. In all patients, arterial blood gases were monitored beside hemodynamic and respiratory parameters. End tidal sevoflurane concentrations which provides anesthetic depth was recorded. Continuous epidural analgesia was provided in the postoperative period in all patients. Paired t test, chi-square and Wilcoxon-match paired-tests were used for statistical analysis. All patients well tolerated induction with inhalation and intubation. The hemodynamic and respiratory parameters showed similar changes. The mean end tidal sevoflurane concentration of the patients for surgical anesthesia was 2.4±0.4 %. Postoperative pulmonary complications or respiratory depression were not encountered in any patient. As a conclusion, induction and maintenance with sevoflurane, combined with thoracic epidural anesthesia may be preferred in MG patients undergoing thymectomy. It was considered that, thoracic epidural anesthesia as a good choise for the stabilization of the postoperative period.
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    The effect of 3?,4?-dihydroxyflavonol on plasma oxidant and antioxidant systems in testis ischemia-reperfusion injury in rats
    (AMG Transcend Association, 2018) Duman A.; Mogulkoc R.; Baltaci A.K.; Sivrikaya A.
    The purpose of the present study was to determine the effect of 3’,4’-dihydroxyflavonol (DiOHF) on plasma lipid peroxidation in experimental testicular torsion-detorsion.The study involved 60 Wistar-albino type male rats weighing 250-260 gr. The experiment groups were formed as follows: 1. Control; 2. Sham-control; 3.720o-4 hours torsion; 4. 720o-4 hours torsion + 4 hours detorsion; 5. 720o-4 hours torsion + DiOHF; 6. 720o-4 hours torsion + DiOHF + 4 hours detorsion; 7. 720o-4 hours torsion + 24 hours detorsion; 8. 720o-4 hours torsion + DiOHF + 24 hours detorsion. The animals in the experimental groups were anesthetized after the procedures and their blood samples were taken to determine the levels of plasma glutathione peroxidase (GPx), nitric oxide (NO), malondialdehyde (MDA), and erythrocyte glutathione (GSH). Among the study groups, group 5 was found to have the highest plasma glutathione peroxidase values (p<0.001). Groups 3 and 4, which were torsion and detorsion groups, had the lowest plasma GPx values (p<0.001).Plasma NO values were found be higher in groups 3 and 4 than all other groups (p<0.001).Groups 3, 4, and 7 had the highest plasma MDA levels (p<0.001).Erythrocyte GSH levels in groups 5 and 7 were significantly higher than the levels in other groups (p<0.001).The results of the study indicate that lipid peroxidation that increases in plasma during testis ischemia-reperfusion injury in rats is prevented by intra-peritoneal DiOHF administration. © 2018 by the authors.
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    Lowest dose of spinal ropivacaine and adjuvant should be used in cesarean delivery [1]
    (2003) Ö?ün C.Ö.; Duman A.; Kirgiz E.N.; Ökesli S.
    [Abstract not Available]
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    Premptive analgesia with ketamine or tenoxicam before remifentanil anesthesia [Remifentanil anestezisinden önce ketamin ve tenoksikam ile preemptif analjezi]
    (2003) Öztin Ö?ün C.; Duman A.; Erol A.; Kirgiz E.N.; Ökesli S.; Duman I.
    The postoperative analgesic effectiveness and side effects of preemptive ketamine and tenoxicam, which were used before remifentanil-based anesthesia, were compared in gynecological laparotomies. Before anesthesia induction, 4 ml saline i.v. was administered to Group P (n=31), 1 mg/kg ketamine to Group K (n=30) and 40 mg tenoxicam to Group T (n=33). Anesthesia was induced with 1-1.5 mg/kg propofol and 0.6 mg/kg rocuronium and maintaned with 0.2 mg/kg/hour remifentanil and 67 % nitrous oxide and sevoflurane. Sedation, pain scores and meperidine consumptions (after extubation and at 3, 6, 12, 24, 48th hours) were recorded. Hemodynamic and respiratory variables were similar in all groups. Sedation level was higher in ketamine group than placebo (p<0.05). Pain scores were lower in Group K than placebo at first 6 hours and at 48th hour, but pain scores were lower in Group T than placebo at all times (p<0.05). Meperidine consumption was lower at 6, 12, 24th hour than the other groups in Group T, it was similar between tenoxicam and ketamine groups in 3rd, 48th hour and totally (p<0.05). It was thought that preincisional tenoxicam has preemptive effectiveness but ketamine does not, although it has a short analgesic effect and is likely to prevent hyperalgesia.
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    Sensitivity of Schur stability of systems of linear difference equations with constant coefficients
    (2011) Duman A.; Aydin K.
    In this work, sensitivity of the Schur stability and the ?*-Schur stability of linear difference equation systems with constant coefficients have been investigated, and new results on the sensitivity problem have been given. The results have applied the scalar-linear difference equations with order ? and supported with numerical examples and also compared with the existing ones in the literature. © 2011 Academic Journals.
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    Spinal anesthesia in children: A single-center experience of 371 cases [ÇocukIarda spinai anestezi: Tek merkezin 371 oiguiuk deneyimi]
    (2010) Apilio?ullari S.; Gök F.; Duman A.
    Aim: In children, spinal anaesthesia (SA) seems to be preferred for complex cases rather than routine surgical procedures. However, its' use in children is as simple, safe, and inexpensive as it is in adults. The aim of this study is to present our experiences concerning the efficacy and safety of SA for routine surgical procedures in children. Material and Method: The files of 371 patients who underwent surgery under spinal anesthesia between the years 2007 to 2009 at Konya Dr. Faruk Sükan Do?um ve Çocuk Hastanesi were retrospectively analyzed. SA was performed using hyperbaric bupivacaine with either 27 G pencil point or 26 G cutting point needles. Fentanyl 0.2 ?g kg-1 or morphine 2 ?g kg-1 or both of them were used as adjuvants for bupivacaine. Demographic data, technical data, and complications were evaluated. Results: The mean age was 6 years (1yr-17yrs). Successful SA was achieved in 94 % at the first attempt. Intravenous sedation was required in 26 % of children during the operation. Intraoperative conversion to general anesthesia was necessary in ten patients (2.7 %). Fentanyl was used in 134 patients, morfin was used in 50 patients, both fentanil and morfin were used in 40 patients as adjuvants. The main side effect was high spinal block which occurred in three patients (0.8 %). No severe neurological and cardiovascular side effects were reported. Conclusion: SA with hyperbaric bupivacaine is a safe, effective and feasible anesthetic method in children. Fentanyl 0.2 ?g kg-1 and and morphine 2 ?g kg-1 are valuable for intrathecal analgesia in children.