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  • Küçük Resim Yok
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    Comparison of propofol-remifentanil and desflurane-remifentanil anesthesia for intracranial mass surgery [İntrakraniyal kitle cerrahisinde propofol-remifentanil ile desfluran-remifentanil anestezisinin karşilaştirilmasi]
    (2006) Tavlan A.; Erol A.; Topal A.; Dayto?lu M.; Kara I.; Otelcio?lu Ş.
    Aim: In this study, we aimed to evaluate the effects of propofol-remifentanil and desflurane-remifentanil anaesthesia on haemodynamics and recovery in elective intracranial mass surgery. Materials and Methods: Forty cases, ASA I-III, between 18-63 years age were randomly assigned into two groups (Group I: Propofol, Group II: Desflurane). All of the cases were premedicated with 0.03 mg kg-1 midazolam, anaesthesia induced with 1 mg kg-1 lidocaine and 1 ?g kg-1 remifentanil intravenous (iv) bolus in 60 seconds. At the same time remifentanil infusion 0,5 ?g kg-1 min-1 was started. After remifentanil administration, 2 mg kg-1 propofol applied to the patient. After dural opening, remifentanil infusion decreased 50 % of the beginning rate. Anaesthesia maintained in the first group with 6 mg kg-1 h -1 propofol infusion and in the second group with 3 % desflurane concentration to mean arterial pressure between 60-100 mmHg. Heart rate (HR), mean arterial pressure (MAP), recovery criteria, perioperative complications were evaluated. Results: In Group I. MAP was higher at 2 minutes (t3) and 10 minutes (t4) after intubation; during head holder application (t5) (respectively; p=0.008, p=0.008, p=0.013). Ten minutes after head holder application (t7) and at dural incision (tB) MAP was higher in Group II (p=0.030, p=0.037). When groups were compared according to heart rates, at 2 minutes (t3) and 10 minutes (t 4 after intubation decrement in Group II was higher (respectively; p=0.001. p=0.001). However, during head holder application (t5), ten minutes after head holder application (t7) and at durai incision (t8) decrement in Group I was higher than Group II (respectively; p=0.002, p=0.010, p=0.007). In Croup II eye opening, and extuhation times were shorter (respectively; p=0.005, p=0.001). Conclusion: In conclusion, we decided that remifentanil combined desflurane and propofol anesthesia suppressed the intraoperative hemodynamic responses efficiently but desflurane remifentanil combination had a shorter recovery time in intracranial mass surgery.
  • Küçük Resim Yok
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    A comparison of the effects of intraoperative tramadol and ketamine usage for postoperative pain relief in patients undergoing tonsillectomy [I?ntraoperatif tramadol ve ketaminin tonsillektomi uygulanan hastalarda ameliyat sonrasi a?ri üzerine etkilerinin karşilaştinlmasi]
    (2013) Sizer C.; Kara I.; Topal A.; Çelik J.B.
    Objectives: We aimed to compare the effects of ketamine and tramadol administered intraoperatively on postoperative pain and analgesic demand in children undergoing tonsillectomy operations. Methods: Ninety children undergoing tonsillectomy, aging 5-15 years old, with ASA I - II, were included in this study. Cases were arranged in three groups and given standardized general anesthesia. After coagulation, ketamine (0.5 mg.kg-1) was administered intravenously (iv) in the ketamine group, and tramadol iv (2 mg.kg-1) was given in the tramadol group and the control group received a physiologic iv. The duration of anesthesia, duration of operation, and length of stay in the PACU were recorded. NRS and CHEOPS scales were used to assess postoperative pain. Paracetamol (15 mg.kg-1) was given rectally in the first 6 hours (hrs) and orally over the subsequent 6 hrs, if NRS greater than 3 and CHEOPS greater than 8 were observed. All data were recorded concerning the initial and total dosage of analgesic and the presence of complications within 24 hrs. Results: Demographic data, duration of anesthesia, duration of operation, and duration of stay in the PACU were similar between groups (p>0.05). The number of patients requiring additive analgesic was higher in the control group. No differences were found between the tramadol and ketamine groups (p>0.05). Additional analgesic was given earlier in the control group (p<0.05), but the need for additional analgesic was similar in tramadol and ketamine groups (p>0.05). Paracetamol dosage was significantly higher in the control group (p<0.05), but similar between the tramadol and ketamine groups (p>0.05). The frequency of nausea and vomiting was found to be significantly higher in tramadol and ketamine groups compared to the control group (p<0.05). Conclusion: Postoperative pain was effectively managed using 2 mg.kg-1 tramadol and 0.5 mg.kg-1 ketamine in pediatric tonsillectomies.
  • Küçük Resim Yok
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    Palmar skin temperature importance during transthoracic endoscopic sympathectomy for palmar hyperhidrosis [Palmar hiperhidrozis i?çin yapılan transtorasik endoskopik sempatektomi sırasında palmar cilt sıcaklı?ının önemi]
    (Ege University Press, 2012) Oncel M.; Sudam G.S.; Karabagli H.; Kara I.; Celik J.B.
    Background: The primary goal of this study is to identity and analysis age, diagnosis, sympathic chain levels, complications and results associated with successful endoscopic surgical treatment for hyperhydrosis and also this study was to investigate of palmar temperature changes during the operation and to prove the successful surgical procedures and beneficial of the bilateral sympathectomy during the peroperative case. Methods: Fifty one patients with severe primary palmar hyperhidrosis received bilateral endoscopic thoracic sympathectomy. Different levels of transection from T4 to T2 were performed step by step until the successful extirpation was implied by the recorded unilateral right palmar temperature intraoperative monitoring. The results of the operations were studied. All patients were followed up and evaluated for symptom resolution, postoperative complication, levels of satisfaction, and severity of compensatory sweating. Effective extirpation ganglia occurred with the intraoperative increasing palmar temperature. Results: Of a total of 102 lateral procedures, 76 laterals (76%) ended the procedure at the T4 level, 23 laterals (23%) ended the procedure at the T3-T5 level, and 1 lateral (1%) ended the procedure at the T2 level. The postoperative complication was minor, and no Horner's syndrome was detected. The rate of symptom resolution was 100% and no recurrence was found. The satisfaction rate was 92%, and the incidence of mild, moderate, and severe compensatory sweating were 12%, 8%, and 6%, respectively. Conclusions: Concerning the sympathectomy for palmar hyperhidrosis, there is a possibility that the level of the transection varies and should be adjusted for each individual patient. Intraoperative monitoring of temperature may be a useful tool in establishing a kind of standardized reference for finding the correct target level.
  • Küçük Resim Yok
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    The preventive effect of diphenhydramine on bacterial growth in propofol: A laboratory study
    (2008) Güzelant A.; Apiliogullari S.; Kara I.; Turhan V.; Apiliogullari B.; Yilmaz H.; Balasar M.
    Background and objective: Diphenhydramine has local anaesthetic and antimicrobial activity and may be used to prevent intravenous propofol injection pain. We studied the effect of adding diphenhydramine to propofol emulsions for preventing bacterial growth. Methods: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Candida albicans cultures were inoculated into the following solutions: 1% propofol, 0.05% diphenhydramine + 1% propofol, 0.1% diphenhydramine + 1% propofol, 0.2% diphenhydramine + 1% propofol, 0.3% diphenhydramine + 1% propofol, 1% diphenhydramine and 0.1% lidocaine + 1% propofol. A 100-?L of inoculum suspension adjusted for each of the micro-organisms was added separately to each tube and left at 20°C. A 10-?L aliquot of each mixture was inoculated onto blood agar medium at 5 and 24 h. These plates were incubated at 35°C for 24 h. Each plated medium was read, and the number of colony-forming units were counted and recorded (n = 2). Analysis of variance (ANOVA) with a post hoc Tukey HSD test and paired t-tests were used for data analysis. P < 0.05 was considered as significant. Results: Diphenhydramine inhibited bacterial growth in propofol solutions in a dose-dependent manner. It was more effective than 0.1% lidocaine at similar concentrations in preventing bacterial growth for all organisms. Conclusion: Diphenhydramine had a significant inhibitory effect on bacterial growth in propofol. © 2008 Copyright European Society of Anaesthesiology.
  • Küçük Resim Yok
    Öğe
    Transdermal fentanyl for neuropathic pain: A case report [Nöropatik a?rida transdermal fentanil kullanimi: Olgu sunumu]
    (2006) Tuncer S.; Reisli R.; Kara I.; Otelcio?lu Ş.
    The mechanisms responsible for neuropathic pain are not fully understood. Most treatment modalities are ineffective or insufficient for this important clinical condition. Better understanding of pain mechanisms and opioid drug action has widened the indications for opioids in pain therapy of non-malignant pain including neurophatic pain. In this report of a female patient with chronic non-malignant neurophatic pain was followed-up for pain and side effects, for approximately fourteen months with the use of transdermal fentanyl (TDF). Pain reduction was good throughout the study. Severe side effects did not occur. TDF was effective and well tolerated in the treatment of chronic neuropathic pain of non-malignant origin.

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