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    Comments on "Local Anesthetic Systemic Toxicity"
    (OXFORD UNIV PRESS INC, 2016) Onal, Ozkan; Saltali, Ali Ozgul; Apiliogullari, Seza
    [Abstract not Available]
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    The effect of the trendelenburg position on the internal jugular vein's cross-sectional area in overweight and obese children
    (E-CENTURY PUBLISHING CORP, 2016) Sekmenli, Tamer; Nayman, Alaaddin; Onal, Ozkan; AriYuca, Sevil; Apiliogullari, Seza; Ciftci, Ilhan; Celik, Jale Bengi
    Background: The Trendelenburg position is a common technique used during internal jugular vein (IJV) cannulation in pediatric patients. There has been some speculation as to the correlation between Trendelenburg positioning and increases in the cross-sectional area (CSA) of the IJV in obese child patients. In the present study, we use ultrasound (US) measurements to assess and determine the predictivity of Trendelenburg positioning on the CSA of the right IJV in obese child patients. Methods: The researchers of this studyenrolled 30 cases from the American Society of Anesthesiologists (ASA) II of patients under the age of 18 who underwent ultrasonographic examination between December 2013 and March 2015. US images of the right IJV of each patient were obtained in a transverse orientation at the cricoid level. The CSAs of the right IJVs were measured undert wo different conditions applied in a random orderin a sealed envelope: State 0, in which the table was flat (no tilt) and the patient lay in the supine position; and State T, in which the operating table wastilted 20 degrees to the Trendelenburg position. Results: The change in the CSA of the IJV from the supine to the Trendelenburg position (0.99 cm(2) vs 0.96 cm(2)) was not significant. In contrast, the CSA of the right IJV decreased in 14 of the 30 patients (9 of the 14 were female). Conclusions: The Trendelenburg position does not cause the mean CSA of the right IJV in obese child patients to increase; in fact, the position causes the CSA in some patients to decrease. The researchers of this study do not support the use of the Trendelenburg position for IJV cannulation in obese child patients.
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    The effectiveness of trendelenburg positioning on the cross-sectional area of the right internal jugular vein in obese patients
    (PROFESSIONAL MEDICAL PUBLICATIONS, 2015) Onal, Ozkan; Apiliogullari, Seza; Nayman, Alaaddin; Saltali, Ali; Yilmaz, Huseyin; Celik, Jale Bengi
    Objective: Trendelenburg positioning is a common approach used during internal jugular vein (IJV) cannulation. No evidence indicates that Trendelenburg positioning significantly increases the cross-sectional area (CSA) of the IJV in obese patients. The primary aim of this study was to determine the effectiveness of Trendelenburg positioning on the CSA of the right internal jugular vein assessed with ultrasound measurement in obese patients. Methods: Forty American Society of Anesthesiologists II patients with body mass index >= 30 kg/m(2) undergoing various elective surgeries under general endotracheal anesthesia were enrolled. Ultrasound images of the right IJV were obtained in a transverse orientation at the cricoid level. We measured the CSA of the right IJV two different conditions in a sealed envelope were applied In random order: State 0, table flat (no tilt), with the patients in the supine position, and State T, in which the operating table was tilted 200 to the Trendelenburg position. Results: The change in the CSA of the IJV from the supine to the Trendelenburg position (1.80 cm(2) vs 2.08cm(2)) was not significantly different. The CSA was paradoxically decreased in 10 of 36 patients when the position changed from State 0 to State T. Conclusions: Trendelenburg positioning does not significantly increase the mean CSA of the right IJV in obese patients. In fact, in some patients, this position decreases the CSA. The use of the Trendelenburg position for IJV cannulation in obese patients can no longer be supported.
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    The Leverage Method: A Novel Technique for Difficult Temporomandibular Joint Reduction
    (PREMCHAND SHANTIDEVI RESEARCH FOUNDATION, 2018) Onal, Ozkan; Aslanlar, Emine; Onal, Merih; Elsurer, Cagdas; Ciftci, Cansu
    [Abstract not Available]
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    Post-spinal hyperacute subdural hematoma
    (ELSEVIER SCIENCE INC, 2017) Onal, Ozkan; Aslanlar, Emine; Apiliogullari, Seza; Erkocak, Omer Faruk; Celik, Jale Bengi
    [Abstract not Available]
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    Prophylactic Ozone Administration Reduces Intestinal Mucosa Injury Induced by Intestinal Ischemia-Reperfusion in the Rat
    (HINDAWI LTD, 2015) Onal, Ozkan; Yetisir, Fahri; Sarer, A. Ebru Salman; Zeybek, Naciye Dilara; Onal, C. Oztug; Yurekli, Banu; Celik, H. Tugrul
    Objectives. Intestinal ischemia-reperfusion injury is associated with mucosal damage and has a high rate of mortality. Various beneficial effects of ozone have been shown. The aim of the present study was to show the effects of ozone in ischemia reperfusion model in intestine. Material and Method. Twenty eight Wistar rats were randomized into four groups with seven rats in each group. Control group was administered serum physiologic (SF) intraperitoneally (ip) for five days. Ozone group was administered 1 mg/kg ozone ip for five days. Ischemia Reperfusion (IR) group underwent superior mesenteric artery occlusion for one hour and then reperfusion for two hours. Ozone + IR group was administered 1 mg/kg ozone ip for five days and at sixth day IR model was applied. Rats were anesthetized with ketamine\xyzlazine and their intracardiac blood was drawn completely and they were sacrificed. Intestinal tissue samples were examined under light microscope. Levels of superoxide dismutase (SOD), catalase (CAT), glutathioneperoxidase (GSH-Px), malondyaldehide (MDA), and protein carbonyl (PCO) were analyzed in tissue samples. Total oxidant status (TOS), and total antioxidant capacity (TAC) were analyzed in blood samples. Data were evaluated statistically by Kruskal Wallis test. Results. In the ozone administered group, degree of intestinal injury was not different from the control group. IR caused an increase in intestinal injury score. The intestinal epithelium maintained its integrity and decrease in intestinal injury score was detected in Ozone + IR group. SOD, GSH-Px, and CAT values were high in ozone group and low in IR. TOS parameter was highest in the IR group and the TAC parameter was highest in the ozone group and lowest in the IR group. Conclusion. In the present study, IR model caused an increase in intestinal injury. In the present study, ozone administration had an effect improving IR associated tissue injury. In the present study, ozone therapy prevented intestine from ischemia reperfusion injury. It is thought that the therapeutic effect of ozone is associated with increase in antioxidant enzymes and protection of cells from oxidation and inflammation.
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    Pulsed Radiofrequency of Dorsal Root Ganglia for the Treatment of Complex Regional Pain Syndrome in an Adolescent with Poliomyelitis Sequel: A Case Report
    (OXFORD UNIV PRESS, 2015) Apiliogullari, Seza; Aydin, Bahattin Kerem; Onal, Ozkan; Kirac, Yunus; Celik, Jale Bengi
    ObjectiveComplex regional pain syndrome (CRPS) is a painful and disabling syndrome in which the patient presents with neuropathic pain, edema, or vasomotor or pseudomotor abnormalities that are often refractory to treatment. Polio paralysis is caused by the damage or destruction of motor neurons in the spine, which lead to corresponding muscle paralysis. This report is a case report on the application of a pulsed radiofrequency (PRF) current to dorsal root ganglia (DRG) for the treatment of CRPS type 1 in an adolescent patient. DesignSingle case report. SettingSelcuk University Hospital. PatientA 16-year-old girl who suffered from CRPS type 1 secondary to surgeries for the sequelae of poliomyelitis. InterventionsPRF current application to the lumbar 4 and lumbar 5 DRG. Outcome MeasuresPain reduction. ResultsThe patient had complete resolution of her symptoms, which was maintained at a 6-month follow-up. ConclusionsThis case illustrates that PRF applied to lumbar 4 and lumbar 5 DRG may play a significant role in CRPS type 1 management after the surgical treatment of poliomyelitis sequelae in adolescent patients. Further randomized, controlled studies are needed to support this argument.
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    Randomization in a Crossover Design Is Not to Be a Minor Issue
    (LIPPINCOTT WILLIAMS & WILKINS, 2015) Apiliogullari, Seza; Onal, Ozkan
    [Abstract not Available]
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    Spinal anaesthesia for orthopaedic surgery in children with cerebral palsy: Analysis of 36 patients
    (PROFESSIONAL MEDICAL PUBLICATIONS, 2015) Onal, Ozkan; Apiliogullari, Seza; Gunduz, Ergun; Celik, Jale Bengi; Senaran, Hakan
    Background and Objective: Cerebral palsy is one of the most common childhood neuromuscular diseases in the world. Spinal anaesthesia in children is an evolving technique with many advantages in perioperative management. The aim of this retrospective study was to provide first-hand reports of children with cerebral palsy who underwent orthopaedic surgery under spinal anaesthesia. Methods: Records of the children with cerebral palsy who underwent orthopaedic surgery under spinal anaesthesia between May 2012 and June 2013 at Selcuk University Hospital were investigated. In all patients, lumbar puncture was performed in lateral decubitus position with mask sevoflurane-nitrous oxide anaesthesia. In patients who were calm prior the spinal block, inhalation anaesthesia was terminated. In patients who were restless before the spinal block, anaesthesia was combined with light sevoflurane anaesthesia and a laryngeal mask. From anaesthesia records, the number of attempts required to complete the lumbar puncture, and the success rates of spinal anaesthesia and perioperative complications were noted. Data were expressed as numbers and percentages. Results: The study included 36 patients (20 girls and 16 boys). The mean age was 71 months. The rate of reaching subarachnoid space on first attempt was 86%. In all patients, spinal anaesthesia was considered successful. In 26 patients, laryngeal mask and light sevoflurane anaesthesia were required to maintain ideal surgical conditions. No major perioperative complications were observed. Conclusion: Spinal anaesthesia alone or combined with light sevoflurane anaesthesia is a reliable technique with high success rates in children with cerebral palsy undergoing orthopaedic surgery.