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Öğe Effect of dexmedetomidine on haemodynamic responses to laryngoscopy and intubation: Perioperative haemodynamics and anaesthetic requirements(2006) Yildiz M.; Tavlan A.; Tuncer S.; Reisli R.; Yosunkaya A.; Otelcioglu S.Background: Dexmedetomidine reduces the dose requirements for opioids and anaesthetic agents. The purpose of this study was to evaluate the effect of a single pre-induction intravenous dose of dexmedetomidine 1 ?g/kg on cardiovascular response resulting from laryngoscopy and endotracheal intubation, need for anaesthetic agent and perioperative haemodynamic stability. Methods: Fifty patients scheduled for elective minor surgery were randomised into two groups (dexmedetomidine group and placebo group, n = 25 in each group). During and after drug administration, the Ramsey sedation scale was applied every 5 minutes. Fentanyl 1 ?g/kg was administered to all patients and thiopental was given until lash reflex disappeared. Anaesthesia continuation was maintained with 50%:50%, oxygen:nitrous oxide. Sevoflurane concentration was adjusted to maintain systolic blood pressure within 20% of preoperative values. After extubation, the Steward awakening score was applied at 5 and 10 minutes. Haemodynamic parameters and adverse effects were recorded every 10 minutes for 1 hour after surgery. Results: During intubation the need for thiopental and sevoflurane concentration were decreased by 39% and 92%, respectively, in the dexmedetomidine group compared with the placebo group. In all groups, blood pressure and heart rate increased after tracheal intubation; both were significantly lower in the dexmedetomidine group than in the placebo group (p < 0.05). Fentanyl requirement during the operation was 74.20 ± 10.53?g in the dexmedetomidine group and 84.00 ± 27.04?g in the placebo group (p < 0.05). At 5 minutes, the Steward scores were >6 in 56% of the dexmedetomidine group and in 4% of the placebo group (p < 0.05). At 10 minutes, sedation scores were ?4 in all patients in the dexmedetomidine group (p < 0.05). Arterial blood pressure and heart rate in the postoperative period were significantly lower in the dexmedetomidine group compared with the placebo group (p < 0.05). Conclusion: Preoperative administration of a single dose of dexmedetomidine resulted in progressive increases in sedation, blunted the haemodynamic responses during laryngoscopy, and reduced opioid and anaesthetic requirements. Furthermore, dexmedetomidine decreased blood pressure and heart rate as well as the recovery time after the operation. © 2006 Adis Data Information BV. All rights reserved.Öğe The usage of tramadol hydrochloride in intraoperative and early postoperative analgesia [Intraoperatif ve erken postoperatif analjezide tramadol hidroklorid kullanimi](1999) Tuncer S.; Bariskaner H.; Aydemir T.; Yosunkaya A.; Otelcioglu S.Tramadol hydrochlorid (TH), a synthetic opioid, is an efficient analgesic. But there are various views on its usage in anaesthesia. In this study, the efficiency of TH in intraoperative and early postoperative analgesia, its effect to hemodynamic parameters and its side effects were studied. Premedication with 10 mg diazepam, 0.5 mg atropine was applied to 20 cases from the group of ASA I-II which would undergo elective gynaecological laporoscopic surgery. Anaesthesia induction was provided by 5 mg/kg thiopental, 1.5 mg/kg TH and 1.5 mg/kg sucsynilcholine and also continuation was provided by 2-2.5 % sevoflurane. Atracurium was added when necessary. When insufficient anaesthesia symptoms were seen. 25 mg. TH was added. With the aim of postoperative analgesia, 1.5 mg/kg TH was applied to the cases in the waking up room. As a result, when TH is added to anaesthesia, it can be tolerated very well in the depth of anaesthesia and providing sufficient analgesia and we believe that it will be used safely due to its minimal side effects and the immediate recovery it provides, especially in daily surgery.