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Öğe Comparison of alfentanil and remifentanil at total intravenous anesthesia in short-term elective surgery [Kisa süreli cerrahi girişimlerde alfentanil ve re?ifentanilin tiva'da karşilaştirilmasi](2002) Özel M.; Yosunkaya A.; Tavlan A.; Reisli R.; Ökesli S.In our study, adding alfentanil as an opioid analgesic to propofol for total intravenous anesthesia in short-term elective surgery was compared to remifentanil. We aimed to study the anesthesia induction, maintenance and recovery characteristics of the two drugs. This study was carried out on 50 patients in ASA I-II group. They were between the ages of 18-60 and they were planned to be discharged from the hospital in 1-2 days. They were randomised into two groups, 20 ?g kg-1 alfentanil was given to group I and 1 ?g kg-1 remifentanil iv to group II patients as bolus injection, 2 ?g kg-1 min-1 alfentanil and 0.5 ?g kg-1 min-1 remifentanil iv infusion was also started respectively. Following this, these two group of patients were intubated by applying 2 mg kg-1 propofol+0.15 mg kg-1 vecuronium iv bolus and 90 ?g kg-1 min-1 iv propofol infusion. Alfentanil and remifentanil infusions were halfened 5 min after tracheal intubation and propofol infusion was decreased to 60 ?g kg-1 min-1 30 min after beginning. All patients were vetilated with 100 % O2 during the operation. Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure and heart rate measurements were recorded before anesthesia, 1, 3, 5 min after remifentanil or alfentanil application, after the intubation and skin incision, and during surgery every 10. min. The haemodynamic and somatic responses to intubation-skin incision and surgical stimulation were identified. After operation, recovery time and adverse events were recorded. The response to tracheal intubation and skin incision was less in remifentanil group than in alfentanil group, statistically considerable difference was not identified. No differences were compared in the evaluation of times, seeing reponse to surgical. A smaller proportion of remifentanil patients than alfentanil patients had required addition opioid doses during maintenance (p < 0.05). When comparing the recovery period of each group, it was significantly shorter in the remifentanil group than in the alfentanil group (p < 0.05). These two groups were similar in the aspect of observing postoperative adverse events. As a result, we think that remifentanil can be prefered to alfentanil as an addition opioid agent in TIVA which is applied for short-term surgical procedures because a smaller remifentanil patients require a study opioid adjustments needed to treat light anesthesia responses and remifentanil provides rapid recovery.Öğe Dexketoprofen for postoperative pain relief [Postoperatif a?rida deksketoprofen kullanimi](2006) Tuncer S.; Tavlan A.; Köstekçi H.; Reisli R.; Otelcio?lu Ş.Dexketoprofen trometamol is a water-soluble salt of the dextrorotatory enantiomer of nonsteroidal anti-inflamatory drug ketoprofen. The aim of the study was to investigate the effect of dexketoprofen on postoperative pain. This study was performed on 50 (ASA I-II) patients planned for abdominal hysterectomy. Fifty patients were randomized into two equal groups. Patients received oral placebo (group I) and 25 mg dexketoprofen (group II) 1h before surgery and 8-16 h after surgery. All patients received a standard anesthetic protocol. At the end of surgery, all patients received tramadol IV via a PCA (Patient Controlled Analgesia) -device. Pain scores and sedation scores were assessed at 3, 6, 12 and 24 h after surgery. Tramadol consumption, adverse effects, and patient satisfaction were noted during 24 h after the surgery. The pain scores were significantly lower in the dexketoprofen group compared with the placebo group p<0.05). The cumulative tramadol consumption was lower in the dexketoprofen group than placebo group (p<0.05). No significant difference was observed in sedation scores, adverse effects and patient satisfaction between the groups (p>0.05). We conclude that the preoperative and postoperative administration of dexketoprofen provided a significant analgesic benefit and decreased the opioid requirements in patients undergoing abdominal hysterectomy.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 effects of desflurane, sevoflurane and propofol anaesthesia on bronchoalveolar lavage cells [Propofol, desfluran ve sevofluran anestezisinin bronkoalveolar lavaj hücreleri üzerine etkisi](2005) Çiçekci F.; Reisli R.; Toy H.; Sarkilar G.; Otelcio?lu Ş.This study compared the effects of desflurane, sevoflurane and propofol anaesthesia on alveolar macrophage, PMNL, bronchial epithelia cells and morphological structure. Sixty patients varying in age between 18 and 60 and scheduled to undergo extremity surgery were included in the study. Patients were randomly allocated to three groups consisting of 20 patients each. In all groups, general anesthesia was induced with 2-3 mg kg-1 of propofol, 1?g kg-1 of fentanyl, 0.6 mg kg-1 of rocuronium bromide. Anesthesia was maintained with 6% desflurane (Group D) and 2% sevoflurane (Group S) to obtain 1 MAC. In Group P, propofol infusion was started with a dose of 12 mg kg-1 h-1, which was reduced to 9, 6 and then 4 mg kg-1 at 20 minute intervals after the first dose. All patients were given 50% O2-50% dry air 4 L min-1. As required, patients were given rocuronium 0.2 mg kg-1, fentanyl 1?g kg-1. Bronchoalveolar lavage fluid (BAL) was collected following induction of anesthesia (T0) and at the 120th minute of the operation (T1). Mature and immature alveolar macrophages, PMNL and brochial epithelial cells in T0 and T1 preparation were counted under a light microscope. Comparison within each group indicated that there was a statistically significant difference in time dependent increase on PMNL augmentation and a decrease in bronchial epithelial cells. We concluded that during the two hour period of anesthesia and the operation, no changes were detected in bronchoalveolar lavage cells in the groups. As a result, we can say that no group showed superiority over the others. Further studies are needed to explain the time dependent increase in PMNL.Öğe The effects of intravenous dexketoprofen on postoperative analgesia and morphine consumption in patients undergoing abdominal hysterectomy [Abdominal histerektomi uygulanan olgularda intravenöz deksketoprofenin postoperatif analjezi ve morfin tüketimine etkisi](2010) Tuncer S.; Reisli R.; Keçecio?lu M.; Erol A.Objectives: Dexketoprofen trometamol is a water-soluble salt of the dextrorotatory enantiomer of the nonsteroidal anti-inflammatory drug ketoprofen. The aim of this study was to investigate the effect of intravenous dexketoprofen on postoperative pain. Methods: This study was performed on 50 (ASA I-II) patients scheduled for abdominal hysterectomy. Fifty patients were randomized into two equal groups. Patients received saline solution (Group I) or 50 mg intravenous dexketoprofen (Group II) 1 hour (h) before surgery and 8-16 h after surgery. All patients received a standard anesthetic protocol. At the end of surgery, all patients received intravenous (IV) morphine via a PCA (patient- controlled analgesia) device. Pain scores were assessed at 2, 6,12 and 24 h after surgery. Morphine consumption and adverse effects were noted during the first 24 h after the surgery. The pain scores were significantly lower in the dexketoprofen group compared with the control group (p<0.05). Results: The cumulative morphine consumption was also lower in the dexketoprofen group than the control group (p<0.05). No significant difference was observed in adverse effects between the groups (p>0.05). Conclusion: We conclude that the administration of IV dexketoprofen provided a significant analgesic benefit and decreased the morphine requirements in patients undergoing abdominal hysterectomy.Öğe The effects of intravenous paracetamol on postoperative analgesia and tramadol consumption in cesarean operations [Sezaryen cerrahisinde intravenöz parasetamolün postoperatif analjezi ve tramadol tüketimine etkisi](2010) Kiliçaslan A.; Tuncer S.; Yüceaktaş A.; Uyar M.; Reisli R.Objectives: In this study, the effects and side effects of intravenous paracetamol application, combined with patient-controlled intravenous tramadol analgesia, were investigated in elective cesarean operations for postoperative pain control and its tramadol-sparing effect. Methods: Fifty ASA I-II patients scheduled for cesarean operation were enrolled in this study. Patients were randomly divided into two groups: group I served as a control group, with saline administration (100 ml) 15 min before the end surgery and every 6 h for 24 h, whereas group II received paracetamol (1 g/100 ml) at the stated time points. All patients received a standard anesthetic protocol. At the end of surgery, all patients received tramadol i.v. via a PCA (patient-controlled analgesia) device. Pain and sedation scores were assessed at 1, 3, 6, 12 and 24 h postoperatively. Results: Tramadol consumption and adverse effects were noted in the first 24 hours following surgery. The pain scores were significantly lower in the paracetamol group when compared with the control group (p<0.05). The cumulative tramadol consumption was lower in the paracetamol group than the control group (p<0.05). No significant difference was observed in sedation scores and nausea-vomiting scores between the groups (p>0.05). Conclusion: We conclude that paracetamol is a safe and effective treatment option in post-cesarean pain for combination with tramadol, as it produces effective analgesia and reduces tramadol consumption.Öğe The effects of preemptive dexketoprofen use on postoperative pain relief and prmadol consumption [Preemptif deksketoprofen kullaniminin postoperatif a?ri ve tramadol tüketimine etkisi](2011) Kaka I.; Tuncer S.; Erol A.; Reisli R.Onjectives: In this study, the efficacy of preemptive dexketoprofen usage on postoperative pain relief and tramadol consumpation was evaluated. Methods: Fifty American Socity of Anestbesiologists(ASA)-I or ASA-II patients undergong plastic surgery were randomized into two groups. Groups. 1 received dexketoprofen 25 mg and Group 2 received placebo tablets 1 hour (h) before surgery. All patients received a standard anesthetic protocol. At the end of the surgery, all patients received intravenous tramadol with Patient Controlled Analgesia (PCA) device. Pain scores was evaluated with visual analog scale during the postoperative 1st, 8th and 24th h. Tramadol consumption, adverse effects and patient satisfaction were recorded. Results: The pain scores and tramadol consumption were significantly lower in Group 1 (p<0.05). Nausea and vomiting were observed more in Group 2 than Group 1, and patient satisfaction was better in Group 1 (p<0.05). Conclusion: Preemptive use of dexketoprofen reduced postoperative tramadol consumption and incidence of adverse events.Öğe The effects of the administration of suhfacial levohupivacaine infusion with the ON-Q pain pump system on postoperative analgesia and tramadol consumption in cesarean operations [Sezaryen cerrahisinde on-q a?ri pompa sistemi ile uygulanan subfasiyal levobupivakain infüzyonunun postoperatif analjezi ve tramadol tüketimine etkisi](2010) Tuncer S.; Aysolmaz G.; Reisli R.; Erol A.; Yalçin N.; Yosunkaya A.Objectives: In this study, the effects of administration of suhfacial levobupivacaine infusion with the ON-Q pain pump system were investigated in elective cesarean operations for postoperative pain control and tramadol-sparing effect. Methods: Fifty ASA I-II patients scheduled for cesarean operation were enrolled into this study. Patients were randomly divided into two groups: Group I served as a control group, without the ON-Q pain pump system, whereas Group II received the ON-Q pain pump system with subfacial 0.25% levobupivacaine infusion for 24 hours at 4 ml/hour. All patients received a standard anesthetic protocol At the end of the surgery, all patients received tramadol i.v. via a PCA (Patient Controlled Analgesia) device. Pain scores were assessed at 2, 6, 12 and 24 hours postoperatively. Tramadol consumption and adverse effects were noted in the first 24 hours following surgery. Results: The pain scores were significantly lower in the levobupivacaine group when compared with the control group (p<0.05). The cumulative tramadol consumption was lower in the levobupivacaine group than in the control group (p<0.05). Group II used less antiemetic and had less postoperative nausea and vomiting and the difference was statistically significant (p<0.0S). Conclusion: No complication occurred as a result of the ON-Q pain pump system. Subfacial levobupivacaine infusion with the ON-Q pain pump system diminished postoperative pain and the need for tramadol use following cesarean operations.Öğe Gabapentin for neurophatic pain in children: A case report [Nöropatik a?rili bir çocukta gabapentin kullanimi: Olgu sunumu](2008) Dayio?lu M.; Tuncer S.; Reisli R.Gabapentin is used as an analgesic in neuropathic pain. In this report a children with nerophatic pain because of mercury poising was followed-up for pain and side effects with the use of gabapentin. Pain reduction was good throughout the patient treatment. Severe side effects did not occur. Gabapentin was effective and well tolerated in the treatment of neuropathic pain in children.Öğe Systemic effects of epidural betamethasone injection(2004) Tuncer S.; Barişkaner H.; Yosunkaya A.; Reisli R.; Ökesli S.A single epidural injection of a steroid may produce a suppression of the adrenocortical secretion. We aimed to evaluate systemic effects of a single epidural injection of betamethasone in this study. The study included 33 patients with low back pain. None of the patients had received local or systemic steroid therapy within 2 months before the injection. The epidural injection consisted of 10 mg of betamethasone diluted in 8 ml 0.25% bupivacaine. Injections were performed between 8:00 and 9:00 a.m. Before the injection in the same day (D0) cortisol, ACTH, fasting levels of glucose, triglycerides, cholesterol, sodium, and potassium were checked in the blood. The same assays were done again by the same laboratory at 15, 30, 45 min, and 7 (D7) and 21 (D21) days after the steroid injections. In all patients, cortisol and ACTH were normal at D0. ACTH and cortisol significantly decreased 45 min and at D7 after steroid injection, but returned to normal on D21. There were no significant changes in mean fasting glucose, sodium, potassium, triglycerides or cholesterol levels during the study. Blood pressure values were normal in all patients. As a result, it is concluded that a single epidural injection of betamethasone is associated with transient adrenal suppression.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.
