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Öğe Comparison of Maintenance and Recovery Characteristics of Desflurane and Sevoflurane in Children [çocuklarda Desfluran-sevofluran Anestezisinin İdame Ve Derlenme Üzerine Olan Etkilerinin Karşilaştirilmasi](2003) Uzun, S.; Tuncer, S.; Tavlan, Aybars; Reisli, Ruhiye; Sarkilar, Gamze; Ökesli S.In this study, the characteristics of desflurane and sevoflurane were compared for maintenance of anaesthesia in short-term surgery of children. Fifty children, 4-12 years old were studied. Thirty minutes prior to the induction of anaesthesia, all patients received 0.5 mg kg-1 midazolam orally. They were randomly assigned to receive 6-7 % desfurane (group I) and 2-2.5 % sevoflurane (group II) with 60 % nitrous oxide in oxygen for maintenance of anaesthesia. For anaesthesia induction all patients were given 2-2.5 mg kg -1 propofol, 10 ?g kg-1 alfentanil and 0.1 mg kg -1 cisatracurium and after two minutes all patients were intubated. Before surgery, patients received 20 mg kg-1 paracetamol rectally for postoperative analgesia. Dexamethasone 150 ?g kg-1 was given to reduce the incidence of postoperative nausea and vomiting. Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure and heat rate were measured: before induction, after induction and during intubation, 5, 10, 20 minutes after surgery and at the end of anaesthesia. At the end of the operation extubation and recovery times were determined. Agitation was evaluated by using the three -point score. Hemodynamic parameters were satisfactorily maintained within ± 30 % of baseline values in both groups. Recovery time was significantly shorter in the desflurane group than sevoflurane group (p<0.05). Extubation time and incidence of agitation were similar for both groups. Differences in the incidence of postoperative vomiting were not statistically significant between the groups. As a result, we concluded that both sevoflurane and desflurane can be used safely for the maintenance of anaesthesia after induction of propofol in children.Öğe EFFECT OF DEXMEDETOMIDINE ON PAIN CAUSED BY INJECTION OF PROPOFOL(NOBEL ILAC, 2012) Sarkilar, Gamze; Kara, Inci; Duman, Ates; Aygin, Feride; Okesli, SelminObjective: This study was designed to assess the local and systemic effects of two different pre-anesthetic infusion dose of dexmedetomidine in preventing propofol injection pain. Material and Method: Two hundred fifty adults were assigned into five groups. Before injection of propofol, group 1 (placebo n=50) received an infusion of saline solution, group 2 (n=50) received 0.5 mu g kg(-1) of dexmedetomidine and group 3 (n=50) received 1 mu g kg(-1) of dexmedetomidine from the same vein. Group 4 (n=50) received 0.5 mu g kg(-1) of dexmedetomidine and group 5 (n=50) received 1 mu g kg(-1) dexmedetomidine followed by an injection of propofol from a vein located in the opposite hand. Pain assessment was made immediately after propofol injection. Results: Two hundred twenty five patients completed the study. The number of patients who suffered from any degree of pain was significantly high when compared to dexmedetomidine group (p=0.05). When compared with placebo and opposite hand, administering dexmedetomidine from the same vein was more efficient to prevent propofol pain (p=0.003). 1 mu g kg(-1) of dexmedetomidine was similar to 0.5 mu g kg(-1) of dexmedetomidine in preventing propofol pain. Conclusion: Dexmedetomidine infusions in p re-anesthetic sedative doses of 0.5 mu g kg(-1) and 1 mu g kg(-1) decrease the incidence of propofol injection pain compared to placebo.Öğe The Potential Effect of Epidural Anesthesia on Mesenteric Injury after Supraceliac Aortic Clamping in a Rabbit Model(ELSEVIER SCIENCE INC, 2016) Onoglu, Rasit; Narin, Cuneyt; Kiyici, Aysel; Sarkilar, Gamze; Hacibeyoglu, Gurhan; Baba, Fusun; Sarigul, AliBackground: Epidural anesthesia is known to increase blood flow by producing vasodilatation on mesenteric circulation. In this experimental study, we aim to examine the effect of epidural anesthesia on mesenteric ischemic-reperfusion ( IR) injury induced by supracoeliac aortic occlusion in a rabbit model. Methods: Twenty-eight male white New Zealand rabbits were assigned into 4 separate groups, with 7 rabbits in each group: group I, control group; group II, IR-only group; group III, IR plus epidural anesthesia group; group IV, epidural anesthesia-only group. IR model was produced by clamping supraceliac aorta with an atraumatic vascular clamp for 60 min, followed by reperfusion for 120 min. An epidural catheter was placed via Th12-L1 intervertebral space by using open technique before aortic clamping in those assigned to epidural anesthesia. IR injury was assessed using blood markers interleukin-6 and IMA and tissue markers superoxide dismutase and malondialdehyde. Also histopathological examination was performed to evaluate the degree of injury. Results: All biochemical markers in group II were significantly elevated in comparison with the other 3 groups ( p < 0.05). This was paralleled by a more severe histopathological injury in IR-only group ( group II). The group receiving IR plus epidural anesthesia ( group III) had lower biochemical marker levels as compared with the IR-only group ( group II). Conclusions: Mesenteric IR injury that can occur during abdominal aorta surgery can be reduced by epidural anesthesia, which is commonly used during or after major operations for pain control. Controlled clinical studies are required to evaluate these findings.Öğe Successful Mitral Valve Surgery in a Patient with Myasthenia Gravis(WILEY-BLACKWELL PUBLISHING, INC, 2009) Narin, Cueneyt; Sarkilar, Gamze; Tanyeli, Omer; Ege, Erdal; Yeniterzi, MehmetMyasthenia gravis (MG) is an autoimmune disease characterized by a weakness of the muscles with remissions and exacerbations due to antibodies against acetylcholine receptors. Most of the patients die because of a respiratory failure toward the end of the disease. A 49-year-old male patient with MG in whom a thymectomy operation had been performed five years ago had dyspnea, palpitation, and chest pain during his admission. After his examination, a severe mitral regurgitation was detected, and he underwent a successful mitral valve replacement. A general anesthesia management was performed using sufentanyl and propophol without any muscle relaxant agent. He was extubated seven hours after the surgery. He had difficulty in swallowing at postoperative day three, and his medication doses were increased. He was discharged from the hospital at postoperative day seven without any complication. MG is a rare disease and may cause morbid complications during the cardiac surgery, but can be successfully managed. (J Card Surg 2009;24:210-212).Öğe Surgical treatment of postinfarction pseudoaneurysms of the left ventricle(WILEY, 2008) Narin, Cueneyt; Ege, Erdal; Ozkara, Ahmet; Tanyeli, Omer; Sarkilar, Gamze; Soylu, Ahmet; Sarigul, AliBackground: Left ventricular pseudoaneurysm is a rare and frequently fatal complication of acute myocardial infarction. It occurs as a consequence of rupture of the ventricular free wall that gets confined by a portion of the pericardium. The purpose of this study was to present our surgical experience of postinfarction left ventricular pseudoaneurysms and to evaluate mid-term results. Methods: The study population comprised five symptomatic patients diagnosed with left ventricular pseudoaneurysm and treated surgically in a short period of time. There were three males and two females. The mean age of the patients was 66.8 +/- 10.8 years. The diagnosis was made initially by echocardiography and subsequently confirmed by angiography. An additional cardiac magnetic resonance imaging study was performed in three patients. Surgical resection of the pseudoaneurysm was combined with an endoaneurysmorrhaphy procedure in all patients. Associated cardiac operations were performed in three patients. Definitive diagnosis of pseudoaneurysm was confirmed by histopathological evaluation of the excised wall in all patients. Results: All patients survived the operation and were discharged to home care. The mean duration of hospital stay was 11.6 +/- 4.6 days. Patients were either in class I or II of New York Heart Association classification at discharge. All patients are still being followed after surgery with a mean follow-up period of 10.4 +/- 6.6 months with no further problems. Conclusion: Surgical repair is indicated in left ventricular pseudoaneurysm as it carries a high risk of rupture and sudden cardiac death. Surgical repair combined with an endoaneurysmorrhaphy procedure carries a low mortality risk and improves functional capacity.
