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    A Comparison of Ropivacaine With Bupivacaine for Pediatric Caudal Block [çocuklarda Kaudal Blok Uygulanmasinda Bupivakain I?le Ropivakainin Karşilaştirilmasi]
    (2001) Tuncer, S.; Orhan, R.; Çelik, J.; Reisli, Ruhiye; Tavlan, A.; Ökesli, Selmin
    Caudal anaesthesia is a widely used method for lower abdominal, penoscrotal and lower extremity surgery in children. The aim of this study was to evaluate the quality of anaesthesia, the effects on hemodynamic parameters, postoperative pain and side effects of ropivacaine and bupivakaine in caudal anaesthesia. All patients received rectal midazolam 0.4 mg/kg for premedication 30 minutes before surgery. After routine monitorization, patients were randomized into two groups. All patients received 2-2.5 mg/kg bolus propofol intravenously and then propofol infusion was continued through the operation. Immediately after propofol bolus Group I (n=20) received 2 mg/kg 0.25% bupivacaine and Group II (n=20) received 2 mg/kg 0.2% ropivacaine for caudal anaesthesia. Heart rate, arterial blood pressure, SpO2 was measured 5 and 15 minutes after caudal blockade and every 15 minutes until discharged from the operating room. Postoperative pain was assessed according to Modified Pediatric Objective Pain Scale (MPOPS). The level of anaesthesia was satisfactory in both groups. No further analgesia was required. Heart rate, arterial blood pressure, SpO2 and the values of MPOPS were similar in both groups. 45% of Group I and 40% of Group II didn't need postoperative analgesia. As a result, we concluded that ropivacaine (2 mg/kg 0.2%) is as efficacious as bupivacaine (2 mg/kg 0.25%) anaesthesia and postoperative analgesia for caudal anesthesia in children.
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    The Effects of Halothane and Sevoflurane on Qtc Interval
    (2000) Reisli, Ruhiye; Çelik, J.; Özdemir, K.; Tavlan, A.; Apillioğlu, S.; Ökeşli, S.
    Prolongation of the QT interval may cause hazardous arrhythmias. The effects of halothane and sevoflurane on the Q T interval (QTc) have been investigated during induction of anaesthesia in 30 ASA I-II class patients. No premedication was used to avoid the effects of other anaesthetic agents. Anaesthesia was induced with either halothane (n=15) or sevoflurane (n=15), and inspired concentration was increased gradually to achieve a constant initial end-tidal concentration of 2 MAC. After pupils came to midline 0.05 mg/kg atracurium was administered and end-tidal concentration was reduced to 1 MAC. Recordings of ECG, heart rate, systolic and diastolic arterial blood pressure were obtained at the following times: prior to induction of anaesthesia, after the lost of eye slash reflex, 3 min following atracurium administration, 1 and 3 min after tracheal intubation. QT interval was corrected for the heart rate (QTc). Both halothane and sevoflurane prolonged QTc one minute after the tracheal intubation, but it was statistically significant only in sevoflurane group (p<0.05). The heart rate increased 1 and 3 rain after tracheal intubation with sevoflurane (p<0.05). In both groups, systolic and diastolic arterial blood pressures decreased after induction of anaesthesia (p<0.05). In conclusion the prolongation of the QTc interval by halothane and sevoflurane suggests that caution should be used during administration of these agents to patients with long QTc syndrome.