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Öğe Anaesthetic and Haemodynamic Effects of Continuous Spinal Versus Continuous Epidural Anaesthesia With Prilocaine(Greenwich Medical Media Ltd, 2003) Reisli, Ruhiye; Çelik, J.; Tuncer, S.; Yosunkaya, Alper; Otelcioğlu, S.Background and objective: To compare, using prilocaine, the effects of continuous spinal anaesthesia (CSA) and continuous epidural anaesthesia (CEA) on haemodynamic stability as well as the quality of anaesthesia and recovery in patients undergoing transurethral resection of the prostate gland. Methods: Thirty patients (>60 yr) were randomized into two groups. Prilocaine, 2% 40 mg, was given to patients in the CSA group, and prilocaine 1% 150 mg was given to patients in the CEA group. Incremental doses were given if the level of sensory block was lower than T-10 or if needed during surgery. Results: There was a significant decrease in mean arterial pressure in Group CEA compared with Group CSA (P < 0.01). The decrease in heart rate in Group CSA occurred 10 min after the first local anaesthetic administration and continued through the operation (P < 0.05). The level of sensory anaesthesia was similar in both groups. The times to reach the level of T-10 and the upper level of sensory blockade (T-max) were 18.0 +/- 4.7 and 25.3 +/- 7.0 min in Groups CSA and CEA, respectively, and were significantly longer in Group CEA. The duration of anaesthesia was 76.8 +/- 4 min and was shorter in Group CSA (P < 0.01). Conclusions: Spinal or epidural anaesthesia administered continuously was reliable in elderly patients undergoing transurethral resection of the prostate. Continuous spinal anaesthesia had a more rapid onset of action, produced more effective sensory and motor blockade and had a shorter recovery period. Prilocaine appeared to be a safe local anaesthetic for use with either continuous spinal anaesthesia or continuous epidural anaesthesia.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 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, SelminCaudal 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.Öğe A Comperative Study on Allergic Reactions Related to Various Anaesthetic Agents(1997) Altındiş, M.; Tuncer, S.; Özmen, S.; Ökeşli, S.; Sütçü, A.; Baysal, B.This study was designed to determine and compare allergic reactions due to IV anaesthetic agents used during surgical operations. From the Departments of general surgery, urology and orthopaedics 60 adults patients (27 male and 33 female with 35.9±12.5 mean age) having no tumoral-endocrine pathology or allergy/athopy history and being classified as ASA I and II were included to the study. They were divided into four groups as equal in number. The groups were similar demographically. After permission of the hospital's ethic comittee, the 4 groups were respectively infused with propofol (2.5 mg/kg) thiopentone (5 mg/kg), etomidate (0.3 mg/kg) and midazolam (0.3 mg/kg) for induction. Serum IgE levels (by ELISA using EIA-Bioclone, Australia) and eosinophil and basophil counts (by using autoanalyser) were measured in blood samples drawn both just before, after induction and 24 hrs later. As a result, we detected thiopentone to cause significant increase in serum IgE levels and eosinophil and basophil counts more than those of the other 3 agents (p<0.05). We concluded that, instead of using thiopentone, propofol, etomidate or midazolam may be a safer alternative for patients with an allergy/athopy history.Öğe Effects of Bupivacaine and Ropivacaine on Hemodynamic Parameters in Rabbits(PROUS SCIENCE, SA, 2001) Barışkaner, H.; Tuncer, S.; Ulusoy, H.; Doğan, N.In the present study the toxic effects of ropivacaine and bupiavacaine on the cardiovascular and respiratory systems of rabbits were studied. Both drugs were administered intravenously at doses of 0.5, 1, 2.5, 5 and 10 mu mol/kg. The effects of the two drugs on blood pressure, ECG and respiration rate were evaluated by considering the changes occurring 30 sec after intravenous bolus injection. High doses (5 and 10 mu mol/kg) of bupivacaine and ropivacaine significantly reduced the heart rate and systolic pressure (p < 0.05). Five and 10 mu mol/kg of bupivacaine significantly reduced diastolic pressure (p < 0.05), but only the 10 mu mol/kg dose of ropivacaine had the same effect. Low doses of bupivacaine and high doses of ropivacaine significantly increased the PR interval, QRS duration and QT interval (p < 0.05). The 5 mu mol/kg dose of bupivacaine caused ventricular tachycardia in 3 of 6 rabbits, whereas ropivacaine caused tachycardia in 1 of 5 rabbits. Neither drug had a significant effect on respiration rate or blood gas values (p > 0.05). The results indicate that ropivacaine is less cardiodepressive and arrhythmogenic than bupivacaine.Öğe Evaluation of Halothane and Sevoflurane Effects With Two Different Anaesthesia Induction Methods in Children [Çocukların Anestezi İndüksiyonunda Farklı İki Yöntem İle Uygulanan Halotan ve Sevofluranın Etkilerinin Değerlendirilmesi](2001) Yosunkaya, A.; Aydemir, T.; Tuncer, S.; Reisli, R.; Otelcioğlu, S.In this study, we compared the induction characteristics of halothane and sevoflurane with two different anaesthesia induction methods on eighty children (1-6 years old) ASA I-II class scheduled for elective surgery. None of the patients were premedicated. Patients were randomly assigned to four equal groups. Anaesthesia induction was achieved as follows: in 50 % O2/N2O, in Group I, starting with halothane 0.5 % concentration, increasing 0.5 % and reaching to 3.5 % maximum; in Group II, starting with sevoflurane 1 % concentration, increasing 1-1.5 % and reaching to 7 % maximum; in Group III, starting with 3.5 % and Group IV, starting with 7 % concentration. The duration of induction, it's completion, intubation and the complications which developed during induction were determined. Measurements of systolic arterial pressure, diastolic arterial pressure and heart rate were recorded before induction, after induction, after intubation, 3 and 5 minutes after intubation. The induction duration was determined shorter in Group III than Group I and in Group VI titan Group II (p<0.05). As there were significant differences for the duration of the induction between Group I and Group II while Group III and Group IV were similar (p?0.05). We didn't see a statistically difference between the groups regarding the completion of the induction, the duration of the intubation, and complications (p>0.05). As a result, sevoflurane was found to be a good alternative to halothane in paediatric patients and the induction with high concentration could be preferred because of the reliable and significantly faster induction.Öğe Intraperitoneal Versus Interpleural Analgesia on Post-Operative Pain to Laparoscopic Cholecystectomy(2000) Çelik, J.; Tuncer, S.; Reisli, R.; Ökeşli, S.; Otelcioğlu, S.In our study, we aimed to compare the quality and duration of analgesia intrapleural bupivacaine, bupivacaine+morphine, only morphine and intraperitoneal bupivacaine, bupivacaine+morphine and only morphine administration for relieving pain after laparoscopic cholecystectomy. 90 cases of ASA I-II class were included in the study. Cases were randomly allocated in six groups. At the end of surgery, Group I (n=15) intraperitoneal 3 mg morphine in 30 mL saline; Group II (n=15) intraperitoneal 30 mL % 0.25 bupivacaine; Group III (n=15) intraperitoneal 30 mL % 0.25 bupivacaine+3 mg morphine; Group IV (n=15) interpleural 3 mg morphine in 30 mL saline; Group V (n=15) interpleural 30 mL % 0.25 bupivacaine; Group VI (n=15) interpleural 30 mL % 0.25 bupivacaine+3 mg morphine were administered. Postoperatif pain was assesed by a visual analog scale, numeric rating scale in 1,2,4,6,12, 24 hours and side effect were recorded for 24 hours. Interpleural bupivacaine was effective for postoperative pain relief and adding morphine to bupivacaine does not increase the quality and duration of analgesia. There were no differences in intraoperative fentanyl consumption and postoperative pain scores (NRS, VAS) were less in groups V and VI than groups I,II,III,IV.Öğe Prevention of Postoperative Nausea-Vomiting in Children: Comparison of Granisetron and Droperidol Plus Metoclopramide(2001) Çelik, J.; Reisli, R.; Tuncer, S.; Duman, A.; Ökeşli, S.This study was performed to compare the efficacy of a droperidol-metoclopramide combination with granisetron to prevent postoperative nausea and vomiting after tonsillectomy with or without adenoidectomy in children. Ninety pediatric patients, ASA class I, aged 4-10 years, were enrolled in a prospective, randomized, double-blind investigation and assigned to one of two treatment regimens; granisetron 40 mg/kg (Group G, n=45), droperidol 50 mg/kg plus metoclopramide 0.25 mg/kg (Group DM, n=45). Antiemetic drugs were administered intravenaously (IV) after inhaled induction of general anaesthesia. The same standard general anesthetic technique was used. Tracheal extubation was performed while patients were still deeply anaesthetized. Acetaminophen (10-25 mg/kg PR) was applied for postoperative analgesia to all children. The rate of complete response, defined as no emesis and no need for rescue antiemetics, 0-3 h after anaesthesia were 85% in group G, 87% in group DM (p>0.05). No clinically important adverse events were observed in any of the groups.
