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Öğe Effect of caudal block on stress responses in children(BLACKWELL PUBLISHING ASIA, 2004) Tuncer, S; Yosunkaya, A; Reisli, R; Tavlan, A; Cicekci, F; Otelcioglu, SBackground: The present study was performed during lower abdominal and genitourinary surgery, to assess the effects of caudal block on plasma cortisol, prolactin, insulin and glucose concentrations during and after surgery. Methods: Thirty male children aged 3-10 years who were scheduled for elective surgery, were selected for the study. The children were premedicated with oral midazolam 0.5 mg/kg. All children received induction with nitrous oxide in oxygen and sevoflurane. The children were randomly allocated into two groups: Group I, control group (n=15) and group II, caudal group (n=15). Anesthesia was maintained by face mask with the same agent in both groups. Caudal block was performed with 0.25% bupivacaine 2 mg/kg after induction of anesthesia in the caudal group. Blood samples were obtained after induction of anesthesia (T-0) in order to measure baseline concentrations of cortisol, prolactin, glucose and insulin. Additional samples were obtained 30 min after the start of surgery (T-1), and 60 min after the end of surgery (T-2). Results: All of the basal values (T-0) were within the normal ranges accepted by Meram Medical Faculty of Selcuk University for children of this age group and there were no differences between the groups (P>0.05). In both groups, glucose concentration increased at T-1, compared with T-0 and T-2 values (P<0.05). However glucose concentration was lower in the caudal group than in the control group at T-1 (P<0.05). In both groups, prolactin concentration increased at T-1, compared with T-0 (P<0.05). The mean plasma prolactin and cortisol concentration were lower in the caudal group than the control group at T-1 and T-2 (P<0.05). The mean insulin concentration was lower in the caudal group than the control group at T-2 (P<0.05). Conclusion: These results indicate that caudal anesthesia suppresses the metabolic and endocrine responses to stress associated with lower abdominal and genitourinary surgery in children.Öğe Effect of gamma-hydroxybutyric acid on lipid peroxidation and tissue lactate level in experimental head trauma(LIPPINCOTT WILLIAMS & WILKINS, 2004) Yosunkaya, A; Ak, A; Bariskaner, H; Ustun, ME; Tuncer, S; Gurbilek, MBackground. This study was designed to determine the effects of gammahydroxybutyric acid (GHB) on tissue lactate and malondialdehyde (MDA) levels in rabbit brain after experimental head trauma. Methods. Thirty New Zealand rabbits were divided equally into three groups: group S was the sham-operated group, group C, and group GHB received head trauma, where group C was the untreated and group GHB was the treated group. Head trauma was delivered by performing a craniectomy over the right hemisphere and dropping a weight of 10 g from a height of 80 cm. GHB was administered 400 mg/kg intravenously for 10 minutes after the head trauma to group GHB. The nontraumatized side was named "1" and the traumatized side was named "2." One hour after trauma, brain cortices were resected from both sides and the concentrations of lactate and MDA were determined. Results There were significant differences between lactate and MDA levels of group S and all other groups (C-1, C-2, GHB(1), and GHB(2)) except between lactate levels of group S and group GHB(1), the nontramnatized and traumatized sides of groups C and group GHB, group C-2 versus group GHB(2), and group C-1 versus group GHB(1) (p < 0.05). Rectal temperature after the administration of GHB in group GHB was found lower than in groups S and C (p < 0.05). Conclusion. These results demonstrate that head trauma leads to an increase in brain tissue lactate and MDA levels, and GHB effectively suppresses the increase of lactate and MDA.Öğe Effect of gamma-hydroxybutyric acid on tissue Na+,K+-ATPase levels after experimental head trauma(WILEY, 2004) Yosunkaya, A; Ustun, ME; Bariskaner, H; Tavlan, A; Gurbilek, MBackground: A failure of the Na+,K+-ATPase activity (which is essential for ion flux across the cell membranes) occurs in many pathological conditions and may lead to cell dysfunction or even cell death. By altering the concentration of specific opioid peptides, gamma-hydroxybutyric acid (GHB) may change ion flux across cell membranes and produce the 'channel arrest' which we assumed will inhibit the failure of Na+,K+-ATPase activity and therefore lead to energy conservation and cell protection. Therefore we planned this study to see the effects of GHB at two different doses on Na+,K+-ATPase activity in an experimental head trauma model. Methods: Forty New Zealand rabbits were divided equally into four groups: group I was the sham-operated group, group II (untreated group), group III received head trauma and intravenous (i.v.) 500 mg/kg GHB and group IV received head trauma and i.v. 50 mg/kg GHB. Head trauma was delivered by performing a craniectomy over the right hemisphere and dropping a weight of 10 g from a height of 80 cm. The non-traumatized (left) side was named as 'a' and the traumatized (right) side as 'b'. One hour after the trauma in groups II and III and craniotomy in group I, brain cortices were resected from both sides and in group I only from the right side was the tissue Na-K-ATPase activity determined. Results: The mean +/- SD of Na+,K+-ATPase levels of each group are as follows: group I - 5.97 +/- 0.55; group IIa - 3.90 +/- 1.08; group IIb - 3.58 +/- 0.90; group IIIa - 5.53 +/- 0.60; group IIIb - 5.33 +/- 0.88; group IVa - 5.05 +/- 0.72; group IVb - 4.93 +/- 0.67. The Na+,K+-ATPase levels of group IIa, IIb, IVa and IVb were significantly different from group S (P < 0.05). There were also significant differences between group IIa and groups IIIa and IVa; group IIb and groups IIIb and IVb (P < 0.05). Conclusions: We conclude that GHB is effective in suppressing the decrease in Na+,K+-ATPase levels in brain tissue at two different dose schedules after head trauma.Öğe The effects of adding diphenhydramine hydrochloride to lidocaine in intravenous regional anaesthesia(VSP BV, 2003) Reisli, R; Celik, J; Tuncer, S; Apilliogullari, S; Duman, A; Yosunkaya, A; Okesli, SThis study aimed to evaluate whether diphenhydramine hydrochloride (DPH) could be used to reduce the dose of lidocaine for intravenous regional anaesthesia (IVRA). Sixty patients undergoing upper limb operations were divided into three groups (20 each). All patients received IVRA as follows: group 1 received 3 mg/kg lidocaine, group 2 received 40 mg DPH and 1.5 mg/kg lidocaine, and group 3 received 1.5 mg/kg lidocaine diluted to 40 ml with 0.9% saline solution. The onset of sensory block was tested by a pinprick. The duration of anaesthesia time was also recorded. Intraoperative pain was assessed using a five point pain score system. Side effects during surgery and after release of the tourniquet were recorded. Only 4 patients in group 3 had sufficient analgesia. Therefore, the patients in group 3 were excluded from the study. Data from 40 patients (group I and 2) were analysed. The onset time of sensory block was significantly shorter in group I than group 2 (2.4 +/- 1.54 min and 6.85 +/- 1.46 min, respectively). The tourniquet pain time was also significantly longer in group I than in group 2 (57.15 +/- 10.90 min and 42.65 +/- 9.67 min, respectively). One patient from each group experienced tinnitus for 30-60 s, and 4 patients in group 2 had minimal sedation after tourniquet release. According to our results, DPH is a safe and useful adjunct to IVRA in minor procedures of short duration. Decreasing the dose of lidocaine also decreases the risk of local anaesthetic toxicity in the event of accidental release of tourniquet pressure.Öğe Effects of isoflurane and sevoflurane on the survival of skin flaps in rats(TAYLOR & FRANCIS AS, 2005) Tosun, Z; Tuncer, S; Yosunkaya, A; Ozkan, A; Senturk, S; Savaci, NThe effects of inhalational anaesthetic agents on survival of flaps are not well known. We investigated the effect of isoflurane and sevoflurane anaesthesia on survival of flaps using a caudally-based McFarlane skin flap in 20 male Wistar rats. Sevoflurane 1 minimum alveolar concentration (MAC) and isoflurane (1 MAC) in oxygen mixture was given to the animals. A 4 x 10 cm caudally-based standard McFarlane flap was raised. There were no differences in any haemodynamic values or blood gases between the sevoflurane group and the isoflurane group. Skin flaps were assessed on the seventh day. The isoflurane group had a significantly smaller area of skin flap necrosis and an increased area of flap surviving than the sevoflurane group. We conclude that survival is significantly improved when isoflurane is used as the inhalational anaesthetic rather than sevoflurane.Öğe Effects of magnesium sulfate on Na+,K+-ATPase and intracranial pressure level after cerebral ischemia(JOHN LIBBEY EUROTEXT LTD, 2004) Ustun, ME; Bariskaner, H; Yosunkaya, A; Gurbilek, M; Dogan, NIn the present study, the effects of magnesium sulfate on Na+,K+-ATPase levels and intracranial pressure (ICP) after cerebral ischemia in rabbits were studied. Thirty New Zealand rabbits were divided into three groups. Group I was the control group. In group 2 (untreated group) cerebral ischemia was produced by clamping bilateral common carotid arteries for 60 min but in group 3 magnesium sulfate was administered 100 mg/kg i.v. 10 min after opening the clamps. In group 1, ICP recordings were obtained 5, 60 and 120 min after craniectomy. In groups 2 and 3, ICP recordings were obtained 5 min after craniectomy but before clamping, 60 min after clamping and 60 min after opening the clamps. After taking ICP recordings, brain cortices were resected and Na+,K+-ATPase activity was determined by subtracting the enzyme activity in the presence of ouabain from the total activity in the absence of ouabain method. There was a significant difference between Na+,K+-ATPase levels of ;group 1 and group 2 (P < 0.05). There was no significant difference in Na+,K+-ATPase levels between group 1 and 3 (P > 0.05), also preischemic ICP values were same in all groups (P > 0.05). Preischemic and postischemic ICP values were significantly different between groups 1 and 2 (P < 0.05), also postischemic (120 min) ICP values were significantly different between group 2 and group 3 (P < 0.05). ICP values correlate well with Na+,K+-ATPase level. These results demonstrate that cerebral ischemia leads to a decrease of ATPase level in the brain and magnesium sulfate suppresses the decrease of Na+,K+-ATPase, also magnesium sulfate treatment improves the ICP changes.
