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    Central Vein Catheterization-r Elated Thrombosis and Superior Vena Cava Syndrome: Case Report
    (2009) Yosunkaya, A.; Çelik, J. B.; Dayıoğlu, M.; Erkoçak, R.; Paksoy, Y.
    Catheter-related central vein thrombosis is a frequent complication of central venous catheterization in criti cal care patients and is rarely associated with superior vena cava syndrome. In this report, thrombosis and superior vena cavil syndrome due to central venous catheterization were discussed in critical care patient with previous multiple catheter placement on same region. The l)atieflt was 35 years old; women and she had cardiac arrest after sectin operation. She had multiple unsuccessful atteml)ts for central venous catheterization into the left and right internal jugular vein and had a history of several central catheter placements into the right internal jugular vein for four nionths. In last catheterization, edema, erythe- ma was observed on her right face, chest wall and neck. In the magnetic resonance imaging, thrombosis in tight internal jugular vein, right subclavian vein and right external jugular veils were demonstrated. In conclusion, central venous catheterization plays an important role in the delivery of modern medical care but is not without its drawbacks. The healthcare professionals need to lie aware of complications iluring the central venous catheterization.
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    Epidural Administration of Midasolam for Chronic Central Pain and Spasticity in Spinal Cord Injured Patients
    (1997) Özerbil, O. M.; Duman, A.; Yosunkaya, A.; Bayram, A.; Üstün, M. E.
    In the patients with spinal cord injury (SCI) chronic pain and spasticity affect significantly both the efficacy of rehabilitation and the quality of life. Recently it was shown that intrathecally and epidurally administered midasolam has analgesic and antispatic effects in both animals and humans so that it constitutes an alternative to be used in patients with SCI. In this study, four paraplegics who suffered from chronic central pain and spasticity in their lower extremities were given midasolan 6 times daily (dose 40 ?g/kg dose dissolved in 10 ml normal saline) via lumbar epidural catheter using pain management provider. Spasticity was monitored by means of a modified Ashwort scale, and pain evaluation was performed by face scale and VAS. The patients were hospitalized at least for two weeks and were observed for the efficacy of the drug. Although epidural administration of midasolam relieved both central pain and spasticity, it's efficacy on central pain was more pronounced. There were no significant side effects is any patient. We propose that midasolam may be given by epidural catheter or implantable drug pump for the treatment of central pain and/or spinal spasticity in spinal cord injured patients.
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    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.
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    Sufentanil ve Remifentanilin İzole Perfüze Rat Böbreği Üzerine Etkileri
    (2004) Barışkaner, H.; Tuncer, Sema; Otelcioğlu, Ş.; Doğan, N.; Yosunkaya, A.; Kılıç, M.
    In this in vitro study on isolated perfused rat kidney, the effects of indomethacin, NG-nitro-L arginin methyl ester (L-NAME), propranolol, naloxone, glibenclamide and tetraethylammonium (TEA) on the responses induced by fentanyl, sufentaniyl and remifentanil were investigated. In isolated perfused rat kidney, under a constant flow of 8-10 ml/min, mean basal perfusion pressure and the responses of used inhibitors or antagonists were recorded on a polygraph. Fentanyl (10-9-10-6 M), sufentanil (10 -9-10-6 M) and remifentanil (10-9-10 -6 M) caused a dose-dependent decrease in perfusion pressure raised by submaximum concentration of phenylephrine. Fentanyl induced relaxations were inhibited by glibenclamide (10-5 M, n = 5) and TEA (10-3 M, n = 5) (p < 0.05) but not indomethacin (10-5 M, n = 5), L-NAME (10-4 M, n = 5), propranolol (10-6 M, n = 5) and naloxone (10-6 M, n = 5) (p > 0.05). Both sufentanil- and remifentalin-induced relaxations were not inhibited by indomethacin (10 -5 M, n = 5), L-NAME (10-4 M, n = 5), propranolol (10 -6 M, n = 5), naloxone (10-6 M, n = 5) (p > 0.05) and glibenclamide (10-5 M, n = 5) but TEA (10-3 M, n = 5) was effective (p < 0.05). These results suggest that in isolated perfused rat kidney, K+ channels may play a role in fentanyl-, sufentanil- and remifentanil-induced relaxation by opening ATP sensitive-potassium channels and calcium-activated potassium channels.