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Airway management in an osteogenesis imperfecta case in the lateral decubitus position
(Medicine Science, 2016) Uçar, Muharrem; Özkan, Ahmet Selim; Demiröz, Duygu; Erdoğan, Mehmet Ali; Özgul, Ülkü; Durmuş, Mahmut
Abstract Osteogenesis imperfecta that is a connective tissue disorder is a rare autosomal disease. Osteogenesis imperfecta in the presence spinal deformity, respiratory disorders, cardiac anomalies and bone deformities may create several problems in the management of anesthesia. The risks of teeth, mandible and cervical trauma and difficulty making positions due to bone deformity challenge difficult airway management. We aim to provide airway management with ProSeal Laryngeal Mask Airway in left lateral decubitus position in a child patient who has severe thoracic spine deformity and can not be given supine position. Keywords: Osteogenesis imperfecta, PLMA, airway management
Anaesthesia Management of a Morbid Obese Woman Undergoing Transsphenoidal Hypophysectomy
(KARGER, ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND, 2018) Özkan, Ahmet Selim
Anestezi Yönetimi, Hava Yolu Yönetiminde Farklı Sturge-Weber Sendromlu Pediyatrik Hastada Bir Yaklaşım
(Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, 2016) Akbaş, Sedat; Özkan, Ahmet Selim; Polat, Nihat; Kadıoğlu, Mustafa; Durmuş, Mahmut
Öz: Sturge-Weber Sendromu (SWS); deri, beyin ve göz ile ilgili lezyonlarla sonuçlanan, ensefalotrigeminal anjiomatozis ve konjenital deri anjiomları ile karakterize ender görülen bir sendromdur. SWS'li hastaların hava yollarında sıkça anjiomlar görülmesinden dolayı maske ile ventilasyonda, laringoskopi ve entübasyonda çok dikkatli olunmalıdır. Zor hava yolu yönetimi için alternatif hava yolu gereçleri hazır bulundurulmalıdır. Bu olguda, glokom nedeniyle göz cerrahisi planlanan SWS'li pediatrik hastada anestezi yönetimi sunuldu
Anesthesia Management in A Case with Prader-Willi Syndrome
(2023) Tunç, Yeliz; Karaaslan, Erol; Özkan, Ahmet Selim
Prader Willi (PWS) is the most common and rare genetic cause of obesity. Airway problems associated with obesity and hypotonia, increased risk of aspiration due to gastrointestinal (GI) motility and hyperphagia, obstructive sleep apnea syndrome (OSAS), difficult airway management, and postoperative respiratory failure risk due to narrow airway are the factors that complicate anesthesia management. It should be noted that there are many anatomical and physiological factors that may adversely affect perioperative anesthesia management in patients with PWS. For this reason, preoperative anesthesia evaluation and all preparations should be performed completely.
Anesthesia management in pediatric patients undergoing percutaneous closure of atrial and ventricular septal defects in catheter laboratory: Retrospective clinical study
(2018) Akbaş, Sedat; Özkan, Ahmet Selim
Along with technological and medical advances, diagnostic and therapeutic cardiac catheterization commonly used in pediatric patients; it is frequently preferred the percutaneous closure of ASD/VSD. In this study, it was aimed to evaluate anesthesia management of pediatric patients undergoing percutaneous closure of ASD/VSD in catheter laboratory. This was a retrospective review of pediatric patients undergoing percutaneous closure of ASD/VSD in catheter laboratory between 2012–2017. Demographic and clinical characteristics were recorded, and all results of anesthesia management were evaluated. Thirty-eight patients (18 males, 20 females) with a mean age of 7,71 ± 3,57 years underwent percutaneous closure of ASD/VSD. Of the cases; 78,4% diagnosed ASD, 21,6% diagnosed VSD were operated. The most common presenting symptoms were murmur (55,3%), chest pain (21,1%) and palpitation (10,5%), Mean defect size was 11.60 ± 6.27 mm for ASD and 6.00 ± 4.64 mm for VSD. Mean anesthesia time was 71.33 ± 22.77 minutes for ASD and 85.83 ± 26.91 minutes for VSD. Mean procedure time was 56.00 ± 20.56 minutes for ASD and 69.16 ± 28.70 minutes for VSD. Premedication was performed for 94,7%, anesthesia induction was performed with propofol (94,7%), fentanyl (63,2%), rocuronium (65,8%). Sevoflurane was used for anesthesia maintenance. TEE was used in 86,8% of the cases. Complications developed for 3 cases. IV paracetamol was preferred in 84,2%. Anesthetist must consider carefully premedication, anesthetic agent preferences, general anesthesia or sedation, complications by catheterization, discomforts of transesophageal echocardiography, hemodynamic instability, requirement of immobility and adequate analgesia.
Anesthesia management in sleeve gastrectomy: Single center experience
(2018) Özkan, Ahmet Selim
Aim: Sleeve gastrectomy surgery is performed by laparoscopic method and preferred by obesity surgeons, frequently. Because these patients are morbidly obese,many additional diseases are seen and anesthesia management is challenging for anesthesiologist. In this study, demographic and perioperative data of 23 patients undergoing sleeve gasterectomy surgery (SGS) in our hospital were presented.Material and Methods: This study was performed in 23 adult patients undervent SGS with laparoscopic bariatric surgery. The demographic and operative data, hemodynamics and blood glucose values of the cases were recorded at specified times. The data were evaluated by mean ± SD and the ranges of the data were also calculated.Results: The mean age of patients was 37.6±10.2 years.The mean body mass index was 45.8±5.4 kg/m2. The mean duration of anesthesia was 153.3±65.6 min, and the mean duration of surgery was 136.6±63.8 min.There were no statistically differences in terms of heart rate and peripheral oxygen saturation. There was significant increase in mean arterial pressure at T3 when compared to T2(p=0,09). End-tidal carbon dioxide value significantly decreased at T2 when compared toT1(p<0,001) and significantly increased at T6 when compared toT5 (p=0,005). Blood glucose values were increased significantly at T2 and T7 when compared to T0 values (p<0,001).Conclusion: Anesthesia management of morbid obese patients is challenging for anesthesiologist, because the hemodynamic stability and hormonal values of the patients can be changed due to the increased BMI. Preoperative hemodynamics and blood glucose values should be closely monitored and necessary interventions should be applied considering the operation periods.
Anesthesıa Management In Adult Scolıosıs Patıents
(İnönü Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Malatya, Türkiye, 2019) Özkan, Ahmet Selim; Korkmaz, Mehmet Fatih
Abstract: Introduction: Adult scoliosis surgery management is challenging procedure for both orthopedic surgeons and anesthetists because of the long duration of surgery, difficulties in cannulation and intubation and serious bleeding. In this retrospective study, the anesthesia records of 25 adult patients who underwent scoliosis surgery under general anesthesia between 2010 and 2013 were evaluated in the light of current literature. Material and Methods: Twenty-five adult patients who underwent scoliosis surgery between January 2010 and December 2013 were included in the study. Demographic data, American Society of Anesthesiologists (ASA) classification, Mallampati (MP) score, duration of anesthesia, duration of operation, amount of blood loss data were recorded. Results: The mean age of 25 patients who underwent scoliosis surgery was 26.6 ± 8.80 years. 2 (8 %) of the patients were classified as ASA I, 19 (76 %) ASA II and 4 (4 %) ASA III. MP score was I in ten (40 %) patients, and was recorded as II in 10 (40 %) patients and III in 5 (20 %) patients. The mean duration of anesthesia was 289.80 ± 81.01 minute, the mean amount of blood loss was recorded as 1162 ± 466.72 ml. Twenty (88 %) patients underwent peroperative blood transfusion. Conclusion: Anesthesia management is important in scoliosis surgery due to many complications that may develop especially because of blood loss. Detailed preoperative evaluation should be performed and appropriate preparations should be planned before surgery.
Anesthetic management in a patient with Friedreich’s Ataxia: A different approach
(2017) Akbaş, Sedat; Toy, Erol; Özkan, Ahmet Selim
Abstract: Friedreich's Ataxia (FA) is a rare autosomal recessive disease. FA is clinically characterized by progressive ataxia, especially loss of reflex and power in the lower extremities, spasticity and loss of proprioceptive sensory. There is an increased sensitivity to non-depolarizing muscle relaxants in neurodegenerative diseases. Care must be taken of anesthesia management for the use of volatile anesthetics and muscle relaxants, and precautions should be taken for difficult airway management which is due to secondary to kyphoscoliosis and comorbidities. In this case, anesthesia management of emergency operation for septal hematoma by TIVA without using of muscle relaxants and minimalized hemodynamic response depending on the intubation by videolaryngoscope were presented
Ascites and hepatic involvement: a rare and atypical presentation of Burkitt Lymphoma
(Turgut Özal Tıp Merkezi Dergisi, 2016) Seçkin, Yüksel; Cagin, Yasir Furkan; Özkan, Ahmet Selim; Bilgiç, Yılmaz; Yıldırım, Oğuzhan; Erdoğan, Mehmet Ali; Atayan, Yahya; Kırımlıoğlu, Hale; Aydoğdu, İsmet
Abstract Burkitt lymphoma (BL) is an uncommon form of lymphoma in adults. In this disease, extensive involvement of the omentum and the peritoneum is rare. We present this case with ascites because it is such a rare and overlooked clinical presentation of BL. A previously healthy 20-year-old man was admitted to our hospital with abdominal pain, distension, and night sweats. Physical examination revealed massive ascites. Computerized tomography showed liver metastasis and ascites, but no pathologic thoracal or abdominal lympadenopathy was reported. Atypical lymphocytic cells with cytoplasmic vacuoles were determined on cytologic examination of ascites. We detected starry sky view on the bone marrow examination. On immunophenotyping, cells were CD20 positive, but negative for CD30, CD79a/Tdt. Patient was diagnosed as BL. Burkitt lymphoma should be considered in young patients presenting with ascites and hepatic mass even without lymphadenopathy or focal gastrointestinal masses. Keywords: Ascite; Hepatic İnvolvement; Burkitt Lymphoma.
Bilateral Diş Apsesi Olan Gebe Hastada Anestezi Yönetimi
(2015) Özkan, Ahmet Selim; Kaçmaz, Osman; Uçar, Muharrem; Durmuş, Mahmut
[Abstract Not Available]
The Case of a Diplopia and Visual Impairment Developing Patient after Spinal Anaesthesia
(Turgut Özal Tıp Merkezi Dergisi, 2015) Aydoğan, Mustafa Said; Miniksar, Ökkeş Hakan; Özkan, Ahmet Selim; Kaçmaz, Osman; Yücel, Aytaç; Durmuş, Mahmut
Yıl: 2015Cilt: 22Sayı: 1ISSN: 1300-1744Sayfa Aralığı: 74 - 75 Metin Dili: İngilizce Öz: Başlık ( ): Spinal Anestezi Sonrası Diplopi ve Görme Bozukluğu Gelişen Bir Hasta Olgusu Öz ( ):
Cataract Surgery Anesthesia Management of a Patient with Biotinidase Deficiency
(2019) Miniksar, Ökkeş Hakan; Toy, Erol; Özkan, Ahmet Selim
Abstract: Biotinidase deficiency is an autosomal recessive rarecongenital disease involving multisystem. Treatmentof the disease with biotin results in rapid biochemicaland clinical improvement. This enzyme deficiencyincludes increased susceptibility to infections,neurological, neuromuscular, respiratory,dermatological and immunological problems.Anesthesia management in these patients; The aim ofthis study is to determine the problems related tocomorbidity and congenital anomalies and to applycomprehensive preoperative strategies to ensure thesafety of the patient peroperatively. In this study, wepresent the successful anesthesia management of a10-month-old boy with BD in cataract surgery.
Catheter Malposition in Liver Transplantation Recipients
(Turgut Özal Tıp Merkezi Dergisi, 2014) Şanlı, Mukadder; Toprak, Hüseyin İlksen; Özkan, Ahmet Selim
Yıl: 2014Cilt: 21Sayı: 2ISSN: 1300-1744Sayfa Aralığı: 162 - 163 Metin Dili: İngilizce Öz: Başlık ( ): Karaciğer Nakli Alıcısında Kateter Malpozisyonu Öz ( ):
The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study
(2019) Akbaş, Sedat; Özkan, Ahmet Selim; Sevimli, Reşit; Alan, Saadet
Abstract: Aim: Peripheral nerve blockade is a common regional anesthetic technique in surgical procedures in daily clinical practice. The aim of this experimental study was to compare perineural dexmedetomidine alone with perineural sodium bicarbonate added to dexmedetomidine for measurement of analgesia, sensorial and motor blockade and histopathologic evaluation. Material and Methods: Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham, Group D: perineural dexmedetomidine (20 mcg/kg) and Group D+SB: perineural dexmedetomidine (20 mcg/kg) plus sodium bicarbonate. (8.4%, 0.125 mL). Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades, also were recorded at baseline, 30, 60, 90 and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. Results: Latency times of Group D or Group D+SB were significantly longer when compared with Group S at 30, 60, 90 and 120 min. There was no significant difference between Group D and Group D+SB for the all scheduled times. Sensorial and motor blockade scores were similar in all groups. Group D or Group D+SB caused edema, inflammation with neutrophil leukocytes, and degeneration of myelin fibers, increased in vacuolization, granulation tissue and fibrosis. Conclusion: Perineural dexmedetomidine alone or in combination with sodium bicarbonate prolonged the duration of analgesia, but did not enhance the sensorial and motor blockade, when compared with placebo. Perineural dexmedetomidine combined with sodium bicarbonate didn’t enhance the blockage. Dexmedetomidine caused edema, inflammation and degeneration of myelin fibers, increased in granulation tissue and fibrosis.
The clinical and histopathological effects of perineural dexmedetomidine in combination with bupivacaine in sciatic nerve block in rabbits undergoing sevoflurane anesthesia
(2022) Sevimli, Reşit; Akbaş, Sedat; Karaaslan, Erol; Özkan, Ahmet Selim
Many drugs or additives have been tried as adjuvants in the blocking of nerve blocks with local anesthetics, and it is aimed to increase the duration of action and analgesia quality of local anesthetics in this way. In this study, we aimed to see the adjuvant efficacy of Dexmedetomidine [Dex] added to bupivacaine and its effect on analgesia and histopathological effects in rabbits by administering sevoflurane anesthesia. Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham [0.5 ml saline], Group B: perineural bupivacaine [0.5 mg/kg] [0.5 ml] and Group BD: perineural bupivacaine [0.5 mg/kg] combined with Dex [20 µr/kg] [0.5 ml]. Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades also were recorded at baseline, 30, 60, 90, and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. In the hot-plate test applied for the measurement of acute thermal pain; when compared to Group S, significant prolongation was found in Group B and Group BD at 0, 30, 60, 90, and 120 minutes [p<0.05]. When Group BD was compared with Group B, a significant prolongation was found at 60 minutes [p=0.012]. No significant difference was found in other times. No significant differences were found between the groups in sensory and motor block tests. In the BD group, compared to the B group, edema and inflammation in the epineurium and surrounding tissues were significantly reduced on the 1st day [p<0.05]. On the 14th day, there was no difference in terms of edema. In rabbits administered sevoflurane anesthesia, the mixture of bupivacaine and Dex applied to provide analgesia in the application of sciatic block prolongs the delay time and increases the quality of analgesia in the hot-plate test evaluating acute thermal pain. Dex added to bupivacaine contributed positively when the analyzed histopathological parameters were evaluated.
The clinical and histopathological effects of perineural dexmedetomidine in combinationwith bupivacaine in sciatic nerve block in rabbits undergoing sevoflurane anesthesia
(2022) Özkan, Ahmet Selim; Akbaş, Sedat; Sevimli, Reşit; Alan, Saadet; Karaaslan, Erol
Many drugs or additives have been tried as adjuvants in the blocking of nerve blocks with local anesthetics, and it is aimed to increase the duration of action and analgesia quality of local anesthetics in this way. In this study, we aimed to see the adjuvant efficacy of Dexmedetomidine [Dex] added to bupivacaine and its effect on analgesia and histopathological effects in rabbits by administering sevoflurane anesthesia. Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham [0.5 ml saline], Group B: perineural bupivacaine [0.5 mg/kg] [0.5 ml] and Group BD: perineural bupivacaine [0.5 mg/kg] combined with Dex [20 µr/kg] [0.5 ml]. Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades also were recorded at baseline, 30, 60, 90, and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. In the hot-plate test applied for the measurement of acute thermal pain; when compared to Group S, significant prolongation was found in Group B and Group BD at 0, 30, 60, 90, and 120 minutes [p<0.05]. When Group BD was compared with Group B, a significant prolongation was found at 60 minutes [p=0.012]. No significant difference was found in other times. No significant differences were found between the groups in sensory and motor block tests. In the BD group, compared to the B group, edema and inflammation in the epineurium and surrounding tissues were significantly reduced on the 1st day [p<0.05]. On the 14th day, there was no difference in terms of edema. In rabbits administered sevoflurane anesthesia, the mixture of bupivacaine and Dex applied to provide analgesia in the application of sciatic block prolongs the delay time and increases the quality of analgesia in the hot-plate test evaluating acute thermal pain. Dex added to bupivacaine contributed positively when the analyzed histopathological parameters were evaluated.
Comparison of %6 Hydroxyethyl Starch and %4 Gelatine Solutions in Major Surgery
(Journal of Clinical and Analytical Medicine, 2015) Korkmaz, Mehmet Fatih; Özkan, Ahmet Selim
Yıl: 2015Cilt: 6Sayı: 2ISSN: Sayfa Aralığı: 277 - 277 Metin Dili: İngilizce Öz: Başlık ( ): %4 Jelatin Solüsyonu ve %6 Hidroksietil Nişastanın Major Cerrahilerde Karşılaştırılması Öz ( ):
A comparison of general versus regional anesthesia in patients over 100 years old: A retrospective cohort study
(2021) Akbas, Sedat; Özkan, Ahmet Selim; Korkmaz, Mehmet Fatih
Abstract: Aim: As the life expectancy maintains to rise, the number of centenarians applied for surgery is increasing. Functional and anatomical changes in elderly patients may cause postoperative morbidity and mortality. The aim of this retrospective cohort study is to analyze and compare general and regional anesthesia in centenarians underwent different surgeries. Material and Methods: Patients aged over 100 years (American Society of Anesthesiology scores of II–IV) were included in our study. The centenarians were divided into two study groups: general anesthesia (Group GA, n=20) and regional anesthesia (Group RA, n=18). The demographic characteristics, procedure, and hospital data were evaluated. Results: There were no significant differences betveen two groups with regards to gender, height, weight, body mass index, ASA scores, perioperative colloid and crystalloid fluid consumptions. Duration of anesthesia and procedure in Group RA was shorter than that in Group GA. The requirement for invasive arterial monitorization, central venous catheterisation, and nasogastric tube in Group GA was higher than that in Group RA. Postoperative delirium was similar in both groups. Heart rate, mean arterial pressure, and peripheral oxygen saturation were similar. In-hospitality mortality was 26.3% in the entire group of centenarians. Conclusions: This study examined the role of different anesthetic methods in extremely elderly patients over 100 years old during different surgeries. Anesthetic agent preferences, long duration of anesthesia and surgery, and hemodynamic instability can cause serious complications. We therefore conclude that careful considerations are required in extremely elderly patients.
Comparison of the effects of direct laryngoscopy and fiberoptic oral endotracheal intubation on the intraocular pressures of non-ophthalmic patients: A prospective, randomised, clinical trial
(2022) Yıldırım, Sait; Akbaş, Sedat; Durmus, Mahmut; Özkan, Ahmet Selim; Karaaslan, Erol; Polat, Nihat; Mutlu, Kayhan
Abstract Aim: In this prospective, randomised, clinical study; we aimed to compare the effects of endotracheal intubation (ETI) via direct laryngoscope (DLS) and fiberoptic bronchoscope (FOB) on intraocular pressure (IOP) and hemodynamic data of non-ophthalmic patients. Materials and Methods: Fifty-four adult patients undergoing non-ophthalmic surgeries performed in the supine position under general anesthesia requiring orotracheal intubation were included into the study. The patients were randomly and prospectively divided into 2 groups: Group DLS (n=27) and Group FOB (n=27). Mean arterial pressure (MAP), Heart rate (HR), IOP were measured at before induction (basal), post-induction and 1st, 2nd, 3rd, and 5th minutes of intubation. Results: There was no statistically significant difference in distribution of patient characteristics. Duration of intubation was significantly longer in Group FOB (p<0.001). There was no statistically significant difference in MAP and HR when groups compared each other. Statistically significant increase was found in IOP at 1st minute of intubation in Group DLS when compared with Group FOB (p<0.001). No significant difference was found in terms of IOP in other time periods. Conclusion: We thought that endotracheal intubation by FOB could be more useful with respect to endotracheal intubation by DLS in patients with high IOP due to significantly less rise caused in IOP when performed by experienced anesthesiologists.
A comparison of the success of intubation using C-MAC D-Blade and McGrath MAC X3 Blade videolaryngoscopes during double lumen tube insertion in one-lung ventilation: A prospective, randomized clinical trial
(2024) Ertürk, Kasım; Özkan, Ahmet Selim; Akbaş, Sedat; Karaaslan, Erol; Durmuş, Mahmut
Aim: To compare the effects of C-MAC D-Blade and McGrath MAC X3 Blade videolaryngoscopes (VLs) during double lumen tube (DLT) insertion in one-lung ventilation (OLV) in patients who underwent chest surgery in terms of intubation durations, hemodynamic responses, and intubation-induced complications. Materials and Methods: Fifty patients aged 18?65 who were scheduled for OLV were included in this study. The patients were divided randomly into two groups: a Storz C-MAC D-Blade VL group (C-MAC group, n = 25) and a McGrath MAC X3 Blade VL group (McGrath group, n = 25). The results of a preoperative airway assessment, a number of intubation attempts and incidence of success at the first attempt, glottic view times, intubation times, Cormack?Lehane scores, percentage of glottic opening (POGO) scores, ease of intubation, comorbidities, hemodynamic responses, and intubation-related adverse events were recorded. Results: The demographic characteristics and comorbidities of both groups were similar. The intubation characteristics of both groups were similar in terms of Cormack?Lehane scores, thyromental and intergingival distances, and POGO scores. In the C-MAC group, the glottic view times (p = 0.001) and intubation times (p = 0.001) were significantly shorter than those in the McGrath group. As shown by ease of intubation scores, ease of intubation in the C-MAC group was significantly better than that in the McGrath group (p = 0.001). All the patients in the C-MAC group were intubated at the first attempt, without a statistically significant difference. The two groups were similar with respect to intubation-related complications and hemodynamic responses (mean arterial pressure and heart rate). Conclusion: We conclude that the C-MAC D-Blade VL is more beneficial for airway management due to shorter glottic view and intubation times, high success rates at the first attempt, and ease of intubation in patients intubated with a DLT in OLV.

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