Yazar "Şahin T." seçeneğine göre listele
Listeleniyor 1 - 3 / 3
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Anaesthesia for caesarean delivery in a pregnant with acute type B aortic dissection(2013) Kayhan G.E.; Gülhaş N.; Şahin T.; Özgül Ü.; Şanli M.; Durmuş M.; Ersoy M.Ö.About 50% of aortic dissections in women younger than 40 years occur during pregnancy; mostly in the 3rd trimester and postpartum period. Aortic dissection in pregnancy creates a serious mortality risk for both mother and the foetus. The ultimate goal is to ensure the safety of both the mother and the foetus. In such cases, the best method of anaesthesia for caesarean delivery is still controversial. The first aim of anaesthetic management is to reduce the effect of cardiovascular instability on the dissected aorta. Here, we report anaesthetic management of a 36 year-old patient who developed acute type B aortic dissection at the 30th gestational week and whom was scheduled for caesarean section. Since haemodynamic stability could not be achieved despite nitroglycerine and esmolol infusions, together with invasive arterial monitoring, the decision for caesarean delivery was taken. A team of Cardiovascular Surgeons and an operating room were prepared because of the risks of aortic rupture and haemodynamic collapse during operation. A combined-spinal epidural anaesthesia was administered using 5 mg hyperbaric bupivacaine and 20 ?g fentanyl given at the L3-4 spinal level in the lateral position. After achieving T4 sensorial level, the operation proceeded and a baby weighing 1432 grams was delivered in 4 mins with a median sub-umbilical incision. Epidural patient controlled analgesia was applied to the patient during follow-up with medical treatment at postoperative period. Application of combined-spinal epidural anaesthesia with a combination of low dose local anaesthetics and an opioid with additional doses for insufficient sensorial levels is a suitable method for pregnant women with acute type B aortic dissection. © 2013 by Turkish Anaesthesiology and Intensive Care Society.Öğe Comparison of analgesic effects of intravenous dexketoprofen trometamol, lornoxicam and paracetamol on postoperative pain after total abdominal hysterectomy(AVES, 2011) Gülhaş N.; Durmuş M.; Yücel A.; Şahin T.; Erdil F.A.; Yolo?lu S.; Ersoy M.O.Objective: This study was intended to evaluate the analgesic efficacy of intravenously administered dexketoprofen trometamol in comparison with lornoxicam and paracetamol for acute postoperative pain. Material and Methods: 120 ASA physical status I-II patients undergoing total abdominal hysterectomy were enrolled in this study and randomly allocated into four groups (Groups D, L, P, and C). Following standard monitorization, in all groups, induction of anaesthesia was achieved via intravenous route using 5-7 mg kg-1 thiopental, 1 ?g kg-1 fentanyl, and 0.1 mg kg-1 vecuronium bromide, and also 6-8 % concentration of desflurane in 50 % O2 50 % N2O was used for the maintenance of anaesthesia in all groups. Patients received intravenous dexketoprofen trometamol 50 mg (Group D), 8 mg lornoxicam (Group L), 1 g paracetamol (Group P) and 100 mL SF (Group C) 30 min before the end of the surgery and 8-16 h after the surgery in Groups D, L, C. Group P received rescue medication at 6., 12., 18. and 24h after the surgery. At the end of the surgery, all patients received fentanyl via a patient controlled iv analgesia (PCA) device. Pain scores, cumulative fentanyl consumption, and patient satisfaction scores were assessed at 30 min, 2., 4., 6., 12. and 24h postoperatively. Results: The VAS scores at all evaluation time points, were similar among the groups. Fentanly consumption at 6., 12. and 24h postoperatively in Group P, L, and D was significantly lower when compared with Group C (p<0,05). Fentanyl consumption in Group L was lower relative to the other groups without any statistical significance. The patients' satisfaction scores at 6., 12. and 24h postoperatively in Group L were higher than the other groups (p<0,05). There was no significant difference between groups regarding sedation scores and side effects observed like postoperative nausea and vomiting and indigestion. Conclusion: We concluded that iv paracetamol, lornoxicam and dexketoprofen trometamol were equivalent in terms of analgesic efficiency in the management of postoperative pain after total abdominal hysterectomy.Öğe Evaluation of effectiveness and neurotoxicity of rasemic ketamine in rat sciatic nerve block model(Anestezi Dergisi, 2017) Aslan A.; Erdo?an Kayhan G.; Şahin T.; Gül M.Objective: The aim of this study is to investigate the effects of two different doses of racemic ketamine on block times in the rat sciatic nerve block model and to determine whether ketamine leads to nerve damage. Method: Sixty-four, Sprague-Dawley female rats were included into the study. Rats were anesthetized with ether and then the sciatic nerves were exposed by lateral incision on posterior approach. A total of 7 groups were formed, including Sham and Saline (0.2 mL saline) for the first step of the study. The other groups according to the test doses were: Group B (0.1 mL 05% bupivacaine+ 0.1 mL saline); Group K1 (0.1 mL ketamine 0.5 mg kg-1+0.1 mL saline); Group K2 (0.1 mL ketamine 1 mg kg-1+0.1 mL saline); Group BK1 (0.1 mL 0.5% bupivacaine+0.1 mL ketamine 0.5 mg kg'); Group BK2 (0.1 mL 0.5% bupivacaine+0.1 mL ketamine 1 mg kg-1). An investigator blinded to the groups evaluated the durations of proprioceptive, motor, and sensorial block. After neurobehavioral examinations, the sciatic nenes were removed on 8th days, and were analysed for perineural inflammation, or nerve damage. Results: Ketamine (0.5mg kg-1) combination with bupivacaine prolonged the durations of proprioceptive, motor and sensorial block about %4l, %23, %33 rates, respectively. Ketamine (1mg kg-1) combination with bupivacaine prolonged the durations of proprioceptive, motor and sensorial block about %45, %37, %31 rates, respectively. While sole injection of ketamine to the sciatic nerve did not develop motor block, it provided a shorter proprioceptive block than other groups, and a similar duration for sensorial block. It was seen that the changes in durations of block were not dose-dependent. There were no statistical difference between groups according to neurotoxicity. Conclusion: We believe that rasemic ketamine may be a good adjuvant in terms of sciatic nerve block, however further studies are needed in terms of safety and systemic side effects in humans, in spite of the positive results of our study.
