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Öğe 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, MahmutÖz: 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 sunulduÖğe 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 SelimAlong 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.Öğe ANESTHESIA MANAGEMENT IN PEDIATRIC SCOLIOSIS PATIENTS: A RETROSPECTIVE CLINICAL STUDY(Journal of Turkish Spinal Surgery, 2019) Akbaş, Sedat; Korkmaz, Mehmet FatihÖz: Introduction: Neurological, cardiovascular and respiratory system pathologies are frequently accompanied by pediatric scoliosis surgery. The aim of this retrospective clinical study was to evaluate the demographic characteristics, operation characteristics, and complications associated with anesthesia and surgery in pediatric patients undergoing scoliosis surgery. Material and Methods: In this study, 33 pediatric patients undergoing elective scoliosis surgery were reviewed retrospectively. Demographic characteristics, surgical procedure data, complications related anesthesia or surgery were examined in terms of anesthesia management. Medications, concomitant diseases, laboratory values, postoperative service and intensive care unit records were obtained from the university database. Results: The mean age of thirty-three patients was 13.09 ± 2.98 years. Three patients had meningomyelocele and one had neuromuscular disease. 72.7 % of patients (24 patients) have thoracolumbar scoliosis. The duration of anesthesia and surgery was 241.21 ± 55.55 min and 214.84 ± 54.55 min, respectively. The mean number of instrumented level was 10.78 ± 3.54. Blood transfusion was performed in 97 % of the patients (32 patients). All patients were transferred to the intensive care unit in the postoperative period. In each two patients, bradycardia and hypotension were observed. In the perioperative period, the mean blood loss of the patients was 843.93 ± 246.14 mL. Conclusion: Pediatric scoliosis surgery; is an important orthopedic procedure which may results in serious intraoperative blood loss and postoperative pain and can be accompanied by syndromes, difficult airway management, serious respiratory and circulatory system complications during perioperative and postoperative period. Evaluation of localization and the extent of curvature, length of surgery, concomitant diseases and congenital anomalies are important for the management of anesthesia in patients undergoing pediatric scoliosis surgery.Öğe Anesthetic management in a patient with Friedreich’s Ataxia: A different approach(2017) Akbaş, Sedat; Toy, Erol; Özkan, Ahmet SelimAbstract: 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 presentedÖğe 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, SaadetAbstract: 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.Öğe 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 SelimMany 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.Öğe 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, ErolMany 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.Öğe 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, KayhanAbstract 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.Öğe 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, MahmutAim: 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.Öğe The effect of perineural application of bupivacaine combined with sodium bicarbonate on the synatic nerve block in rabbits after sevofluran anesthesia(2020) Sevimli, Reşit; Türkmen, Ersen; Özkan, Ahmet Selim; Akbaş, Sedat; Alan, SaadetAbstract: Aim: The aim of this study was to investigate the effect of combining sodium bicarbonate with bupivacaine on prolonging peripheral nerve block time. Material and Method: Following the approval of the required Ethics Committee, 24 male New Zealand rabbit (4250-5350 g) were randomized and divided into three groups. Group 1 sham n: 8; Group 2 (bupivacaine): 0.5 mL of 0.5% bupivacaine (0.5 mg / kg) injected into the perineural area. n: 8; and Group 3 (bupivacaine + sodium bicarbonate): 0.5 ml of 0.5% bupivacaine + sodium bicarbonate (125 ml of 8.4% injected into the perineural area. n: 8. After the skin was closed in all groups, the paw pull response was monitored and recorded every 30 minutes until the sensory block of the experimental animal returned back. Hot-plate test was used for analgesia evaluation. In addition, tissue histopathology was examined for histopathological evaluation of the injection site. Sensory block was evaluated with claw tightening test and claw pull test (hot-plate) response. The measurements were carried out every 30 minutes for 120 minutes or until the block was completely resolved. Results: 30., 60. and 90.min paw pull response in Group 2 and Group 3 showed statistically significant elongation when compared to Group 1, this difference disappeared in 120 minutes. Compared to the sham group, the 30 min hot plate and claw pull response was significantly longer in group 3 (sodium bicarbonate and bupivacaine), this difference disappeared in 60 minutes (p = 0.018). Conclusion: When sodium bicarbonate and bupivacaine are combined, it was seen in this study that the sensory block was prolonged. We believe that the current results can be used as a guide for future studiesÖğe Effects of Glutamine on Healing of Traumatic Oral Mucosal Lesions: An Experimental Study(2019) Güngör, Gürcan; Düzgün Ergün, Dilek; Aydın, Övgü; Sutaş Bozkurt, Ayşe Pervin; Karabulut, Enes; Akbaş, SedatÖz: Objective: Glutamine (GLN) plays an important role in the regulation of acid–base balance, protein turnover, ammonia metabolism, catabolic situations, and immune system enhancement. The prevention, treatment, and care of oral mucosal lesions are very important in terms of leading to several clinical and economic problems. The aim of the present study was to investigate the positive and different effects of GLN on traumatic oral mucosal lesions by its administration via the topical or systemic (enteral and parenteral) route. Methods: Twenty-one Wistar albino rats were included in the experimental study and divided into four groups. Traumatic oral mucosal lesions were created in all rats after the intraperitoneal administration of anesthesia. In the control group, traumatic oral mucosal lesions were created and no treatment was applied. In the study groups, GLN was applied via the parenteral, enteral, and topical routes. Healing of lesions was macroscopically observed on high-resolution photographs. Rats were sacrificed, and biopsies were obtained for histopathological and biochemical evaluations. Results: In histopathological evaluations of the biopsies, a significant difference was observed between the control and parenteral/topical groups for acute inflammation, between the control and parenteral groups for epithelial proliferation, and between the control and topical groups for fibrosis. In biochemical evaluations, only malondialdehyde levels had a significant difference between the control and enteral groups (p<0.02). Conclusion: A positive effect of GLN administration was observed for the treatment of traumatic oral mucosal lesions. It was considered that GLN administration via the topical or enteral route may present an alternative on traumatic oral mucosal lesions. However, GLN administration via the parenteral route had better results than that via topical and enteral routes.Öğe Effects of perineural administration of phenytoin in combination with levobupivacaine in a rat sciatic nerve block(Medicine Science, 2018) Özkan, Ahmet Selim; Akbaş, Sedat; Durak, Mehmet Akif; Erdoğan, Mehmet Ali; Parlakpınar, Hakan; Vardı, Nigar; Özer, AliÖz: Peripheral nerve blocks are commonly preferred worldwide for the purposes of anesthesia application and postoperative analgesia. In this study, we investigated the effects of phenytoin which has a similar mechanism to local anesthetics in terms of the duration of analgesia and quality. The study was performed on 32 Sprague-Dawley male rats. Rats were randomly grouped into 4 groups. Group S: Sham group (n: 8); 0,2 ml saline perineural unilateral sciatic nerve. Group L: Perineural levobupivacaine (0,2 ml 0,5% levobupivacaine, n: 8); Group Ph: Perineural phenytoin (0,2 ml 62,5 mg / kg, n: 8); Group L + PH: Perineural phenytoin and levobupivacaine (0,2 ml 0,5% levobupivacaine + 62,5 mg / kg phenytoin, n: 8). Hot-plate and tail- ?ick tests were performed to measure acute thermal pain and histological changes were evaluated. The latency time at 30 minute in Group L+Ph were significantly increased when compared to the other groups during evaluation of the hot plate test. There was a significant difference in terms of latency time at 30 minute in Group L+Ph in the Tail Flick test and the latency time in Group L+Ph was longer when compared to the other groups (p<0,05) These results were obtained according to hot-plate and tail-?ick tests and indicated that the analgesic quality. Perineural administration of phenytoin in combination with levobupivacaine did not affect the duration of the sensory and motor blockade at doses used in our study. However, phenytoin combined with levobupivacaine increased the duration and quality of the analgesia.Öğe General anesthesia management in 15 preterm infant undergoing diode laser photocoagulation for retinopathy of prematurity: a retrospective study(2018) Polat, Nihat; Akbaş, Sedat; Özkan, Ahmet SelimAbstract: Anesthesia management of preterm infants is challenging for the anesthesiologist. Because of the rudimentary build of the infants, many medical and physical problems have been observed in the treatment of the disease such as complications, airway problems, temperature disregulation and deficient drug metabolism. This retrospective study evaluates the perioperative management and postoperative course in premature infants undergoing diode laser photocoagulation (DLP) for retinopathy of prematurity (ROP). We analyzed the preoperative data, anesthesia chart, and postoperative course of 15 preterm infants for general anesthesia exposures for ROP surgery. Minimum weight and gestational age at birth were 480 g and 23 weeks, respectively. Mean value of weight at birth was less than 1000 g (886,3g) differently from other studies. The mean anesthesia and surgery duration were 80,9 and 60,4 min, respectively. Paracetamol was implemented for postoperative analgesia through rectal route in 5 infants and intravenous route in 10 infants at the start of surgery. Eleven patients were extubated in the operating room and 4 infants were extubated in the following days. Birth weights of infants were between 480 and 1240 g. Supraglottic airway such as I-gel was applied in 5 infants, laryngeal mask airway (LMA) in 5 infants and endotracheal intubation (ETI) was applied in 4 infants. In the present study, we found that intraoperative complications, duration of anesthesia and surgery were acceptable and similar to those of other studies. However, the value of apnea in current study was less significant when compared to other studies,which can be correlated with intubation without muscle relaxant or post-conceptual age over 35 weeks.Öğe General anesthesia management in carotid endarterectomy surgery: a single center experience(2017) Özkan, Ahmet Selim; Akbaş, Sedat; Durak, Mehmet Akif; Kaçmaz, Osman; Ersoy, Mehmet Özcan; Durmuş, MahmutAbstract: Carotid endarterectomy (CEA) is an effective surgery which is applied in order to reduce the risk of stroke associated with severe stenosis of the carotid artery. Anesthesia management is important in these patients due to high incidence of cardiovascular disease and studies are in progress for ideal anesthesia management. In this study, we aimed to share our experience in carotis endarterectomy and evaluate the clinical outcomes and review retrospectively. Patients informations were obtained from the patients and anesthesia records. Age, ASA physical status, Mallampati score (MP), anesthesia and surgery duration, ICU and discharge time, blood transfusion rate, anesthetic and analgesic drugs, invasive procedures, complications, smoking, stenosis side and ratio, comorbid conditions of patients and drugs were recorded. The mean age of patients was 67.19±1.07 . It was evaluated that 44 patients (61.2%) were ASA II, 28 patients (38.8%) were ASA III. It was recorded that mean duration of anesthesia was 226.25 ± 37.99 min, duration of surgery was 195.83±38 min, ICU stay was 2.45 ± 2.52 days and hospital stay time was 5.23 ± 2.77 days. 29 of patients (40.3%) were smokers and 7 of patients (9.7%) were identified as secondary smokers. The mortality rate was 6.9% (5 patients). Clinical experience and outcome data from our study are consistent with the literature. In CEA surgery, anesthetic technique that is safe enough to guide the evidence is not there yet. Experience of the anesthesiologist and the surgeon as surgical anesthetic management of CEA is an important point to be noted that the current developments in the patient's characteristics and monitoringÖğe General Anesthesia Versus Local Anesthesia Plus Sedation in High Risk Patients Underwent Transcatheter Aortic Valve Implantation (TAVI): A Retrospective Cohort Study(Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, 2019) Akbaş, Sedat; Özkan, Ahmet SelimÖz: Objective: Transcatheter Aortic Valve Implantation (TAVI) poses significant challenges concerning anesthesia management. There is no current consensus on the type of safer anesthesia for high-risk patients undergoing TAVI procedures. The aim of this retrospective cohort study was therefore to describe the pre- and perioperative issues related to anesthesia and to compare the outcomes of high-risk patients treated with general anesthesia (GA) versus local anesthesia plus sedation (LAPS) during TAVI procedures. Method: We conducted a study with 49 patients who underwent TAVI under general anesthesia or local anesthesia plus sedation. Patients were retrospectively allocated to two cohort-study groups: GA (n=23) and LAPS (n=26). Demographic characteristics and procedural data were recorded at important time points. Results: The two groups were similar with respect to demographic characteristics. Total colloid consumption was significantly higher in GA group (p<0.001). Heart rates after valve implantation in GA were significantly lower (p<0.05). Mean arterial pressures were similar. Peripheral oxygen saturations before and after valve implantation in GA were significantly higher. The durations of anesthesia and procedure in LAPS group were significantly shorter (p<0.001). Conclusion: Careful preoperative assessments concerning anesthetic agent preferences, complications related to catheterization and hemodynamic stability, as well as a requirement for immobility and adequate analgesia, are very important for successful outcomes. Particularly for cases where there is no need for transesophageal echocardiography or for a cardiovascular surgeon to dissect and repair the artery, we have concluded that LAPS can be used safely during TAVI procedures. Başlık (Türkçe): Transkateter Aort Kapak İmplantasyonu (TAVİ) Uygulanan Yüksek Riskli Hastalarda Genel Anestezi ile Lokal Anesteziye Eşlik Eden Sedasyon Uygulamasının Karşılaştırılması: Retrospektif Kohort Çalışma Öz (Türkçe): Amaç: Transkateter Aort Kapak İmplantasyonu (TAVİ), anestezi yönetimi konusunda önemli zorluklar doğurmaktadır. Yüksek riskli TAVI işlemi için hangi tip anestezinin daha güvenli olduğu konusunda gün- cel bir görüş birliği yoktur. Bu retrospektif kohort çalışmanın amacı, anestezi ile ilişkili pre- ve periopera- tif sorunları tanımlamak ve TAVI işlemleri sırasında genel anestezi (GA) ve lokal anestezik ile sedasyon (LAPS) ile tedavi edilen yüksek riskli hastaların sonuçlarını karşılaştırmaktır. Yöntem: Bu çalışma, genel anestezi veya lokal anestezi ile sedasyon altında TAVİ uygulanan 49 hasta üzerinde gerçekleştirildi. Hastalar retrospektif olarak iki kohort çalışma grubuna ayrıldı: Genel Anestezi (GA, n=23) ve Lokal Anestezi ile Sedasyon (LAPS, n=26). Demografik özellikler ve işlem verileri önemli zaman noktalarında kaydedildi. Bulgular: İki grup demografik özellikler açısından birbirine benzerdi. Total kolloid tüketimi GA grubunda anlamlı derecede daha yüksekti (p<0.001). GA grubunda kapak implantasyonu sonrası kalp atım hızları anlamlı olarak düşüktü (p<0.05). Ortalama arter basınçları benzerdi. GA grubunda kapak implantasyo- nu öncesi ve sonrası periferik oksijen satürasyonu anlamlı olarak yüksekti. LAPS grubunda anestezi ve işlem süreleri anlamlı olarak kısaydı (p<0.001). Sonuç: Dikkatli preoperatif değerlendirme, anestetik ajan tercihleri, hemodinamik stabilite ve kateteri- zasyon ile ilgili komplikasyonların yanı sıra immobilite gerekliliği ve yeterli analjezi başarılı sonuçlar için çok önemlidir. Özellikle transözofageal ekokardiyografiye ya da kardiyovasküler cerrahın arter diseksi- yonu ve onarımına gereksinim duymadığı durumlarda, lokal anestezi ile sedasyon uygulamasının TAVI işlemlerinde güvenle kullanılabileceği sonucuna vardık.Öğe Glutaminin Travmatik Oral Mukozal Lezyonların İyileşmesi Üzerine Etkileri: Deneysel Çalışma(2019) Güngör, Gürcan; Akbaş, Sedat; Karabulut, Enes; Düzgün Ergün, Dilek; Aydın, Övgü; Bozkurt Sutaş, Ayşe PervinÖz:Objective: Glutamine (GLN) plays an important role in the regulation of acid–base balance, protein turnover, ammonia metabolism, catabolic situations, and immune system enhancement. The prevention, treatment, and care of oral mucosal lesions are very important in terms of leading to several clinical and economic problems. The aim of the present study was to investigate the positive and different effects of GLN on traumatic oral mucosal lesions by its administration via the topical or systemic (enteral and parenteral) route. Methods: Twenty-one Wistar albino rats were included in the experimental study and divided into four groups. Traumatic oral mucosal lesions were created in all rats after the intraperitoneal administration of anesthesia. In the control group, traumatic oral mucosal lesions were created and no treatment was applied. In the study groups, GLN was applied via the parenteral, enteral, and topical routes. Healing of lesions was macroscopically observed on high-resolution photographs. Rats were sacrificed, and biopsies were obtained for histopathological and biochemical evaluations. Results: In histopathological evaluations of the biopsies, a significant difference was observed between the control and parenteral/topical groups for acute inflammation, between the control and parenteral groups for epithelial proliferation, and between the control and topical groups for fibrosis. In biochemical evaluations, only malondialdehyde levels had a significant difference between the control and enteral groups (p<0.02). Conclusion: A positive effect of GLN administration was observed for the treatment of traumatic oral mucosal lesions. It was considered that GLN administration via the topical or enteral route may present an alternative on traumatic oral mucosal lesions. However, GLN administration via the parenteral route had better results than that via topical and enteral routes.Öğe İleri Derecede Kifoskolyotik Çocukta Lateral Pozisyonda Fiberoptik Entübasyon(2016) Özkan, Ahmet Selim; Akbaş, Sedat; Begeç, Zekine; Durmuş, MahmutÖz: Kifoskolyoz, omurganın eğriliği ve rotasyonunun beraber görüldüğü, ciddi bir anatomik anormalliktir. Sendromların eşlik edebileceği kifoskolyoz, genel anestezi sırasında zor havayoluna neden olabilir. Bu yazıda, dental tedavi nedeniyle genel anestezi uygulanan ve supin pozisyon verilemeyecek kadar ileri derecede kifoskolyotik olan bir çocuk hastadaki zor havayolu yönetimi deneyimimizi sunmayı amaçladıkÖğe İntraatriyal Anjiyosarkoma Bağlı Kardiyak Tamponat Gelişen Hastada Anestezi Yönetimi(2016) Özkan, Ahmet Selim; Kaçmaz, Osman; Akbaş, Sedat; Erdil, Feray; Durmuş, MahmutÖz: Anjiyosarkomlar ender görülen kardiyak tümörlerdir ve mortaliteleri yüksektir. Genelde nonspesifik bulgularla başvururlar ve agresif seyirlidirler. Kitlenin büyüklüğüne bağlı olarak sağ ventrikül dolumunun engellenmesi nedeniyle hemodinamik instabilite gelişebilir. Bu nedenle anestezi yönetimi özellik gösterir. Bu olgu sunumunda, sağ atriyal anjiyosarkoma bağlı kardiyak tamponad gelişen hastadaki anestezi yönetimi sunuldu.Öğe Nasotracheal intubation for dental surgery: A comparison of direct laryngoscopy with McGrath MAC videolaryngoscopy(2021) Toy, Erol; Özkan, Ahmet Selim; Akbaş, Sedat; Sanli, Mukadder; Durmus, MahmutAim: The purpose of our study was to compare the McGrath MAC videolaryngoscope (VL) with the Macintosh direct laryngoscope (DL) for the efficacy during nasotracheal intubation (NTI) in patients undergoing dental surgery. Material and Methods: In total, 70 American Society of Anesthesiologist physical status (ASA) I-II patients who underwent elective dental surgery requiring NTI were included in this study. The patients were divided to two groups based on intubation using McGrath MAC VL (n=35) and Macintosh DL (n=35). The patients were monitored via electrocardiography (ECG), noninvasive arterial pressure, and peripheral oxygen saturation (SpO2) after they were taken to the operating room. Preoxygenation was performed with face mask for at least 3 minutes with 100 % O2. In addition, 2 mg/kg propofol and 1 µg/kg fentanyl were administered for anesthesia induction, and 0,6 mg/kg rocuronium was administered for muscular relaxation. NTI was performed 3 minutes after rocuronium injection with a nasotracheal tube. Anesthesia was maintained with sevoflurane and 50% air in oxygen. Mean arterial pressure (MAP), heart rate (HR), SpO2 and end tidal-carbon dioxide (EtCO2) were recorded at baseline; after anesthesia induction; and 1st, 2nd, 3th and 5th minutes after intubation. Cormack-Lehane and Mallampati Scores (MPS), laryngeal compression, duration of intubation, using Magill forceps, ease of intubation, and the incidence of complications due to intubation were recorded. Results: The demographic characteristics of the groups were similar. Regarding the success of the intubation, no significant difference was detected between the McGrath MAC VL group and the Macintosh DL group (p >0,05). However, when intubation times were compared, a significant difference was noted between groups (p<0,05). The intubation time was reduced in the McGrath MAC VL group. No statistically significant difference was observed regarding MAP and HR values. Intubation using McGrath MAC VL was significantly easier than direct laryngoscopy (p<0,05). No difference in complications was observed (p>0,05). Conclusion: We compared the McGrath MAC VL with the Macintosh DL for NTI and found that intubation was applied in less time using McGrath MAC VL than Macintosh DL. Intubation was more easy with McGrath MAC VL than Macintosh DL. We believe that McGrath MAC VL can be preferred to DL for NTI.Öğe Nasotracheal intubation with c-mac video-laryngoscope in a patient with Treacher Collins Syndrome(2017) Syndrome, Collins; Özkan, Ahmet Selim; Akbaş, Sedat; Toy, Erol; Yalın, Mehmet Rıdvan; Yılkınc, AyseAbstract: Treacher Collins Syndrome (TCS) is a dominantly inherited autosomal disease which limited to head and neck movement. In management of difficult airways which is seen in patients with TCS, the direct laryngoscope, video-laryngoscope (VL), and fiber-optic laryngoscope (FOB) were successfully utilized. No study that was indicated the successful execution of nasotracheal intubation on a patient with TCS by using C-MAC video-laryngoscope was found in literature review. In this case report, we aimed to share our airway management on a patient with TCS for whom we planned nasotracheal intubation due to a dental surgery
