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Öğe Anaesthesia induction with ketamine:Propofol combination (ketofol) in caesarean delivery(2013) Kayhan G.E.; Toprak H.I.; Aslan A.; Çolak Y.Z.; Gülhaş N.; Durmuş M.; Ersoy M.Ö.Objective: The aim of this study was to compare the maternal and foetal effects of ketamine:propofol (ketofol) combination with thiopental, used in anaesthesia induction for caesarean delivery. Methods: Eighty, 18-35 years-old parturients in ASA I-II class, who were admitted for caesarean delivery under general anaesthesia, were allocated to this prospective, double-blind, randomised study. Patients were divided into two groups according to thiopental (Group T) or ketofol (Group K) administration. In anaesthesia induction, 4 mg kg-1 thiopental for Group T, 1 mg kg-1 ketamin + 1 mg kg-1 propofol (ketofol) for Group K were administered. Haemodynamic effects, BIS values, foetal parameters in the perioperative period and postoperative pain levels and morphine consumption were evaluated. Results: There were no significant differences between groups with regard to demographic data. Heart rate values were lower in Group K than Group T and there were significant differences between values immediately after intubation and 15 min after intubation. There were no significant differences in systolic and diastolic blood pressures between the two groups. Apgar scores recorded at the 5th minute were higher in Group K, while there were no differences in the 1st minute scores between groups (p=0.01). Upon analyses of umbilical artery blood gas, pH values were higher in Group K (p=0.034). While pain scores were similar in groups, total morphine consumption for 24 hours was found to be higher in Group K (p=0.008). Conclusion: We believe that 1 mg kg-1 ketofol (1:1), when used for anaesthesia induction of caesarean delivery, may be a good alternative to thiopental in terms of maternal and especially foetal effects; however, patients need to be followed closely for postoperative analgesic requirements. © 2013 by Turkish Anaesthesiology and Intensive Care Society.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.Öğe The use of suture cover as an internal nasal splint [11](2004) Gürlek A.; Çoban Y.K.; Aydog?n H.; Çelik M.; Aslan A.[No abstract available]
