Yazar "Aydogan, Mustafa S." seçeneğine göre listele

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    Comparison of Antioxidant Effects of Isoflurane and Propofol in Patient Undergoing Right Donor Hepatectomy
    (Wiley-Blackwell, 2012) Ucar, Muharrem; Ozgul, Ulku; Polat, Alaadin; Toprak, Huseyin I.; Erdogan, Mehmet A.; Aydogan, Mustafa S.; Durmus, Mahmut
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    The effects of cognitive impairment on anaesthetic requirement in the elderly
    (Lippincott Williams & Wilkins, 2012) Erdogan, Mehmet A.; Demirbilek, Semra; Erdil, Feray; Aydogan, Mustafa S.; Ozturk, Erdogan; Togal, Turkan; Ersoy, Mehmet O.
    Context Patients with dementia have a lower bispectral index score (BIS) when awake than age-matched healthy controls. Objectives The primary aim was to compare the BIS and the dose of propofol required for induction in patients suffering from cognitive impairment with that in those who had normal cognitive function. This study also evaluated the effects of cognitive impairment in the elderly on anaesthetic agent consumption during surgery and on emergence from anaesthesia. Design and setting This randomised controlled study was carried out in a university hospital. Patients over 65 years of age, ASA I-II and scheduled for elective orthopaedic procedures were allocated to one of two groups. Interventions Patients (n = 92) were allocated according to their Mini Mental State Examination score: 25 or higher (group 1) or 21 or less (group 2). All patients received propofol 0.5 mgkg(-1) following the commencement of a remifentanil infusion at 0.5 mu gkg(-1) min(-1). After incremental doses of propofol up to loss of consciousness, a propofol infusion was started at 75 mu gkg(-1) min(-1). Propofol and remifentanil infusion doses were adjusted to keep the BIS value between 45 and 60 during surgery. Main outcome measure MMSE score was evaluated 24 h before and after surgery. The anaesthetic consumption, mean arterial pressure, HR and BIS values of the patients were recorded. Results Before surgery, mean Mini Mental State Examination scores were 26.8 +/- 1.6 and 16.6 +/- 4.2 in group 1 and 2, respectively. These returned to baseline value 24 h after surgery in group 1 (26.6 +/- 1.5) and group 2 (15.6 +/- 4.3). Before induction, four of 45 patients (8.9%) in group 1 had a BIS value less than 93 compared with 13 of 47 (27.7%) in group 2 (P = 0.02). The mean BIS value was significantly lower in group 2 than in group 1 before induction, during loss of consciousness, 3 and 5 min after discontinuation of the anaesthetic agents and before extubation (P < 0.05). The induction dose of propofol was lower in group 2 than in group 1 (P = 0.02). The eye opening time was significantly longer in group 2 than in group 1 (P = 0.03). Conclusion The baseline BIS value was lower in patients with cognitive impairment than in those with normal cognitive function. The former received less propofol during induction and eye opening time was longer. On the basis of our findings from the recovery period, we suggest that the recommended target BIS value for adequate anaesthesia in the general population is inappropriate for patients with cognitive impairment. Eur J Anaesthesiol 2012; 29:326-331
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    Pain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolam
    (Wiley-Blackwell, 2013) Aydogan, Mustafa S.; Korkmaz, Mehmet F.; Ozgul, Ulku; Erdogan, Mehmet A.; Yucel, Aytac; Karaman, Abdurrahman; Togal, Turkan
    Background The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the early postoperative period in adolescents who underwent scoliosis surgery. Methods We performed a prospective, randomized trial in an intensive care unit (ICU) in a tertiary care center. In this study, 42 patients (American Society of Anesthesiology physical status I and II) who underwent scoliosis surgery were divided into two groups according to sedation protocols: group dexmedetomidine (DEX) (n=22) and group midazolam (MDZ) (n=20). Adolescents (1218years) requiring mechanical ventilation underwent a continuous infusion of either dexmedetomidine (group DEX; starting dose, 0.4g center dot kg1 center dot h1) or midazolam (group MDZ; starting dose, 0.1mg center dot kg1 center dot h1) with intermittent fentanyl, as needed. The efficacy of sedation was assessed using the Richmond Agitation Sedation Scale (RASS). Quality of pain relief was measured using the Numeric Visual Analog Scale (NVAS). Delirium was determined in patients in the RASS range of 2 to +1 using the Confusion Assessment Method for the ICU (CAM-ICU). Fentanyl consumption, incidence of delirium, NVAS scores, and hemodynamics were recorded postoperatively at 2, 4, 6, and 24h in the ICU. Results The NVAS pain scores and fentanyl consumption at all the evaluation time points were significantly higher in group MDZ than those in group DEX (P<0.05). Further, total fentanyl consumption in group MDZ was significantly higher than that in group DEX (P<0.05). Delirium was significantly higher in the group MDZ than that in group DEX (31.3% vs 12.5%) when analyzed as the endpoint of CAM-ICU (P<0.05). The heart rate was significantly lower in group DEX compared with that in group MDZ at all the evaluation time points (P<0.05). Conclusion Dexmedetomidine was associated with the decreased postoperative fentanyl consumption, NVAS scores, and a decreased incidence of delirium. These findings may be beneficial for managing sedation protocols in adolescents who have undergone scoliosis surgery.