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    The effect of dexmedetomidine on middle ear pressure
    (Otolaryngol Head Neck Surg, 2007) Fırat, Yezdan; Kızılay, Ahmet; Akarçay, Mustafa; Yücel, Aytaç; But, Abdulkadir; Yoloğlu, Saim
    Dexmedetomidine is a preferred anesthetic agent in otological surgery because it provides controlled hypotension and good surgical field visibility. The aim of this study was to evaluate the influence of this novel agent on middle ear pressure. STUDY DESIGN AND SETTING: This prospective clinical trial was performed in 60 patients who were scheduled for elective surgery. They received dexmedetomidine or saline infusion for 20 minutes before induction of anesthesia. Tympanometric measurements were recorded for both ears at preoperative, intraoperative, and postoperative states. RESULTS: Mean difference of tympanometric peak pressure from baseline was statistically significant between dexmedetomidine and control group at the 30th minute of operation (24.8 daPa, P 0.003 for right ear; 20.5 daPa, P 0.02 for left ear) and at the end of the operation (25.8 daPa, P 0.01 for right ear; 28.1 daPa, P 0.004 for left ear). CONCLUSIONS: Dexmedetomidine anesthesia raises the tympanometric parameters, but they never exceed the limits of normal. © 2007 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved.
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    Propofol and erythropoietin antioxidant properties in rat brain injured tissue
    (Pergamon-Elsevier Science Ltd, 2008) Ozturk, Erdogan; Demirbilek, Semra; Koroglu, Ahmet; But, Abdulkadir; Begec, Zekine Oezpolat; Gulec, Mukaddes; Akyol, Omer
    So far, several treatment modalities have been attempted to brain protection in cases such as brain trauma, stroke or brain hemorrhage. However, a treatment method that the effect begins immediately and definitely helpful has not been discovered yet. In this study, we aimed to compare the effects of propofol and erythropoietin (Epo) on brain injury caused by oxidative stress and antioxidant properties of these agents after closed head injury (CHI) in rats. For this study, female Wistar Albino rats were divided into five groups: non-traumatic control group, trauma performed group CHI, trauma with propofol (100 mg/kg) intraperitoneally (i.p.), trauma with Epo (5000 U/kg) i.p. and trauma with propofol and Epo performed study groups. Twenty-four hours after CHI, rats were sacrificed and the brains were removed. Superoxide dismutase (SOD), catalase (CAT), xanthine oxidase (XO), nitric oxide (NO), and malondialdehyde (MDA) levels were measured in brain tissue. MDA and NO levels were decreased significantly in Groups Epo, Propofol and Epo + Propofol than Group CHI (p < 0.0 1). XO activity was significantly lower in Group Epo than Group CHI (p <0.05). Epo and propofol decreased oxidative stress by decreasing MDA and NO level in brain tissue after CHI. However, combination of Epo and propofol has no significant beneficial advantage than Epo or propofol alone. (c) 2007 Elsevier Inc. All rights reserved.
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    The role of oxidative stress in postoperative delirium
    (General Hospital Psychiatry, 2006) Karlıdağ, Rıfat; Ünal, Süheyla; Sezer, Özlem; Bay Karabulut, Aysun; Battaloğlu, Bektaş; But, Abdulkadir; Özcan, Abdulcemal
    Aim: This study aimed to determine a marker that predicts delirium using preoperative oxidative processes in patients undergoing cardiopulmonary bypass surgery. Method: Twelve of the 50 patients included in the study showed signs of delirium during postoperative follow-up. The Delirium Rating Scale was used in patients with delirium according to DSM-IV-TR in the postoperative period. Venous blood samples were obtained from the patients the day before and the day after the surgery to determine plasma antioxidant enzyme levels. Results: While there were no differences in preoperative superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) levels in both groups, catalase (CAT) levels were significantly lower in the delirium group. Postoperative SOD and MDA levels were also higher in the delirium group, while the GSH-Px levels were found to be lower when compared with those during the preoperative period. In the nondelirium group, the postoperative MDA and GSH-Px levels were found to be lower than preoperative levels, and postoperative SOD levels were found to be higher than preoperative levels. CAT levels were lower in the delirium group when the pre- and postoperative levels were compared in both groups. The postoperative levels of SOD, GSH-Px and CAT in the nondelirium group and MDA in the delirium group were significantly higher than preoperative levels. Conclusion: Patients with low preoperative CAT levels appeared to be more susceptible to delirium than patients with higher CAT levels.
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    Sezaryenlerde bupivakain ve ropivakainin hemodinami üzerine etkileri
    (Türk Anestezi ve Reanimasyon Dergisi, 2006) Öztürk, Erdoğan; But, Abdulkadir; Gülhaş, Nurçin; Begeç, Zekine; Doğan, Zafer; Yapıcı, Engin; Ersoy, Mehmet Özcan
    Öz: Giriş: Spinal anestezide lokal anestezikler, yaptıkları duyusal-motor blok nedeniyle hasta ve cerrah için konforlu bir anestezi sağlarken gelişen sempatik blok hastada hipotansiyon meydana gelmesine neden olur. Hipotansiyon, hastada bulantı-kusma ve uterin kan akımının azalmasına yol açabilir. Bu çalışmada elektif sezaryen olgularına eşdeğer dozda uygulanan bupivakain ve ropivakainin, spinal anestezideki hemodinamik etkilerinin karşılaştırılması amaçlandı. Gereç ve Yöntem: ASA I-II, 36 elektif sezaryen olgusu çalışmaya alındı. Olgulara 15 mL kg-1 Ringer laktat verildikten sonra oturur pozisyonda kombine spinal-epidural anestezi uygulandı. Olgular rasgele Grup B (n=18) (bupivakain heavy 11 mg) ve Grup R (n=18) (ropivakain heavy 11 mg) olarak ayrıldılar. Lokal anesteziklere 25 µg fentanil eklendi. Sistolik arter basıncı (SAB), kalp atım hızı (KAH) ve duyusal blok seviyesi operasyon boyunca izlendi. Operasyon boyunca olgulara stabil hemodinami sağlamak için efedrin infüzyonu verildi. Bulgular: Grup R’de total efedrin infüzyonu ile total efedrin tüketimi Grup B’ye göre fazla tespit edildi (p< 0.01). Grup B’de başlangıca göre 2., 4., 6., 8., 10. dakikalardaki SAB değerleri anlamlı düşük bulundu (p< 0.05). Grup R’de başlangıca göre 2., 4., 6. ve 8. dakikalarda ölçülen kalp atım hızı (KAH) değerleri anlamlı yüksek bulundu (p< 0.05). Grup B’de başlangıca KAH değeri ile karşılaştırıldığında KAH 20 hariç ölçülen diğer zamanlarda anlamlı yüksek bulundu (p< 0.05). Ortalama duyusal blok seviyesi Grup R’de (T6) Grup B’den (T4) daha düşük tespit edildi (p=0.001). Grup R’de 8 olguya epidural kataterden ek lokal anestezik verildi (p=0.001). Grup B’de hiçbir olguya ek LA gerekmedi. Sonuç: Eşdeğer dozdaki bupivakain ile karşılaştırıldığında ropivakain daha düşük duyusal seviye sağlamıştır. Opioid eklenmesine rağmen, bupivakainin ropivakainden daha potent olduğu sonucuna varıldı.