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The analgesic effect of apelin-13 and its mechanism of action within the nitric oxide and serotonin pathways
(Lithographia, 2015) Turtay, M. G.; Karabas, M.; Parlakpinar, H.; Colak, C.; Sagir, M.
Background: Apelin has various effects on a lot of systems such as central nervous system and cardiovascular system. This study investigated the possible analgesic effects of apelin-13 using the hot-plate and the tail-flick thermal analgesia tests in rats. We also evaluated the mechanism underlying the analgesic effects of apelin-13 by pretreating with Nw-nitro-L-arginine methyl ester (L-NAME) or ondansetron. Material & Methods: Forty male rats were used. The rats were randomly assigned to five groups according to the treatment received: Group I: Control; Group II: Morphine; Group III: Apelin-13; Group IV: Apelin-13+L-NAME; Group V: Apelin-13+ Ondansetron. Acute thermal pain was modeled using the hot-plate and the tail-flick tests. Results: During the hot-plate test, i.p. Morphine and apelin-13 administered at zero-and 30 min produced significantly greater analgesic effects compared to the control. When the nitric oxide pathway was inhibited by administration of L-NAME with apelin-13, the analgesic effect continued. When apelin-13 and ondansetron were co-administered, the analgesic effect of apelin-13 disappeared at zero-and 30 min. During the tail-flick test, at 30 min, significantly higher levels of analgesia were observed in both the morphine and apelin group (which did not differ from each other) compared to the control group. L-NAME co-administered with apelin-13 did not affect the degree of analgesia, but apelin-13 co-administered with ondansetron was associated with a greater reduction in analgesia compared to the other groups. Conclusion: Our results demonstrate that apelin-13 exerts an analgesic effect; co-administration of apelin-13 and ondansetron inhibits antinociception, an effect apparently mediated by five-hydroxytryptamine-three (5-HT3) receptors.
Can Apelin-13 be a new actor in control of obesity?
(Wiley-Blackwell, 2014) Tekin, S.; Erden, Y.; Etem, E.; Sandal, S.; Colak, C.
[Abstract Not Available]
A comparison of computerized tomography and flair-SWI MRI results of patients with head injury attending the emergency department
(Verduci Publisher, 2022) Durak, M. A.; Gurbuez, S.; Derya, S.; Yildirim, I. o.; Ekmekyapar, M.; Tetik, B.; Colak, C.
- OBJECTIVE: Detection of trau-matic brain injury (TBI) is of vital importance in patients who apply to the emergency depart-ment with a history of trauma. The aim of initial imaging in patients with suspected TBI is to de-tect trauma-related injury quickly and accurate-ly. In this study, the effectiveness of prospec-tively cranial computed tomography (CT) and fluid attenuation inversion recovery (FLAIR) and susceptibility weighted imaging (SWI) sequence magnetic resonance imaging (MRI) examination results of patients diagnosed with TBI in the emergency department in terms of bleeding de-tection was investigated in the light of the liter-ature. PATIENTS AND METHODS: Patients with traumatic brain injury who applied to the emer-gency department between 2016 and 2020 were included in this prospective study. Crani-al CT and MRI images containing SWI-FLAIR se-quence were taken on the same day, immediate-ly after cranial CT, for a total of 500 patients. RESULTS: In our study, TBI was detected in 242 males (70.8%) and 100 females (29.2%), for a total of 342 patients. The mean age was 41.45, the mean GCS was 13.35. There was a history of trauma such as falling in 155 patients (45.3%), traffic accidents in 171 patients (50%), and trau-ma in 16 patients (4.7%). In the comparative eval-uation of CT and FLAIR-SWI MRI examinations no bleeding was detected in the FLAIR-SWI sec-tions of 239 patients who did not have bleed-ing on CT; however, bleeding was detected in FLAIR-SWI sections in 14 patients who did not have bleeding on CT. CONCLUSIONS: FLAIR-SWI MR, which is a more reliable examination method, should be per-formed before control CT, especially in patients with incompatible clinical and admission CT.
A descriptive analysis of 188 liver transplant patient visits to an Emergency Department
(Verduci Publisher, 2012) Turtay, M. G.; Oguzturk, H.; Aydin, C.; Colak, C.; Isik, B.; Yilmaz, S.
Background: The aim of the study is to seek the causes of application, the demographic and clinical characteristics of liver transplant patients and to share the experiences of our Emergency Department. Materials and Methods: One hundred eighty-eight Emergency Department visits of ninety patients who underwent liver transplant operations between 2002 and 2009 were evaluated retrospectively. Results: The patients applied to the Emergency Department with the complaints of fever 28.2% and abdominal pain 30.9%. It was detected that the final diagnosis of 52.4% of the patient visits was associated with the gastrointestinal system. It was observed that the most common treatment was drug therapy by 45.2% and that antibiotics treatment was the most applied method in drug treatment. Alanine aminotransferase (ALT) median value of hospitalized patients (45.5 U/L) is significantly higher than that of discharged patients (35 U/L) (p = 0.04). From the records of the patients, positive correlations between the length of hospitalization and levels of total bilirubin, direct bilirubin, ALT and fever during the visit were detected (p = 0.001, p < 0.001, p = 0.01, p = 0.01, respectively). Conclusions: Most frequently liver transplant recipients visited the Emergency Departments with the complaints of fever and abdominal pain. The diagnosis was generally associated with gastrointestinal system disorders. The percentage of hospitalization was high and the length of stay at the hospital was long. The treatment of these patients required a multidisciplinary approach and antibiotics constituted the most used drug treatment. Also, fever and liver function tests examined at the time of admittance to the Emergency Department affected the length of hospitalization.
Ectopic bone formation in thyroid gland: report of sixteen cases and comprehensive literature review
(Verduci Publisher, 2023) Sogutcu, N.; Akbulut, S.; Sari, A.; Yavuz, R.; Yagmur, Y.; Colak, C.
- OBJECTIVE: This study aimed to analyze the outcomes of patients with ectopic bone formation (EBF) diagnosed in thyroidecto-my specimen.PATIENTS AND METHODS: We retrospec-tively analyzed the data of 16 patients who un-derwent thyroidectomy between February 2009 and June 2018 and whose pathology examina-tion diagnosed EBF. RESULTS: Fourteen patients underwent bilat-eral total thyroidectomy (BTT), one patient re-quired BTT with central lymph node dissection, and one patient was subjected to BTT with func-tional lymph node dissection. On histopatholog-ical examination, left lobe EBF was diagnosed in four patients; left lobe EBF with bilateral pap-illary thyroid carcinoma (PTC) in two; left lobe EBF with left lobe PTC in one; left lobe EBF with left follicular adenoma in one; left lobe EBF with right lobe papillary thyroid microcarcinoma in one; bilateral EBF in one; right lobe EBF with ex-tramedullary hematopoiesis in one; right lobe EBF in three; right lobe EBF with right lobe med-ullary thyroid carcinoma in one, and right lobe EBF with bilateral lymphocytic thyroiditis in one. One of the five patients who underwent bone marrow biopsy was diagnosed with myelopro-liferative dysplasia, and another with polycythe-mia vera. Three patients were treated medically for anemia because no other pathological find-ings could be observed.CONCLUSIONS: There is a lack of literature data about the clinical significance of EBF in the thyroid gland in cases with no concomitant he-matological diseases. People who have been di-agnosed with EBF in the thyroid gland should be checked for hematological diseases.
Effect of alkalinisation of lignocaine for propofol injection pain: a prospective, randomised, double-blind study
(Australian Soc Anaesthetists, 2013) Ozgul, U.; Begec, Z.; Erdogan, M. A.; Aydogan, M. S.; Sanli, M.; Colak, C.; Durmus, M.
The aim of this study was to determine whether pretreatment with alkalinised lignocaine reduced the incidence and severity of pain during propofol injection. This prospective, randomised, double-blind study included 300 adult, American Society of Anesthesiologists physcial status I to II patients undergoing elective surgery. Patients were randomly allocated to one of three groups: Group L received 0.05 ml/kg of 1% lignocaine (5 ml normal saline + 5 ml 2% lignocaine), Group A received 0.05 ml/kg alkalinised lignocaine (5 ml 2% lignocaine + 1 ml 8.4% NaHCO3 + 4 ml normal saline), and Group S, the control group, was given the same amount of normal saline (NaCl 0.9%). All drugs were given as a bolus over 20 seconds before propofol administration. A blinded researcher assessed the patient's pain level using a four-point scale. The pain score [median (range)] and the incidence of pain in Group A (6%) was significantly lower than in groups L (41%) and S (88%, P <0.001). In addition, the pain score and the incidence of pain were found to be significantly different between Group L and Group S (P <0.001). The incidence of moderate and severe pain were greater in Group S when compared with groups A and L (P <0.001). Intravenous pretreatment with alkalinised lignocaine appears to be effective in reducing the pain during propofol injection.
The effect of angiotensin II type 2 receptor agonist treatment on doxorubicin induced heart failure
(Oxford Univ Press, 2016) Ermis, N.; Ozhan, O.; Ulutas, Z.; Vardi, N.; Colak, C.; Parlakpinar, H.
[Abstract Not Available]
THE EFFECT OF MELATONIN ON THE EXPERIMENTALLY PRODUCED ALZHEIMER IN RATS AND RELATIONSHIP WITH FEZ1 GENE EXPRESSION
(Wiley, 2017) Demir, M.; Yilmaz, U.; Sandal, S.; Colak, C.; Cigremis, Y.; Tekedereli, I.
[Abstract Not Available]
Effect of Preoperative Iron Deficiency in Liver Transplant Recipients on Length of Intensive Care Unit Stay
(Elsevier Science Inc, 2013) Aydogan, M. S.; Ozgul, U.; Erdogan, M. A.; Yucel, A.; Toprak, H. I.; Durmus, M.; Colak, C.
Liver transplant (LT) recipients often display iron deficiency preoperatively, which significantly increases the quantity of blood that needs to be transfused intraoperatively, A risk factor for a prolonged intensive care unit (ICU) stay. The aim of this retrospective study was to determine whether there was a clinically significant association between iron deficiency and the length of ICU stay, among 153 patients scheduled for OLT from September 2011 to June 2012. Patients were divided into 2 groups according to their baseline iron status: iron- deficient (ID) and non-ID (normal iron profile) cohorts. Iron deficiency was assessed on the basis of several parameters; transferrin saturation as well as serum iron, ferritin, soluble transferrin receptor, and C-reactive protein levels. We retrospectively analyzed the data regarding demographic and clinical features, preoperative laboratory values, intraoperative transfusions, and length of ICU stay. Patient demographic features and preoperative values were similar between the groups. Preoperative iron deficiency, which was diagnosed in 72 patients (58.6%), was associated with a greater intraoperative use of fresh frozen plasma and red blood cell transfusions (P = .0001). The median length of ICU stay after LT was longer among the ID versus the non-ID group (5 and 3 days per patient, respectively; P = .0001). Therefore, we have suggested that preoperative iron deficiency may be a prognostic factor for the length of ICU stay after LT.
Effect of ursodeoxycholic acid on liver regeneration capacity after living donor hepatectomy: a prospective, randomized, double-blind clinical trial
(Verduci Publisher, 2023) Aloun, A.; Akbulut, S.; Garzali, I. J.; Gonultas, F.; Baskiran, A.; Hargura, A. S.; Colak, C.
- OBJECTIVE: Ursodeoxycholic acid (UDCA) has multiple hepatoprotective ac-tivities: it modifies the bile acid pool, decreas-es levels of endogenous, hydrophobic bile ac-ids while increasing the proportion of nontoxic hydrophilic bile acids. It also has cytoprotective, antiapoptotic, and immunomodulatory proper-ties. The aim of this study was to analyze the ef-fect of postoperative administration of UDCA on liver regeneration capacity.PATIENTS AND METHODS: This is a sin-gle-center, prospective, randomized, dou-ble-blind study that was carried out in our Liv-er transplant Institute. Sixty living liver donors (LLDs) who underwent right lobe living donor hepatectomy were divided into two groups us-ing computer-generated random numbers: one group received oral UDCA 500 mg 12 hourly for 7 days (UDCA group; n=30) from the first postop-erative day (POD) and the other did not receive UDCA (non-UDCA group; n=30). Both groups were compared in terms of the following param-eters: clinical and demographic parameters, liv-er enzymes (ALT, AST, ALP, GGT, total bilirubin, direct Bilirubin), and INR. RESULTS: The median ages in the UDCA and non-UDCA were 31 years (95% CI for median: 26-38) and 24 years (95% CI for median: 23-29), respectively. Liver function tests showed signif-icant differences at various times within the first seven PODs. The INR was lower in UDCA group patients on POD3 and POD4. However, GGT was significantly lower on POD6 and POD7 for the UDCA group. Total bilirubin was also significant-ly lower on POD3 for the UDCA group patients, but ALP was lower all from POD1 to POD7. A sig-nificant difference was also observed in AST on POD3, POD5 and POD6. CONCLUSIONS: Postoperative administra-tion of oral UDCA significantly improves liver function tests and INR among LLDs.
Effects of chronic central administration of irisin on food intake, body weight and body temperature in the rats
(Wiley-Blackwell, 2014) Tekin, S.; Erden, Y.; Colak, C.; Sandal, S.
[Abstract Not Available]
Effects of Isoflurane and Propofol on Hepatic and Renal Functions and Coagulation Profile After Right Hepatectomy in Living Donors
(Elsevier Science Inc, 2013) Ozgul, U.; Ucar, M.; Erdogan, M. A.; Aydogan, M. S.; Toprak, H. I.; Colak, C.; Durmus, M.
We compared postoperative hepatic and renal functions and coagulation profiles in living donors undergoing right hepatectomy under isofiurane (n = 40) versus propofol (n = 40) anesthesia. After induction, anesthesia was maintained with isoflurane/air-O-2 (group I) or propofol/air-O-2 (group P) in addition to remifentanil and atracurium infusion in both groups. Aspartate aminotransferase, alanine aminotransferase, international normalized ratio (INR), activated partial thromboplastin time (aPTT), albumin, total bilirubin, blood urea nitrogen, creatinine, estimated glomerular filtration rate (GFR), platelet count, and hemoglobin levels were measured in the preoperative period, after end of the operation, and on the first, third, fifth and seventh postoperative days (PODs). INR was significantly increased on POD 3 and aPTT on POD 5 in group I compared with group P (P < .05). Albumin level was significantly lower in Group I on POD 1 and 3 (P < .05). GFR was significantly lower on POD 1 in the group I compared with group P (P < .05). The postoperative coagulation, GFR, and albumin values were superior following administration of propofol than isoflurane in donors who underwent living hepatectomy; however, both approaches were clinically safe, with no significant clinical difference.
Estimation of the relationships between irisin concentration and food intake, body weight and body temperature using polynomial regression models in the rats
(Wiley-Blackwell, 2014) Tekin, S.; Colak, C.; Erden, Y.; Sandal, S.
[Abstract Not Available]
Identifying the determinants of microalbuminuria in obese patients in primary care units: the effects of blood pressure, random plasma glucose and other risk factors
(Springer, 2016) Pehlivan, E.; Ozen, G.; Taskapan, H.; Gunes, G.; Sahin, I.; Colak, C.
Objective The objective of this study is to evaluate the demographic characteristics, blood pressure and blood glucose and the other related factors that affect the microalbuminuria levels in the obese patients aged 40 and above who applied to the primary care for medical evaluation. Materials and methods The population of the research, which was a cross-sectional type, comprised obese patients aged 40 and above who had applied to the community health centers in the center of Malatya. A total of 422 obese patients consisting of 116 males and 306 females were included in the research. The anthropometric measurements of the participants were determined, their blood pressures and their random blood glucoses were evaluated, as well. A microalbuminuria measurement was performed in the urine samples taken from the patients using Nycocard Reader II device. Findings The incidence of microalbuminuria in patients was found as 31.5 %, whereas the incidence of macroalbuminuria was 6.6 %. The incidence of microalbuminuria in female patients was 32.7 %, while it was 28.4 % in male patients; on the other hand, the incidence of macroalbuminuria in female patients was found as 6.8 %, whereas this percentage was determined as 7.8 in male patients (p > 0.05). The probability of the incidence of microalbuminuria increased 2.8 times more in those with the diastolic blood pressure of 90 mmHg and above when compared to those without it (GA: 1.79-4.56), whereas the incidence increased 3.2 times more in those with the random blood glucose of 200 mg/l and above (GA: 1.327.84) (p < 0.001). In our study, among the variables predicting the microalbuminuria in obese patients; the cutoff values of the diastolic and systolic blood pressures, the waist circumference were found as > 85 mmHg; > 130 mmHg; > 141 mg/dl, respectively, in male patients and found as > 85 mmHg, > 114 cm, and 109 cm, respectively, in female patients. The sensitivity and specificity of the tests indicating the cutoff values showed significance (p < 0.05). There was no statistically significant relevance between the microalbumin levels of the obese patients via the anthropometric criteria, except for their waist circumference (p > 0.05). Result In this study, the blood pressure and blood glucose levels of the patients along with their waist circumference that indicated a central obesity were specified as the determinants of microalbuminuria. While the obese patients are being evaluated in terms of proteinuria, the cutoff values of these variables can be taken into consideration.
Increased frequency of restless legs syndrome in atopic dermatitis
(Wiley, 2012) Cicek, D.; Halisdemir, N.; Dertioglu, S. B.; Berilgen, M. S.; Ozel, S.; Colak, C.
Background. Restless legs syndrome (RLS) is characterized by an unpleasant sensation in the legs, which is difficult to describe, but produces an urge to move the legs frequently. Aim. To assess the prevalence and severity of RLS in patients with atopic dermatitis (AD) and patients with psoriasis, and to investigate the factors potentially associated with RLS. Methods. In total, 253 people were enrolled (120 with AD, 50 with psoriasis and 83 healthy controls). A diagnosis of RLS was made according to the criteria of the International RLS Study Group (IRLSSG), and severity was assessed using the IRLSSG severity scale. Results. RLS was significantly more common in patients with AD (40.8%) than in patients with psoriasis (18.0%) or in controls (10.8%) (P < 0.01 and P < 0.001, respectively). Prevalence of RLS was higher in patients with active AD than in those with inactive AD (55.3% vs. 23.6%) or controls. There was a significant difference in RLS prevalence between patients with active and those with iactive AD, between patients with active AD and healthy controls, between patients with active AD and patients with psoriasis, and between patients with inactive AD and healthy controls (P < 0.001, P < 0.001, P < 0.001, P = 0.04, respectively). There was no significant difference in RLS prevalence between patients with active AD and patients with psoriasis, or between patients with psoriasis and healthy controls (P > 0.05). Of patients who were positive for RLS, 56.9% had a family history of atopy and 40.3% had a family history of RLS, and there was a significant relationship between the presence of RLS and family history of atopy or RLS (P < 0.001 for both). Conclusions. RLS is common in patients with AD, particularly in those with active disease.
Is there a new pathway relationship between melatonin and FEZ1 in experimental rat model of Alzheimer's disease?
(Comenius Univ, 2019) Demir, M.; Yilmaz, U.; Colak, C.; Cigremis, Y.; Ozyalin, F.; Tekedereli, I; Sandal, S.
Alzheimer's disease (AD) is a progressive neurodegenerative disease. This study was performed to determine the possible relationship between melatonin, which is known to play a role in the neuro-protective mechanism in AD, and fasciculation and elongation protein zeta 1 (FEZ1). Thirty male rats were included and separated into 3 groups (n = 10) as vehicle (artificial cerebrospinal fluid), streptozotocin (STZ) and STZ+melatonin (MLT). Two intracerebroventricular (icv) injections of 3 mg/kg STZ were made 48 hours apart. MLT injections were implemented for 14 days (ip; 10mg/kg/day). The Morris Water Maze (MWM) test was performed and rats were sacrificed to assess FEZ1 gene expression and protein levels from the hippocampus tissues and serum levels of noradrenaline (NA), dopamine and serotonin were determined from the blood samples. It was determined that the FEZ1/beta-actin protein ratio in the STZ group was significantly higher than that of the Vehicle group (p < 0.05) and in the MLT-administered group, the protein levels were decreased to the levels observed in the Vehicle group. Serum NA levels of STZ and STZ+MLT groups were found to be lower than those in the Vehicle group, while no difference was found regarding dopamine and serotonin levels. These findings show that reversal of increased FEZ1 levels in AD-induced rats with melatonin administration is the evidence of the effect of melatonin through FEZ1 in AD (Tab. 2, Fig. 5, Ref. 67).
Postoperative Pulmonary Complications After Liver Transplantation: Assessment of Risk Factors for Mortality
(Elsevier Science Inc, 2015) Aydin, C.; Otan, E.; Akbulut, S.; Karakas, S.; Kayaalp, C.; Karagul, S.; Colak, C.
Background. The aim of this study was to identify the risk factors related to mortality in liver transplant (LT) patients with post-transplantation pulmonary complications. Method. Patients who underwent liver transplantation in our clinic between January 2010 and January 2012 were retrospectively reviewed for post-transplantation pulmonary complications. Demographic, clinical, radiologic, and postoperative chart data of 153 patients with pulmonary complications were analyzed using an independent samples Student t test, Pearson's chi(2) test, Fisher's exact test, and Yate's corrected chi(2) test. Mortality was analyzed using a multiple logistic regression model. The best-fit breakpoint resulting in a cut-off value for the variables of interest was determined using ROC curves and the Youden index. Results. The 153 patients with pulmonary complication were divided into 2 groups: mortality (n = 53) and survival (n = 100). Univariate analyses showed significant differences between these 2 groups with respect to MELD score (P = .035), duration of mechanical ventilation (P>.001), pneumonia (P = .01), and endotracheal culture results (P = .001). In the multivariate analysis, hemoglobin (P = .03, odds ratio [OR]: 1.239), MELD score (P = .027, OR: 1.064), duration of mechanical ventilation (P = .003, OR: 1.091), and age (P = .042, OR: 1.001) were significant risk factors for mortality. The best-fit breakpoint analysis yielded cut-off values for hemoglobin (>11.2, sensitivity: 50.9%, specificity: 70%), MELD score (>16, sensitivity: 73.6%, specificity: 42%) and duration of mechanical ventilation (>3, sensitivity: 62.3%, specificity: 76%). Conclusion. Advanced age, high hemoglobin level, high MELD score, and long-term mechanical ventilation are significant risk factors for mortality in liver transplant patients with postoperative pulmonary complications.
Quality of life, emotion dysregulation, attention deficit and psychiatric comorbidity in children and adolescents with vitiligo
(Wiley, 2021) Ucuz, I.; Altunisik, N.; Sener, S.; Turkmen, D.; Kavuran, N. A.; Marsak, M.; Colak, C.
Background Vitiligo is an acquired pigmentation disorder, which can have a negative effect on patient quality of life (QoL). Aim To evaluate QoL and psychiatric comorbidity in paediatric patients with vitiligo. Methods In total, 30 patients aged 8-18 years who were diagnosed with vitiligo and 30 age- and sex-matched healthy controls (HCs) were included in the study. The Children's Depression Inventory, Screen for Child Anxiety Related Disorders, State-Trait Anxiety Inventory for Children and Child Somatization Inventory were completed for both patients and controls. The Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL) was administered to all patients by a child psychiatrist. Families were also asked to complete the Pediatric Quality of Life Inventory and Emotion Regulation Checklist for children. Results The K-SADS-PL evaluation showed that 90% of the patients in the vitiligo group had at least one psychiatric diagnosis, whereas this rate was 20% in the HCs (P < 0.001). There were statistically significant differences between vitiligo and HCs in terms of anxiety, state and trait anxiety scores (P < 0.05). Attention deficit and hyperactivity disorder (ADHD) was detected in 36.6% of the patients. Conclusion The most important finding of this study is that anxiety disorders are more prominent than depression in childhood vitiligo. Another important finding of this study is that the prevalence of ADHD is significantly higher than the normal population.
A rare cause of ankle pain: concomitant intravenous lobular capillary haemangioma and arteriovenous fistula
(Verduci Publisher, 2012) Turtay, M. G.; Samdanci, E.; Oguzturk, H.; Colak, C.; Dogan, M.
Intravenous lobular capillary haemangioma (ILCH), also called intravenous pyogenic granuloma, is a rare benign lesion. These lesions are frequently showed themselves in the veins of the neck and upper extremities of young women. Clinical features are not specific. Ultrasonography can be used for diagnosis and showing additional pathologies such as arteriovenous fistula. The treatment is surgical excision. Correct pathologic diagnosis is required for differential diagnosis. We report an ILCH case presented to the Emergency Department with the complaints of pain and swelling in the ankle, originated from an arteriovenous fistula in vena saphena magna.
Sevoflurane alone and propofol with or without remifentanil for electroconvulsive therapy-a randomised, crossover study
(Australian Soc Anaesthetists, 2013) Begec, Z.; Kayhan, G. Erdogan; Toprak, H. I.; Sahin, T.; Konur, H.; Colak, C.; Durmus, M.
We compared the effectiveness of three anaesthetic regimens (propofol alone, propofol with remifentanil and sevoflurane alone), with respect to seizure duration and seizure quality in patients undergoing electroconvulsive therapy. Thirty-nine patients underwent a total of 234 electroconvulsive therapy treatments in this prospective, observer blinded, crossover study. Each patient received either propofol 1 mg/kg alone (Group P), propofol 0.5 mg/kg and remifentanil 1 mu g/kg (Group R), or sevoflurane alone 6% (Group S) for their initial electroconvulsive therapy session. The patients subsequently received an alternative regimen in their next session, such as from propofol 1 mg/kg alone to propofol 0.5 mg/kg and remifentanil 1 mu g/kg, from propofol 1 mg/kg alone to propofol 0.5 mg/kg and remifentanil 1 mu g/kg to sevoflurane alone 6%, or from sevoflurane alone 6% to a continuing alternation between drugs at each session, until their sixth session. Muscle paralysis was achieved with 1 mg/kg succinylcholine. Seizure duration, postictal suppression index, early and midictal amplitude were recorded. The mean motor and electroencephalogram seizure durations were significantly longer in Groups P and R compared to Group S (P <0.001). The postictal suppression index and early and midictal amplitude values were not significantly different among the groups. These findings indicate that the three anaesthetic regimens had similar effects on seizure quality parameters, although sevoflurane was associated with shorter seizure durations than propofol or propofol-remifentanil.

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