Yazar "Demirbilek S." seçeneğine göre listele
Listeleniyor 1 - 11 / 11
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Anaesthesia for Caesarean section in the presence of aortic coarctation [5](Greenwich Medical Media Ltd, 2002) Togal T.; Durmus M.; Koroglu A.; Demirbilek S.; Karaaslan K.; Ersoy O.[No abstract available]Öğe Antioxidant effects of midazolam, isoflurane and desflurane during coronary artery by-pass grafting surgery(2009) Öztürk E.; But A.; Toprak H.I.; Demirbilek S.; Güleç M.; Ersoy M.Ö.It has been suggested that the reactive oxygen species (ROS) have essential role in the pathogenesis of myocardial ischemia-reperfusion injury. ROS may cause cardiac problems such as myocardial stunning, tissue damage and reperfusion cardiac arrhythmias may occur during weaning from pump in coronary artery bypass grafting (CABG). The aim of this study was compare the effects of midazolam, isoflurane, and desflurarie on the oxidative stress and hemodynamic parameters during CABG. After standard anesthesia induction, ninety patients were randomly allocated to Group M (midazolam), Group 1 (isoflurane), Group D (desflurane). Blood samples were obtained from the retrograde cannula placed in the coronary sinus; just prior to connecting to the pump (T1) and 5 minute after the cross-clamp removal (T2). In group M, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and adenosine deaminase (ADA) significantly increased, and nitric oxide (NO) and malondialdehyde (MDA) decreased at the T2 compared to the T1 (p<0.05). In Group 1, SOD and ADA increased at the T2 compared to the T1. While NO and MDA decreased, ADA increased in Group D at the T2 in comparison with the T1 (p<0.05). GSH-Px was significantly higher in Group M than Group 1 and D at the T2 (p<0.05). Although ADA was lower at the T2 in Group M than Group 1 and D, but there was only statistically significant difference between Group M and D (p<0.05). Midazolam had greater stimulating capacity on the endogenous antioxidant system and may caused less cellular damage than isoflurane and desjlurane due to its effects on the ADA.Öğe Combination of low-dose (0.1 mg) intrathecal morphine and patient-controlled intravenous morphine in the management of postoperative pain following abdominal hysterectomy(2004) Togal T.; Demirbilek S.; Gulhas N.; Koroglu A.The aim of this double-blind prospective randomized study was to investigate combination of low-dose (0.1 mg) intrathecal morphine and patient-controlled intravenous morphine in the management of postoperative pain following abdominal hysterectomy. Side-effects, satisfaction and sedation were also evaluated. Fifty patients (ASA I) between 30 and 65 years of age, scheduled for elective abdominal hysterectomy were randomized to receive intrathecal 0.1 mg of morphine sulfate (ITM) or placebo and intravenous morphine (IVM). Both groups received standard general anesthesia. In the ITM group, 0.1 mg morphine was administered intrathecally just before emergence from anesthesia while an equal volume of sterile saline was administered in the IVM group. Thereafter, all patients received IV morphine via a patient controlled analgesia (PCA) pump, set to deliver a bolus of 1 mg with a lock-out of 7 minutes and maximum dose of 20 mg per 4 hours. Hemodynamics, respiration, PCA demands, VAS, sedation scores, total morphine consumption, satisfaction and side effects were recorded for 24 hours after surgery. There were no significant differences between the groups with respect to satisfaction score. Total morphine consumption was lower in the ITM group; VAS scores at the first 8 hours were lower in the ITM group. Sedation scores at 4, 8, and 12th hours were higher in the ITM group. There was no significant difference in terms of adverse effects. In conclusion, intrathecal morphine (0.1 mg) combined with intravenous PCA is a safe and effective method of providing analgesia after hysterectomy as evidenced by lower pain scores and total morphine consumption and improved patient satisfaction.Öğe Comparison of the Effects of Ketamine and Propofol Combined with Remifentanil 1 ?g kg-1 Bolus on Hemodynamic Changes and Intubating Conditions during Anesthetic Induction(2003) Demirbilek S.; To?al T.; Gülhaş N.; Çiçek M.; Do?an Z.; Ersoy M.O.Aim of this study was to compare the effects of ketamine and propofol combined with remifentanil 1 ?g kg-1 bolus on hemodynamic changes and intubating conditions during anesthetic induction. After obtaining approval from the Ethics Committee and patient informed consent, 44 patients, ASA physical status I, aged 20-56 years, who scheduled for elective surgery, were divided into two groups randomly. After administration of a bolus dose of remifentanil 1 ?g kg-1, patients in group K (n=22) received ketamine 1-1.5 mg kg-1, group P (n=22) received propofol 1.5-2 mg kg-1. The trachea was intubated 3 minutes after administration of vecuronium 0.1 mg kg-1 in all patients. The quality of intubation was scored as perfect, good and poor. Anesthesia was maintained with sevoflurane 1-1.5 % and 50 % nitrous oxide in oxygen, and if necessary remifentanil 0.5 pg kg-1 was administered. Systolic blood pressure (SAP), diastolic blood pressure (DAP), mean arterial pressure (MAP) and heart rate (HR) were recorded before (control) and after induction, before and 1, 3 and 5 min after placement of the tracheal tube, 1 min after surgical incision and every 5 min up to 30 minutes. Until surgical incision, SAP, DAP, MAP and HR were higher in group K than group P. There were no significance between groups regarding intubation scores and additional remifentanil requirements. As a result, we concluded that 1 pg kg-1 bolus of remifentanil combined with ketamine during induction provides better hemodynamic stability, and similar intubating conditions, when comparing those of propofol-remifentanil induction.Öğe Comparison of the Fresh Gas Flows Adjusted to the Body Weights in Patients Undergoing Low Flow Anaesthesia Either with Isoflurane or Desflurane(2004) To?al T.; Ayas A.; Demirbilek S.; Gedik E.; Köro?lu A.; Karaaslan K.; Ersoy M.O.In this study, we aimed to examine the effects of fresh gas flow (FGF) adjusted to the body weight (10-20-30 mL kg-1 min-1) in patients undergoing low flow anesthesia either with isoflurane or desflurane on hemodynamics, body temperature, concentration of oxygen and anesthetic gases. Sixty ASA I-II adult patients undergoing elective surgical procedures were included into the study. Patients were randomly allocated into two basic groups to receive either isoflurane or desflurane. Then these basic groups were randomly divided into 3 sub-groups to receive 10, 20 or 30 mL k-1 min-1 FGF. After standard anesthetic induction and intubation, during the first 10 minutes, FGF was 4 L min-1 with isoflurane 1.5 % or desflurane 6 % in 50% oxygen and 50 % nitrous oxide. Then concentrations of isoflurane and desflurane were set as 2 % and 8 % respectively and FGF was adjusted according to the groups. Heart rate (HR), mean arterial pressure (MAP), SpO2, esophageal temperature, vaporizer settings, inspired and expired anesthetic concentrations were recorded at regular intervals throughout the study. Inspired and expired anesthetic concentrations were found to be decreased significantly in the 10 mL kg-1 min-1 flow groups when compared to the 20 and 30 mL kg-1 min-1 flow groups (p<0.05). The inspired oxygen concentration (FiO2) decreased parallel to the duration of anesthesia. Low FiO2 was observed in 2 cases in isoflurane group with 10 mL kg-1 min -1 flow and in 8 cases in desflurane group with 10 mL kg -1 min-1 flow (p<0.05). We concluded that, isoflurane and desflurane could be used safely with FGF of 10 and 20 mL kg-1 min-1 providing hemodynamic stability. However, there is was a risk of hypoxia in desflurane group with FGF of 10 mL kg-1 min -1. But, this can be prevented by increasing FiO2.Öğe The effects of fetal sex on local anaesthetic requirement in cesarean sections(2005) Gülhaş N.; Demirbilek S.; Öztürk E.; But A.K.; Do?an Z.; Ersoy M.Ö.Aim: Anaesthetic needs are different between female and male adults. The effect of fetal sex on maternal local anaesthetic requirements has not been examined in detail. The aim of this study was to assess if fetal sex was associated with maternal regional anaesthetic requirements in elective cesarean sections. Material and Methods: After obtaining hospital Ethics Committee approval, 46 elective cesarean sections in ASA class I and II patients were reviewed. After a pre-load of 10 mL kg-1 Ringer Lactate, combined spinal epidural anaesthesia was administered. Spinal block was performed with 7.5 mg hyperbaric bupivacaine. If the sensory block didn't reach the T 4 dermotome 5 mL of 7.5% ropivacaine was administered through the epidural catheter. Time to reach T4 sensory block and required local anaesthetic doses were recorded. Results: Sensory block levels of mothers with female fetuses were statistically higher at 5 min after subarachnoid injection (p<0.05). Additionally time to reach T4 was shorter and required less ropivacaine in the group with female fetuses (p<0.05). Conclusion: The results of this trial, suggest that mothers with female fetuses have reduced regional anesthetic requirements for Cesarian section. Further studies are warrated.Öğe The efficacy of remifentanil combined with either propofol, sevoflurane or desflurane during controlled hypotension(2004) Demirbilek S.; Gülhaş N.; Öztürk E.; But A.K.; Aslan Ü.; Ersoy M.Ö.The aim of this study was to compare the effects of a combination of remifentanil with propofol, desflurane or sevoflurane on intraoperative controlled hypotension, quality of the surgical field and recovery characteristics in patients undergoing nose surgery. ASA physical status I, 18-47 yr of age, 54 patients were randomly divided to three groups and received remifentanil 1?g kg-1 as a bolus dose followed by a continuous infusion of 0.25 ?g kg-1 min-1. In propofol group, anesthesia was induced 1.5-2 mg kg-1 of propofol and maintained with a continuous infusion of 100-200 ?g kg-1 min-1. In sevoflurane group, anesthesia was induced with 7% sevoflurane in 100% oxygen, and was maintained with 1-2% sevoflurane and air in oxygen. In desflurane group, anesthesia was induced 1.5-2 mg kg-1 of propofol and maintained with 4-6% desflurane and air in oxygen. The study drug titration was adjusted to keep the systolic blood pressure (SBP) between 80-100 mmHg during surgery. During controlled hypotension, while SBP was significantly lower in desflurane and sevoflurane groups than in propofol group, mean blood pressure (MBP) was significantly lower in sevoflurane group than in other groups (p<0.05). Supplemental hypotensive agent was administered to 2 patients in propofol group and 1 patient in desflurane group. After extubation, MBP and heart rate (HR) significantly increased in propofol group, HR significantly increased in sevoflurane group, SBP, MBP and HR significantly increased in desflurane group according to preinduction values (p<0.05). Estimated blood loss and surgical field score was similar in all three groups. The time to extubation and early recovery was significantly shorter in desflurane group than in sevoflurane and propofol groups (p<0.05). We concluded that since all three anesthetic techniques provided hemodynamic stability and good visualization of the surgical field, they may be used for controlled hypotension management. However, sevoflurane-remifentanil combination may be preferable, because it did not cause any increase in blood pressure after extubation.Öğe Erratum: Does pneumoperitoneum always require laparotomy? Report of six cases and review of the literature (Pediatric Surgery International (2005) DOI: 10.1007/s00383-005-1489-3))(2006) Karaman A.; Demirbilek S.; Akin M.; Gürünlüo?lu K.; Irşi C.[No abstract available]Öğe Hemodynamic, Hepatorenal and Postoperative Effects of Desflurane-Fentanyl and Midazolam-Fentanyl Anaesthesia in Coronary Artery Bypass Surgery(2004) But A.K.; Durmuş M.; Toprak H.I.; Öztürk E.; Demirbilek S.; Ersoy M.O.In this study, we aimed to compare the hemodynamic, hepatorenal and postoperative effects of desflurane-fentanyl and midazolam-fentanyl anaesthesia during coronary artery bypass surgery. Sixty patients undergoing elective coronary artery bypass surgery with ejection fraction of more than 45% were included in the study. Patients were randomly divided into two groups as desflurane (Group D, n=30) and midazolam (Group M, n=30). Anaesthesia was induced with etomidate, 0.2 mg kg-1 and fentanyl, 5 ?g kg -1 in Group D and with midazolam, 0.1-0.3 mg kg-1 and fentanyl, 5 ?g kg-1 in Group M. For the maintenance of anaesthesia; desflurane, 2-6% and fentanyl, 15-25 ?g kg-1 were given in group D and infusion of midazolam at a rate of 0.1-0.5 mg kg -1 hr-1 and fentanyl at a rate of 15-25 ?g kg -1 were used in group M. Heart rate, mean arterial blood pressure, central venous pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index, systemic vascular resistance index, pulmonary vascular resistance index, left ventricle stroke work index and right ventricle stroke work index were measured before induction (t0), after induction (t1), after intubation (t2), after incision (t3), after sternotomy (t4), before cardiopulmonary bypass (t5), after protamine administration (t6) and at the end of the surgery (t7). Blood samples were taken to measure total bilirubine, aspartate amino transferase, gamma glutamyl transferase, lactate dehydrogenase, alkalane phosphatase, creatinine and blood urea nitrogen just before induction and at the 1st 4th and 14th days of postoperative period. In conclusion; intraoperative hemodynamic responses were similar in both of the groups and transient hepatic and renal dysfunction were observed in the postoperative period in both groups. The extubation and ICU discharge time were found to be shorter in the desflurane-fentanyl group.Öğe The Postoperative Analgesic Effects of Celecoxib and Rofecoxib in Total Abdominal Hysterectomy(2003) Durmuş M.; Köro?lu A.; Demirbilek S.; Özgül Ü.; Özcan Ersoy M.Celecoxib and rofecoxib that have been used in our country for treatment of osteoartritis and rheumatoid artritis are two COX-2 selective inhibitor non-steroidal antiinflammatory drugs. The aim of this study is to investigate postoperative analgesic and morphine sparing effects of single dose celecoxib or rofecoxib which were given before surgery in patients undergoing total abdominal hysterectomy. After obtaining approval from Ethics Committee, we studied 60 ASA I-II females undergoing total elective abdominal hysterectomy in a randomised, placebo controlled, double blind study. Patients were divided into 200 mg celecoxib (Group I, n=20), 50 mg rofecoxib (Group II, n=20) and placebo (Group III, n=20) groups. Anaesthesia was induced with 1.5 ?g kg -1 fentanyl, 4-6 mg kg-1 thiopental and 0.1 mg kg -1 vecuronyum. Morphine consumption, VAS scores at rest, on movement and on coughing and degree of sedation were evaluated during postoperative 2nd, 4th, 8th, 12th, and 24th h. Total morphine consumption was lesser in Group II at 8th h compared to Group III and at 12th and 24th h compared to Group I and III (p<0.05). VAS scores at rest, on coughing in Group I and II were significantly decreased during the first 24 h. There are no statistically significant differences between three groups regarding adverse effects. Although both celecoxib and rofecoxib produced a significant decrease in morphine consumption and VAS scores at rest, on movement and on coughing, we concluded that rofecoxib could produce better analgesia in early postoperative period and could decrease morphine consumption after 12th h with its long term effect.Öğe Preemptive effectiveness of celecoxib in patients undergoing total abdominal hysterectomy(2003) Karaaslan E.; Durmuş M.; Demirbilek S.; Köro?lu A.; To?al T.; Karaaslan K.; Ersoy M.O.We aimed to investigate the effects of preemptive oral 100 mg and 200 mg celecoxib in relief of postoperative pain and morphine consumption after total abdominal hysterectomy. Fifty-four, ASA I-II class adult cases were enrolled in this study. One hour before the operation, celecoxib was administered per oral 100 and 200 mg to group I and II respectively and group III served as a control. All patients received IV PCA with morphine. PCA was programmed as follows: 2 mg loading dose, 1 mg bolus dose and 10 minutes lock-out time for a 20 mg limitation for four hours. All patients underwent a standardized general anaesthetic induction and maintenance. During the operation no analgesic medication was used. After operation, pain scores (VAS at rest, on movement and on coughing) were evaluated at 2, 4, 8, 12, 24, 48 and 72. hours. The morphine consumption was recorded at 2, 4, 8, 12 and 24. hours post-operatively. Sedation scores and peripheral oxygen saturation were recorded at 1, 2, 4, 8, 12, 16 and 24. hours post-operatively. The total morphine consumption was 24.78±5.95, 24.44±9.18 and 34.78±10.38 in group I, II and III. That consumption in group 3 was significantly higher than group I and II. VAS at rest, movement and coughing were significantly higher in group III. We concluded that preemptive oral celecoxib 100 mg may be used as an additive to IV PCA with morphine for post-operative analgesia after abdominal hysterectomy.
