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Öğe Accuracy of non-invasive hemoglobin monitoring by pulse CO-oximeter during hepatectomy in living liver donors(2021) Colak, Yusuf Ziya; Demiroz Aslan, DuyguAim: To evaluate the accuracy and agreement of the measurements made with the Masimo Rad7 device in living donor hepatectomy (LDH). Materials and Methods: A total of 63 living liver donors (LLDs) with ASA I-II scores who scheduled for LDH were included in the study. The Masimo noninvasive measurement probe was inserted to measure SpHb (mg/dL), pleth variability index (PVI, %) and perfusion index (PI,%). Heart rate, mean artery pressure, SpO2, body temperature, BIS, PVI, SpHb, and PI were recorded as basal, after anesthesia induction, post-intubation, post-intubation plus 5 min, 10 min, and plus 1, 2, 3, 4, 5, 6 and 7h. In addition blood samples were collected for laboratory hemoglobin (Hblab) before the surgery incision and after the surgical procedure, and the values were recorded simultaneously with the other values. Results: Fifty-five LLDs age between 18 and 55 years were assessed. The mean PI value increased in all measurements compared to baseline, and it was statistically significant at the 5th minute (p<0.05). This value prominently decreased after the 20th minute and dropped below the baseline value at the 7th hour. This decrease was statistically significant at the 2nd hour measurements (p<0.05). A significant correlation was observed between SpHb and LabHb before the surgical incision (r=0.694, p<0.001). Correlation decreased in after surgery measurement. In addition, there was a statistically significant difference between the before surgery and after surgery PI measurements (p<0.001). Conclusion: We think that in LDH procedures, surgical process leads to a decrease in PI and reduces the accuracy of SpHb measurement, and thus, intraoperative SpHb monitoring should be evaluated together with PI value.Öğe The effect of vitamin D deficiency in patients with trigeminal neuralgia: A case control study(2021) Altunkaya Yagci, Neslihan; Demiroz Aslan, Duygu; Durmus, MahmutAn association between vitamin D deficiency and chronic pain has been suggested in several observations. The objective of this study was to determine whether there was an interrelation between patients with trigeminal neuralgia and vitamin D levels. This study included 45 patients. All patients were diagnosed with trigeminal neuralgia in the Department of Pain Management. Age, sex, diagnosis year, antiepileptic drug use and medication for trigeminal neuralgia (TN) treatment were obtained and recorded. Patients included in the study were grouped based on the Barrow Neurological Institute Pain lntensity Scale (BNI) as BNI <4 Group 1, BNl > 4 Group 2. Trigeminal neuralgia patient’s quantitative assessment of pain was performed under the supervision of a pain specialist who was blinded to the study. Demographic data were similar in each group. A patient in Group I and 13 patients in Group 2 had interventional pain therapies before blood samples were obtained. The mean level of vitamin D was found as 29.6 + 5.8 ng/ml in Group I and defined as insufficient. The mean level of vitamin D was 12.9 + 5.0 ng/ml in Group 2. The mean level of Vitamin D was significantly lower in patients with a BNI pain intensity value ?4 (p < 0.001). lt is concluded that decreased serum vitamin D concentration was associated with trigeminal neuralgia. Although it is not easy to determine any causal correlation with a cross-sectional case control study, we concluded that vitamin D deficiency, as a risk factor for many acute and chronic diseases, was associated with pain severity in trigeminal neuralgia patients.Öğe Effects of ketofol and propofol on intubation conditions and hemodynamics without the use of neuromuscular blockers in patients undergoing tympanomastoidectomy(2019) Demiroz Aslan, Duygu; Ucar, Muharrem; Erdogan, Mehmet Ali; Sanli, Mukadder; Gulhas, Nurcin; Çolak, Cemil; Durmus, MahmutAbstract: The effect of ketofol, a mixture of ketamine and propofol in various ratios, on hemodynamic, for intubation without the use of neuromuscular blockers, has not been elucidated in patients undergoing tympanomastoidectomy. We evaluated the effects of ketofol and propofol on intubation conditions and hemodynamic without the use of a neuromuscular blocker. The prospective randomized, double-blinded study was scheduled for tympanoplasty or mastoidectomy. The patients were divided randomly into a propofol group (Group P) and a ketofol group (Group KP). Intubation conditions, changes in hemodynamics, HR, MAP, systolic arterial pressure (SAP), and SpO2 values were recorded before induction, after induction, after intubation, and at 3-min intervals during the first 30 min, 5-min intervals for the next 30 min, and 10-min intervals after that. In the intragroup evaluation, SAP, DAP, MAP and HR values were lower in both groups compared to the baseline values. Hemodynamic values were significantly lower in Group P than in Group KP after intubation compared to baseline. DAP at 12 and 18 min, DAP and MAP at 24 min, SAP, DAP and MAP at 27 min, and SAP and MAP at 30 min after the start of the operation were significantly lower in Group P than in Group KP. The need for ephedrine and the number of patients who required ephedrine were significantly lower in Group KP than in Group P. Ketofol provided appropriate intubation conditions similar to propofol, without the use of a neuromuscular blocker, and contributed to better hemodynamic conditions in patients undergoing tympanomastoidectomy.Öğe The effects of sedation with propofol and propofol- ketamin combination on postoperative cognitive function in elderly patients undergoing spinal anesthesia(2021) Colak, Yusuf Ziya; Ozgul, Mustafa; Demiroz Aslan, Duygu; Cumurcu, Hatice; Colak, Cemil; Durmus, MahmutAim: Elderly patients frequently require surgery. Postoperative cognitive dysfunction (POCD) is an adverse event and reduces the patient’s quality of life. We aimed to compare the effects of sedation applied with propofol or propofol-ketamine (ketofol) combination on hemodynamics and POCD during spinal anesthesia in elderly patients undergoing urological surgery. Materials and Methods: Study was performed on 60 ASA I-III patients over 65 years of age. Before the operation (standardized Mini Mental Test) sMMT was applied by a blind researcher. The cases were randomly divided into two groups as propofol (Group P, n=30) and ketofol (Group K, n=30). ECG, SpO 2 , Bispectral Index (BIS), noninvasive blood pressure (NIBP) was monitored. After spinal anesthesia, group P received propofol 0.5 mg/kg IV bolus and then 1.5 mg/kg/hour infusion. Group K received propofol 0.4 mg/ kg and ketamine 0.1 mg/kg IV bolus and then propofol 1.2 mg/kg/hour and ketamine 0.3 mg/kg/hour infusion. Hemodynamic and respiratory data were recorded. The sedation level was monitored by RAMSAY sedation score. sMMT was repeated by the researcher who performed the initial test at postoperative first 24 hours and postoperative 3rd day. Results: Significant decreases were observed for heart rate, SAP, and MAP in both groups compared with baseline values. No statistically significant difference was detected between the groups in sMMT values at postoperative 1 st and 3 rd days. Within- group comparisons revealed significant differences between preoperative sMMT and postoperative 1 st day sMMT and between postoperative 1 st and postoperative 3 rd day sMMT (p< 0.001). No difference was detected between preoperative and postoperative 3 rd day sMMT (p< 0.25). In Group P, there was statistically significantly higher injection pain (p<0.05). Conclusion: In this study we found that the recovery period of the patients was longer and BIS values were higher in group K, but no significant difference could be found in hemodynamic and cognitive functions.Öğe Evaluation of monitorization in anesthesia applications outside the operating room, compatibility of standard infrastructure and equipment : A survey study(2021) Demiroz Aslan, Duygu; Ferlengez, Ayse Gul; Altunkaya Yagci, NeslihanWe aimed to evaluate the suitability of monitoring, standard infrastructure and equipment in anesthesia applications of anesthesiology reanimation specialists and resident physicians working in Istanbul and increase the awareness of them. 106 anesthesiology reanimation specialists and resident physicians working in Istanbul and Malatya included in the study. The results of the survey consisted of 31 questions were obtained by collecting data via electronic data form on the web. Statistical analysis was used. In our study, the presence of oxygen supply, aspirator and probes in the areas of anesthesia outside the operating room, the presence of light source is sufficient, the most commonly used respiratory parameters of the monitoring methods and cardiovascular monitoring was followed. In these areas it was seen that 94% of the emergency trolleys were found and in the emergency boxes it was seen that the drugs used for cardiac arrhythmia and arrest treatment were usually found. There was a 40% defibrillator and a 60% support team for emergency situations and 56% of the system that could communicate for assistance. 74% of the recovery unit and 37% of the waste gas system were found outside the operating room. We believe that monitoring, compliance of standard infrastructure and equipment are effective to prevent complications in anesthesia outside the operating room applications.Öğe Successful use of spinal anesthesia for incarcerated inguinal hernia repair in a patient with Hunter syndrome(2019) Altunkaya, Neslihan; Demiroz Aslan, DuyguAbstract: Mucopolysaccharidosis type II (MPS II, Hunter syndrome) is a rare X-linked lysosomal storage disorder caused by a deficiency of the enzyme iduronate-2-sulphatase, leading to the accumulation of glycosaminoglycan (GAG). GAG accumulation causes difficult airway due to changes in the upper airway. In this report we present spinal anesthesia that was administered to a patient with Hunter syndrome to avoid complications related to anticipated difficult airway.
