Yazar "Durmuş M." seçeneğine göre listele
Listeleniyor 1 - 20 / 35
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Acute Normovolemic Hemodilution in Coronary Artery Bypass Surgery: Effects on Inflammatory Response(2003) Durmuş M.; Karaaslan K.; But A.K.; Do?an Z.; Sezgin N.; Ersoy M.Ö.Acute normovolemic hemodilution is the removal of the blood from patients before or shortly after induction of anesthesia, and simultaneous replacement with acellular fluid, that is crystalloid or colloid and retransfusion of removed blood if needed. In this study we aimed to evaluate the effects of acute normovolemic hemodilution on and enflammatory response in patients undergoing coronary artery bypass surgery. After Ethics Committee approval 40 patients undergoing coronary artery bypass surgery were divided into two groups randomly. After induction of anesthesia, one or two units of blood were drawn from the Group I (n=20) until the hematocrit values became lesser than < 35%. At the same time, volume replacement was achieved with same amount of colloid infusion from peripheral vein. Any additional procedure was not done to the control group (Group II, n=20). Alanine transaminase, aspartate transaminase, lactate dehydrogenase, creatine kinase MB, creatine phosphokinase, ?-glutamyl transferase, complement 3a, complement 4a, ferritin, transferrin, nitric oxide, C-reactive protein and haptoglobulin levels were measured before induction, after operation, postoperative 6th and 24th hours. The amount of transfused allogenic blood was lower in Group I compared to group II (p<0.05). It was detected that complement system was not induced in two groups; lactate dehydrogenase, creatine kinase MB and nitric oxide levels were higher in Group II at postoperative 6 th, ferritin level was higher in group I at postoperative 24 th hours statistically (p<0.05). It was concluded that the effect of acute normovolemic hemodilution regarding to complement system was not different from control group and lower levels in lactate dehydrogenase, creatine kinase MB and nitric oxide can show that organ functions can be better prevented with acute normovolemic hemodilution.Öğe Anaesthesia for caesarean delivery in a pregnant with acute type B aortic dissection(2013) Kayhan G.E.; Gülhaş N.; Şahin T.; Özgül Ü.; Şanli M.; Durmuş M.; Ersoy M.Ö.About 50% of aortic dissections in women younger than 40 years occur during pregnancy; mostly in the 3rd trimester and postpartum period. Aortic dissection in pregnancy creates a serious mortality risk for both mother and the foetus. The ultimate goal is to ensure the safety of both the mother and the foetus. In such cases, the best method of anaesthesia for caesarean delivery is still controversial. The first aim of anaesthetic management is to reduce the effect of cardiovascular instability on the dissected aorta. Here, we report anaesthetic management of a 36 year-old patient who developed acute type B aortic dissection at the 30th gestational week and whom was scheduled for caesarean section. Since haemodynamic stability could not be achieved despite nitroglycerine and esmolol infusions, together with invasive arterial monitoring, the decision for caesarean delivery was taken. A team of Cardiovascular Surgeons and an operating room were prepared because of the risks of aortic rupture and haemodynamic collapse during operation. A combined-spinal epidural anaesthesia was administered using 5 mg hyperbaric bupivacaine and 20 ?g fentanyl given at the L3-4 spinal level in the lateral position. After achieving T4 sensorial level, the operation proceeded and a baby weighing 1432 grams was delivered in 4 mins with a median sub-umbilical incision. Epidural patient controlled analgesia was applied to the patient during follow-up with medical treatment at postoperative period. Application of combined-spinal epidural anaesthesia with a combination of low dose local anaesthetics and an opioid with additional doses for insufficient sensorial levels is a suitable method for pregnant women with acute type B aortic dissection. © 2013 by Turkish Anaesthesiology and Intensive Care Society.Öğe Anaesthesia induction with ketamine:Propofol combination (ketofol) in caesarean delivery(2013) Kayhan G.E.; Toprak H.I.; Aslan A.; Çolak Y.Z.; Gülhaş N.; Durmuş M.; Ersoy M.Ö.Objective: The aim of this study was to compare the maternal and foetal effects of ketamine:propofol (ketofol) combination with thiopental, used in anaesthesia induction for caesarean delivery. Methods: Eighty, 18-35 years-old parturients in ASA I-II class, who were admitted for caesarean delivery under general anaesthesia, were allocated to this prospective, double-blind, randomised study. Patients were divided into two groups according to thiopental (Group T) or ketofol (Group K) administration. In anaesthesia induction, 4 mg kg-1 thiopental for Group T, 1 mg kg-1 ketamin + 1 mg kg-1 propofol (ketofol) for Group K were administered. Haemodynamic effects, BIS values, foetal parameters in the perioperative period and postoperative pain levels and morphine consumption were evaluated. Results: There were no significant differences between groups with regard to demographic data. Heart rate values were lower in Group K than Group T and there were significant differences between values immediately after intubation and 15 min after intubation. There were no significant differences in systolic and diastolic blood pressures between the two groups. Apgar scores recorded at the 5th minute were higher in Group K, while there were no differences in the 1st minute scores between groups (p=0.01). Upon analyses of umbilical artery blood gas, pH values were higher in Group K (p=0.034). While pain scores were similar in groups, total morphine consumption for 24 hours was found to be higher in Group K (p=0.008). Conclusion: We believe that 1 mg kg-1 ketofol (1:1), when used for anaesthesia induction of caesarean delivery, may be a good alternative to thiopental in terms of maternal and especially foetal effects; however, patients need to be followed closely for postoperative analgesic requirements. © 2013 by Turkish Anaesthesiology and Intensive Care Society.Öğe Anaesthetic management of a patient ivith sturge-weber syndrome; different approach to aincay management(Turkish Anaesthesiology and Intensive Care Society, 2016) Akbaş S.; Özkan A.S.; Polat N.; Kadio?lu M.; Durmuş M.Sturge-Weber Syndrome (SWS) is a rare syndrome characterized by congenital skin angiomas and enscfalotrigeminal angiomatosis resulting in development of lesions on skin, brain und eyes. Since patients with SWS have frequently angiomas in their airways, laryngoscopy, intubation, and ventilation by facemask should be performed very carefully Alternative ainvayÖğe Anaesthetic management of a phaeochromocytoma patient with aortic valve insufficiency(2002) But A.K.; Durmuş M.; Gedik E.; Karaaslan K.; Toprak H.I.; Ersoy M.O.Phaeochromocytoma is an uncommon neuroectodermic tumour of adrenal medulla. Additional cardiac problems make anaesthesia management of phaeochromocytoma more complicated. We aimed to present the anaesthetic management of phaeochromocytoma patient with aortic valve insufficiency (AVI). A 45 years-old, 65 kg, female patient with third degree of AVI was admitted for phaeochromocytoma surgery. Before surgery, she was pre-treated with phenoxybenzamine and nicardipine for a week. In the operation room, thoracic epidural analgesia was maintained with 10 mL 0.5% bupivacaine loading dose, followed by 5 mL 0.5% bapivacaine for every hour during surgery. Then anaesthesia was induced with midazolam, droperidol, fentanyl, vecuronium, metoprolol and lidocaine. High dose fentanyl anaesthesia with 0.5-1.5% isoflurane were preferred for maintenance of anaesthesia. Haemodynamic stability was obtained with this anaesthesia management with lower dose vasodilators until the resection of adrenal mass. After the resection, severe hypotension was controlled with inotropic agents. Surgery was completed uneventfully and patient was transferred to ICU. In phaeochromocytoma cases with AVI, we think that appropriate anaesthetic approach is the thoracal epidural analgesia and high dose fentanyl anaesthesia with support of vasodilatators or vasoactive agents.Öğe Anaphylactic shock in caesarean section(Turkish Anaesthesiology and Intensive Care Society, 2014) Şanli M.; Gülhaş N.; Akgül Erdil F.; Miniksar H.; Demiröz D.; Durmuş M.Following contact with the allergen, allergic reactions ranging from the urticaria to anaphylaxis can be seen. The incidence of anaphylactic reactions in patients with asthma and allergic rhinitis are in higher rates in general population. Perianaesthetic anaphylaxis are important. It may be severe and potentially associated with adverse outcomes unless urgently recognized and treated. Anaphylaxis has been reported in the literature, with commonly used substances like latex, antibiotics, ranitidine, colloid solutions. Development of anaphylactic shock due to use of oxytocin is a rare side effect. In this case report, we aimed to present the anesthetic management of anaphylactic shock in a pregnant women, without a history of allergic reaction, developed immediately after infusion of oxytocin during cesarean section.Öğe Anesthesia Management of a Child With Scimitar Syndrome(Turkish Anaesthesiology and Intensive Care Society, 2014) Özkan A.S.; Şahin M.; Karademir A.; Aydo?an M.S.; Durmuş M.Scimitar syndrome (SS) is an uncommon complex congenital cardiopulmonary anomaly defined by a partial anomalous pulmonary venous return into the inferior vena cava or right atrium incorporated with right lung hypoplasia, cardiac dextroposition and a systemic right pulmonary arterial supply from the systemic circulation. SS is a rare variant of anomalous pulmonary venous return occurring in 2/100000 live births. Diagnosis is suspected on a chest radiograph demonstrating an arched vascular shadow of the anomalous pulmonary vein descending towards the diaphragm along the right side of the heart (scimitar sign). In these patients, cardiac problems added to respiratory problems are important in the anesthetic management of patients. In this case, we aimed to present the anesthetic management and postoperative complications of emergency bronchoscopy in a pediatric patient with scimitar syndrome.Öğe Anesthetic management of cardiac tamponade due to intraatrial angiosarcoma(Turkish Anaesthesiology and Intensive Care Society, 2016) Özkan A.S.; Kaçmaz O.; Akbaş S.; Erdil F.; Durmuş M.Angiosarcoma are rarely seen cardiac tumors with higher rates of mortality. Patients with angiosarcoma generally present with nonspecific symptoms and these tumors lead an aggressive course. Hemodynamic instability can develop due to the blocking of right ventricular load depending on the tumor size. Therefore, anesthetic management is important. In this case presentation, anesthetic management of the patient with cardiac tamponade developed secondary to right atrial angiosarcoma was presented. © 2016 Turkish Anaesthesiology and Intensive Care Society.All rights reserved.Öğe Anesthetic management of thoracic sympathectomy surgery: Retrospective clinical trial(Turkish Anaesthesiology and Intensive Care Society, 2015) Özkan A.S.; Ulutaş H.; Uçar M.; Aydo?an M.S.; Erdil F.; Çelik M.R.; Durmuş M.Introduction Thoracic sympathectomy is a simple and reliable method in the. treatment of primary hyper- hidrosis and some vascular diseases. Sympathectomy applications performed previoiusly using thoracotomy are now done icith the aid of thoracoscope procedure which is a video-assisted minimally invasive surgical technique. In this retrospective study, we aimed to present the anesthetic Management of thoracic sympathectomy performed on 84 patients. Material and Method: A total of 84 patients who hail undergone thoracic sympathectomy between the years 1099, and 2014 were included in the study after approval from the ethics committee was obtained. Information about the patient were obtained from patient files and anesthesia records. Result The mean age of the patients treated with thoracic sympathectomy teas 23.65±6.93 years. Fifty-one (60.7%) patient s were female and33 (39.3%) of them were male. Mean operative time was recorded as 86.0li.42.31 minutes. Surgery left? scheduled with the indications of hyperhidrosit (n-64; 76.2%), Raynaud's syndrome, (n- 13:15.5%) and reflex sympathetic dystrophy (n 7; 8.3%) Surgical techniques applied were open thoracotomy (n- II; 13.2%), uniport VATS (n 17; 20.2%), and 3-port VATS (n- 56; 66.6%). No complication was observed in 73 (86.9%) patients. However in the early Postoperutiue pe-riod pneumothorax was observed in 8 (9.5%), prolonged air leak in 2 (2.4%), and transient paresthesia on foot in I (1.2%) patient. The average time (o discharge time was recorded as 3.02±2.42 day. Discussion and Conclusion: In conclusion, thanks to developments in surgical methods, despite lower complication, mortality, and morbidity rates, need for analgesic drugs, and operative timet in thoracic sympathectomy applications in this group of low risk patients, one should also be careful in terms for posloperative complications and intraoperative management.Öğe Anesthetic management of Vena Cava Superior syndrome due to mediastinal mass(Turkish Anaesthesiology and Intensive Care Society, 2014) Özkan A.S.; Uçar M.; Erdo?an M.A.; Miniksar Ö.H.; Durmuş M.Superior Vena Cava Syndrome (SVCS) is a clinical condition that cause edema of the upper extremities and neck induced by decreased blood flow return to the heart, and compression of the mediastinal mass on surrounding structures. The anesthetic management of patients with SVCS must be carefully performed because of life-threatening complications such as difficult airway management and cardiovascular collapse. In this case report, we aimed to present the anesthetic management of SVCS in patient scheduled for biopsy of the mediastinal mass lesion.Öğe Caudal block in paediatric surgery: A retrospective survey in 2262 patients(2005) Begeç Z.; Durmuş M.; Toprak H.I.; Köro?lu A.; Ülger H.; Ersoy M.Ö.; Özpolat Z.Aim: The caudal block is a common regional anaesthetic techniques in infant and children. Limited data regard complications have been reported. We reviewed the anaesthesia records of 2262 paediatric patients in whom caudal block was performed between June 1995-May 2004 in our institution and describe the associated morbidity and complications. Results: Anaesthesia was induced with inhalation agents in 1633 patients, and intravenous agents in 629 patients. Caudal blocks were obtained by administering 1 mL kg-1 of 0.25% bupivacaine in 1563 patients, 0.25% bupivacaine and 1% prilocaine in 400 patients, 0.25% bupivacaine and 0.5 mg kg-1 ketamine in 61 patients, 0.25% bupivacaine and 1 mg kg-1 fentanil in 106 patients, and 0.2% ropivacaine in 132 patients. Complications rates were not different between patients over 10 kg and ?10 kg. There were statistically significant differences regarding total complications, and subcutaneous infiltration and intravenous injection rates comparing 1-2 years residents with 2-3 years and 3-4 years residents and staff anaesthesiologists (p<0.05). Conclusion: We conclude that caudal block is an appropriate technique in paediatric patients scheduled for surgery below the umbilicus. Complication rates decrease after the first year of aneasthesia training.Öğe Cerebral embolism during off-pump coronary artery bypass(Turkish Anaesthesiology and Intensive Care Society, 2016) Özkan A.S.; Durak M.A.; Altunkaya N.; Çolak Y.Z.; Durmuş M.Off-pump coronary artery bypass (OPCAB) is an alternative method to on pump cardiopulmonary bypass (OPCPB) thanks to the protection of physiological circulation and lung function. Stroke is one of the major complication of bypass surgery and seen more rarely during OPCAB. In the present case, we presented middle cerebral artery (MCA) infarction due to the cerebral embolism during OPCAB. © 2016 Turkish Anaesthesiology and Intensive Care Society.All rights reserved.Öğe Comparison of analgesic effects of intravenous dexketoprofen trometamol, lornoxicam and paracetamol on postoperative pain after total abdominal hysterectomy(AVES, 2011) Gülhaş N.; Durmuş M.; Yücel A.; Şahin T.; Erdil F.A.; Yolo?lu S.; Ersoy M.O.Objective: This study was intended to evaluate the analgesic efficacy of intravenously administered dexketoprofen trometamol in comparison with lornoxicam and paracetamol for acute postoperative pain. Material and Methods: 120 ASA physical status I-II patients undergoing total abdominal hysterectomy were enrolled in this study and randomly allocated into four groups (Groups D, L, P, and C). Following standard monitorization, in all groups, induction of anaesthesia was achieved via intravenous route using 5-7 mg kg-1 thiopental, 1 ?g kg-1 fentanyl, and 0.1 mg kg-1 vecuronium bromide, and also 6-8 % concentration of desflurane in 50 % O2 50 % N2O was used for the maintenance of anaesthesia in all groups. Patients received intravenous dexketoprofen trometamol 50 mg (Group D), 8 mg lornoxicam (Group L), 1 g paracetamol (Group P) and 100 mL SF (Group C) 30 min before the end of the surgery and 8-16 h after the surgery in Groups D, L, C. Group P received rescue medication at 6., 12., 18. and 24h after the surgery. At the end of the surgery, all patients received fentanyl via a patient controlled iv analgesia (PCA) device. Pain scores, cumulative fentanyl consumption, and patient satisfaction scores were assessed at 30 min, 2., 4., 6., 12. and 24h postoperatively. Results: The VAS scores at all evaluation time points, were similar among the groups. Fentanly consumption at 6., 12. and 24h postoperatively in Group P, L, and D was significantly lower when compared with Group C (p<0,05). Fentanyl consumption in Group L was lower relative to the other groups without any statistical significance. The patients' satisfaction scores at 6., 12. and 24h postoperatively in Group L were higher than the other groups (p<0,05). There was no significant difference between groups regarding sedation scores and side effects observed like postoperative nausea and vomiting and indigestion. Conclusion: We concluded that iv paracetamol, lornoxicam and dexketoprofen trometamol were equivalent in terms of analgesic efficiency in the management of postoperative pain after total abdominal hysterectomy.Öğe Comparison of morphine usage in intravenous PCA and epidural PCA(2003) To?al T.; Şahin Ş.; Durmuş M.; Türköz A.; Köro?lu A.; Ayas A.; Ersoy M.Ö.The aim of this study is to compare morphine for postoperative pain management by using intravenous and epidural patient controlled analgesia (PCA), for analgesic efficacy and side effects. After ethical committee approval was obtained, thirty cases aged 30-65 years (ASA I-II) were divided randomly into two groups. Group I received epidural PCA as loading dose morphine 2 mg, basal infusion rate 0.2 mg/h, bolus dose 0.5 mg and lockout time 30 minutes. Group II received intravenous PCA as loading dose morphine 5 mg, basal infusion rate 0.3 mg/h, bolus dose 1 mg and lockout time 15 minutes. Standard general anaesthesia procedure was performed. Procedure was started just after the operation. The mean arterial pressure, heart rate, respiratory rate, Visual Analogue Scale (VAS) and sedation scores were recorded at the end of the operation and at 1st, 2nd, 4th, 8th, 12th, 16th, 20th, 24th hour after the operation. Total morphine consumption, the number of request, the bolus dose delivery rate and side effects were recorded at the end of postoperative 24th hour. During 24 hours, morphine consumption and bolus dose delivery rate was significantly lower in Group I and the number of the request was significantly lower in Group II. There was no statistical difference between the two groups in terms of efficacy and VAS during 24 hours, except for the 8th hour. The VAS rates were below 3, after 8th hour in groups. VAS 8 score was lower in Group I. VAS rates at the hours 1, 2, 4, 8, 12, 16, 20, 24 decreased significantly compared to the rates at the beginning in each of the groups. Sedation scores at 1st, 2nd, 4th and 8th hour in Group I was lower than Group II. Pruritis was higher in Group I. There was no significant statistical difference between the two groups in terms of heart rate, mean arterial pressure and respiratory rate. As a result we conclude that the usage of morphine for the postoperative pain management by epidural or intravenous PCA provide effective analgesia only by short lock-out time and appropriate loading and bolus close.Öğe Does the supplementation of fentanyl to bupivacaine affect unilateral spinal block?(2001) Durmuş M.; Türköz A.; To?al T.; Ayas A.; Öztürk E.; Ersoy M.O.The purpose of this study was to evaluate the affects of supplementation of fentanyl to rapid administered low dose hyperbaric bupivacaine for unilateral spinal anaesthesia in arthroscopic surgery. Thirty patients undergoing arthroscopic surgery were placed in the lateral position. After dural puncture (25-gauge Whitacre spinal needle), the needle hole was turned toward the dependent side and patients were randomly assigned to receive 7.5 mg of 0.5 % hyperbaric bupivacaine (Group I, n=15) or 7.5 mg of 0.5 % hiperbaric bupivacaine + 25 ?g fentanyl (Group II, n=15). Lateral and horizontal positions were maintained for 15 min before the patients were turned to supine position. Sensory block levels were assessed with three minutes intervals during lateral position and 5 minutes intervals during supine position and motor block levels were assessed with 15 minutes intervals. Spinal anaesthesia was unilateral in 80 % of group I and 13 % of group II at the end of the 15 min; after 60 min, spinal anaesthesia was unilateral in 80 % of group I and 0 % of group II (p<0.005). We conclude that fentanyl supplementation to low dose hyperbaric bupivacaine was disadvantageous in obtaining unilateral spinal anaesthesia although we can obtain long-term sensory block.Öğe The effect of body-mass index on the duration of spinal anesthesia(AVES İbrahim KARA, 2006) Gülhaş N.; Begeç Z.; Durmuş M.; Erdem T.B.; Yücel A.; Ersoy M.Ö.Aim: The purpose of our study was to examine the duration of spinal anaesthesia obtained with same volume of local anesthetics in patients who have different bodymass index (BMI). Materials and Methods: After the approval from the faculty ethical committee and patient informed consent, 90 patient (ASA I-II, 15-65 years-old) who have undergoing elective urological surgery were included in to the study. Patients had normal body weight (BMI= 20-25), excessive body weight (BMI- 25-30) and obese patients (BMI= 30-35) were divided in N, EW (Excessive weight) and O groups, respectively. Spinal block was achieved by 3 mL hyperbaric bupivacaine with a 25 G Quincke spinal needle through L4-L5. Following the spinal block, maximum sensory block level, the periods to reaching the maximum sensory block, to decline of the sensory block at two levels, the time of the motor block relief were recorded in each patient in two minutes intervals. Results: The time to two level decline of sensory block and the time of the motor block relief were longer significantly in Group EW and O than Group N (p<0.05). Although motor block relief time was similar between group EW and O, there was a significant difference between these groups regarding to two level declining time (p<0.05). 2nd and 4 th minute Bromage scores were higher in Group O than Group N and Group EW (p<0.05) Conclusion: We considered that the duration of the spinal anaesthesia obtained with same volume of local anaesthetics were lengthened parallel to BMI.Öğe The effect of ginger and ondansetron on nausea and vomiting after middle ear surgery(2003) Gülhaş N.; Durmuş M.; Köro?lu A.; Gedik E.; Noyan F.; Ersoy M.Ö.We aimed to compare the effects of orally administered ginger and ondansetron tablet on postoperative nausea and vomiting (PONV) in patients undergoing middle ear surgery. The patients received either 1gr Ginger [250 mg, 4 capsules (Group I, n=30)] with 30 mL water, ondansetron orally disintegrating tablet 8 mg with 30 mL water (Group II n=30) or only 30 mL water (Group III n=30) one hour before the operation in a randomized, double blind manner. The patients' nausea and vomiting episodes were evaluated between 0-1 th, 1-8th and 8-24th hour periods. Nausea occurred in 11 (36.6%), 2 (6.6%) and 3 (10%) patients during 0-1 hour and 6 (20%), 1 (3.3%) and 1 (3.3%) patients during 1-8 hour in Group I, II and, III, respectively. Nausea did not occurre in any patients during 8-24 hour. The incidence of nausea was significantly higher in Group I compared to Group II and III in 0-1 hour (p<0.05). In the first hour, vomiting occurred in 11 (36.6%), 2 (6.6%) and 3 (10%) patients in Group I, II and, III, respectively. 4 patients (13.3%) vomitted in Group I in 1-8 hours. None of the patients vomitted in Group II and III during this period. No patient vomitted during 8-24 hour period. The incidence of vomiting was significantly higher in the first hour in Group I when compared to Group II and III (p<0.05). We concluded that ondansetron orally disintegrating tablet does not change the incidence of PONV and Ginger increases PONV in middle ear surgery.Öğe The effect of intra-abdominal insufflation pressure on liver function in adult patients undergoing laparoscopic cholecystectomy(2005) Özpolat Z.; Durmuş M.; Toprak H.I.; Öztürk E.; Temel I.; Ersoy M.Ö.Aim: The relation between age and the effect of laparoscopic cholecystectomy on hepatocellular integrity has not been evaluated. We aimed to compare conventional liver function tests in two groups of adults of differing age undergoing elective laparoscopic cholecystectomy. Materials and Methods: We studied 43 patients divided into two groups according to age: Group 1, age 18-60 years (n=22) and Group 2, over 65 years (n=21). All patients received general anesthesia. CO2 was used to insufflate the peritoneal cavity, and intraperitoneal pressure was maintained at 10-14 mmHg during cholecystectomy. Reverse Trendelenburg position was maintained after CO2 insufflation. Arterial blood was sampled before the induction of anesthesia, at the end of surgery, and 1, 3, 6 and 24h after surgery for determination serum alanine aminotransferase (ALT) aspartate aminotransferase (AST), alpha-glutathione S-transferase (alpha-GST), and ganima-glutamyl transpeptidase (GGT) concentrations. Results: Baseline values of alpha-GST were within normal limits in both groups. Alpha-GST increased significantly in two groups at the end of surgery and at 1st hour after surgery. The increase of alpha-GST in Group 2 was higher than Group 1. Alpha-GST returned to normal values at 3,6 and 24h after surgery in both groups. Alpha-GST returned to the preoperative value at 24th h after surgery in Group 1 but not in Group 2. Conclusion: We conclude that elderly patients undergoing laparoscopic cholecystectomy have more hepatocellular injury when intraperitoneal pressure is greater than 10 mmHg.Öğe Effect of intratechal morphine on postoperative stress response and postoperative analgesic requirements on cardiac patients in major abdominal surgery(2000) To?al T.; Türköz A.; Durmuş M.; Şahin S.; Yilmaz S.; Ersoy M.Ö.This study investigated the use of single dose intratechal (IT) morphine on cardiac patients undergoing major abdominal surgery and its effect on postoperative stress response, hemodynamic response and postoperative analgesic requirements. ASA class III 20 patients were randomized to receive either 10 ?g/kg of intratechal morphine or control group. Induction were performed by fentanyl 5 ?g/kg, thiopentone 2-4 mg/kg and vecuronium 0.08 mg/kg and anaesthesia was maintained by 33% N2O/O2 mixture with sevoflurane. There were no significant differences in the serum cortisol, glucose, BUN, creatinine, ALP, ALT, AST, CK, CK-MB concentrations recorded in the two groups pre and postoperatively. Cortisol, CK and CK-MB concentrations increased in both groups postoperatively. Plasma glucose concentrations increased in control group postoperatively. There were no significant differences of hemodynamic parameters between the two groups. Analgesic requirements of control group increased postoperatively comparing IT group. Three patients died postoperatively, other side effects were clinically insignificant. In conclusion IT morphine had no effect upon hemodynamic response, did not inhibit the stress response to surgery perioperatively on cardiac patients but we demonstrated the decrease of the postoperative analgesic requirements.Öğe The effect of lidocaine infusion on neurocognitive dysfuction after cardiopulmonary bypass(2003) Ilksen Toprak H.; Türköz A.; To?al T.; Özcan Y.; Durmuş M.; Öztürk E.; Ersoy M.Ö.Although technically, surgical, and pharmacological research to prevent neuropsychological (NP) dysfunction are ongoing, NP dysfunction after cardiopulmonary bypass (CPB) is among the most important causes of postoperative morbidity and mortality. In recent years lidocaine, which has being investigated for being its effects on cerebral protection, showed many side effects on central nervous system even at clinical doses. In this study, we investigated whether lidocaine at clinical doses increase the disturbances on cognitive functions after CPB. Twenty-three cases enrolled in this study with coronary artery disease were divided into two groups randomly. Just after the pump, the first group (group I) was received 100 mg IV bolus of lidocaine and 1 mg min-1 lidocaine infusion, and the other group (group II) received same amounts of saline solution. Infusions were stopped at postoperative 24th hour. Cases were evaluated by a psychiatrist who does mot know the groups of patients for NP functions by Wechsler Memory Scale-Revised Form with seven subtests, one day before (ti), 24 hours after operation (ts) and at postoperative 7th day (tt). There was a significant decrease in score of two subtests evaluated at ts compared with ti in group I and it was observed that total NP function scores at ts were significantly decreased compared to ti. Whereas, in group II, there was a significant decrease in only one subtest and there was no significant difference in comparison of total scores. In addition, when two groups were compared, decrease in logical memory score and total NP function score at ts were more significant in group I than in group II. It was thought that lidocaine used after CPB could increase postoperative NP dysfunction. Nevertheless, a psychometric test with wider content should be used and we think that our results should be supported by other studies.