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    Anaesthetic Management in Electroconvulsive Therapy During Early Pregnancy
    (Aves, 2014) Ozgul, Ulku; Erdogan, Mehmet Ali; Sanli, Mukadder; Erdil, Feray; Begec, Zekine; Durmus, Mahmut
    The management of major psychiatric conditions during pregnancy is exceptionally difficult. Pharmacoresistant, life-threatening and severe symptoms such as catatonia and suicidal behavior affect the health and safety of both mother and child. In such cases, electroconvulsive therapy (ECT) may be considered as an alternative to pharmacologic treatment. In this report, we aimed to present anaesthetic management of a patient, who was 13 weeks pregnant and needed ECT due to major depression.
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    Anesthesia Management in Aortic Dissection in Patients Undergoing Kidney Transplant
    (Baskent Univ, 2016) Ucar, Muharrem; Erdil, Feray; Sanli, Mukadder; Aydogan, Mustafa Said; Durmus, Mahmut
    Kidney transplant is a last resort to increase the life expectancy and quality of life in patients with renal failure. Aortic dissection is a disease that requires emergency intervention; it is characterized by sudden life-threatening back or abdominal pain. In the case described, constant chest pain that increased with respiration was present on exam-ination of a 28-year-old man (85 kg, 173 cm) who presented at our emergency department complaining of severe back pain. He had undergone a kidney transplant in 2004 from his mother (live donor). He was diagnosed with acute Type II aortic dissection and was scheduled for emergent surgery. Because there were no surgical or anesthetic complications, the patient with 79 and 89 minutes aortic cross-clamping and cardiopulmonary bypass durations was sent, intubated, to intensive care unit. When nephrotoxic agents are avoided and blood flow is stabilized, cardiovascular surgery with cardiopulmonary bypass may be performed seamlessly in patients who have undergone a kidney transplant.
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    Anesthetic management of Guillain Barre Syndrome in a pregnant woman
    (2017) Gulhas, Nurcin; Erdogan Kayhan, Gulay; Karademir, Ali; Sanli, Mukadder; Durmus, Mahmut
    Guillain-Barre syndrome (GBS) is an acute demyelinating polyneuropathy with symmetrical weakness characterized by loss of sensation and reflexes. During pregnancy the morbidity and mortality of GBS is high. GBS patients are prone to acute respiratory failure due to weaknes of respiratory muscles, hypotension associated with autonomic dysfunction, hemodynamic instability such as the development of hypertension and arrhythmia. Patients may need intensive care. The anesthetic technique for pregnant women with Guillain-Barre syndrome requiring cesarean section remains at discretion of the anesthesiologist, who should be guided by the clinical conditions and comorbidities of each patient. Therefore, we aimed to present the anesthetic management of cesarean planned in a GBS case.
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    The antimicrobial effects of ketamine combined with propofol: An in vitro study
    (Elsevier Science Inc, 2013) Begec, Zekine; Yucel, Aytac; Yakupogullari, Yusuf; Erdogan, Mehmet Ali; Duman, Yucel; Durmus, Mahmut; Ersoy, M. Ozcan
    Background and objectives: Ketamine and propofol are the general anesthetics that also have antimicrobial and microbial growth-promoting effects, respectively. Although these agents are frequently applied together during clinical use, there is no data about their total effect on microbial growth when combined. In this study, we investigated some organisms' growth in a ketamine and propofol mixture. Method: We used standard strains including Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans in this study. Time-growth analysis was performed to assess microbial growth rates in 1% propofol. Antimicrobial activity of ketamine, alone and in propofol was studied with microdilution method. Results: In propofol, studied strains grew from 103-104 cfu/mL to ?AO cfu/mL concentrations within 8-16 hours depending on the type of organism. Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) (for candida, minimal fungicidal concentration) of ketamine were determined as follows (MIC, MBC): E.coli 312.5, 312.5 pg/mL; S.aureus 19.5, 156 pg/mL; P.aeruginosa 312.5, 625 pg/mL; and C.albicans 156, 156 pg/ml. In ketamine+propofol mixture, ketamine exhibited antimicrobial activity to E.coli, P.aeruginosa and C.albicans as MBCs at 1250, 625 and 625 pg/mL, respectively. Growth of S. aureus was not inhibited in this mixture (ketamine concentration=1250 pg/mL). Conclusion: Ketamine has sustained its antimicrobial activity in a dose-dependent manner against some organisms in propofol, which is a strong microbial growth-promoting solution. Combined use of ketamine and propofol in routine clinical application may reduce the risk of infection caused by accidental contamination. However, one must keep in mind that ketamine cannot reduce all pathogenic threats in propofol mixture. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.
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    Changes in melatonin, cortisol, and body temperature, and the relationship between endogenousmelatonin levels and analgesia consumption in patients undergoing bariatric surgery
    (Sprınger, 233 sprıng st, new york, ny 10013 usa, 2018) Altunkaya, Neslihan; Erdogan, Mehmet Ali; Ozgul, Ulku; Sanli, Mukadder; Ucar, Muharrem; Ozhan, Onural; Sumer, Fatih; Erdogan, Selim; Colak, Cemil; Durmus, Mahmut
    Background Melatonin has analgesic, anti-inflammatory, sedative, and anxiolytic properties. However, the relationship between endogenous melatonin levels and postoperative analgesic requirements has not been well elucidated in patients undergoing bariatric surgery. We studied endogenous melatonin levels, cortisol levels, body temperatures, and the relationship between the level of endogenous melatonin and postoperative morphine consumption. Methods The trial was conducted among 30 patients who were scheduled for laparoscopic bariatric surgery. Their ages were between 18 and 65 years and their BMIs were above 40 kg/m(2). Secretion of melatonin, cortisol, and body temperature was monitored before the anesthetic induction, at 2 h intraoperatively, and at 2, 6, 10, (2:00 A.M.) and 24 h postoperatively. For each patient, morphine consumption was assessed at postoperative visits. The primary outcomes were to measure endogenous melatonin levels and to examine the relationship between these levels and morphine consumption. The secondary outcome was to observe the changes in cortisol and body temperature. Results There was a significant decrease in melatonin levels when preoperative melatonin levels were compared with intraoperative and all postoperative follow-up periods (p < 0.05). When the correlation between plasma melatonin levels and the postoperative morphine consumption of the patients was inspected, there was a significant correlation in all of the follow-up periods (p < 0.05). When preoperative cortisol levels were compared with intraoperative and postoperative cortisol levels, there was a significant difference in the follow-up periods, except two periods (p < 0.05). Body temperatures were similar in all measurement periods. Conclusions Endogenous melatonin secretion was significantly decreased in the intraoperative and postoperative periods. Furthermore, there was a significant inverse correlation between changes in endogenous melatonin levels and morphine consumption.
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    Comparison of Antioxidant Effects of Isoflurane and Propofol in Patient Undergoing Right Donor Hepatectomy
    (Wiley-Blackwell, 2012) Ucar, Muharrem; Ozgul, Ulku; Polat, Alaadin; Toprak, Huseyin I.; Erdogan, Mehmet A.; Aydogan, Mustafa S.; Durmus, Mahmut
    [Abstract Not Available]
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    Comparison of effects of propofol and ketamine-propofol mixture (ketofol) on laryngeal mask airway insertion conditions and hemodynamics in elderly patients: a randomized, prospective, double-blind trial
    (Springer Japan Kk, 2013) Erdogan, Mehmet Ali; Begec, Zekine; Aydogan, Mustafa Said; Ozgul, Ulku; Yucel, Aytac; Colak, Cemil; Durmus, Mahmut
    The objective of this study was to compare the effects of ketamine-propofol mixture (ketofol) and propofol on ProSeal laryngeal mask airway (PLMA) insertion conditions and hemodynamics in elderly patients. Eighty elderly patients, American Society of Anesthesiologists (ASA) physical status I and II, were randomly divided into two groups to receive either propofol 0.15 ml/kg (n = 40), or ketofol (using a 1:1 single-syringe mixture of 5 mg/ml ketamine and 5 mg/ml propofol) (n = 40) before induction of anesthesia. Sixty seconds after induction, the PLMA was inserted. Heart rate and arterial blood pressure (systolic [S] BP) were recorded prior to the induction of anesthesia, immediately following induction, immediately after PLMA insertion, and 5 and 10 min after PLMA insertion. PLMA insertion conditions were scored according to mouth opening, swallowing, coughing, head and body motion, laryngospasm, and ease of PLMA insertion by the same experienced anesthesiologist, who did not know which agents were used. There were no differences in PLMA insertion conditions between the groups. The number of patients in need of ephedrine (P = 0.043) and the total dose of ephedrine (P = 0.022) were significantly lower, and apnea duration (P < 0.001) was significantly higher in the ketofol group compared with the propofol group. SBP was significantly higher in the ketofol group than in the propofol group immediately after PLMA insertion and 5 min after PLMA insertion. The same PLMA insertion conditions were found with ketofol and propofol. The number of patients in need of ephedrine and the total ephedrine dose were lower and apnea duration was increased in the ketofol group.
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    Comparison of hemodynamic responses and QTc intervals to tracheal intubation with the McGRATH MAC videolaryngoscope and the Macintosh direct laryngoscope in elderly patients
    (Wiley, 2019) Colak, Fatih; Ozgul, Ulku; Erdogan, Mehmet A.; Kayhan, Gulay E.; Erdil, Feray A.; Colak, Cemil; Durmus, Mahmut
    Our hypothesis was that intubations with the McGRATH MAC videolaryngoscope in elderly patients would produce less hemodynamic responses and ECG changes than the Macintosh direct laryngoscope. The patients were divided into two groups: patients who were intubated using the McGRATH MAC (Group V, n = 45) and patients who were intubated using the Macintosh direct laryngoscope (Group L, n = 45). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR) were recorded before induction with anesthesia (baseline), immediately after induction and at 1min, 3min, and 5 min after intubation, with simultaneous ECG. When Group L was compared to Group V, there was an increase in the first, third and fitth minutes after intubation in terms of HR. SBP, MAP increased only at 1 min after intubation and DBP increased in the first and third minutes after intubation in Group L. In Group L, there was a significant difference in the HR values immediately after induction and the first minute after intubation compared with the baseline values. There was a difference in the SBP values immediately after induction and at 3 min and 5 min after intubation compared with the baseline values. There was a difference in DBP and MAP values immediately after induction and at 5 min after intubation. When the McGRATH MAC videolaryngoscope was compared with the Macintosh direct laryngoscope in elderly patients, the McGRATH MAC videolaryngoscope decreased the hemodynamic fluctuations due to tracheal intubation.
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    Comparison of the effects of direct laryngoscopy and fiberoptic oral endotracheal intubation on the intraocular pressures of non-ophthalmic patients: A prospective, randomised, clinical trial
    (2022) Yıldırım, Sait; Akbaş, Sedat; Durmus, Mahmut; Özkan, Ahmet Selim; Karaaslan, Erol; Polat, Nihat; Mutlu, Kayhan
    Abstract Aim: In this prospective, randomised, clinical study; we aimed to compare the effects of endotracheal intubation (ETI) via direct laryngoscope (DLS) and fiberoptic bronchoscope (FOB) on intraocular pressure (IOP) and hemodynamic data of non-ophthalmic patients. Materials and Methods: Fifty-four adult patients undergoing non-ophthalmic surgeries performed in the supine position under general anesthesia requiring orotracheal intubation were included into the study. The patients were randomly and prospectively divided into 2 groups: Group DLS (n=27) and Group FOB (n=27). Mean arterial pressure (MAP), Heart rate (HR), IOP were measured at before induction (basal), post-induction and 1st, 2nd, 3rd, and 5th minutes of intubation. Results: There was no statistically significant difference in distribution of patient characteristics. Duration of intubation was significantly longer in Group FOB (p<0.001). There was no statistically significant difference in MAP and HR when groups compared each other. Statistically significant increase was found in IOP at 1st minute of intubation in Group DLS when compared with Group FOB (p<0.001). No significant difference was found in terms of IOP in other time periods. Conclusion: We thought that endotracheal intubation by FOB could be more useful with respect to endotracheal intubation by DLS in patients with high IOP due to significantly less rise caused in IOP when performed by experienced anesthesiologists.
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    Comparison of videolaryngoscope-guided versus standard digital insertion techniques of the ProSeal™ laryngeal mask airway: a prospective randomized study
    (Bmc, 2019) Ozgul, Ulku; Erdil, Feray Akgul; Erdogan, Mehmet Ali; Begec, Zekine; Colak, Cemil; Yucel, Aytac; Durmus, Mahmut
    Background: This study were designed to investigate the usefulness of the videolaryngoscope-guided insertion technique compared with the standard digital technique for the insertion success rate and insertion conditions of the Proseal (TM) laryngeal mask airway (PLMA). Methods: Prospective, one hundred and nineteen patients (ASA I-II, aged 18-65 yr) were randomly divided for PLMA insertion using the videolaryngoscope-guided technique or the standard digital technique. The PLMA was inserted according to the manufacturer's instructions in the standard digital technique group. The videolaryngoscope-guided technique was performed a C-MAC (R) videolaryngoscope with D-Blade, under gentle videolaryngoscope guidance, the epiglottis was lifted, and the PLMA was advanced until the tip of the distal cuff reached the oesophagus inlet. The number of insertion attempts, insertion time, oropharyngeal leak pressure, leak volume, fiberoptic bronchoscopic view, peak inspiratory pressure, ease of gastric tube placement, hemodynamic changes, visible blood on PLMA and postoperative airway morbidity were recorded. Results: The first-attempt success rate (the primary outcome) was higher in the videolaryngoscope-guided technique than in the standard digital technique (p = 0.029). The effect size values with 95% confidence interval were 0.19 (0.01-0.36) for the first and second attempts, 0.09 (- 0.08-0.27) for the first and third attempts, and not computed for the second and third attempts by the groups, respectively. Conclusion: Videolaryngoscope-guided insertion technique can be a help in case of difficult positioning of a PLMA and can improve the PLMA performance in some conditions. We suggest that the videolaryngoscope-guided technique may be a useful technique if the digital technique fails. Trial registration: ClinicalTrials.gov NCT03852589 date of registration: February 22th 2019.
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    Dexmedetomidine ameliorates TNBS-induced colitis by inducing immunomodulator effect
    (Academic Press Inc Elsevier Science, 2013) Kayhan, Gulay Erdogan; Gul, Mehmet; Kayhan, Basak; Gedik, Ender; Ozgul, Ulku; Kurtoglu, Elcin Latife; Durmus, Mahmut
    Background: Since sedatives are often administered to immune-compromised and critically ill patients, our understanding of immunomodulation by sedation will be critical. Dexmedetomidine, a selective alpha(2)-adrenergic receptor agonist, is often used for sedation and analgesia especially in intensive care units. There are conflicting and little data concerning both the effect and the mechanism of dexmedetomidine on immune response. In our study, we aimed to investigate the effect of dexmedetomidine on immune system at two different doses (5 mu g.kg(-1) and 30 mu g.kg(-1)) during inflammatory bowel disease by using an experimental model, which resembles both systemic and local inflammation. Methods: The effect of dexmedetomidine on the course of inflammatory bowel disease was investigated by measuring macroscopic and microscopic parameters. We investigated pro-inflammatory Th1, Th2, and Th17 cytokine levels in serum samples to analyze systemic immune response. Following this, local immune response was investigated by measuring cytokine levels in the presence of dexmedetomidine in spleen cell culture. Results: Dexmedetomidine administration led to amelioration of all disease associated pathological manifestations. According to our in vitro and in vivo results, dexmedetomidine shows anti-inflammatory effect by increasing IL-4 and IL-10 levels responsible from anti-inflammatory response via Th2 pathway. Moreover, we showed for the first time in the study that dexmedetomidine administration reduces IL-23, which is responsible from initiation of inflammatory response via Th17 pathway. Conclusions: Dexmedetomidine can have beneficial effect on preoperative or postoperative inflammatory bowel disease patients in intensive care units by down-regulating inflammatory immune response not only in systemic circulation but also in tissue-specific manner. (c) 2013 Elsevier Inc. All rights reserved.
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    Dexmedetomidine attenuates lung injury induced by liver ischemia-reperfusion injury in rats
    (Scientific Publishers India, 2017) Sahin, Taylan; Begec, Zekine; Elbe, Hulya; Vardi, Nigar; Durmus, Mahmut; Ersoy, M. Ozcan
    Objectives: It was aimed to evaluate histological effects of different doses of dexmedetomidine on lung injury induced by liver ischemia-reperfusion in rats. Materials and methods: Forty rats were included into the study in Inonu University Animal laboratory at 2013, In Group 1, the liver was manipulated and no occlusion of the vessels of the liver was performed. In IR Group 2, 60 min of ischemia and 60 min of reperfusion were applied. In Group 3, 10 mu g/kg of dexmedetomidine was injected into the peritoneal cavity 30 min before ischemia. In Group 4, 100 mu g/kg of dexmedetomidine was administered via intraperitoneal route 30 min before ischemia. Further procedures in groups 3 and 4 were the same as those of group 2. After the experiment was completed, the rats were killed and then histologic assessments were performed to the lung tissues. Results: Histopathological damage score in group 2 was higher than in group 1. Although lung damage was recognized as alleviated in group 3, the lesions did not completely improve. However, treatment with 100 mu g/kg of dexmedetomidine was more effective than 10 mu g/kg of dexmedetomidine injection in respect to protection of alveolar structures. The difference was found to be statistically significant between group 3 and group 4 in terms of histopathological damage score. Conclusions: The present study suggests that dexmedetomidine administration may be beneficial for preventing lung injury induced by hepatic IR.
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    Difficult Airway Control in a Neonatal Patient with Oropharynx Mass
    (Medicine Science, 2016) Ozkan, Ahmet Selim; Ucar, Muharrem; Erdogan, Mehmet Ali; Firat, Cemal; Yucel, Aytac; Durmus, Mahmut
    Yıl: 2016Cilt: 5Sayı: supplement 1ISSN: 2147-0634Sayfa Aralığı: 155 - 157 Metin Dili: İngilizce Öz: Başlık (İngilizce): Öz (İngilizce): Tracheal intubation using direct laryngoscopy has become an essential part in the anesthesia management of the surgical patient. Big oropharynx mass can cause serious problems depending on their locations. Mass lesions of oropharynx may lead to difficult intubation. In this letter, we present a successful application of airway management with general anesthesia in a neonatal patient with big oropharynx mass.
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    Difficult airway management of a child with Blepharophimosis Syndrome: Case report
    (2018) Ozkan, Ahmet Selim; Polat, Nihat; Akbas, Sedat; Koylu, Zeynep; Durmus, Mahmut
    Blepharophimosis syndrome (BS) is a rare autosomal dominant syndrome characterized by eyelid malformations, and abnormal facial morphology. Flat and wide nasal roots, short neck, restricted mouth opening and neck extension, characteristic facial appearance, microcephaly and micrognathia make airway management of patients with BS important for anesthesiologists. Due to systemic pathologies and craniofacial anomalies, difficult airway may be seen in these patients and anesthesia management is important in patients with BS. Because of the difficult airway risk, it is important to determine the anesthetic method and make the necessary preparations. In this case report, we aimed to present difficult airway management of a patient with BS who underwent surgery for ocular disorders. This case report is the second case presented by successful airway management in general anesthesia practice
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    Difficult airway management of a child with Blepharophimosis Syndrome: Case report
    (İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi, 2018) Özkan, Ahmet Selim; Polat, Nihat; Akbas, Sedat; Köylü, Zeynep; Durmus, Mahmut
    Öz: Blepharophimosis syndrome (BS) is a rare autosomal dominant syndrome characterized by eyelid malformations, and abnormal facial morphology. Flat and wide nasal roots, short neck, restricted mouth opening and neck extension, characteristic facial appearance, microcephaly and micrognathia make airway management of patients with BS important for anesthesiologists. Due to systemic pathologies and craniofacial anomalies, difficult airway may be seen in these patients and anesthesia management is important in patients with BS. Because of the difficult airway risk, it is important to determine the anesthetic method and make the necessary preparations. In this case report, we aimed to present difficult airway management of a patient with BS who underwent surgery for ocular disorders. This case report is the second case presented by successful airway management in general anesthesia practice.
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    Does Rocuroinum Dose Adjusted Due to Lean Body Weight Provide Adequate Intubation Conditions?: A Prospective Observational Study
    (Wiley-Hindawi, 2022) Demiroz, Duygu; Colak, Yusuf Ziya; Iclek, Sumeyye Koc; Erdogan, Mehmet Ali; Yagci, Neslihan Altunkaya; Durmus, Mahmut; Gulhas, Nurcin
    Introduction and Aim. There is no consensus on the weight parameters to use when titrating the dosage of the neuromuscular blocking agents during intubation. In our study, we administered rocuronium, based on either the lean body weight (LBW) or the total body weight in patients with body mass index (BMI) of 18.5 to 34.9 and compared the duration of action of the drug and its effects on tracheal intubation conditions and hemodynamic parameters. Methods. This is a prospective, observational study. Patients between the ages of 18 and 65 with BMI of 18.5-34.9, who are expected to be under general anesthesia for less than 6 hours, were divided into 3 groups according to their BMI (Group 1 BMI = 18.5-24.9, Group 2 BMI = 25-29.9, Group 3 BMI = 30-34.9). These groups were randomly divided into 2 subgroups: Groups LBW; 1 LBW, 2 LBW, and 3 LBW were given rocuronium intubation dosages based on their LBW while control groups; 1K, 2K, and 3K were given 0.6 mg/kg rocuronium according to their total body weight. The data on the duration of action of rocuronium and its effects on the endotracheal intubation conditions were evaluated. Results. In Group 1, T1 time was found to be significantly longer (p=0.001). Intubation score and the use of additional rocuronium dose were found to be significantly higher in Group 1 LBW than in Group 1K (p=0.001). In Group 1, an additional rocuronium dose was needed to achieve optimal intubation conditions for subgroup 1 LBW. Rocuronium duration of action was found to be significantly longer in control groups 2 and 3, that received TBW-based dosage. Conclusion. In adult patients with a BMI of 18.5 and 24.9 BMI, we report optimal intubation conditions with the LBW-adjusted rocuronium dosage.
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    The effect of low-dose ketamine on ephedrine requirement following spinal anesthesia in cesarean sections: a randomised controlled trial
    (Drunpp-Sarajevo, 2012) Gulhas, Nurcin; Ozgul, Ulku; Erdil, Feray; Sanli, Mukadder; Nakir, Hamza; Yologlu, Saim; Durmus, Mahmut
    Background: We aimed to assess the effectiveness of subanesthetic doses of ketamine on ephedrine requirement in patients scheduled for Cesarean section under spinal anesthesia. Methods: ASA I-II, 105, patients were enrolled in the study. Spinal anesthesia was achieved with 12.5 mg hyperbaric bupivacaine and 15 mu g fentanyl. Following spinal anesthesia, patients were randomly allocated to three groups. Group Placebo: 2 mL of intravenous physiological saline, Group Ketamine 0.25: 0.25 mg.kg(-1) of intravenous ketamine, and Group Ketamine 0.5: 0.5 mg.kg(-1) of intravenous ketamine was received. Results: The systolic and mean blood pressures were similar in the groups. There were no significant differences between the groups, number of hypotensive attacks, as well as the amount of ephedrine used. The sedation scores in Group Ketamine 0.25 and Group Ketamine 0.5 were significantly higher than Group Placebo (p=0.001) Conclusions: Subanesthetic dose of ketamine is not effective on decreasing ephedrine requirement in Cesarean section under spinal anesthesia.
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    Effect of the Addition of Ketamine to Sevoflurane Anesthesia on Seizure Duration in Electroconvulsive Therapy
    (Lippincott Williams & Wilkins, 2015) Erdil, Feray; Ozgul, Ulku; Colak, Cemil; Cumurcu, Birgul; Durmus, Mahmut
    Objectives We evaluated the effects of a subanesthetic dose of ketamine, which was administered as an adjunct to sevoflurane, on duration of seizure activity, hemodynamic profile, and recovery times during electroconvulsive therapy in patients with major depression. Methods Patients were randomly allocated to a group receiving either sevoflurane-ketamine (group SK) or sevoflurane-saline (group SS). Sevoflurane was initiated in both groups at 8% for anesthesia induction until loss of consciousness was achieved, at which point it was discontinued. After loss of consciousness, ketamine was administered to the group SK in the form of a 0.5-mg/kg intravenous bolus. Patients in the group SS received saline in the same manner. Mean arterial pressure (MAP) and heart rate were recorded before anesthetic induction (T1); after anesthetic induction (T2); as well as 0, 1, 3, and 10 minutes after the seizure had ended (T3, T4, T5, and T6, respectively). Motor and electroencephalogram seizure durations were recorded. Results Motor and electroencephalogram seizure durations in the group SS were similar to those observed for the group SK. The heart rate increased significantly during T2 to T6 in both group SS and group SK compared with the baseline. The MAP increased in the group SS during the period between T3 and T6 as well as in the group SK during the same period compared with the baseline. The MAP increased more in the group SK, in comparison with the group SS, during T2 (P < 0.05). Conclusions The addition of ketamine at subanesthetic doses, for the purposes of anesthetic induction with sevoflurane, yielded results similar to those in the control group in terms of both seizure duration and hemodynamic stability.
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    Effect of the addition of ketamine to sevoflurane anesthesia on seizure duration in electroconvulsive therapy
    (The Journal of ECT., 2015) Erdil, Feray; Özgül, Ülkü; Çolak, Cemil; Cumurcu, Birgül; Durmus, Mahmut
    Objectives We evaluated the effects of a subanesthetic dose of ketamine, which was administered as an adjunct to sevoflurane, on duration of seizure activity, hemodynamic profile, and recovery times during electroconvulsive therapy in patients with major depression. Methods Patients were randomly allocated to a group receiving either sevoflurane-ketamine (group SK) or sevoflurane-saline (group SS). Sevoflurane was initiated in both groups at 8% for anesthesia induction until loss of consciousness was achieved, at which point it was discontinued. After loss of consciousness, ketamine was administered to the group SK in the form of a 0.5-mg/kg intravenous bolus. Patients in the group SS received saline in the same manner. Mean arterial pressure (MAP) and heart rate were recorded before anesthetic induction (T1); after anesthetic induction (T2); as well as 0, 1, 3, and 10 minutes after the seizure had ended (T3, T4, T5, and T6, respectively). Motor and electroencephalogram seizure durations were recorded. Results Motor and electroencephalogram seizure durations in the group SS were similar to those observed for the group SK. The heart rate increased significantly during T2 to T6 in both group SS and group SK compared with the baseline. The MAP increased in the group SS during the period between T3 and T6 as well as in the group SK during the same period compared with the baseline. The MAP increased more in the group SK, in comparison with the group SS, during T2 (P < 0.05). Conclusions The addition of ketamine at subanesthetic doses, for the purposes of anesthetic induction with sevoflurane, yielded results similar to those in the control group in terms of both seizure duration and hemodynamic stability.
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    The effect of vitamin D deficiency in patients with trigeminal neuralgia: A case control study
    (2021) Altunkaya Yagci, Neslihan; Demiroz Aslan, Duygu; Durmus, Mahmut
    An 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.