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Öğe Density matters most Reply(Wiley-Blackwell Publishing, Inc, 2010) Erdil, F.; Bulut, S.; Demirbilek, S.; Gedik, E.; Gulhas, N.; Ersoy, M. O.[Abstract Not Available]Öğe Dexmedetomidine blunts acute hyperdynamic responses to electroconvulsive therapy without altering seizure duration(Wiley, 2008) Begec, Z.; Toprak, H. I.; Demirbilek, S.; Erdil, F.; Onal, D.; Ersoy, M. O.Background: This study was designed to evaluate the effect of dexmedetomidine on the acute hyperdynamic response, duration of seizure activity and recovery times in patients undergoing electroconvulsive therapy (ECT). Methods: Fourteen patients underwent a total of 84 ECT sessions as a crossover design. Patients were randomly allocated to receive either dexmedetomidine (1 mu g/kg IV over a period of 10 min) or saline (control). Anaesthesia was induced with propofol 1 mg/kg, and then succinylcholine 0.5 mg/kg IV was administered. Arterial blood pressure and heart rate (HR) were recorded during the study period. Results: HR in the dexmedetomidine group was lower than that in the control group at 5 and 10 min after the start of study drug infusion, and at 1, 3 and 10 min after the seizure ended (P < 0.05). Peak HR was lower in the dexmedetomidine group compared with that in the control group (P < 0.05). The mean arterial pressure (MAP) values in the dexmedetomidine group were lower at 0, 1, 3 and 10 min after the seizure ended compared with the control group (P < 0.05). Both motor and electroencephalography (EEG) seizure duration in the control group (35.65 +/- 14.89 and 49.07 +/- 9.94 s, respectively) were similar to that in the dexmedetomidine group (33.30 +/- 12.01 and 45.15 +/- 17.79 s, respectively) (P > 0.05). Time to spontaneous breathing, eye opening and obeying commands were not different between the groups. Conclusion: A dexmedetomidine dose of 1 mu g/kg IV administered over 10 min before the induction of anaesthesia with propofol may be useful in preventing the acute hyperdynamic responses to ECT without altering the duration of seizure activity and recovery time.Öğe The effect of esmolol on the QTc interval during induction of anaesthesia in patients with coronary artery disease(Wiley-Blackwell, 2009) Erdil, F.; Demirbilek, S.; Begec, Z.; Ozturk, E.; But, A.; Ozcan Ersoy, M.The aim of this study was to evaluate whether esmolol has an effect on QT interval during induction of anaesthesia using etomidate and fentanyl in patients with known coronary artery disease. Sixty patients were prospectively randomised to either a control group or the esmolol group. Esmolol was administered as a bolus 1 mg.kg(-1), followed by a continuous infusion at 250 mu g.kg(-1)min(-1). All patients received etomidate 0.3 mg.kg(-1) and fentanyl 15 mu g.kg(-1). The ECG was recorded prior to induction of anaesthesia (T0), 5 min following the start of drug infusions (T1), 1 min following etomidate (T2), 3 min following vecuronium (T3), 30 s (T4), 2 min (T5) and 4 min (T6) after intubation. In the esmolol group, QTc interval was significantly shorter at T1, T2 and T4 compared to the control group (p < 0.05). In conclusion, QTc interval increased following tracheal intubation during induction of anaesthesia using etomidate and fentanyl. An infusion of Esmolol attenuated the QTc interval prolongation associated with tracheal intubation.Öğe The effects of dexmedetomidine and fentanyl on emergence characteristics after adenoidectomy in children(Australian Soc Anaesthetists, 2009) Erdil, F.; Demirbilek, S.; Begec, Z.; Ozturk, E.; Ulger, M. H.; Ersoy, M. O.This randomised controlled study evaluated the effects of fentanyl and dexmedetomidine on emergence characteristics of children having adenoidectomy and anaesthetised with sevoflurane. Ninety children, two to seven years of age and ASA physical status I, were studied. Children were randomly assigned to one of three groups of 30 children, with the study intervention injection given intravenously after intubation. Children in Group F received fentanyl 2.5 mu g.kg(-1), children in Group D received dexmedetomidine 0.5 mu g.kg(-1) and children in Group C received saline solution. Anaesthesia was induced with 50% N(2)O and 8% sevoflurane in O(2) by mask and atracurium 0.6 mg.kg(-1) was administered for tracheal intubation. All children received paracetamol 40 mg/kg rectally one hour preoperatively and dexamethasone 0.5 mg.kg(-1) intravenously. The time to extubation was shorter in Group D than Group E The eye-opening time was longer in Group F (161 +/- 5.3 minutes) than in Groups C (12.0 +/- 4.2 minutes) and D (12.7 +/- 3.2 minutes). The proportion of pain-free children in early recovery was significantly higher in Groups D (47%) and F (43%) than Group C (13%) (P < 0.05). The proportion of children with agitation scores > 3 was lower in Groups D 17% (5/30) and F 13% (4/30) than in Group C 47% (14/30) (P < 0.05). Fentanyl 2.5 mu g.kg(-1) and dexmedetomidine 0.5 mu g.kg(-1) had similar haemodynamic effects and emergence characteristics. Fentanyl has been safely used in children for many years. Further studies of dexmedetomidine safety and its interaction with other anaesthetic agents are required before recommending its routine use during general anaesthesia in children.Öğe The effects of intrathecal levobupivacaine and bupivacaine in the elderly(Wiley-Blackwell Publishing, Inc, 2009) Erdil, F.; Bulut, S.; Demirbilek, S.; Gedik, E.; Gulhas, N.; Ersoy, M. O.P>The objective of this study was to compare the block durations and haemodynamic effects associated with intrathecal levobupivacaine or bupivacaine in elderly patients undergoing transurethral prostate surgery. Eighty patients were prospectively randomised to receive plain 1.5 ml levobupivacaine 0.5% (group levobupivacaine) or 1.5 ml plain bupivacaine 0.5% (group bupivacaine) in combination with fentanyl 0.3 ml (15 mu g) for spinal anaesthesia. The time to reach T10 and peak sensory block level, and to maximum motor block were significantly shorter in group bupivacaine compared to group levobupivacaine (p < 0.05). Peak sensory block level was also significantly higher in group bupivacaine. In group bupivacaine, mean arterial pressure was significantly lower than group levobupivacaine, starting from 10 min until 30 min after injection (p < 0.05). Hypotension and nausea were less common in group levobupivacaine than group bupivacaine (p < 0.05). Because of the better haemodynamic stability and fewer side-effects associated with levobupivacaine, it may be preferred for spinal anaesthesia in elderly patients.Öğe The effects of N-acetylcysteine on pulmonary functions in patients undergoing on-pump coronary artery surgery: a double blind placebo controlled study(Verduci Publisher, 2016) Erdil, N.; Eroglu, T.; Akca, B.; Disli, O. M.; Yetkin, O.; Colak, M. C.; Erdil, F.OBJECTIVE: To investigate the effects of N-acetylcysteine (NAC) on pulmonary function tests and arterial blood gases in patients undergoing on-pump coronary artery surgery. PATIENTS AND METHODS: The effect of NAC was assessed within the scope of a prospective, single center, double-blind, placebo-controlled, parallel group study. Eighty-two patients undergoing coronary artery bypass grafting were randomized into two groups to receive either placebo (group 1, n = 40) or NAC (group 2, n=42). Both the NAC group and the placebo-receiving control group also included a COPD subgroup consisting of patients with an FEV1/FVC ratio of < 0.7 and an FEV1 value of 50-80%. Pulmonary function tests were performed preoperatively and on postoperative day 60. RESULTS: Both groups were similar with respect to age, gender, preoperative risk factors, ejection fraction (EF), mean cross-clamp time, ventilation time, intensive care unit (ICU) stay, atrial fibrillation (AF) and hospital stay (p > 0.05). Postoperative FVC and FEV1 values in group 1 and the postoperative FEV1, FEV1/FVC and FEF 25-75 values in group 2 were lower in comparison to their preoperative values. However, in both group 1 and 2, the decreases observed in these parameters were not statistically significant (p > 0.05). In the COPD subgroup of group 1, a postoperative decrease was observed in the FEV1 and FEF25-75 values, with the FEV1 decreasing by 4.55%, and the FEF25-75 decreasing by 4.2% (p < 0.05). In the COPD subgroup of group 2, no significant decrease was observed in the pulmonary function test values (p > 0.05). CONCLUSIONS: This study demonstrated that NAC administration in COPD patients undergoing on-pump coronary artery surgery resulted in the preservation of pulmonary functions.Öğe Ketamine or alfentanil administration prior to propofol anaesthesia: the effects on ProSeal™ laryngeal mask airway insertion conditions and haemodynamic changes in children(Wiley, 2009) Begec, Z.; Demirbilek, S.; Onal, D.; Erdil, F.; Ilksen Toprak, H.; Ozcan Ersoy, M.This study was designed to compare the effects of ketamine and alfentanil administered prior to induction of anaesthesia with propofol, on the haemodynamic changes and ProSeal laryngeal mask airway((R)) (PLMA) insertion conditions in children. Eighty children, aged between 3-132 months, were randomly allocated to receive either alfentanil 20 mu g.kg(-1) (alfentanil group) or ketamine 0.5 mg.kg(-1) (ketamine group) before induction of anaesthesia. Ninety seconds following the administration of propofol 4 mg.kg(-1), a PLMA was inserted. In the ketamine group, heart rate and mean arterial pressure were higher during the study period compared with the alfentanil group (p < 0.05). The time for the return of spontaneous ventilation was prolonged in the alfentanil group (p = 0.004). In conclusion, we found that the administration of ketamine 0.5 mg.kg(-1) with propofol 4 mg.kg(-1) preserved haemodynamic stability, and reduced the time to the return of spontaneous ventilation, compared with alfentanil 20 mu g.kg(-1) during PLMA placement. In addition, the conditions for insertion of the PLMA with ketamine were similar to those found with alfentanil.
