Yazar "Erdil, Feray" seçeneğine göre listele
Listeleniyor 1 - 20 / 27
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Akut üst solunum obstrüksiyonunu takiben gelişen negatif basınçlı pulmoner ödem: Olgu sunumu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2009) Yücel, Aytaç; Öztürk, Erdoğan; Erdil, Feray; Aydoğan, M. Said; Ersoy, M. ÖzcanÖz: Amaç: Kliniğimizin şaşılık biriminde muayeneleri yapılan ilk 776 hastadaki tanı dağılım oranlarını ve bazı klinik özelliklerini değerlendirmek. Materyal ve metod: Şubat 1994 - Mart 1999 arasında İnönü Üniversitesi Göz Hastalıkları Anabilim Dalı Şaşılık biriminde ilk muayeneleri yapılan 776 şaşılık hastası retrospektif olarak incelendi. Bulgular: Hastaların dağılımına bakıldığında en sık ezotropya (%57.5), ikinci sıklıkta ekzotropya (%24.7), daha sonra 4. kranial sinir felci (%4.5), Duane Sendromu (%3), 6. kranial sinir felci (%2.6), Brown Sendromu (%0.9), 3. kranial sinir felci (%0.5), tiroid oftalmopati (%0.26), blow-out kırığı (%0.26), ekstraoküler kas fibrozisi (%0.26), Möbius Sendromu (%0.4), çift elevatör felci (%0.13) saptandı. İnferior oblik adale disfonksiyonu ezotropyalarda (%28.47), ekzotropyalarda (%17.7) oranında görülürken, superior oblik disfonksiyonu ezotropyalarda %4.7, ekzotropyalarda (%5.2) oranında görülmüştür. Ezotropyalar ve ekzotropyaların (%6.93)'ünde disosiye vertikal deviasyon (DVD) izlenmiştir. Refraksiyonları sferik eşdeğer olarak incelendiğinde ezotropyalarda %80.9 oranında (%48.4, >+2.0) ekzotropyalarda ise %31.3 oranında (%21, +0.5-+2.0 D) hipermetropi izlemiştir. Ezotropyalarda şaşılık ambliyopisi ekzotropyalara göre daha sık olarak bulunmuştur (p<0.05). Sonuç: Ana hatlardaki genel benzerlik yanında, ülkemizdeki önceki çalışmalarda farklı olan tanı oranlarına rastlanmış olup, sonuçlar literatür ışığında tartışılmıştır. Başlık (İngilizce): The evaluation of clinical and diagnostic features in strabismus patients Öz (İngilizce): Purpose: This study was performed to evaluate the diagnostic distribution and clinical findings of seven hundred seventy-six patients who were referred for the first time to the Strabismus Unit of our clinic. Materials and Methods: We studied retrospectively seven hundred seventy-six patients inspected for the first time at the Strabismus Unit of Ophthalmology Department, İnönü University School of Medicine, from February 1994 to March 1999. Results: The prevalance of diagnostic subgroups of strabismus patients, in order of decreasing frequency, were; esotropia (57.5%), exotropia (24.7%), 4th nerve palsy (4.5%), Duane's syndrome (3%), 6th nerve palsy (2.6%), Brown syndrome (0.9%,) 3rd nerve palsy (0.5%), thyroid ophthalmopathy (0.26%), orbital fracture (0.26%), extraocular muscle fibrosis (0.26%), Mobius syndrome (0.4%), and double elevator palsy (0.13%). Inferior oblique dysfunction was seen in 28.47% of esotropia and 17.7% of exotropia patients while superior oblique dysfunction was seen in 4.7% of esotropia and 5.2% of exotropia patients. Dissociated vertical deviation was seen in 6.93% of esotropia and exotropia patients. Eighty point one percent of the esotropia patients (48.4 % >+2.0 D as spheric equivalent) and 31.3% of exotropia patients (21% between +0.5 and +2.0 D as spheric equivalent) were hyperopic. Strabismic amblyopia was seen more frequently in esotropia patients than exotropia patients (p <0.05). Conclusion: Our study results showed some common features, and several differences as to the rates of strabismus subgroups compared to the previous reports in literature.Öğe Alkalinize bupivakain ve ropivakainin antibakteriyel etkinliği(Türk Anestezi ve Reanimasyon Dergisi, 2007) Begeç, Zekine; Gülhaş, Nurçin; Toprak, Hüseyin İlksen; Erdil, Feray; Yetkin, Gülay; Ersoy, M. ÖzcanÖz: Amaç: Çalışmamızda, alkalinize bupivakain ve ropivakainin Escherichia coli, Staphylococcus aureus ve Pseudomonas aeruginosa üzerine antibakteriyel etkisini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmada % 0.5 bupivakain, % 0.2 ropivakain, % 0.5 bupivakain+NaHCO3, % 0.2 ropivakain+NaHCO3 solüsyonları ile E. coli, S. aureus ve P. aeruginosa bakteri kültürleri kullanıldı. Bakteriler standart kanlı agarda üretildi. Bakteri kültürleri % 0.9 serum fizyolojik içerisinde 0.5 McFarlands yoğunluğunda (108 cfu mL-1) hazırlanarak her bir bakteri solüsyonu Mueller-Hinton'da dilüe edilip standart inokulum sağlandı (105 cfu mL-1). Test solüsyonları ve kontrolleri (serum fizyolojik) 2 mL olacak şekilde hazırlanarak üzerlerine 2 mL bakteri inokulumu eklendi. Karışımlar vortekslenerek steril polystyrene spektrofotometre küvetlerine 3 mL aktarıldı ve 37°C'de enkübe edildi. Optik dansite 0., 3. ve 6. sa.'te 540 nm'de spektrofotometre ile ölçüldü. Bulgular: Bupivakain S. aureus ve E. coli üremesini tüm ölçüm zamanlarında inhibe ederken, P. aeruginosayı sadece 6. sa.'te inhibe etti (p<0.05). Alkalinize bupivakain S. aureus üremesini 0. sa.'te E. coliyi ise, 0. ve 6. sa.'te inhibe etti (p<0.05). Bupivakainin E. coli üzerine antibakteriyel etkinliği 6. sa.'te alkalinize bupivakainden anlamlı yüksekti (p< 0.05). Ropivakain S. aureus üremesini 0. ve 3. sa.'te alkalinize ropivakainden daha fazla inhibe ederken, alkalinize ropivakain kontrole göre daha az inhibisyon yaptı (p<0.05). Ropivakain ve alkalinize ropivakain E. coli üremesini 3 ve 6. sa.'te inhibe ederken 0.sa.'te sadece ropivakain inhibe etti (p<0.05). Ropivakain ve alkalinize ropivakain P. aeruginosa üremesini 3.sa.'te inhibe etti (p<0.05). Sonuç: Bupivakainin antibakteriyel etkisinin mevcut olduğu ve alkalinizasyonun bunu değiştirmediği, ropivakainin zayıf antibakteriyel etkisi olduğu ve bunun alkalinizasyon ile daha da azaldığı saptandı.Öğe Anaesthetic Management in Electroconvulsive Therapy During Early Pregnancy(Aves, 2014) Ozgul, Ulku; Erdogan, Mehmet Ali; Sanli, Mukadder; Erdil, Feray; Begec, Zekine; Durmus, MahmutThe 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.Öğe Anesthesia Management in Aortic Dissection in Patients Undergoing Kidney Transplant(Baskent Univ, 2016) Ucar, Muharrem; Erdil, Feray; Sanli, Mukadder; Aydogan, Mustafa Said; Durmus, MahmutKidney 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.Öğe Atan kalbe baypas cerrahisi uygulanan adrenal yetmezlikli olguda anestezik yaklaşım(Türk Anestezi ve Reanimasyon Dergisi, 2008) Erdil, Feray; Begeç, Zekine; Öztürk, Erdoğan; But, A. Kadir; Nisanoğlu, Vedat; Ersoy, M. ÖzcanÖz: Glukokortikoidler fizyolojik ve cerrahi stres durumunda homeostazisi sağlamak için adrenal korteksten yüksek miktarlarda salınır. Ancak, adrenal yetmezliği olan olgularda, anestezi ve cerrahi strese ya da glikokortikoid tedavisinde yetersizliğe bağlı yaşamı tehdit eden adrenal kriz gelişebilir. Bu olgu sunumunda, Cushing Sendromuna bağlı bilateral adrenalektomi ameliyatı geçirmiş ve uzun yıllar glikokortikoid tedavisi alan bir olguda, atan kalpte baypas cerrahisi sırasında başarılı şekilde uygulanan anestezi tekniği ve kortizol tedavisi tartışılmıştır.Öğe Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2010) Begeç, Zekine; Durmuş, Mahmut; Erdil, Feray; Öztürk, Erdoğan; Yücel, Aytaç; Ersoy, M. ÖzcanKaudal anestezi uygulanan çocuklarda laringeal maske (LMA) çıkarılması için gerekli sevofluran minimum alveolar konsantrasyonunu (MAK) değerlendiren bir çalışma bulunmamaktadır. Çalışmanın amacı kaudal anestezi uygulanmış çocuklarda LMA çıkarılması için gerekli sevofluran MAK’ını belirlemektir. Materyal ve Metod: Genel anestezi ile ürolojik cerrahiye giden (<2 saat) 56 çocuk çalışmaya alındı. Sevofluran indüksiyonundan sonra LMA yerleştirilen çocuklar kaudal anestezi yapılan ve yapılmayan grup olarak ayrıldı. Cerrahi işlemin sonunda LMA; grupları bilmeyen bir anestezist tarafından, end-tidal sevofluran konsantrasyonu önceden belirlenen % 0.2’lik konsantrasyonlarla azaltılarak çıkartıldı. LMA çıkarılması sırasında veya çıkarıldıktan sonra 1 dakika içinde, öksürük, diş sıkma, amaçlı hareket, nefes tutma veya laringospazm eşlik etmiyorsa LMA çıkarılması başarılı olarak kabul edildi. Bulgular: Çocuklarda LMA çıkarılması için gerekli sevofluran MAK’ı kaudal anestezi uygulanan grupta %1.60, kaudal anestezi uygulanmayan grupta %1.72 idi. Sonuç: İki ay-8 yaş arası çocuklarda kaudal anestezi; LMA çıkarılması için gerekli sevofluran MAK’ını azaltmadı. Kaudal bloğun infant ve çocuklarda LMA çıkarılması için gerekli sevofluran MAK’ına etkisini araştıran ileri çalışmalara ihtiyaç olduğu kanaatine varıldı.Öğe Coronary bypass surgery in patients with pulmonary hypertension assessment of early and long term results(Ann Thorac Cardiovasc Surgery, 2015) Akça, Barış; Erdil, Nevzat; Dişli, Olcay Murat; Dönmez, Köksal; Erdil, Feray; Çolak, Mehmet Cengiz; Battaloğlu, BektaşPurpose: We aimed to evaluate the effects of preoperative pulmonary hypertension (PH) on early and long term results in patients undergoing coronary bypass surgery and the effects of coronary bypass surgery on PH. Methods: Among 2325 patients who underwent elective isolated coronary artery bypass surgery between March 2003 and March 2012, 287 patients with high preoperative pulmonary arterial pressure (PAP) ≥30 mmHg were examined. Patients’ data were obtained by retrospective examination of our clinic’s database. 69 patients who had complete parameters included in the study. Results: There was no increase in the New York Heart Association (NYHA) functional classification 84% of cases. Preoperative and postoperative values of the mean ejection fraction and mean PAP of patients was respectively 45.28 ± 9.67 (25–65), 46.03 ±12.4 (20–65) (p = 0.447), 36.67 ± 6.81 (30–60) mmHg, 37.81 ± 10.07 (20–70) mmHg (p = 0.378). The late mortality of cases was 5.79%. In our study, during 33.9 ± 17 (9–100) months follow up period, life expectancy was calculated as 94.7 months. Conclusion: Preoperative evaluation of these patients for appropriate medical treatment at peroperative and postoperative period, coronary bypass can be performed with low morbidity and mortality rates. In the late period after surgical revascularization PH showed no significant change and had no adverse effect on quality of life.Öğe Coronary Bypass Surgery in Patients with Pulmonary Hypertension: Assessment of Early and Long Term Results(Medical Tribune Inc, 2015) Akca, Baris; Erdil, Nevzat; Disli, Olcay Murat; Donmez, Koksal; Erdil, Feray; Colak, Mehmet Cengiz; Battaloglu, BektasPurpose: We aimed to evaluate the effects of preoperative pulmonary hypertension (PH) on early and long term results in patients undergoing coronary bypass surgery and the effects of coronary bypass surgery on PH. Methods: Among 2325 patients who underwent elective isolated coronary artery bypass surgery between March 2003 and March 2012, 287 patients with high preoperative pulmonary arterial pressure (PAP) >= 30 mmHg were examined. Patients' data were obtained by retrospective examination of our clinic's database. 69 patients who had complete parameters included in the study. Results: There was no increase in the New York Heart Association (NYHA) functional classification 84% of cases. Preoperative and postoperative values of the mean ejection fraction and mean PAP of patients was respectively 45.28 +/- 9.67 (25-65), 46.03 +/- 12.4 (20-65) (p = 0.447), 36.67 +/- 6.81 (30-60) mmHg, 37.81 +/- 10.07 (20-70) mmHg (p = 0.378). The late mortality of cases was 5.79%. In our study, during 33.9 +/- 17 (9-100) months follow up period, life expectancy was calculated as 94.7 months. Conclusion: Preoperative evaluation of these patients for appropriate medical treatment at peroperative and postoperative period, coronary bypass can be performed with low morbidity and mortality rates. In the late period after surgical revascularization PH showed no significant change and had no adverse effect on quality of life.Öğe Early results of surgery for acute type A aortic dissection without using neurocerebral monitoring(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2010) Erdil, Nevzat; Gedik, Ender; Erdil, Feray; Nisanoglu, Vedat; Battaloglu, Bektas; Ersoy, OzcanBackground: This study aimed to determine if the routine use of unilateral antegrade cerebral perfusion during repair of acute type A aortic dissection can eliminate the need for intraoperative neurophysiologic monitoring. Methods: Between September 2000 and December 2009, 66 consecutive patients with acute type A aortic dissection underwent surgical repair in our clinic. In 57 patients (86.4%), arterial perfusion was provided through a right axillary artery cannula and in the remaining nine patients (13.6%) the arterial perfusion site was the femoral artery. Results: Postoperative hospital mortality was 13.6% (n=9). Postoperative hemorrhage or tamponade requiring resternotomy occurred in seven patients (10.6%). Nine patients (13.6%) required postoperative inotropic support. Postoperative atrial fibrillation was observed in six patients. Mean intensive care unit stay and hospital stay were 5.1 +/- 4.4 days (range, 2 to 26 days) and 10.8 +/- 8.9 days (range, 7 to 60 days), respectively. Mean extubation time was 15.4 +/- 13.9 hours (range, 7 to 74 hours). One of the surviving patients experienced new transient neurological deficits in the postoperative period. Conclusion: Unilateral antegrade selective cerebral perfusion techniques may provide reliable brain protection and reduce cerebral complication rates without the use of routine cerebral monitoring devices, even for longer periods of circulatory arrest during surgery of acute type A aortic dissection.Öğe 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, MahmutBackground: 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.Öğe 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, MahmutObjectives 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.Öğe 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, MahmutObjectives 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.Öğe 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, Hatice Birgül; Durmuş, MahmutObjectives: 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.Öğe The effects of cognitive impairment on anaesthetic requirement in the elderly(Lippincott Williams & Wilkins, 2012) Erdogan, Mehmet A.; Demirbilek, Semra; Erdil, Feray; Aydogan, Mustafa S.; Ozturk, Erdogan; Togal, Turkan; Ersoy, Mehmet O.Context Patients with dementia have a lower bispectral index score (BIS) when awake than age-matched healthy controls. Objectives The primary aim was to compare the BIS and the dose of propofol required for induction in patients suffering from cognitive impairment with that in those who had normal cognitive function. This study also evaluated the effects of cognitive impairment in the elderly on anaesthetic agent consumption during surgery and on emergence from anaesthesia. Design and setting This randomised controlled study was carried out in a university hospital. Patients over 65 years of age, ASA I-II and scheduled for elective orthopaedic procedures were allocated to one of two groups. Interventions Patients (n = 92) were allocated according to their Mini Mental State Examination score: 25 or higher (group 1) or 21 or less (group 2). All patients received propofol 0.5 mgkg(-1) following the commencement of a remifentanil infusion at 0.5 mu gkg(-1) min(-1). After incremental doses of propofol up to loss of consciousness, a propofol infusion was started at 75 mu gkg(-1) min(-1). Propofol and remifentanil infusion doses were adjusted to keep the BIS value between 45 and 60 during surgery. Main outcome measure MMSE score was evaluated 24 h before and after surgery. The anaesthetic consumption, mean arterial pressure, HR and BIS values of the patients were recorded. Results Before surgery, mean Mini Mental State Examination scores were 26.8 +/- 1.6 and 16.6 +/- 4.2 in group 1 and 2, respectively. These returned to baseline value 24 h after surgery in group 1 (26.6 +/- 1.5) and group 2 (15.6 +/- 4.3). Before induction, four of 45 patients (8.9%) in group 1 had a BIS value less than 93 compared with 13 of 47 (27.7%) in group 2 (P = 0.02). The mean BIS value was significantly lower in group 2 than in group 1 before induction, during loss of consciousness, 3 and 5 min after discontinuation of the anaesthetic agents and before extubation (P < 0.05). The induction dose of propofol was lower in group 2 than in group 1 (P = 0.02). The eye opening time was significantly longer in group 2 than in group 1 (P = 0.03). Conclusion The baseline BIS value was lower in patients with cognitive impairment than in those with normal cognitive function. The former received less propofol during induction and eye opening time was longer. On the basis of our findings from the recovery period, we suggest that the recommended target BIS value for adequate anaesthesia in the general population is inappropriate for patients with cognitive impairment. Eur J Anaesthesiol 2012; 29:326-331Öğe Effects of Propofol or Etomidate on QT Interval During Electroconvulsive Therapy(Lippincott Williams & Wilkins, 2009) Erdil, Feray; Demirbilek, Semra; Begec, Zekine; Ozturk, Erdogan; Ersoy, Mehmet OzcanBackground: Because patients with major depression have an altered autonomic nervous system activity, the risk of arrhythmias and sudden cardiac death may be increased. In addition, electroconvulsive therapy (ECT) may cause an acute rise in QT dispersion, which may predispose to arrhythmias. In this study, we investigated the effects of propofol or etomidate on the corrected QT (QTc) interval during ECT in patients with major depression. Materials and Methods: Fourteen unpremedicated American Society of Anesthesiologists 1 patients, each scheduled for 6 ECT sessions for major depression, were included in a prospective, randomized crossover study The patients randomly received either 1-mg/kg propofol (propofol group) or 0.2-mg/kg etomidate (etomidate group). The mean arterial pressure (MAY), heart rate (HR), and electrocardiogram were recorded before anesthetic induction, 0 and 1 minute after the seizure ended, and 3 and 10 minutes after the seizure ended (T3 and T4, respectively). Results: In the propofol group, the QTc interval was shorter than the baseline at 0 minute after the seizure ended. The QTc interval increased from the baseline at T3 and T4 in the etomidate group. In the etomidate group, the QTc interval was longer at T3 and T4 than that in the propofol group (P < 0.05). In the etomidate group, the HR increased at T3 and T4, but the MAP increased at all measurement times from the baseline value. The HR and the MAP were lower at T3 and T4 in the propofol group than in the etomidate group (P < 0.05). Conclusions: Propofol did not induce prolongation of the QT interval and controlled the hemodynamic response better than etomidate during ECT. Therefore, propofol may be more suitable than etomidate for ECT treatments.Öğe The Effects of Remifentanil on Hemodynamic Response Attenuation After Electroconvulsive Therapy Under Sevoflurane Anesthesia(Lippincott Williams & Wilkins, 2017) Erdil, Feray; Ozgul, Ulku; Sanli, Mukadder; Kayhan, Gulay; Colak, Cemil; Durmus, MahmutPurpose We evaluated the effects of a single loading dose of remifentanil (1 g/kg) administered as an adjunct to sevoflurane, on the duration of seizure activity, recovery times, and hemodynamic profiles, during electroconvulsive therapy. Methods The patients were randomly allocated to receive sevoflurane-saline (Group SS) or sevoflurane-remifentanil (Group SR). Sevoflurane (8%) was initiated for anesthesia induction in both groups until loss of consciousness was achieved. Remifentanil was then administered to Group SR via a 1-g/kg intravenous bolus. Patients in Group SS received saline in the same manner. Mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthetic induction (T1), at the loss of consciousness (T2), and at 0, 1, 3, and 10 minutes after the electrical stimuli were completed (T3, T4, T5, and T6, respectively). Results Compared with the baseline values, HR increased significantly in Group SS at times T2 and T4 to T6 and decreased significantly in Group SR at time T2. When the groups were compared, we found that HR decreased significantly in Group SR at T2 and T4 to T6. Compared with baseline, MAP increased in Group SS between T3 and T6, and MAP decreased in Group SR at T2 and increased at T3 to T4. Mean arterial pressure decreased to a greater extent in Group SR than in Group SS during the T2 to T6 period. There were no group differences in seizure duration or recovery time. Conclusions The addition of 1-g/kg remifentanil to anesthetic induction with sevoflurane attenuated the acute hemodynamic response to electroconvulsive therapy under sevoflurane anesthesia without adversely affecting the duration of seizure activity or the recovery profile.Öğe Effects of sevoflurane or ketamine on the QTc interval during electroconvulsive therapy(Springer Japan Kk, 2015) Erdil, Feray; Begec, Zekine; Kayhan, Gulay Erdogan; Yologlu, Saim; Ersoy, Mehmet Ozcan; Durmus, MahmutTo evaluate the effect of sevoflurane or ketamine on the corrected QT (QTc) interval and the interval from the peak to the end of the T wave (Tp-e) during electroconvulsive therapy (ECT) in patients with major depression. This prospective, randomized, double-blinded study included 24 patients that were randomly allocated to receive sevoflurane (group S) or ketamine (group K) for ECT session. Group S patients received 8 % sevoflurane for anesthesia induction, which was maintained at 2-4 % until delivery of the electrical stimulus. Group K patients received a bolus of ketamine (1 mg/kg). The mean arterial pressure (MAP) and heart rate (HR) and the electrocardiogram (ECG) were recorded before (T1) and after induction of anesthesia (T2) and 0, 1, 3, and 10 min after the electrical stimuli ended (T3, T4, T5, and T6, respectively). In both groups, the QTc interval was significantly longer at T2, T4, T5, and T6 than at baseline. The QTc interval was longer at T4, T5, and T6 in group S compared to that in group K, the Tp-e interval was significantly longer at T4 in group K both baseline and group S. The HR in group S was increased at T4 compared with group K. MAP was significantly higher after induction of anesthesia in group K compared to those in group S at all time points. Although group S showed a prolonged QTc interval after ECT compared to group K, the Tp-e interval in both groups was not significantly affected clinically. Sevoflurane blunted MAP and peak HR.Öğe Epinefrinin oluşturduğu hemodinamik yanıtadeksmedetomidin ve midazolam sedasyonunun etkisi(Anestezi Dergisi, 2007) Erdil, Feray; But, A. Kadir; Toprak, Hüseyin İlksen; Öztürk, Erdoğan; Ersoy, M.ÖzcanÖz: Amaç: Septoplastilerde midazolam ve deksmedetomidin sedasyonunun; epinefrin içeren lokal anestezik (LA) infiltrasyonunun oluşturduğu hemodinamik yanıt ve postoperatif analjezik gereksinimi üzerine etkilerini incelemektir. Yöntem: Çalışmamız lokal anestezi ile septoplasti yapılacak 45 olguda gerçekleştirildi. Olgulara Ramsay sedasyon skoru 3-4 olacak şekilde deksmedetomidin (Grup D, n= 25) ve midazolam (Grup M, n=20) verildi. Olguların ortalama arter basıncı (OAB), kalp atım hızı (KAH), ve verbal ağrı skoru (VRS) operasyon öncesi, sedasyon ajanlarının uygulanması, epinefrinli LA infiltrasyonunu takiben ve operasyon sırasında kaydedildi. Postoperatif 1, 2, 4, 6, 12, ve 24. saatlerde O AB, KAH ve olguların ağrıları visual analog skala (VAS) ile değerlendirildi. İlk analjezik gereksinim zamanı ve total diklofenak tüketimleri kaydedildi. Bulgular: Grup D'de, O AB intraoperatif 10. dk'dan itibaren, KAH ise deksmedetomidin yükleme sonrası, intraoperatif20 ve 30. dk ile postoperatif 1. saatte giriş değerine göre anlamlı olarak azaldı (p<0.05). Grup M de, O AB yükleme sonrası ve postoperatif 2. saatten itibaren giriş değerlerine göre anlamlı düşükken, KAH yükleme sonrasından intraoperatif 30. dk'ya kadar anlamlı arttı (p<0.05). Gruplar arası değerlendirmede; Grup D'de O AB, intraoperatif 30 .dk' ya kadar ve postoperatif 1, 4, 24. saatte, KAH ise yükleme sonrasından intraoperatif 30. dk'ya kadar Grup M ye göre anlamlı düşüktü (p<0.05). Total diklofenak tüketimi Grup D' de M'ye göre anlamlı azdı ve ilk analjezik gereksinim zamanı daha uzundu (p<0.05). Postoperatif VAS değerleri Grup D'de M'ye göre anlamlı olarak düşüktü (p<0.05). Sonuç: Septoplasti ameliyatlarında, deksmedetomidin sedasyonunun epinefrinli LA infiltrasy onuna hemodinamik yanıtı daha iyi baskılaması ve postoperatif dönemde etkili analjezi sağlaması nedeniyle, midazolama kıyasla tercih edilebileceği kanısına varıldı.Öğe Erken gebelik döneminde elektrokonvulsif tedavide anestezi yönetimi(Türk Anestezi ve Reanimasyon Dergisi, 2014) Özgül, Ülkü; Erdoğan, Mehmet Ali; Şanlı, Mukadder; Erdil, Feray; Begeç, Zekine; Durmuş, MahmutÖz: Gebelik sırasında şizofreni, bipolar bozukluk gibi majör psikiyatrik durumların yönetimi zordur. Gebelikte ortaya çıkan katatoni, intihar davranışı ve ağır psikoz gibi ilaç tedavisine dirençli, yaşamı tehdit eden ciddi bulgular anne ve bebek sağlığını etkilemektedir. Bu durumlarda elektrokonvulsif tedavi (EKT) farmakolojik tedaviye alternatif bir yöntem olarak düşünülebilir. Bu olguda, major depresyon nedeniyle EKT uygulanan 13 haftalık gebenin anestezi yönetimini sunmayı amaçladık.Öğe İntraatriyal Anjiyosarkoma Bağlı Kardiyak Tamponat Gelişen Hastada Anestezi Yönetimi(2016) Özkan, Ahmet Selim; Kaçmaz, Osman; Akbaş, Sedat; Erdil, Feray; Durmuş, MahmutÖz: Anjiyosarkomlar ender görülen kardiyak tümörlerdir ve mortaliteleri yüksektir. Genelde nonspesifik bulgularla başvururlar ve agresif seyirlidirler. Kitlenin büyüklüğüne bağlı olarak sağ ventrikül dolumunun engellenmesi nedeniyle hemodinamik instabilite gelişebilir. Bu nedenle anestezi yönetimi özellik gösterir. Bu olgu sunumunda, sağ atriyal anjiyosarkoma bağlı kardiyak tamponad gelişen hastadaki anestezi yönetimi sunuldu.
