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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 Anesthetical approach in a patient undergoing beating heart coronary artery bypass surgery with adrenal insufficiency(Turkish Anaesthesiology and Intensive Care Society, 2008) Erdil F.; Begeç Z.; Öztürk E.; But A.K.; Nisano?lu V.; Ersoy M.Ö.Glucocorticoids were released with a high amount from adrenal cortex in physiological and surgical stress situations to supply homeostasis. But the patients who had adrenal insufficiency, as a result of anesthesia and surgical stress or the insufficiency in glucocorticoid treatment, life threating adrenal crisis can exist. In this case report, we discuss the successful anesthesia technique and cortisol treatment in a patient who underwent beating heart coronary artery bypass surgery with bilateral adrenalectomy surgery for Cushing Syndrome and who have been taken glucocorticoid treatment for several years.Öğe Antibacterial effectiveness of alkalinized ropivacaine and bupivacaine(2007) Begeç Z.; Gülhaş N.; Toprak H.I.; Erdil F.; Yetkin G.; Özean Ersoy M.Aim: We aimed to investigate the antibacterial effects of alkalinized ropivacaine and bupivacaine on the Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa Materials and Methods: In this study, solutions of bupivacaine 0.5%, ropivaeaine 0.2%, bupivakain 0.5%+NaHCO3, ropivakain 0.2%+NaHCO3 with bactorial cultures' E. coli, S. aureus and P. aeruginosa were used. Bacteria were grown on standard blood agar. Bacterial cultures were prepared in a density of 0.5 McFarlands units (10 8 efu ml-1) with sterile saline 0.9% and each bacterial solution was further diluted in Mueller-Hinton broth to obtain standard inocula (105 cfu ml-1). The tested solutions (2 ml) and controls (2 ml, physiological saline) were added to 2 ml of standard bacterial preparations. Aliquats (3 ml) were vortexed and pipetted into sterile polystyrene spectrophotometer cuvets and it was incubated at 37°C. The optical density at 540 nm was measured at 0, 3 and 6 h by spectrophotometer. Results: While hupivacaine inhibited the growth of S. aureus and E. coli at all measurements times, P. aeruginosa inhibited at only 6 h (p<0.05). Alkalinized bupivacaine inhibited the growth of S. aureus at 0 h and E. coli at 0 and 6 h (p<0.05). Antibacterial effects of hupivacaine on E. coli was significantly higher than alkalinized bupivacaine at 6h (p<0.05). While ropivaeaine more inhibited the growth of S. aureus at 0 and 3 h than alkalinized ropivauaine, alkalinized ropivacaine less inhibited it according to the control (p<0.05). While both ropivacainc and alkalinized ropivakain inhibited the growth of E. coli at 3 and 6 h, at 0 h only ropivacaine inhibited it (p<0.05). Ropivacaine and alkalinized ropivaeaine inhibited the growth of P. aeruginosa at 3 h (p<0.05). Conclusion: It has been determined that bupivacaine has antibacterial effect and alkalinization of bupivacaine does not change it, ropivacaine has poor antibacterial effect and it more reduced with alkalinization of ropivacaine.Öğe Effect of inhalation anesthesia in postoperative atrial fibrillation after coronary artery bypass surgery(2009) Erdil F.; Begeç Z.; Öztürk E.; But A.K.; Gedik E.; Ersoy M.Ö.Atrial fibrillation (AF) is an important rhytm problem which occurs in the ratio of 10-50 % after CABP. It is shown that the inhalation anaesthetics have important role on protection of cardiac function in the early postoperative period. The purpose of this study is searching the effects of the inhalation agents retrospectively on the frequency of AF which occur after CABG in the early postoperative period. Patients were assigned into three groups as isoflurane (Group I; n=260), sevoflurane (Group S; n=308) and desflurane (Group D; n=349) according to the inhalation anaesthetic administered. Continue ECG monitorization was performed to each patients who was hospitalizated in intensive care unit. Routine ECG monitorization was performed to the patients at just after the operation and in the postoperative 1st., 2nd. and 4th. days. The rhythm controls were assessed by the assistant doctors by palpitation of radial artery four times a day at service controls. ECG monitorization was performed to the suspected patients except this routine clinical assessment. It was recorded when AF was occurred. Atrial fibrillation occurred in a ratio of 11.8 % in the all cases. There was no difference between the groups for development of AF (Group D: 11.5 %, Group I: 12 %, Group S: 11.7 %, p>0.05). In our cases age, Euroscore, postoperative need for inotropic agents, periods for cross-clemping and perfusion were found as independent risk factors in the analyzing of multivariant risks for determining the risk factors (p<0.05). As a result; we think that the uses of sevoflurane, isoflurane and desflurane have similar effects on development of AF in the patients after CABP.Öğe Effects of dexmedetomidine and midazolam sedation on the haemodynamic response to epinephrine(Anestezi Dergisi, 2007) Erdil F.; But A.K.; Toprak H.I.; Öztürk E.; Ersoy M.Ö.Objective: The aim of our study is to evaluate the haemodynamic response of midazolam and dexmedetomidine sedation to local anaesthetic (LA) infiltration containing epinephrine and the analgesic effects and sedation during septoplasty operations. Methods: Dexmedetomidine (Group D; n:25) and midazolam (Group M; n:20) were given to patients as their sedation levels reached 3-4. The mean blood pressure (MBP), heart rate (HR), and visual analog scale (VAS) values were recorded preoperatively, after induction doses of sedation agents, after the infiltration of local anesthesia containing epinephrine and perioperatively. Postoperatively MBP and HR were recorded at 1, 2, 4, 6, 12, and 24 hours and the pain score of the patients was evaluated by VAS. Results: In group D, MBP after 10. minutes perioperatively, and HR after the dexmedetomidine induction, perioperatively at 20 and 30 minutes and postoperatively in the first hour were significantly lower when compared with the initial values (p<0.05). In group M, MBP after the induction and postoperatively at the 2nd hour was significantly lower when compared with the initial values, but HR was significantly increased after the induction, until the perioperative 30th minute (p<0.05). As for the evaluation of the groups: in group D, MBP till the perioperative 30th minute and postoperatively at 1, 4 and 24 hours, and HR between the end of induction and the perioperative 30th minute were significantly lower when compared with group M (p<0.05). Total diclophenac consumption was significantly lower and the time to the first analgesic requirement was also significantly longer in group D when compared with group M (p<0.05). Postoperative VAS values were significantly lower in group D when compared with group M. Conclusion: The results of our study showed that dexmedetomidine sedation could be preferred in septoplasty operations because of its beneficial effects on haemodynamic response after LA infiltration containing epinephrine and for its analgesic properties which is important in the postoperative period.Öğe The effects of solutions of hypertonic saline, hydraxyethyl starch and ringer lactate on hypotension before spinal or combined spinal epidural anesthesia in cesarean sections(AVES İbrahim KARA, 2007) Gülhaş N.; Kadir But A.; Köro?lu A.; Yapici E.; Erdil F.; Özean Ersoy M.Aim: We aimed to compare the effectiveness of different hydration fluids on prevention of maternal hypotension during spinal or combined spinal cpidural anaesthesia (CSEA). Materials and Methods: Sixty nine patients undergoing elective caesarcan section were included in the study. 3% Hypertonie saline solution (4 ml kg-1), 6% hydroxyethyl starch HES (5 mL kg -1) and lactated Ringer's solution (15 mL kg-1) were administered to Group HS (n=23), Group HES (n=23) and Group LR (n=23), respectively. The patients were performed CSEA with 0.5% hyperbaric bupivacainc 2.2 mL. For electrolyte measurements, serum samples were obtained before preloading the solutions and after CSEA, and from the umbilical cord after delivery. Results: There were no significant differences among the groups in the incidence of hypotension (in groups HS, HES, and LR, % 56, % 47, % 60, respectively) and the amount of ephedrine consumption. Maternal sodium, chloride and osmolarity values after preloading were higher in Group HS than in Group HES (p<0.05). Maternal glucose value after preloading was higher in Group LR than in Group HS and HES (p<0.05). Maternal potassium values were similar among groups. Sodium and nsmnlarity values of the umbilical cord were higher in Group HS than in Group HES and LR (p<0.05). The values of umbilical venous1 pH were similar among groups. Conclusion: Although the incidence of maternal hypotension and the amount of ephedrinc consumption were not different among the loading solutions, we hold the opinion that due to hypertonic saline may allow smaller preloading volume it may be an alternative.Öğe Induction of anaesthesia in coronary artery bypass graft surgery in elderly patients: Sevofluran-fentanyl versus midazolam-fentanyl(2006) But A.K.; Gedik E.; Yücel A.; Erdil F.; Nisano?lu V.; Durmuş M.; Ersoy M.Ö.We designed this study to compare the effects of sevoflurane-fentanyl and midazolam fentanyl during anesthetic induction in elderly patients in coronary artery bypass graft (CABG) surgery. Forty patients aged more than 65 years who underwent elective CABG surgery were included in this study. Anaesthesia was induced with sevoflurane 6% within 100% oxygen in Group S (n=20) and with midazolam, 0.2 mg kg-1, in Group M (n=20). Both techniques were supplemented by fentanyl, 5 ?g kg-1, and muscle relaxation was obtained with cis-atracurium, 0.1 mg kg-1. Time to loss of the consciousness, loss of eyelash reflex and intubation were recorded during induction in both of the groups. Heart rate and mean arterial blood pressure were recorded at baseline (T0), post-induction (T1), pre-intubation (T2), from the first minute with two-minute intervals for five minutes in post-intubation period (T3,T4,T5), post-incision (T6) and post-sternotomy (T7). Central venous pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index, systemic vascular resistance index, and pulmonary vascular resistance index were measured at T0, T1, T3, T6, and T7. Patient's satisfaction scores were obtained postoperatively. We concluded that inhalation induction with sevoflurane-fentanyl in elderly patients is fast, smooth and hemodynamically safe, similar to induction with intravenous agents in cardiac surgery.
