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Öğe Airway management using the ProSeal™ laryngeal mask airway in a child with Goldenhar syndrome(Verduci Publisher, 2012) Aydogan, M. S.; Begec, Z.; Erdogan, M. A.; Yucel, A.; Ersoy, M. O.Children with congenital anomalies such as Goldenhar syndrome affecting the airway can be a problem for the anaesthesiologist. We present the case of an 18 month-old child with Goldenhar syndrome, in whom the ProSeal (TM) Laryngeal Mask Airway was successfully used for inguinal hernia surgery.Öğe Bispectral Index Monitoring to Guide End-Tidal Isoflurane Concentration at Three Phases of Operation in Patients With End-Stage Liver Disease Undergoing Orthotopic Liver Transplantation(Elsevier Science Inc, 2011) Toprak, H. I.; Sener, A.; Gedik, E.; Ucar, M.; Karahan, K.; Aydogan, M. S.; Ersoy, M. O.It has been shown that anesthetic requirements during liver transplantation are inversely proportional to the degree of hepatic dysfunction. We investigate alterations during the three phases of requirements for intraoperative isoflurane within the target of 40 to 55 Bispectral Index (BIS) values concerning patients with end-stage liver disease who are undergoing liver transplantation. After faculty ethics committee approval, we studied 50 patients of (age range, 18 to 65 years) who were undergoing liver transplantation. After induction, we used isoflurane with air/oxygen (FiO(2) = 0.5%) for anesthestic maintenance. The isoflurane concentration was set within the range of 40 to 55 BIS values. Remifentanil (0.15 mu g/kg/min) was infused for analgesia and cisatracurium was administered via continuous infusion. After anesthetic induction, we inserted arterial, pulmonary artery, and central venous catheters. The heart rate, mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), body temperature, BIS values, end-tidal isoflurane concentration (ETiso) and end-tidal carbon dioxide concentration (ETCO(2)) were recorded at 30-minute intervals during the dissection and neohepatic phases, at 15-minute intervals during the anhepatic phase. In addition, we calculated the cardiac index during the three phases. There was no difference in heart rates among the operative phases. In contrast, there were significant changes in MAP, MPAP, BIS, ETCO(2) and body temperature values. However, all of these parameters were in physiological ranges and clinically acceptable. The ETiso values were lowest in the anhepatic phase compared to other phases, but the differences were not clinically important. The ETiso values in the dissection and neohepatic phases were compared with the anhepatic phase higher 5% and 8.6% respectively. During liver transplantation, ETiso requirement for the anhepatic phase was lower compared with the other two phases within the range of 40 to 55 BIS values.Öğe The comparative effects of sevoflurane and propofol for electroconvulsive therapy(Lippincott Williams & Wilkins, 2004) Toprak, H. I.; Gedik, E.; Ozpolat, Z.; Ozturk, E.; Kaya, B.; Ersoy, M. O.[Abstract Not Available]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 Dexmedetomidine in children requiring sedation for magnetic resonance imaging: preliminary results(Lippincott Williams & Wilkins, 2004) Koroglu, A.; Demirbilek, S.; Teksan, H.; But, A. K.; Ersoy, M. O.[Abstract Not Available]Öğe Effects of Desflurane and Isoflurane on Hepatic and Renal Functions and Coagulation Profile During Donor Hepatectomy(Elsevier Science Inc, 2012) Toprak, H. I.; Sahin, T.; Aslan, S.; Karahan, K.; Sanli, M.; Ersoy, M. O.We compared the effect of two inhalation anesthetics desflurane and isoflurane on postoperative hepatic and renal functions as well as coagulation profiles in living donors undergoing right hepatectomy. This study was performed on 80 patients who were randomly allocated to group D (desflurane, n = 40) or group I (isoflurane, n = 40) after Faculty Ethics Committee approval. After induction, isoflurane or desflurane was used with air/oxygen for anesthetic maintenance. The isoflurane or desflurane concentration was set at one minimum alveolar concentration (MAC). Remifentanil was infused for analgesia as well as cisatracurium. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), international normalized. ratio (INR), albumin, total bilirubin, blood urea nitrogen, creatinine, platelet count, and hemoglobin levels were analyzed preoperatively at end of the operation, and on postoperative days (PODs) 1, 2, 3, 5, 7, and 30. Both AST and ALT differed significantly and continually except on POD 30. AST showed significant elevations from the end of the operation to POD 2 and ALT, from the end of the operation to POD 5 in group I compared with group D. INR was significantly higher from the end of the operation to POD 3 in group I and to POD 2 in group D. At the end of the operation as well as on POD 1 and POD 2, INR was significantly increased in group I compared with group D. Albumin level was significantly lower at the end of the operation in both groups, but it was not different. No patient developed hepatic or renal failure. Our study showed better postoperative hepatic tests and INR using desflurane than isoflurane at equivalent. doses of 1 MAC in living donors undergoing right hepatectomy.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 ephedrine on maternal hypothermia in caesarean sections: a double blind randomized clinical trial(Verduci Publisher, 2013) Gulhas, N.; Tekdemir, D.; Durmus, M.; Yucel, A.; Erdil, F. A.; Yologlu, S.; Ersoy, M. O.BACKGROUND: The purpose of the study was to investigate the effect of bolus and the combination of bolus and infusion of ephedrine on maternal hypotermia which are used for treating maternal hypotension under spinal anaesthesia. PATIENTS AND METHODS: 110 ASA I-II patients who developed maternal hypotension were included into the study. Spinal anaesthesia was performed with 12.5 mg heavy bupivacaine + 15 mu g fentanyl. Group I: Ephedrine bolus 5 mg plus ephedrine infusion, Group B: Ephedrine bolus 5 mg plus normal saline infusion. The systolic blood pressure was allowed to range between 20% from baseline values. Ephedrine solution infusion started after hypotension occurred (0.5 mg/minute). The body temperature under 35.5 degrees C was accepted as hypothermia. The newborns' rectal temperature was measured. Moreover, the Apgar scores, umbilical vein-arterial blood gas and acid-base status were evaluated. RESULTS: In Group I, the body core temperatures which were measured at 9, 18, 33, and 39th minutes were significantly higher than Group B (p < 0.05). The prevalence of maternal hypothermia in Group I was significantly lower than the Group B, which were as 65.5% (36/55) and 85.5% (47/55), respectively (p < 0.05). In Group I, the newborn rectal temperatures and the total dose of ephedrine were significantly higher than Group B (p < 0.05). In Group I, the systolic and mean blood pressures were higher than Group B (p < 0.05). CONCLUSIONS: As a result, we found that combined bolus and infusion of ephedrine for treating maternal hypotension prevents maternal and neonatal hypothermia during caesarean section under spinal anaesthesia compared to bolus administrations alone.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 Ketofol (mixture of ketamine and propofol) administration in electroconvulsive therapy(Australian Soc Anaesthetists, 2012) Kayhan, G. Erdogan; Yucel, A.; Colak, Y. Z.; Ozgul, U.; Yologlu, S.; Karlidag, R.; Ersoy, M. O.The aim of this study was to evaluate the effect of a ketamine:propofol combination ('ketofol') for electroconvulsive therapy on seizure activity, haemodynamic response and recovery parameters, and to compare with these with the effects of propofol alone. Twenty-four patients underwent a total of 144 electroconvulsive therapy sessions, allocated in this prospective, double-blind, crossover study. Patients were randomly assigned to receive 1 mg/kg ketofol (0.5 mg/kg propofol plus 0.5 mg/kg ketamine) or 1 mg/kg propofol 1% for anaesthesia induction. Seizure duration and quality, haemodynamic data, recovery parameters and side-effects were recorded and analysed between groups. Both motor and electroencephalography seizure durations in the ketofol group (29 +/- 17 and 41 +/- 17 seconds, respectively) were similar to that in the propofol group (28 +/- 13 and 38 +/- 16 seconds, respectively). Postictal suppression index was higher in the ketofol group (89.63 +/- 7.88) than in the propofol group (79.74 +/- 14.6) (P <0.05). In the ketofol group, heart rate after the seizure ended and mean arterial pressures, recorded at 0 and 5 minutes after the seizure ended, were higher than in the propofol group. Time to obeying commands was longer in the ketofol group (P <0.05). There were no untoward psychological reactions following ketofol. Although no superiority to propofol in terms of seizure duration, haemodynamic or recovery parameters was found, the ketofol mixture selected in our study provided better seizure quality than propofol. We conclude that ketofol can be an alternative strategy to enhance the seizure quality and clinical efficiency of electroconvulsive therapy.Öğe Single intrathecal fentanyl for combined spinal epidural anesthesia confers no advantage over hemodynamic effects in elderly patients(Verduci Publisher, 2012) Yucel, A.; Gulhas, N.; Aydogan, M. S.; Erdogan, M. A.; Beytur, A.; Tasdemir, C.; Ersoy, M. O.Background: Neuroaxial blockade for ambulatory transurethral resection of the prostate is a well established technique. Patients in this group are often at high risk for perioperative complications from concurrent diseases. The purpose of this study was to compare the elderly patients who received intrathecal fentanyl alone or intrathecal fentanyl plus bupivacaine or epidural anesthesia for transurethral resection of prostate surgery. Material and Methods: Ninety-nine patients were prospectively randomized to receive fentanyl 25 mu g (Group F), fentanyl 25 mu g plus hyperbaric bupivacaine 2.5 mg (Group BF), or epidural anesthesia adding fentanyl 50 mu g (Group E) by combined spinal epidural anesthesia technique. Results: The amount of local anesthetics used until when the sensorial block reached the level of T10 was significantly lower in the Group BF than in the Group E and the Group F (p < 0.001). Maximum level of sensory block was significantly lower in the Group BF than in the Group E and the Group F (p = 0.01). The time elapsed until the sensory block reached T10, the regression of sensory block to L5 level were significantly lower in the Group BF than in the Group E and the Group F (p = 0.005, p < 0.001, respectively). Compared to the basal values, mean arterial pressures were significantly lower in the Group BF than in the Group E and the Group F (p < 0.05). The occurrence of hypotension was significantly lower in the Group BF (9.4%) than in the Group E (18.2%) and the Group F (24.2%). Conclusions: Intrathecal hyperbaric bupivacaine 2.5 mg plus fentanyl 25 mu g administration provides shorter motor block onset time, less local anesthetic usage and adequate hemodynamic stability in elderly patients.Öğe Tracheal intubation without muscle relaxant after induction with remifentanil, S-ketamine and propofol(Lippincott Williams & Wilkins, 2004) Demirbilek, S.; Togal, T.; Gulhas, N.; Ozpolat, Z.; Dogan, Z.; Demir, K.; Ersoy, M. O.[Abstract Not Available]
