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Öğe Anaesthesia for Caesarean section in the presence of aortic coarctation [5](Greenwich Medical Media Ltd, 2002) Togal T.; Durmus M.; Koroglu A.; Demirbilek S.; Karaaslan K.; Ersoy O.[No abstract available]Öğe Carbon dioxide pneumothorax during laparoscopic surgery.(2002) Togal T.; Gulhas N.; Cicek M.; Teksan H.; Ersoy O.BACKGROUND: Anesthetic considerations for laparoscopic cholecystectomy are similar to those for other laparoscopic procedures and result from the creation of a pneumoperitoneum by insufflation of carbon dioxide (CO 2) into the abdominal cavity. The resultant problems such as decreased functional residual capacity, increased airway pressure, hypercarbia, and circulatory impairment are well known [1]. The reported case is that of a healthy 45-yr-old man who underwent elective laparoscopic cholecystectomy under general anesthesia. As surgery proceeded he developed hypercapnia (arterial blood partial pressure of CO 2 [pCO] 2], 97.1 mmHg; extrapolated end-tidal CO 2 tension [P ETCO 2], 90 mmHg) and hypoxemia (partial pressure of oxygen [pO 2], 53.1 mmHg). The cause was attributed to absorption of CO 2 directly related to the surgical pneumoperitoneum. This report illustrates the diagnosis and management of an unusual case of CO 2 absorption, resulting in hypercapnia and hypoxemia, and a spontaneous recovery within 30 to 60 min without need of thoracentesis.Öğe Comparison of propofol and ketamine + propofol in the induction of anaesthesia for caesarean section(1997) Aydin O.N.; Ersoy O.; Ersepciler M.; Esmaoglu A.; Tercan E.; Boyaci A.The aim of the study is to investigate the effects of propofol and propofol + ketamine in the induction of anaesthesia for caesarean section on cardiovascular system in addition to adverse effects on newborn and the mother. Forty parturients aged between 18-35 years of ASA I or II were included in the study. Patients were randomly allocated into two groups: Group I (n = 20) received propofol 2.5 mg/kg IV while Group II (n = 20) received ketamine 0.5 mg/kg IV + propofol 1.5 mg/kg IV. Systolic, diastolic and mean, arterial pressures (SAP, DAP, MAP) and heart rate (HR) were recorded before induction and Immediately, 3 and 10 minutes following intubation. The duration from anaesthesia induction to delivery (I-D), from uterine incision to delivery (U-D) and APGAR scores at the first and fifth minutes were recorded. Awareness and discrimination abilities of the parturients were tested during and after the procedures. MAP decreased significantly immediately after the intubation while significant increases were observed at the 3 and 10th minutes. Group II revealed haemodynamic stability following induction and significant increases were recorded following and 3 minutes after intubation. There was a negative correlation between APGAR scores and I-D and U-D. Groups did not show significant differences with regard to awareness and discrimination abilities. Ketamine + propofol group provided better cardiovascular stability and the APGAR scores were higher in this group although not significant statistically. Ketamine and propofol were concluded to lessen cardiovascular side effects and to be of benefit.Öğe Dextrane 40 followed by cardiac arrest(2000) Turkoz A.; Gulcan O.; But A.K.; Hazar A.; Ersoy O.Anaphylactic reaction due to dextrane 40 is uncommon. A case of anaphylactic reaction followed by cardiac arrest after intravenous dextran 40 infusion in postoperative period is reported. In this case, Cardiopulmonary resuscitation was continued for 116 min after the cardiac arrest and the case was recovered completely. The possible etiology, manifestations, and management of the adverse drug reaction are discussed.Öğe Early detection of the turp syndrome [13](Lippincott Williams and Wilkins, 2000) Bakan N.; Gedik E.; Ersoy O.[No abstract available]Öğe Effect of spinal anaesthesia level on the dosage of sedation(1999) Turkoz A.; Togal T.; Toprak H.I.; Ersoy O.It is sometimes observed that the patients under high spinal anaesthesia (T3-6) alter their wakefulness and that the patients become drowsy without sedative drugs. In these cases, the dosages of the sedative drugs should be decrease if the sedative drugs necessary. We have tested whether sensory level of T8 may affect the susceptibility to the soporific effect of sedatives. ASA grade I, 63 male patients undergoing elective lower extremity surgery were randomized to receive either spinal anaesthesia with sedation (group I), or general anesthesia with sedation (group 2). Patients in group 1 were given a subarachnoid injection of 3.5 mL hyperbaric bupivacine and those patients who had a sensory blockade level of T8 after 10 min. were divided in to three subgroups consisting ten patients (group 1a, 1b, 1c) and the patients in group II were also divided into three subgroups of ten patients (group IIa, IIb, IIc). Propofol, thiopenthone and midazolam were given until patients' sedation score achieve '3' and then stopped. In group Ia patients were given thiopenthone at the rate of 40 mg/kg/hr and in group 1c, the patients were given midazolam 1 mg intravenously, every 30 seconds. In group IIa, b, c infusion of drugs were started as stated above till the sedation score of '3' then general anaesthesia were induced. In group I and group II, the dose of propofol administered until the patients sedation score of '3' was achieved was 78±12.9 (group 1a), 83.8±11.1 mg (group IIa) p>0.05, the dose of thiopenthone was 147.5±35.4 mg (group 1b), 152.0±39.4 mg (group IIb) (p>0.05) and the dose of midazolam was 5.7±1.0 mg (group 1c), 6.4±2.2 mg (group II) (p>0.05). Although all three drugs were used less in group I than in group 2, no significant differences were observed between the groups statistically. In conclusion it is not required to reduce the amount of sedative drugs in the patients having a T8 level spinal anaesthesia.Öğe Resistance to vecuronium in a patient with testicular feminization (Case report)(1999) Turkoz A.; Ersoy O.A 19 year old patient was diagnosed with testicular feminization. She was scheduled to undergo bilateral inguinal gonadectomy. All the preoperative laboratory tests were found to be normal except the elevated plasma testosterone and low plasma estrogen levels. In the operating room, the patient was intubated after following standard monitorization. Full return of train-of-four-twitches were observed at approximately five minutes after the surgical incisions. The total dose of vecuronium given over 90 minutes was 22 mg until the end of the operation. An investigation after the operation identified that the patients sister also had a similar operation a year earlier and high doses of vecuronium was used. The possible causes were carefully assessed, this case and her sister confirmed a possible interaction between vecuronium and testosterone.
