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Öğe Anaesthetic management of a phaeochromocytoma patient with aortic valve insufficiency(2002) But A.K.; Durmuş M.; Gedik E.; Karaaslan K.; Toprak H.I.; Ersoy M.O.Phaeochromocytoma is an uncommon neuroectodermic tumour of adrenal medulla. Additional cardiac problems make anaesthesia management of phaeochromocytoma more complicated. We aimed to present the anaesthetic management of phaeochromocytoma patient with aortic valve insufficiency (AVI). A 45 years-old, 65 kg, female patient with third degree of AVI was admitted for phaeochromocytoma surgery. Before surgery, she was pre-treated with phenoxybenzamine and nicardipine for a week. In the operation room, thoracic epidural analgesia was maintained with 10 mL 0.5% bupivacaine loading dose, followed by 5 mL 0.5% bapivacaine for every hour during surgery. Then anaesthesia was induced with midazolam, droperidol, fentanyl, vecuronium, metoprolol and lidocaine. High dose fentanyl anaesthesia with 0.5-1.5% isoflurane were preferred for maintenance of anaesthesia. Haemodynamic stability was obtained with this anaesthesia management with lower dose vasodilators until the resection of adrenal mass. After the resection, severe hypotension was controlled with inotropic agents. Surgery was completed uneventfully and patient was transferred to ICU. In phaeochromocytoma cases with AVI, we think that appropriate anaesthetic approach is the thoracal epidural analgesia and high dose fentanyl anaesthesia with support of vasodilatators or vasoactive agents.Öğe Anesthetic management of a patients with acute type A aortic dissection immediately after caesarean section(2012) Yücel A.; Gedik E.; Özgül Ü.; Erdo?an Kayhan G.; Koç E.; Erdil N.; Ersoy M.O.Acute aortic dissection is a disease which characterized by arterial wall separation, intimal dissection and hematoma. It has been seen half of dissections in women less than 40 yr of age occur during pregnancy, more commonly in the third trimester and postpartum period. Aortic dissection is a potentially risk factor for mother and baby during pregnancy. Ehlers-Danlos and Marfan's syndrome and number of pregnancy are associated with occurring of the aortic dissection. In this report, we discuss the management of anesthesia a patient with Marfanoid appearance who developed type A dissection of the aorta occurred 4 hours after elective Caeserean section.Öğe The comparison of hemodynamic effects of remifentanil or fentanyl addition to midazolam infusion for total intravenous anesthesia in coronary artery bypass surgery(2004) Köro?lu A.; Gedik E.; Gülhaş N.; Toprak H.I.; Karaaslan K.; Özcan Ersoy M.We aimed to determine the effects of remifentanil or fentanyl infusion with midazolam on response to endotracheal intubation, surgical stimulus and intraoperative hemodynamics in coronary artery bypass surgery. Anesthesia was induced with thiopental sodium 0.5-3 mg kg-1 and 2 ?g kg-1 remifentanil (Group R, n=31), or 15 ?g kg-1 fentanyl (Group F, n=29) in 60 cases included into the study. Anesthesia was maintained with 1 ?g kg-1 min-1 remifentanil in group R or 0.15 ?g kg-1 min-1 fentanyl in group F in addition to the midazolam infusion 0.15 mg kg-1 h-1. Mean arterial pressure (MAP), heart rate (HR) were recorded at 1, 3 and 5 min after intubation and surgical stimulus and 5 min intervals during surgery. Also time to intubation and complications were recorded. Heart rate was lower in group R after anesthesia induction. During opioid infusion both MAP and HR decreased more in group R than F. After skin incision, sternotomy and internal mamarian artery dissection MAP and HR were higher in group F than R. Hypertensive response to sternotomy, skin incision, internal mamarian artery dissection was less in group R than group F. Frequency of hypertension and requirement of nitroglycerin were lower in group R than group F during CPB. We concluded that thiopental sodium with remifentanil or fentanyl in anesthesia induction did not prevent the hypertensive response to intubation. However maintenance with remifentanil and midazolam infusion was more effective in preventing surgical stimuli.Öğe Comparison of the Fresh Gas Flows Adjusted to the Body Weights in Patients Undergoing Low Flow Anaesthesia Either with Isoflurane or Desflurane(2004) To?al T.; Ayas A.; Demirbilek S.; Gedik E.; Köro?lu A.; Karaaslan K.; Ersoy M.O.In this study, we aimed to examine the effects of fresh gas flow (FGF) adjusted to the body weight (10-20-30 mL kg-1 min-1) in patients undergoing low flow anesthesia either with isoflurane or desflurane on hemodynamics, body temperature, concentration of oxygen and anesthetic gases. Sixty ASA I-II adult patients undergoing elective surgical procedures were included into the study. Patients were randomly allocated into two basic groups to receive either isoflurane or desflurane. Then these basic groups were randomly divided into 3 sub-groups to receive 10, 20 or 30 mL k-1 min-1 FGF. After standard anesthetic induction and intubation, during the first 10 minutes, FGF was 4 L min-1 with isoflurane 1.5 % or desflurane 6 % in 50% oxygen and 50 % nitrous oxide. Then concentrations of isoflurane and desflurane were set as 2 % and 8 % respectively and FGF was adjusted according to the groups. Heart rate (HR), mean arterial pressure (MAP), SpO2, esophageal temperature, vaporizer settings, inspired and expired anesthetic concentrations were recorded at regular intervals throughout the study. Inspired and expired anesthetic concentrations were found to be decreased significantly in the 10 mL kg-1 min-1 flow groups when compared to the 20 and 30 mL kg-1 min-1 flow groups (p<0.05). The inspired oxygen concentration (FiO2) decreased parallel to the duration of anesthesia. Low FiO2 was observed in 2 cases in isoflurane group with 10 mL kg-1 min -1 flow and in 8 cases in desflurane group with 10 mL kg -1 min-1 flow (p<0.05). We concluded that, isoflurane and desflurane could be used safely with FGF of 10 and 20 mL kg-1 min-1 providing hemodynamic stability. However, there is was a risk of hypoxia in desflurane group with FGF of 10 mL kg-1 min -1. But, this can be prevented by increasing FiO2.Öğe Early detection of the turp syndrome [13](Lippincott Williams and Wilkins, 2000) Bakan N.; Gedik E.; Ersoy O.[No abstract available]Öğe The effect of ginger and ondansetron on nausea and vomiting after middle ear surgery(2003) Gülhaş N.; Durmuş M.; Köro?lu A.; Gedik E.; Noyan F.; Ersoy M.Ö.We aimed to compare the effects of orally administered ginger and ondansetron tablet on postoperative nausea and vomiting (PONV) in patients undergoing middle ear surgery. The patients received either 1gr Ginger [250 mg, 4 capsules (Group I, n=30)] with 30 mL water, ondansetron orally disintegrating tablet 8 mg with 30 mL water (Group II n=30) or only 30 mL water (Group III n=30) one hour before the operation in a randomized, double blind manner. The patients' nausea and vomiting episodes were evaluated between 0-1 th, 1-8th and 8-24th hour periods. Nausea occurred in 11 (36.6%), 2 (6.6%) and 3 (10%) patients during 0-1 hour and 6 (20%), 1 (3.3%) and 1 (3.3%) patients during 1-8 hour in Group I, II and, III, respectively. Nausea did not occurre in any patients during 8-24 hour. The incidence of nausea was significantly higher in Group I compared to Group II and III in 0-1 hour (p<0.05). In the first hour, vomiting occurred in 11 (36.6%), 2 (6.6%) and 3 (10%) patients in Group I, II and, III, respectively. 4 patients (13.3%) vomitted in Group I in 1-8 hours. None of the patients vomitted in Group II and III during this period. No patient vomitted during 8-24 hour period. The incidence of vomiting was significantly higher in the first hour in Group I when compared to Group II and III (p<0.05). We concluded that ondansetron orally disintegrating tablet does not change the incidence of PONV and Ginger increases PONV in middle ear surgery.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 The effect of oral clonidine on postoperative nausea and vomiting in children undergoing strabismus surgery(2001) Gülhaş N.; Türköz A.; Bayramlar H.; Durmuş M.; Gedik E.; Da?lio?lu M.C.; Ersoy M.Ö.We aimed to investigate the effect of oral clonidine on postoperatory nausea and vomiting (PONV) in forty patients who underwent strabismus surgery. Patients were divided into two groups in this randomized and double blind prospective study. In Group I (n=20), patients were orally administered 4 ?g/kg clonidine within 0.2 mL/kg apple juice one hour before surgery. Group II, the control Group, were given only apple juice in same volume. Anesthesia was induced by atropine 0.02 mg/kg, lidocaine 2 mg/kg, propofol 3 mg/kg and vecuronium 0.1 mg/kg. Sevoflurane 2 % and N20 60 % in oxygen 40 % was used for maintenance The nausea and vomiting episodes were scored from 0 to 3 as follows: score 0: no nausea-vomiting; score 1: only nausea; score 2: some nausea-vomiting not needed treatment; score 3: severe vomiting needing treatment (metoclopramide 0.15 mg/kg). Nausea and vomiting was observed in five children in Group I (25 %) and in 8 children in Group II (40 %) (p<0.05) in first 6 hours of postoperative period. During first 48 hours, the rate of nausea and vomiting increased to 8 (40 %) and 12 (60 %) children in Group I and II, respectively (p<0.05). There was no statistically significant difference between two groups at other intervals. In conclusion clonidine which is given orally preoperatively reduced the rate of PONV in children who underwent strabismus surgery.Öğe The effects of intra-operative low-dose dexmedetomidine infusion on postoperative pain in patients undergoing septorhinoplasty(Maney Publishing, 2006) Cicek M.; Yucel A.; Gedik E.; Sagir O.; But A.K.; Ersoy M.O.Study objective: To determine the effects of intra-operative low-dose dexmedetomidine infusion on postoperative morphine consumption, pain, sedation and patient satisfaction in patients undergoing septorhinoplasty. Method: Fifty adult patients were randomised to receive either dexmedetomidine (a loading dose of 1 ?g kg-1 for the first ten minutes and a maintenance dose of 0.2 ?g kg-1 h-1 afterwards, Group D) or 0.9% saline in the same manner (Group C) after induction of anaesthesia. At the end of the operation, the infusions were discontinued. After extubation, patient controlled analgesia was started intravenously. Results: Patients in Group D consumed 47% less morphine than patients in Group C during the first 24 h and had a lower cumulative morphine consumption at all times after starting patient controlled analgesia (7.08 mg vs. 8.56 mg at 2 h (p < 0.05), 10.84 mg vs. 14.0 mg at 4 h (p < 0.05), 13.56 mg vs. 18.28 mg at 6 h (p < 0.05) and 17.96 mg vs. 33.72 mg at 24 h (p < 0.05), respectively in Group D and Group C). Visual analogue scale scores for pain were higher at all times in Group C than in Group D (p < 0.05). Sedation scores were higher in Group D than in Group C at 30 min after starting patient controlled analgesia (p < 0.05). Patient satisfaction scores were higher at all times in Group D than in Group C (p < 0.05). Conclusions: Intra-operative low-dose dexmedetomidine infusion during septorhinoplasty decreases postoperative morphine consumption, provides effective postoperative pain relief and achieves better patient satisfaction without increased adverse effects. © 2006 VSP.Öğe The effects of lidocaine filled endotracheal tube cuff on extubation responses(2001) Durmuş M.; To?al T.; Türköz A.; Gedik E.; Özturk E.; Ersoy M.Ö.This study was undertaken to evaluate the effects of lidocaine and alcalinized lidocaine filled endotracheal tube cuffs on extubation responses. Thirty five patients of Asa class I-II undergoing elective surgery were included. They were randomly assigned into three groups. After tracheal intubation, the endotracheal tube cuff was filled with one of the following solutions: serum physiologic (group A, n:12), 4 % lidocaine (group B, n:12) and 4 % lidocaine 4 ml + 8.4 % NaHCO3 1 mL (group C, n:11). Changes in heart rate, systolic, mean and diastolic arterial pressures were measured before and 1.3 and 5 min after tracheal extubation. Side effects such as coughing, sore throat, laryngospasm, bronchospasm, nausea and vomiting was evaluated after tracheal extubation and in recovery period. There was no statistically significant difference between three groups regarding to hemodynamic changes and adverse effects. We concluded that filling the endothraceal tube cuff with lidocaine or alcalinized lidocaine can not affect the heart rate and blood pressure increase which are seen after extubation and can not reduce the frequency of other side effects.Öğe The Effects of Sevoflurane and Propofol on Induction, Maintenance and Recovery in Elderly Patients(2003) But A.K.; Durmuş M.; To?al T.; Gedik E.; Yücel A.; Özcan Ersoy M.In this study, we aimed to compare the effects of sevoflurane and propofol on induction, maintenance and recovery in elderly patients. Forty patients, ASA class I-II, more than 60 years of age, undergoing elective surgery that last between 2-4 hours were taken into the study. Anaesthesia was induced with 66 % N2O and 7 % sevoflurane in the group S (n=20) and 1-2 mg kg -1 propofol approximately within 30 seconds in the group P (n=20). In the two groups; loss of consciousness, loss of eyelid reflex, time to intubation, adverse effects during induction, heart rate (HR) and mean arterial pressure (MAP) after first, third and fifth minutes of induction were recorded. Maintenance of anaesthesia was provided with 66 % N2O and 1-4 % sevoflurane in group S, 2-10 mg kg -1 h-1 propofol and 66 % N2O in group P. HR and MAP values were determined after first minutes of intubation until the end of the operation. At the end of operation after discontinuation of anaesthetic agents, times to extubation, eye opening, verbal response, orientation and Aldrete score >8 were recorded. The only difference is that induction time was shorter significantly in the group P (p<0.05). Sevoflurane and propofol recovery times and postoperative complications were similar in ASA I-II, elderly cases undergoing elective surgery. Although its hypotensive effect was prominent, induction was faster with propofol. We concluded that both of sevoflurane and propofol can be used safely for ASA I-II elderly patients, if the dose of propofol decreased and given slowly.Öğe The Effects of The Alfentanil and Remifentanil on Haemodynamic Variables and Postoperative Recovery at Gynaecologic Laparoscopy(2003) Toprak H.I.; Köro?lu A.; Gülhaş N.; To?al T.; Gedik E.; Aslan Ü.; Ersoy M.Ö.Anaesthetic and surgical developments increase the interest to outpatient surgery. Remifentanil, a short acting opioid, is a good alternative to alfentanil for outpatient surgery. We aimed to compare the effects of the alfentanil and remifentanil on haemodynamic variables, postoperative recovery and complication incidence during desflurane used at gynaecologic laparoscopic procedures. Fourty-two patients were included to the study after approval by local ethic committee. After anaesthesia induction was performed by 2 mg kg -1 propofol and 0.1 mg kg-1 vecuronium, the patients were randomly allocated into two groups. In alfentanil group (group A), alfentanil was received 15 ?g kg-1 bolus followed by 1 ?g kg dk -1 until incision and then continued 0.5 ?g kg dk-1. In remifentanil group (group R), remifentanil was received 1 ?g kg -1 bolus followed by 0.5 ?g kg dk-1 until incision and then continued 0.25 ?g kg dk-1. Anaesthesia was maintained with desflurane 3-5 % volume with 40 % oxygen in air. Mechanical ventilation was adjusted to achieve ETCO2 pressure of 35-40 mmHg. Mean arterial pressure (MAP), heart rate (HR) and SpO2 were recorded 10 min intervals during operation and 15 min intervals for postoperative 90 min period. End of the operation, the times of spontaneous ventilation, eye opening, extubation and orientation, and visual analogue scores (VAS), time for Aldrete score >8, first analgesic used and vomiting-nausea were recorded. There were no significant differences in recovery profiles and complications between two groups. All MAP values and HR at the time of 10th, 20th, 30th min, before and after extubation were significantly higher in group A than the other group. In group A, although MAP values were significantly higher at 40th min, before and after extubation, HR values were significantly lower at 20th, 30th, 40th and 50th min compared with baseline values. In group R, MAP values except 40th min and after extubation were lower compared with baseline values. HR values except after extubation were lower compared with baseline value. VAS was lower significantly at postoperative 15th min in group R. In conclusion, remifentanil is a better choice in gynaecologic laparoscopic procedures for haemodynamic stability in balanced anaesthesia than alfentanil. When remifentanil used, postoperative analgesia should be performed before the end of the operation.Öğe Evaluation by train of four vecuronium induced neuromuscular block during sevoflurane and isoflurane anaesthesia(1999) Togal T.; Gedik E.; Ersoy M.O.Volatile anaesthetics enhance the action of neuromuscular blockade to various degrees, the purpose of the present study is to compare the effects of volatile anaesthetics (isoflurane and sevoflurane) on the onset time of the neuromuscular blockade by vecuronium. Following approval from the ethic committee, 20 ASA I-II patients of either sex, aged 17-61 years old, were scheduled for elective laparoscopic surgery. Patients were randomly allocated to two groups. While induction of anaesthesia was performed with thiopentone 6 mg/kg and vecuronium 0.07 mg/kg, fentanyl 1 ?g/kg, lidocaine 1 mg/kg and maintained by 66/33 % N2O/O2 and sevoflurane (1.7 %) group I and isoflurane (1.2 %) in group II. The EMG response of the adductor pollicis was monitored by TOF-Guard stimulator (Biometer) at 20s intervals after train of four (TOF) stimulation of the ulnar nerve. Following intubation, whenever T1 returned to 25 % control additional doses of vecuronium was given (0.02 mg/kg). Supramaximal stimuli, duration 0.2 miliseconds and frequency 2 Hz were delivered at 20 seconds intervals to the ulnar nerve. The onset time (T1 max), duration of block (T1 25 %), time to maximal block after the second dose (T2 max), duration of action of maintenance doses (T2 25 %) and recovery times (T2 75 % - 25 %) were the parameters measured. There were no statistical significant differences between two volatile anaesthetics effects. In conclusion the effects of sevoflurane are similar to those of isoflurane on the neuromuscular block produced by vecuronium.Öğe Identifying malnutrition with subjective global assessment in hospitalized elective surgical patients(2007) Çiçek M.; Gedik E.; Gülhaş N.; Do?an Z.; Ersoy M.Ö.Aim: Malnourished patients have longer hospitalization time, increased drug usage, less functional capacity and higher morbidity and mortality rates compared to well-nourished patients. It has been reported that American Society of Anesthesiologists physical status (ASA) evaluation is not suitable in 'estimating nutritional status and this should be evaluated seperately. In this study, the aim was to determine nutritional status of adult hospitalized elective surgical patients with Subjective Global Assessment during preanesthetic evaluation. In addition, patients' age and hospitalization time was evaluated before preanesthetic evaluation with regard to their nutritional status. Material and Method: A total of 450 adult patients from 9 departments were included in this study. Following preanesthetic evaluation, patients' nutritional evaluation were performed in accordance with Subjective Global Assessment. Results: Overall prevalence of malnutrition in adult hospitalized elective surgical patients was determined as 24.22 %. Highest risk of malnutrition was determined in cardiovascular (50.00 %), orthopedic (36.17 %) and general surgery (31.70 %) patients. Mean age and hospitalization time were significantly higher in malnourished patients when compared to well-nourished patients as determined in the preanesthesic evaluation (p<0.05). Conclusion: Overall prevalence of malnutrition in adult elective surgical patients was 24.22 %. The departments with highest rates of patients with malnutrition were Cardiovascular Surgery, Orthopedic Surgery and General Surgery. In addition, it was concluded that malnourished patients tended to have higher mean age and a longer mean hospitalization time before preanesthesic evaluation.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.Öğe Intensive care admission in patients with hellp syndrome in a tertiary referral hospital(SpringerOpen, 2015) Gedik E.; Yücel N.; Sahin T.; Koca E.; Çolak Y.Z.; Togal T.[No abstract available]Öğe Life-threatening poisoning associated with datura stramonium: Case report(Turkiye Klinikleri, 2014) Biçakcioğlu M.; Gedik E.; Şayan H.; Gök A.; Toğal T.In this case report, seven patients who poisoned after eating the plant Datura stramonium are presented. Datura stramonium is an hallucinogenic plant that can be found easily, and includes a quite anticholinergic agent. Central and peripheral anticholinergic effects may result in after eating the plant. Our patients presented to the emergency department with nausea, vomiting, agitation, visual hallucinations, blurred vision, and meaningless conversations. On physical examination tachycardia, flushing, mydriasis, and delirium were present. Nasogastric tube, gastric lavage and activated charcoal were administered to the patients. Two cases were taken into the intensive care unit. One of the patients with respiratory distress and delirium was intubated. © 2014 by Türkiye Klinikleri.Öğe Performance of size 1 I-gel compared with size 1 ProSeal laryngeal mask in anesthetized infants and neonates(Hindawi Publishing Corporation, 2015) Kayhan G.E.; Begec Z.; Sanli M.; Gedik E.; Durmus M.Purpose. The size 1 I-gel, recommended for small infants and neonates weighing 2-5 kg, has recently been released. There are no prospective studies available that assess the insertion conditions, sealing pressures, or ventilation quality of it. This study was designed to compare the performance of recently released size 1 I-gel with size 1 ProSeal LMA. Methods. Fifty infants and neonates, ASA I-II were included in this prospective, randomized, and controlled study. Patients were divided into two groups for placing I-gel or ProSeal LMA. The primary outcome was airway leak pressure, and secondary outcomes included insertion time, insertion success and conditions, initial airway quality, fiberoptic view of the larynx, and complications. Results. There were no significant differences in terms of airway leak pressure between the I-gel (27.44 ± 5.67) and ProSeal LMA (23.52 ± 8.15) (P = 0.054). The insertion time for the I-gel was shorter (12.6 ± 2.19 s) than for the ProSeal LMA (24.2 ± 6.059 s) (P = 0.0001). Insertion success and conditions were similar in groups. We encountered few complications. Conclusion. Our study demonstrates that the size 1 I-gel provided an effective and satisfactory airway as the size 1 ProSeal LMA. It may be a good alternative supraglottic airway device for use in small infants and neonates. This trial is registered with: ClinicalTrials.gov NCT01704118. © 2015 Gulay Erdogan Kayhan et al.Öğe A pneumonia case caused by Cedecea Lapagei(2008) Yetkin G.; Ay S.; Kayabaş Ü.; Gedik E.; Güçlüer N.; Çalişkan A.Cedecea spp. which are the members of Enterobacterioceae family, are mostly isolated from sputum and their clinical importance is not yet demonstrated. This report presents a pneumonia case caused by Cedecea lapagei. A 38-years-old male patient admitted to Inonu University Faculty of Medicine Emergency department with prediagnosis of subarachnoid haemorrhage was operated and transferred to Intensive Care Unit of Reanimation where he underwent artificial ventilation. On the third day of hospitalization his temperature was 39°C, white blood cell count was 27.000/ml and he was still unconscious. He had a history of chronic obstructive pulmonary disease. Chest X-ray revealed opacities in the right lower lobe and mucoid tracheal secretion ensued following tracheal entubation performed after operation. Direct microscopic examination of bronchoalveolar lavage (BAL) fluid yielded abundant number of leukocytes and gram-negative bacilli. Bacteria isolated from BAL specimen were identified as Clopagei y Phoenix 100 (Becton Dickinson, USA) automated system and also by API 20E kit (Biomerieux, France). Upon the initiation of intravenous amikacin (1 × 1 g) and meropenern (3 × 1 9), the signs of infection decreased in intensity, however, the patient was lost due to subarachnoid hemorrhage on the 12th day of hospitalization. In this case it was estimated that C.lapagei pneumonia originated from the aspiration of upper airway secretion owing to unconsciousness of the patient. Although there were reports of Cedecea infections in the literature, this was 14 first documented case of C.lapagei pneumonia when the accessible related literature was concerned.Öğe Pregnancy and lightning strike (case report)(2006) Borazan H.; Gedik E.; Çiçek M.; Ülger H.; Ersoy Ö.It is estimated that lightning strikes kill nearly 1000 people per year worldwide, but 70% of these injuries have good survival rates and are not fatal. There are three mechanisms in lightning strikes: a direct strike, (most often fatal of causing severe injuries), current deflection from a tree or other tall object, or current transfer from the ground to the lower extremity of the body. In this case report, the clinical diagnosis and subsequent management of a 29 year-old 28 week pregnant woman who had been exposed to a lightning strike while working in the open field are described.
