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Öğe Anesthesia Management in A Case with Prader-Willi Syndrome(2023) Tunç, Yeliz; Karaaslan, Erol; Özkan, Ahmet SelimPrader Willi (PWS) is the most common and rare genetic cause of obesity. Airway problems associated with obesity and hypotonia, increased risk of aspiration due to gastrointestinal (GI) motility and hyperphagia, obstructive sleep apnea syndrome (OSAS), difficult airway management, and postoperative respiratory failure risk due to narrow airway are the factors that complicate anesthesia management. It should be noted that there are many anatomical and physiological factors that may adversely affect perioperative anesthesia management in patients with PWS. For this reason, preoperative anesthesia evaluation and all preparations should be performed completely.Öğe Anesthesia management of open tracheostomy patients: A single center experience(2019) Karaaslan, Erol; Yalin, Mehmet RidvanAbstract: The purpose of the present study of ours was to evaluate anesthesia management and complications in open technique tracheostomy cases. This study was conducted in 105 patients who underwent tracheostomy. The patients were retrospectively screened. The demographic data, anesthesia management, length of hospital stay, Intensive Care Unit stay, mortality, perioperative, postoperative, and early complications of the patients were evaluated. The average age of the patients was 20-91 (60±14.92) years. ASA scores were as follows: 54 cases (51.4%) were ASA II; 45 cases (42.8%) were ASA III; and 6 cases (5.7%) were ASA IV. The most common complaints of the patients were as follows: Head-neck tumor in 75 cases (71.4%). The anesthesia methods were as follows: General anesthesia in 92 cases (87.6%), and sedoanalgesia in 13 cases (12.4%). The most common complications were as follows: Bleeding in 5 patients (4.7%) in the perioperative period; and respiratory failure in 19 patients (18.1%) in the postoperative period. Postoperative mortality was seen in 6 cases (5.7%). There was a statistically significant difference between the mortality rates, hospital stay, and age (P: 0.008) (P<0.0001). In the present study of ours, it was shown that hospital stay and age factor had a significant effect on mortality in tracheostomy cases. We believe that sedoanalgesia, which preservesÖğe The clinical and histopathological effects of perineural dexmedetomidine in combination with bupivacaine in sciatic nerve block in rabbits undergoing sevoflurane anesthesia(2022) Sevimli, Reşit; Akbaş, Sedat; Karaaslan, Erol; Özkan, Ahmet SelimMany drugs or additives have been tried as adjuvants in the blocking of nerve blocks with local anesthetics, and it is aimed to increase the duration of action and analgesia quality of local anesthetics in this way. In this study, we aimed to see the adjuvant efficacy of Dexmedetomidine [Dex] added to bupivacaine and its effect on analgesia and histopathological effects in rabbits by administering sevoflurane anesthesia. Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham [0.5 ml saline], Group B: perineural bupivacaine [0.5 mg/kg] [0.5 ml] and Group BD: perineural bupivacaine [0.5 mg/kg] combined with Dex [20 µr/kg] [0.5 ml]. Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades also were recorded at baseline, 30, 60, 90, and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. In the hot-plate test applied for the measurement of acute thermal pain; when compared to Group S, significant prolongation was found in Group B and Group BD at 0, 30, 60, 90, and 120 minutes [p<0.05]. When Group BD was compared with Group B, a significant prolongation was found at 60 minutes [p=0.012]. No significant difference was found in other times. No significant differences were found between the groups in sensory and motor block tests. In the BD group, compared to the B group, edema and inflammation in the epineurium and surrounding tissues were significantly reduced on the 1st day [p<0.05]. On the 14th day, there was no difference in terms of edema. In rabbits administered sevoflurane anesthesia, the mixture of bupivacaine and Dex applied to provide analgesia in the application of sciatic block prolongs the delay time and increases the quality of analgesia in the hot-plate test evaluating acute thermal pain. Dex added to bupivacaine contributed positively when the analyzed histopathological parameters were evaluated.Öğe The clinical and histopathological effects of perineural dexmedetomidine in combinationwith bupivacaine in sciatic nerve block in rabbits undergoing sevoflurane anesthesia(2022) Özkan, Ahmet Selim; Akbaş, Sedat; Sevimli, Reşit; Alan, Saadet; Karaaslan, ErolMany drugs or additives have been tried as adjuvants in the blocking of nerve blocks with local anesthetics, and it is aimed to increase the duration of action and analgesia quality of local anesthetics in this way. In this study, we aimed to see the adjuvant efficacy of Dexmedetomidine [Dex] added to bupivacaine and its effect on analgesia and histopathological effects in rabbits by administering sevoflurane anesthesia. Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham [0.5 ml saline], Group B: perineural bupivacaine [0.5 mg/kg] [0.5 ml] and Group BD: perineural bupivacaine [0.5 mg/kg] combined with Dex [20 µr/kg] [0.5 ml]. Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades also were recorded at baseline, 30, 60, 90, and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. In the hot-plate test applied for the measurement of acute thermal pain; when compared to Group S, significant prolongation was found in Group B and Group BD at 0, 30, 60, 90, and 120 minutes [p<0.05]. When Group BD was compared with Group B, a significant prolongation was found at 60 minutes [p=0.012]. No significant difference was found in other times. No significant differences were found between the groups in sensory and motor block tests. In the BD group, compared to the B group, edema and inflammation in the epineurium and surrounding tissues were significantly reduced on the 1st day [p<0.05]. On the 14th day, there was no difference in terms of edema. In rabbits administered sevoflurane anesthesia, the mixture of bupivacaine and Dex applied to provide analgesia in the application of sciatic block prolongs the delay time and increases the quality of analgesia in the hot-plate test evaluating acute thermal pain. Dex added to bupivacaine contributed positively when the analyzed histopathological parameters were evaluated.Öğe The comparison of effects of thiopental and ketofol on emergence agitation in patients with nasal surgery: A prospective, single-blind, randomized clinical trial(2020) Karaaslan, Erol; Güldoğan, EmekAbstract: Aim: Emergence agitation (EA) is a postanesthetic phenomenon that is common in patients who undergo nasal surgery with general anesthesia, which manifests itself with confusion and violent behaviors and may cause serious problems such as bleeding in the surgical site, unplanned removal of catheter or endotracheal tube. In this study, we aimed to compare the effect of thiopental and ketofol on EA formation after nasal surgery. Material and Methods: This study was performed as a prospective, randomized, single-blind, clinical trial in 80 patients undergoing nasal surgery. The patients were randomly divided into two groups as thiopental (group P: 40) and ketofol (group K: 40). As the primary outcome; Riker Sedation Agitation Scale (RSAS) was used in order to evaluate EA at the 5th minute after extubation. As the secondary outcome; we aimed to evaluate predisposing factors causing EA. Results: The mean age of the patients was 38.55±13.12 in Group P, while it was 40.68±11.88 in Group K. The incidence of emergence agitation (EA) was significantly higher in Group P than in Group K. There was a statistically significant difference between the two groups (Group P: 12 cases (30%), Group K: 1 case (2.5%), P: 0.001). Residual sedation values in PACU were similar in both groups (P: 0.248). The duration of stay in PACU was significantly lower in Group P (P: <0.001). Duration of anesthesia, duration of surgery, time to extubation and time to verbal response times were similar in both groups. There was no statistically significant difference between the groups. Conclusion: In patients who underwent nasal surgery under general anesthesia; using ketofol instead of thiopental can significantly reduce EA.Öğe The comparison of effects of thiopental and ketofol on emergence agitation in patients with nasal surgery: A prospective, single-blind, randomized clinical trial(2020) Guldogan, Emek; Karaaslan, ErolAim: Emergence agitation (EA) is a postanesthetic phenomenon that is common in patients who undergo nasal surgery with general anesthesia, which manifests itself with confusion and violent behaviors and may cause serious problems such as bleeding in the surgical site, unplanned removal of catheter or endotracheal tube. In this study, we aimed to compare the effect of thiopental and ketofol on EA formation after nasal surgery.Material and Methods: This study was performed as a prospective, randomized, single-blind, clinical trial in 80 patients undergoing nasal surgery. The patients were randomly divided into two groups as thiopental (group P:40) and ketofol (group K:40). As the primary outcome; Riker Sedation Agitation Scale (RSAS) was used in order to evaluate EA at the 5th minute after extubation. As the secondary outcome; we aimed to evaluate predisposing factors causing EA.Results: The mean age of the patients was 38.55±13.12 in Group P, while it was 40.68±11.88 in Group K. The incidence of emergence agitation (EA) was significantly higher in Group P than in Group K. There was a statistically significant difference between the two groups (Group P:12 cases (30%), Group K:1 case (2.5%), P:0.001). Residual sedation values in PACU were similar in both groups (P:0.248). The duration of stay in PACU was significantly lower in Group P (P:0.001). Duration of anesthesia, duration of surgery, time to extubation and time to verbal response times were similar in both groups. There was no statistically significant difference between the groups.Conclusion: In patients who underwent nasal surgery under general anesthesia; using ketofol instead of thiopental can significantly reduce EA.Öğe A comparison of laryngeal mask airway-supreme and endotracheal tube use with respect to airway protection in patients undergoing septoplasty: a randomized, single-blind, controlled clinical trial(Bmc, 2021) Karaaslan, Erol; Akbas, Sedat; Ozkan, Ahmet Selim; Colak, Cemil; Begec, ZekineBackground There are doubts among anesthesiologists on the use of the Laryngeal Mask Airway (LMA) in nasal surgeries because of concerns about the occurrence of blood leakages to the airway. We hypothesized that the use of LMA-Supreme (LMA-S) in nasal surgery is comparable with endotracheal tube (ETT) according to airway protection against blood leakage through the fiberoptic bronchoscopy, oropharyngeal leakage pressure (OLP), heart rate (HR), mean arterial pressure (MAP), and postoperative adverse events. Methods The present study was conducted in a prospective, randomized, single-blind, controlled manner on 80 patients, who underwent septoplasty procedures under general anesthesia, after dividing them randomly into two groups according to the device used (LMA-S or ETT). The presence of blood in the airway (glottis/trachea, distal trachea) was analyzed with the fiberoptic bronchoscope and a four-point scale. Both groups were evaluated for OLP; HR; MAP; postoperative sore throat, nausea, and vomiting; dysphagia; and dysphonia. Results In the fiberoptic evaluation of the airway postoperatively, less blood leakage was detected in both anatomic areas in the LMA-S group than in the ETT group (glottis/trachea, p = 0.004; distal trachea, p = 0.034). Sore throat was detected less frequently in the LMA-S group at a significant level in the 2nd, 6th, and 12th hours of postoperative period; however, other adverse events were similar in both groups. Hemodynamic parameters were not different between the two groups. Conclusion The present findings demonstrate that the LMA-S provided more effective airway protection than the ETT in preventing blood leakage in the septoplasty procedures. We believe that the LMA-S can be used safely and as an alternative to the ETT in septoplasty cases.Öğe A Comparison of McGrath MAC Versus C-MAC Videolaryngoscopes in Morbidly Obese Patients Undergoing Bariatric Surgery: A Randomized, Controlled Clinical Trial(Mary Ann Liebert, Inc, 2019) Akbas, Sedat; Ozkan, Ahmet Selim; Karaaslan, ErolIntroduction: Airway management in morbidly obese patients is a technical challenge for the anesthesiologists. In this study, we aimed to compare the McGrath MAC with C-MAC videolaryngoscopes for tracheal intubation in morbidly obese patients. Materials and Methods: Eighty morbidly obese patients, scheduled for bariatric surgery, were randomly allocated to two study groups: McGrath-MACA (R) and C-MACA (R). The preoperative airway assessment, incidence and attempts for successful intubation, time to intubation, position for successful intubation, percentage of glottic opening (POGO score), ease of intubation, hemodynamic response, and adverse events of tracheal intubation were recorded. Results: Incidence and attempts for successful intubation and position for successful intubation were similar. Time to intubation was significantly shorter in C-MAC than McGrath (p < 0.001). The POGO scores were similar in both groups (p = 0.057). The heart rate and mean arterial pressure of McGrath was significantly higher than C-MAC after tracheal intubation at first minute (p = 0.002). Also adverse events of tracheal intubation were similar. Conclusions: Both devices were efficient and improved the glottic view. However, the C-MAC demonstrated shorter tracheal intubation times, better glottic visualization, and less hemodynamic response than the McGrath. We, therefore, conclude that the C-MAC videolaryngoscope may contribute advantages in performing tracheal intubations in morbidly obese patients.Öğe Comparison of the effects of direct laryngoscopy and fiberoptic oral endotracheal intubation on the intraocular pressures of non-ophthalmic patients: A prospective, randomised, clinical trial(2022) Yıldırım, Sait; Akbaş, Sedat; Durmus, Mahmut; Özkan, Ahmet Selim; Karaaslan, Erol; Polat, Nihat; Mutlu, KayhanAbstract Aim: In this prospective, randomised, clinical study; we aimed to compare the effects of endotracheal intubation (ETI) via direct laryngoscope (DLS) and fiberoptic bronchoscope (FOB) on intraocular pressure (IOP) and hemodynamic data of non-ophthalmic patients. Materials and Methods: Fifty-four adult patients undergoing non-ophthalmic surgeries performed in the supine position under general anesthesia requiring orotracheal intubation were included into the study. The patients were randomly and prospectively divided into 2 groups: Group DLS (n=27) and Group FOB (n=27). Mean arterial pressure (MAP), Heart rate (HR), IOP were measured at before induction (basal), post-induction and 1st, 2nd, 3rd, and 5th minutes of intubation. Results: There was no statistically significant difference in distribution of patient characteristics. Duration of intubation was significantly longer in Group FOB (p<0.001). There was no statistically significant difference in MAP and HR when groups compared each other. Statistically significant increase was found in IOP at 1st minute of intubation in Group DLS when compared with Group FOB (p<0.001). No significant difference was found in terms of IOP in other time periods. Conclusion: We thought that endotracheal intubation by FOB could be more useful with respect to endotracheal intubation by DLS in patients with high IOP due to significantly less rise caused in IOP when performed by experienced anesthesiologists.Öğe Comparison of the effects of supreme laryngeal mask airway and endotracheal tube on airway reflexes in patients who underwent nasal surgery: A randomized, controlled clinical trial(2019) Karaaslan, ErolAim: The primary purpose of this study was to compare the effects of supreme laryngeal mask airway (SLMA) and endotracheal tube(ETT) on (laryngospasm, bronchospasm, cough, desaturation) airway reflexes in patients who undergo nasal surgery. The secondarypurpose was to evaluate the hemodynamic responses in this respect.Material and Methods: The study was conducted as a prospective, randomized, single blind and controlled clinical trial in 92 patientsbetween the ages of 18 and 65 for whom elective nasal surgery was planned, who volunteered for the study and who were AmericanSociety of Anaesthesiologists (ASA) I-II group. The patients were divided randomly into two groups as the supreme laryngeal mask(SLMA Group, n = 46), and the endotracheal tube (ETT Group, n = 46). The laryngospasm, bronchospasm, cough, desaturation (SpO2?90) and hemodynamic parameters were evaluated after the extubation (T1) 5th and (T2) 60th minutes.Results: The demographic data were similar in both groups. In the SLMA Group, laryngospasm was detected at T1: (5th minute afterthe extubation) in 2 (4.3%) patients, Bronchospasm was detected at T1 (2.2%) in 1 patient, cough was detected at T1 in 4 (8.7%)patients, desaturation was detected at 3 (6.5%) patients. In the ETT Group, laryngospasm was detected at T1 (13%) in 6 patients(13%), bronchospasm was detected at T1 in 2 patients (4.3%), cough was detected at T1 (10.9%) in 5 patients, desaturation wasdetected in 5 patients (10.9%). There were no statistically significant differences between the groups in terms of the perioperativerespiratory complications.Conclusion: It was determined in our study that the incidence of the respiratory adverse events (laryngospasm, bronchospasm, andcough) in the patients applied SLMA was less than ETT in nasal surgery patients undergoing general anesthesia.Öğe Comparison of the effects of supreme laryngeal mask airway and endotracheal tube on airway reflexes in patients who underwent nasal surgery: A randomized, controlled clinical trial(2019) Karaaslan, ErolAim: The primary purpose of this study was to compare the effects of supreme laryngeal mask airway (SLMA) and endotracheal tube (ETT) on (laryngospasm, bronchospasm, cough, desaturation) airway reflexes in patients who undergo nasal surgery. The secondary purpose was to evaluate the hemodynamic responses in this respect.Material and Methods: The study was conducted as a prospective, randomized, single blind and controlled clinical trial in 92 patients between the ages of 18 and 65 for whom elective nasal surgery was planned, who volunteered for the study and who were American Society of Anaesthesiologists (ASA) I-II group. The patients were divided randomly into two groups as the supreme laryngeal mask (SLMA Group, n = 46), and the endotracheal tube (ETT Group, n = 46). The laryngospasm, bronchospasm, cough, desaturation (SpO2 ≤90) and hemodynamic parameters were evaluated after the extubation (T1) 5th and (T2) 60th minutes.Results: The demographic data were similar in both groups. In the SLMA Group, laryngospasm was detected at T1: (5th minute after the extubation) in 2 (4.3%) patients, Bronchospasm was detected at T1 (2.2%) in 1 patient, cough was detected at T1 in 4 (8.7%) patients, desaturation was detected at 3 (6.5%) patients. In the ETT Group, laryngospasm was detected at T1 (13%) in 6 patients (13%), bronchospasm was detected at T1 in 2 patients (4.3%), cough was detected at T1 (10.9%) in 5 patients, desaturation was detected in 5 patients (10.9%). There were no statistically significant differences between the groups in terms of the perioperative respiratory complications. Conclusion: It was determined in our study that the incidence of the respiratory adverse events (laryngospasm, bronchospasm, and cough) in the patients applied SLMA was less than ETT in nasal surgery patients undergoing general anesthesia.Öğe Comparison of the effects of the McGRATH MAC, C-MAC, and Macintosh laryngoscopes on the intraocular pressures of non-ophthalmic patients: A prospective, randomised, clinical trial(Elsevier France-Editions Scientifiques Medicales Elsevier, 2021) Ozkan, Ahmet Selim; Akbas, Sedat; Karaaslan, Erol; Polat, NihatIntroduction: In this prospective, randomised study, we compared the effects of the Macintosh, McGRATH MAC, and C-MAC laryngoscopes on intraocular pressure (IOP) and [13_TD$DIFF]haemodynamics of non-ophthalmic patients during endotracheal intubation. Methods: [14_TD$DIFF]One hundred and twenty adult patients undergoing non[15_TD$DIFF]ophthalmic surgeries performed in the supine position under general [16_TD$DIFF]anaesthesia requiring orotracheal intubation [17_TD$DIFF]were included in this study. The patients were separated randomly and prospectively into 3 groups: Macintosh group (n = 40), McGRATH MAC group (n = 40), and C-MAC group (n = 40). Mean arterial pressure (MAP), heart rate (HR) and IOP of left and right eye were measured at specified times. Results: There were no significant differences with regard to patients characteristics. After intubation, the HR increased significantly in the Macintosh group when compared to the other groups ([18_TD$DIFF]p = 0.001) and the MAP increased significantly in the Macintosh group when compared to the McGRATH MAC group ([18_TD$DIFF]p = 0.001) and the C-MAC group ([19_TD$DIFF]p < 0.001). The IOP values increased in the Macintosh group when compared to the McGRATH MAC group ([20_TD$DIFF]p < 0.001) and the C-MAC group ([20_TD$DIFF]p < 0.001) after intubation. [21_TD$DIFF]Additionally, there was a significant difference between the McGRATH MAC group and C-MAC group in the IOP values of the eyes after intubation ([19_TD$DIFF]p < 0.001). According to the evaluation within the groups, there were significant differences in all of the groups at all times when compared with the baseline values ([19_TD$DIFF]p < 0.001). Conclusions: In this study, we concluded that the C-MAC VL may be preferable when compared to the Macintosh and McGRATH MAC laryngoscopes for use in ophthalmic patients in whom a rise in the IOP is undesirable. (C) 2021 Socie acute accent te acute accent franc , aise d'anesthe acute accent sie et de re acute accent animation (Sfar). Published by Elsevier Masson SAS. All rights reserved.Öğe A comparison of the success of intubation using C-MAC D-Blade and McGrath MAC X3 Blade videolaryngoscopes during double lumen tube insertion in one-lung ventilation: A prospective, randomized clinical trial(2024) Ertürk, Kasım; Özkan, Ahmet Selim; Akbaş, Sedat; Karaaslan, Erol; Durmuş, MahmutAim: To compare the effects of C-MAC D-Blade and McGrath MAC X3 Blade videolaryngoscopes (VLs) during double lumen tube (DLT) insertion in one-lung ventilation (OLV) in patients who underwent chest surgery in terms of intubation durations, hemodynamic responses, and intubation-induced complications. Materials and Methods: Fifty patients aged 18?65 who were scheduled for OLV were included in this study. The patients were divided randomly into two groups: a Storz C-MAC D-Blade VL group (C-MAC group, n = 25) and a McGrath MAC X3 Blade VL group (McGrath group, n = 25). The results of a preoperative airway assessment, a number of intubation attempts and incidence of success at the first attempt, glottic view times, intubation times, Cormack?Lehane scores, percentage of glottic opening (POGO) scores, ease of intubation, comorbidities, hemodynamic responses, and intubation-related adverse events were recorded. Results: The demographic characteristics and comorbidities of both groups were similar. The intubation characteristics of both groups were similar in terms of Cormack?Lehane scores, thyromental and intergingival distances, and POGO scores. In the C-MAC group, the glottic view times (p = 0.001) and intubation times (p = 0.001) were significantly shorter than those in the McGrath group. As shown by ease of intubation scores, ease of intubation in the C-MAC group was significantly better than that in the McGrath group (p = 0.001). All the patients in the C-MAC group were intubated at the first attempt, without a statistically significant difference. The two groups were similar with respect to intubation-related complications and hemodynamic responses (mean arterial pressure and heart rate). Conclusion: We conclude that the C-MAC D-Blade VL is more beneficial for airway management due to shorter glottic view and intubation times, high success rates at the first attempt, and ease of intubation in patients intubated with a DLT in OLV.Öğe Drug-drug interactions in intensive care units and potential clinical consequences of these interactions(2019) Oksuz, Ersoy; Bugday, Muhammet Serdar; Soyalp, Celaleddin; Karaaslan, Erol; Oto, Gokhan; Temelli Goceroglu, Rezzan; Berber, IlhamiAim: Drug-drug interactions (DDIs) are an important factor that can lead to serious health problems by increasing or decreasing the effects of drugs. This study aimed to evaluate the frequency of DDIs in the intensive care unit (ICU).Material and Methods: All patients who were hospitalized for more than 24 h in the ICU of our hospital between January and September 2018 and received 2 or more medications were included in this retrospective study. Frequency and severity of the DDIs were detected using the Rx Mediapharma and Lexi-Interact programs.Results: Of the 972 patients enrolled in the study, 2742 incidences of DDIs were detected in 626 patients (64%). Of the different drug pairs administered, 422 had DDIs, and 64 of those had 10 or more DDIs, constituting 67% of all of the DDIs. The most common potential clinical consequences of DDIs were increased risk of bleeding (12.3%), hyperkalemia (8.2%), arrhythmia (7.9%), and CNS depression (6.6%). Conclusion: The results indicated that DDIs in the ICU were very common in our hospital. Moreover, these results indicated that patients should be closely monitored for the prevention of adverse effects, such as electrolyte disturbance, bleeding risk, and arrhythmia of drugs.Öğe Drug-drug interactions in intensive care units and potential clinical consequences of these interactions(2019) Öksüz, Eray; Buğday, Muhammed Serdar; Soyalp, Celaleddin; Karaaslan, Erol; Oto, Gökhan; Temelli Göçeroğlu, Rezzan; Berber, İlhamiAbstract: Aim: Drug-drug interactions (DDIs) are an important factor that can lead to serious health problems by increasing or decreasing theeffects of drugs. This study aimed to evaluate the frequency of DDIs in the intensive care unit (ICU).Material and Methods: All patients who were hospitalized for more than 24 h in the ICU of our hospital between January andSeptember 2018 and received 2 or more medications were included in this retrospective study. Frequency and severity of the DDIswere detected using the Rx Mediapharma and Lexi-Interact programs.Results: Of the 972 patients enrolled in the study, 2742 incidences of DDIs were detected in 626 patients (64%). Of the differentdrug pairs administered, 422 had DDIs, and 64 of those had 10 or more DDIs, constituting 67% of all of the DDIs. The most commonpotential clinical consequences of DDIs were increased risk of bleeding (12.3%), hyperkalemia (8.2%), arrhythmia (7.9%), and CNSdepression (6.6%).Conclusion: The results indicated that DDIs in the ICU were very common in our hospital. Moreover, these results indicated thatpatients should be closely monitored for the prevention of adverse effects, such as electrolyte disturbance, bleeding risk, andarrhythmia of drugs.Öğe Effects of preemptive intravenous paracetamol and ibuprofen on headache and myalgia in patients after electroconvulsive therapy A placebo-controlled, double-blind, randomized clinical trial(Lippincott Williams & Wilkins, 2019) Karaaslan, Erol; Akbas, Sedat; Ozkan, Ahmet Selim; Zayman, Esra PorgaliBackground: The aim of this study is to determine the efficacy of preemptive analgesia with paracetamol and ibuprofen to reduce the intensity and incidence of headache and myalgia after electroconvulsive therapy (ECT). Methods: Sixty patients with major depression who were treated with ECT were randomized to receive ECT 3 times a week. The first 3 sessions were included in the study. The patients were divided into 3 groups; Group C (Control, Saline, n = 20), Group P (Paracetamol, n = 20), and Group I (Ibuprofen, n = 20). Demographics, duration of seizure, visual analog scale (VAS) for headache and myalgia and nausea, vomiting and pruritus were evaluated at postoperative 24 hours period. Results: Duration of seizure after ECT was similar in all groups (P=.148). In the study, heart rate and mean arterial pressure were found to be some changes in some of the sessions. There were no significant differences in any comparison for all groups in all sessions regarding VAS scores for headache and myalgia. Incidence of headache and myalgia in Group I was lower than the other groups (P=.233, P=.011, respectively). But, there was no significant difference between the other groups. There was no significant difference in vomiting, intergroups, and intragroup. Conclusions: The findings of our study indicate that pain intensity of headache and myalgia did not show a significant change between groups and within groups. While pain intensity of myalgia between the groups reached no statistical significance, ibuprofen was significantly lowered the incidence of myalgia at postoperative 24 hours period.Öğe External hemorrhoidal disease in child and teenage: Clinical presentations and risk factors(Professional Medical Publications, 2019) Yildiz, Turan; Aydin, Dilek Bingol; Ilce, Zekeriya; Yucak, Aysel; Karaaslan, ErolObjective: Hemorrhoidal disease (HD), though mostly seen in adults, has recently emerged as a common problem among children. However, the diagnosis and treatment of HD in children is mostly based on the data obtained in adult studies. In this study, we aimed to evaluate risk factors, diagnostic and treatment modalities in the children diagnosed with external HD. Methods: The study was conducted at Sakarya University Medical School Pediatric Surgery Department between January 2012 and July 2018. We reviewed children who were diagnosed as having HD at Pediatric Surgery clinic. Age, gender, presenting symptoms, physical examination findings, risk factors, and treatment outcomes were evaluated for each patient. Results: The study included 56 patients with a mean age of 140.8 +/- 45.2 months. The patients comprised 48 (85.7%) boys and 8 (14.3%) girls. Constipation and a positive family history were the most common risk factor (n=33; 58.9%, n=29; 51.8%, respectively). Conservative treatment was performed in 53 (94.6%) patients. Recurrence was observed in 5 (8.9%) and skin tag was detected in 6 (10.7%) patients. Conclusions: External HD mostly occurs in boys in their second decade of life. Positive family history and constipation were the most common risk factors in our patients. Conservative treatment is sufficient for the management of external HD in children because of its low recurrence rates.Öğe Handling imbalanced class problem for the prediction of atrial fibrillation in obese patient(Allied Acad, 2017) Colak, Cengiz M.; Karaaslan, Erol; Colak, Cemil; Arslan, Ahmet Kadir; Erdil, NevzatObjective: Atrial Fibrillation (AF) is one of the important public health problems with elevated comorbidity, advanced mortality risk, and increasing healthcare costs. In this study, the objective is to explore and resolve the imbalanced class problem for the prediction of AF in obese individuals and to compare the predictive results of balanced and imbalanced datasets by several data mining approaches. Materials and methods: The retrospective study contained 362 successive obese individuals undergoing Coronary Artery Bypass Grafting (CABG) operation at the cardiovascular surgery clinic. AF developed postoperatively (AF Group) in 42 of the patients, whereas AF did not develop (non-AF Group) in 320 individuals. The Synthetic Minority Over-sampling Technique (SMOTE) was performed to balance the distribution of the target variable (AF/non-AF groups). The LogitBoost and GLMBoost ensemble approaches were constructed with 10-fold cross validation. Results: After applying SMOTE algorithm, the number of subjects in AF and non-AF was almost balanced (336 in AF and 320 in non-AF groups). The values of accuracy were 0.8812 (0.8433-0.9127) for GLMBoost and 0.9144 (0.8806-0.9411) for LogitBoost on the imbalanced dataset, and 0.8247 (0.7934-0.853) for GLMBoost and 0.9695 (0.9533-0.9813) for LogitBoost on the balanced dataset by SMOTE. The values of the area under the receiver operating curve for GLMBoost and LogitBoost were 0.5088 (0.485-0.5325) and 0.6827 (0.608-0.7573) on imbalanced dataset, and were 0.8259 (0.7971-0.8546) and 0.9696 (0.9564-0.9827) on balanced dataset, respectively. Conclusions: The predicted results indicated that LogitBoost on the balanced dataset by SMOTE had the highest and most accurate values of performance metrics. Hence, SMOTE and other oversampling approaches may be beneficial to overcome class imbalance issues emerging in biomedical studies.Öğe Hızlı Entübasyonda Roküronyum Bromürün Hemodinami Ve Entübasyon Koşulları Üzerine Etkisinin Farklı İndüksiyon Ajanları İle İncelenmesi(Turgut Özal Tıp Merkezi Dergisi, 2000) Bakan, Nurten; Karaaslan, Erol; Hasçalık, Mehmet; Ersoy, M. ÖzcanHızlı entübasyonun amacı, aspirasyon riskini azaltmak için, anestezik ve kas gevşetici ilaçların birlikte uygulanarak, hızlı ve uygun entübasyon koşulları sağlamaktır. Çalışmamızda, hızlı ve kısa etkili bir nondepolarizan kas gevşetici olan roküronyum bromürün (0.6 mg.kg-1), alfentanil (10 mg.kg-1) ilavesi ve tiyopental (5 mg.kg-1) veya propofol (2.5 mg.kg-1) ile birlikte hemodinami ve 60.- 90. saniyelerdeki (sn) entübasyon koşulları üzerine etkileri karşılaştırıldı. Materyal ve metot: ASA I-II risk grubu, elektif cerrahi girişim geçirecek 80 olgu, dört gruba ayrıldı. Yavaş hızla alfentanil verilmesini takiben tüm olgulara, spontan solunumla preoksijenasyon yapıldı. Grup I’de tiyopental ve roküronyum bromür verilip 60. sn’de, Grup II’de tiyopental ve roküronyum bromür verilip 90.sn’de, Grup III’te propofol ve roküronyum bromür verilip 60. sn’de ve Grup IV’te propofol ve roküronyum bromür verilip 90. sn’de entübasyon yapıldı. Olgular entübasyon öncesi maske ile %100 oksijen almaya devam etti. Kas gevşetici verilmesini takiben 1, 2, 5 ve 15. dakikalarda (dk) kan basıncı, kalp atım hızı, periferik oksijen saturasyonları kaydedildi. Entübasyon durumu, mükemmel, iyi, zayıf ve yetersiz olarak değerlendirilip, mükemmel ve iyi, uygun entübasyon koşulları olarak kabul edildi. Sonuçlar One-Way Analiz ve Chi-square testleri ile karşılaştırıldı. p<0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Propofol gruplarında daha fazla olmak üzere tüm gruplarda uygun entübasyon koşulları sağlandı. En mükemmel entübasyon durumu Grup IV’te saptandı ve bu istatistiksel olarak anlamlı idi (p<0.05). Sonuç: Olgunun klinik durumu göz önünde bulundurularak, acil entübasyon durumlarında en uygun kombinasyon 90 sn’de propofol-roküronyum ile olmakla birlikte, araştırmamızdaki tüm seçenekler uygulanabilir kanısındayız.Öğe Management of anesthesia and complications in children with Tracheobronchial Foreign Body Aspiration(Professional Medical Publications, 2019) Karaaslan, Erol; Yildiz, TuranObjectives: Delayed diagnosis and treatment of tracheobronchial foreign body aspiration (FBA) in children may lead to morbidity and mortality. Our objective was to evaluate the anesthetic management, periand post-operative complications, and predisposing factors for postoperative intensive care unit (ICU) admission in children undergoing rigid bronchoscopy due to tracheobronchial FBA. Methods: This retrospective study included 81 children who underwent rigid bronchoscopy between January 2010 to July 2018 at Inonu University, Department of Pediatric Surgery, Turkey. Data regarding demographic characteristics, anesthetic management, length of ICU and hospital stays, and peri- and postoperative complications were retrieved from the hospital database. Results: The patients included 54 (66.7%) boys and 27 (33.3%) girls with a mean age of 29.6 +/- 31.2 months. The most common presenting symptom was the suspicion of FBA, followed by acute-onset cough, cyanosis, wheezing and respiratory distress. Mean duration of anesthesia was 44.40 +/- 14.72 min. Of the 81 patients, 18 (22.2%) were transferred to ICU and 63 (77.8%) patients were transferred to the ward postoperatively. Of the patients transferred to the ICU, 5 of them required mechanical ventilation. Some peri and postoperative complications, desaturation (n=16; 19.7%; p=0.001), mucosal bleeding (n=6; 7.4%; p=0.02), laryngeal edema (n=11; 13.6%; p<0.001), laryngospasm (n=13; 16.3%; p<0.001), were affected the frequency of intensive care transfer. Conclusion: Bronchoscopy with general anesthesia remains the golden standard for the management of tracheobronchial FBA. In such patients, a combination consisting of a detailed preoperative clinical evaluation of the patient, selection of short-acting anesthetic agents with minimal side effects for the induction and maintenance of anesthesia, and the administration of controlled ventilation can be recommended. Additionally, early diagnosis of peri- and post-operative complications, prediction of postoperative ICU requirement, and a close cooperation of anesthesiologists and surgeons are highly important.
