Yazar "Karaaslan K." seçeneğine göre listele
Listeleniyor 1 - 8 / 8
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Acute Normovolemic Hemodilution in Coronary Artery Bypass Surgery: Effects on Inflammatory Response(2003) Durmuş M.; Karaaslan K.; But A.K.; Do?an Z.; Sezgin N.; Ersoy M.Ö.Acute normovolemic hemodilution is the removal of the blood from patients before or shortly after induction of anesthesia, and simultaneous replacement with acellular fluid, that is crystalloid or colloid and retransfusion of removed blood if needed. In this study we aimed to evaluate the effects of acute normovolemic hemodilution on and enflammatory response in patients undergoing coronary artery bypass surgery. After Ethics Committee approval 40 patients undergoing coronary artery bypass surgery were divided into two groups randomly. After induction of anesthesia, one or two units of blood were drawn from the Group I (n=20) until the hematocrit values became lesser than < 35%. At the same time, volume replacement was achieved with same amount of colloid infusion from peripheral vein. Any additional procedure was not done to the control group (Group II, n=20). Alanine transaminase, aspartate transaminase, lactate dehydrogenase, creatine kinase MB, creatine phosphokinase, ?-glutamyl transferase, complement 3a, complement 4a, ferritin, transferrin, nitric oxide, C-reactive protein and haptoglobulin levels were measured before induction, after operation, postoperative 6th and 24th hours. The amount of transfused allogenic blood was lower in Group I compared to group II (p<0.05). It was detected that complement system was not induced in two groups; lactate dehydrogenase, creatine kinase MB and nitric oxide levels were higher in Group II at postoperative 6 th, ferritin level was higher in group I at postoperative 24 th hours statistically (p<0.05). It was concluded that the effect of acute normovolemic hemodilution regarding to complement system was not different from control group and lower levels in lactate dehydrogenase, creatine kinase MB and nitric oxide can show that organ functions can be better prevented with acute normovolemic hemodilution.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 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 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 The effects of acute normovolemic hemodilution on coagulation parameters in coronary artery bypass surgery(2003) Durmuş M.; Karaaslan K.; But A.K.; Erdem T.B.; Sezgin N.; Ersoy M.Ö.Acute normovolemic hemodilution reduces allogenic blood transfusion requirements during surgery. We aimed to investigate the effects of acute normovolemic hemodilution on hemostasis after cardiopulmonary bypass by comparing routine coagulation tests, thrombin-antithrombin III complex, fibrinogen, D-dimer, protein C and S levels. After Ethics Committee approval 40 patients undergoing coronary artery bypass surgery were divided into two groups randomly. After induction of anesthesia, one or two units of blood were drawn from the Group I (n=20) until the hematocrit values became less than < 35% (Htc < 35%). At the same time, volume replacement was achieved with same amount of colloid infusion from peripheral veins. No additional procedure was done to Group II (n=20). All coagulation tests were measured before induction, at the end of surgery, at postoperative 6th and 24th. In addition to this time periods, thrombin-antithrombin III complex, fibrinogen and D-dimer levels were measured before cardiopulmonary bypass. The amount of transfused allogenic blood was lower in Group I compared to Group II (p<0.05). Routine coagulation tests remained within normal limits. Before cardiopulmonary bypass, fibrinogen, thrombin-antithrombin III complex and D-dimer levels were higher in Group I compared to Group II statistically (p<0.05). Protein C level was less at the end of surgery in Group I (p<0.05). Fragmentation ratio was detected lower in Group I than Group II (P<0.01). We concluded that, although acute normovolemic hemodilution reduces allogenic blood transfusion requirement and fragmentation ratio, it may activate coagulation and fibrinolysis in patients undergoing coronary artery bypass surgery.Öğe The effects of acute normovolemic hemodilution on postoperative cognitive functions in coronary artery bypass surgery(2003) Durmuş M.; Karaaslan K.; But A.K.; Toprak H.I.; Tekşan H.; Ersoy M.Ö.Moderate acute normovolemic hemodilution is tolerated well in most of cardiovascular surgery even in coronary artery bypass grafting (CABG). In this study we aimed to evaluate the effects of acute normovolemic hemodilution on postoperative cognitive functions in patients undergoing CABG surgery. After Ethics Committee approval, 62 patients undergoing coronary artery bypass surgery were studied. Patients were divided into hemodilution (Group H, n=31) and control (Group K, n=31) groups randomly. After induction of anesthesia, one or two units of blood were drawn from the Group H until the hematocrit values were lower than 35 %. At the same time, volume replacement was achieved with same amount of 6 % hydroxyethyl starch (HAES-steril 6 % (HES 200/0.5), Fresenius Kabi) infusion from peripheral vein. Any additional procedure was not performed in the Group K. Cognitive functions were evaluated with using "Wechsler Revised Memory Scale" one day before surgery, third day and at the end of first month after surgery. Both Forward and Reverse Digit Series and Figural Memory scores of Group H were higher than the control group at the postoperative third day and first month (p<0.05). Total scores of two groups were higher than the preoperative scores at the end of first month (p<0.05). It was concluded that acute normovolemic hemodilution during CABG surgery conserves postoperative attention and figural memory functions. Increased total scores in two groups at first month reflect the learning effects.Öğe Preemptive effectiveness of celecoxib in patients undergoing total abdominal hysterectomy(2003) Karaaslan E.; Durmuş M.; Demirbilek S.; Köro?lu A.; To?al T.; Karaaslan K.; Ersoy M.O.We aimed to investigate the effects of preemptive oral 100 mg and 200 mg celecoxib in relief of postoperative pain and morphine consumption after total abdominal hysterectomy. Fifty-four, ASA I-II class adult cases were enrolled in this study. One hour before the operation, celecoxib was administered per oral 100 and 200 mg to group I and II respectively and group III served as a control. All patients received IV PCA with morphine. PCA was programmed as follows: 2 mg loading dose, 1 mg bolus dose and 10 minutes lock-out time for a 20 mg limitation for four hours. All patients underwent a standardized general anaesthetic induction and maintenance. During the operation no analgesic medication was used. After operation, pain scores (VAS at rest, on movement and on coughing) were evaluated at 2, 4, 8, 12, 24, 48 and 72. hours. The morphine consumption was recorded at 2, 4, 8, 12 and 24. hours post-operatively. Sedation scores and peripheral oxygen saturation were recorded at 1, 2, 4, 8, 12, 16 and 24. hours post-operatively. The total morphine consumption was 24.78±5.95, 24.44±9.18 and 34.78±10.38 in group I, II and III. That consumption in group 3 was significantly higher than group I and II. VAS at rest, movement and coughing were significantly higher in group III. We concluded that preemptive oral celecoxib 100 mg may be used as an additive to IV PCA with morphine for post-operative analgesia after abdominal hysterectomy.