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    Comparison of preoperative and postoperative approaches to ultrasoundguided transversus abdominis plane block for postoperative analgesia in total abdominal hysterectomy
    (Scientific Publishers of India, 2017) Dirican B.; Erdogan M.; Ucar M.; Uzgul U.; Gulhas N.; Kayhan G.; Durmus M.
    Background: Transversus Abdominis Plane (TAP) block produces more effective postoperative analgesia and significantly reduces consumption of postoperative opioids after various abdominal surgeries. It can be performed either preoperatively or postoperatively. Furthermore studies investigating the ideal period for TAP block administration are few. The objective of our study was to investigate, which period is more effective for administration of TAP block on postoperative analgesia in patients undergoing total abdominal hysterectomy. Methods: This prospective randomized controlled double-blind study was conducted with 60 patients between the ages of 18-65 and ASA class I-II who were scheduled to undergo total abdominal hysterectomy. Patients who received a TAP block with ultrasound guidance prior to the surgical procedure were referred to as Group 1, the TAP block procedure after surgery made up Group 2. The rest and movement period Visual Analog Score (VAS), sedation score, nausea, vomiting and the need for additional analgesics were recorded at 2, 4, 6, 12 and 24 hours postoperatively. Results: When Group 1 was compared with Group 2, the rest period pain scores were significantly lower in Group 2 at 2 and 4 hours (p<0.05). In Group 2, the 24-hour morphine consumption was significantly lower than that of Group 1 (p<0.05). Conclusion: Post-operative administration of an US guided TAP block in total hysterectomy patients significantly decreased pain scores in early periods and also reduced 24 hour morphine consumption when compared with preoperative administration of the block. © 2017, Scientific Publishers of India. All rights reserved.
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    Effects of esmolol, lidocaine and fentanyl on P wave dispersion, QT, QTc intervals and hemodynamic responses to endotracheal intubation during propofol induction: A comparative study
    (2013) Hanci V.; Yurtlu S.; Karaba? T.; Okyay D.; Hakimo?lu S.; Kayhan G.; Büyükuysal T.
    Background and objectives: In our study we aimed to investigate the effect of esmolol, lidocaine and fentanyl on P-wave dispersion (Pwd), QT and corrected QT (QTc) durations and hemodynamic responses to endotracheal intubation during propofol induction. Methods: A total of eighty adult patients, American Society of Anesthesiologists (ASA) Physical Status I or II aged 18 to 60 years were included in this prospective, randomised, double-blind study. All patients had control electrocardiograms (ECGs) done before anesthesia induction. The patients were randomised into four equal groups. The control group (Group C) received saline 5mL, the esmolol group (Group E) received esmolol 0.5mg.kg-1, the fentanyl group (Group F) received fentanyl 2?g.kg-1 and the lidocaine group (Group L) received lidocaine 1.5mg.kg-1 before anesthesia induction. Anesthesia was induced with intravenous propofol. ECGs for all patients were performed during the 1st and 3rd minutes of induction, 3minutes after administration of muscle relaxant, and at 5minutes and 10minutes after intubation. Pwd and QT intervals were measured on all ECGs. QTc intervals were determined using the Bazett formula. Heart rate (HR) and mean arterial pressure (MAP) were recorded before and after induction of anesthesia, immediately after intubation, and 1, 3, 5, 7 and 10minutes after intubation. Results: Compared with control, HR significantly increased in Group C, Group L and Group F after intubation. However, in Group E, there was no significant difference in HR values between control and after intubation. Compared with control, MAP significantly increased in Group C and Group L after the intubation. However, in Group E and Group F, there was no significant difference in MAP values between control and after the intubation. Compared with control, Pwd significantly increased in Group C after intubation. In Group L, Group F and Group E, there was no significant difference in Pwd values between control and after the intubation. Compared with control, QTc duration significantly increased in Group C and L after the intubation. In Group F and Group E, there was no significant difference in QTc durations between control and after the intubation. Conclusion: We concluded that administration of esmolol before intubation prevents tachycardia and an increase in MAP, Pwd and QTc duration caused by laryngoscopy and tracheal intubation. © 2013 Elsevier Editora Ltda..