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Öğe Anaesthesia for Caesarean section in the presence of aortic coarctation(Lippincott Williams & Wilkins, 2002) Togal, T; Durmus, M; Koroglu, A; Demirbilek, S; Karaaslan, K; Ersoy, O[Abstract Not Available]Öğe Comparison of propofol-alfentanil and propofol-remifentanil anaesthesia in percutaneous nephrolithotripsy(Cambridge Univ Press, 2005) Cicek, M; Koroglu, A; Demirbilek, S; Teksan, H; Ersoy, MOBackground and objective: Percutaneous nephrolithotripsy (PCNL) is used for the fragmentation and removal of stones from the renal pelvis and renal calyceal systems. We compared the effects of propofol-alfentanil or propofol-remifentanil anaesthesia on haemodynamics, recovery characteristics and postoperative analgesic requirements during percutaneous nephrolithotripsy. Methods: Thirty non-premedicated patients were randomly allocated to receive either propofol-alfentanil (Group A) or propofol-remifentanil (Group R). The loading dose of the study drug was administered over 60 s (alfentanil 10 mu g kg(-1) or remifentanil 1 mu g kg(-1)) followed by a continuous infusion (alfentanil 15 mu g kg(-1) h(-1) or remifentanil 0.15 mu g kg(-1) min(-1)). Propofol was administered until loss of consciousness and maintained with a continuous infusion of 75 mu g kg(-1) min(-1) in both groups. Atracuriurn was given for endotracheal intubation at a dose of 0.5 mg kg(-1) and maintained with a continuous infusion of 0.4 mg kg(-1) h(-1) Mean arterial pressure heart rate, the total amount of propofol, time of recovery of spontaneous ventilation, extubation and eye opening in response to verbal stimulus and analgesic requirement were recorded. Results: In Group A, mean arterial pressure was higher at the first minute in the prone position, and during skin incision and lithotripsy, and heart rate was higher during skin incision and lithotripsy when compared with Group R (P < 0.05). The total amount of propofol did not differ between groups. Time of recovery of spontaneous ventilation, extubation and eye opening were significantly shorter in Group R than Group A (P < 0.05). Conclusions: Both propofol-remifentanil and propofol-alfentanil anaesthesia provided stable haemodynamics during percutaneous nephrolithotripsy, whereas propofol-remifentanil allowed earlier extubation.Öğe Effects of S(+) ketamine added to bupivacaine for spinal anaesthesia for prostate surgery in elderly patients(Greenwich Medical Media Ltd, 2004) Togal, T; Demirbilek, S; Koroglu, A; Yapici, E; Ersoy, OBackground and objective: Intrathecal ketamine as the sole anaesthetic agent has demonstrated a lack of cardiovascular depression that should be of advantage in an elderly population. S(+) ketamine has three-times the analgesic potency of R(-) ketamine and its antinociceptive effects after intrathecal administration in rats are known. We decided to evaluate the effects of intrathecal S(+) ketamine added to a small dose of spinal bupivacaine in elderly patients undergoing transurethral prostate surgery. Methods: Forty males over 60 yr old, scheduled for transurethral prostate resection under spinal anaesthesia, were studied in a prospective, double-blinded, randomized way. Patients were allocated to receive either bupivacaine 10 mg or bupivacaine 7.5 mg combined with S(+) ketamine 0.1 mg kg(-1). Spinal block onset time, maximum sensory level, duration of blockade, haemodynamic variables, postoperative analgesic requirements and adverse events were recorded. Results: Onset times of motor and sensory block were shorter in the bupivacaine plus S(+) ketamine group. Incomplete motor block of the lower extremities was seen in 80% of the patients in bupivacaine plus S(+) ketamine group. Duration of complete motor block and spinal analgesia was shorter in the bupivacaine plus S(+) ketamine group. There was no significant difference in arterial pressure. Heart rate decreased after spinal anaesthesia in the bupivacaine plus S(+) ketamine group and was significantly lower until the end of anaesthesia. The incidence of adverse effects was not different between groups. Conclusions: Intrathecal S(+) ketamine administered with a low dose of bupivacaine provides shorter motor and sensory block onset time, shorter duration of action and less motor blockade in elderly males.Öğe Regional anesthesia is a good alternative to general anesthesia in pediatric surgery: Experience in 1,554 children(W B Saunders Co, 2002) Uguralp, S; Mutus, M; Koroglu, A; Gurbuz, N; Koltuksuz, U; Demircan, MBackground/Purpose: Although caudal and spinal blocks are modern and safe techniques, in many centers children still are operated on under general anesthesia (GA), or the blocks are used for postoperative analgesia after GA in infraumbilical operations. The authors aimed to document the results and the complications of 1,554 regional anesthesia cases, thereby assessing their validity. Methods: The analysis of 1,459 caudal and 95 spinal blocks cases collected until January 2001 in children from newborn to 12 years of age are documented retrospectively. The types of anesthesia analyzed in the study were caudal block (CB) only, CB plus GA, GA plus CB, GA plus spinal block, and spinal block only. Results: There were 1,338 caudal and 95 spinal block cases that clinically were satisfactory. Because the duration of CB produce a CB occurred in 82 cases (5.57%). There were 257 of 1,338 patients operated on under GA and supported by caudal block for postoperative analgesia. Conclusions: Caudal anesthesia seems to be an inexpensive, simple, and effective technique not only as a supplement for postoperative analgesia, but also as a single method of anesthesia. and the authors recommend its use in a wider setting of clinical entities in infraumbilical surgical procedures of children. Copyright 2002 Elsevier Science (USA). All rights reserved.Öğe Remifentanil and acute intermittent porphyria(Lippincott Williams & Wilkins, 2002) Durmus, M; Turkoz, A; Togal, T; Koroglu, A; Toprak, HI; Ersoy, MO[Abstract Not Available]Öğe Sedative, haemodynamic and respiratory effects of dexmedetomidine in children undergoing magnetic resonance imaging examination: preliminary results(Elsevier Sci Ltd, 2005) Koroglu, A; Demirbilek, S; Teksan, H; Sagir, O; But, AK; Ersoy, MOBackground. We evaluated the sedative, haemodynamic and respiratory effects of dexmedetomidine and compared them with those of midazolam in children undergoing magnetic resonance imaging (MRI) procedures. Methods. Eighty children aged between 1 and 7 yr were randomly allocated to receive sedation with either dexmedetomidine (group D, n=40) or midazolam (group M, n=40). The loading dose of the study drugs was administered for 10 min (dexmedetomidine 1 mu g kg(-1) or midazolam 0.2 mg kg(-1)) followed by continuous infusion (dexmedetomidine 0.5 mu g kg(-1) h(-1) or midazolam 6 mu g kg(-1) min(-1)). Inadequate sedation was defined as difficulty in completing the procedure because of the child's movement during MRI. The children who were inadequately sedated were given a single dose of rescue midazolam and/or propofol intravenously. Mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (Sp(o2)) and ventilatory frequency (VF) were monitored and recorded during the study. Results. The quality of MRI was significantly better and the rate of adequate sedation was higher in group D than in group M (P < 0.001). In group D, the requirement for rescue drugs was lower and the onset of sedation time was shorter than in group M (P < 0.001). MAP, HR and VF decreased from baseline during sedation in both groups (P < 0.001). Conclusions. Dexmedetomidine provided adequate sedation in most of the children aged 1-7 yr without haemodynamic or respiratory effects during MRI procedures.
