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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 Combination of low-dose (0.1 mg) intrathecal morphine and patient-controlled intravenous morphine in the management of postoperative pain following abdominal hysterectomy(2004) Togal T.; Demirbilek S.; Gulhas N.; Koroglu A.The aim of this double-blind prospective randomized study was to investigate combination of low-dose (0.1 mg) intrathecal morphine and patient-controlled intravenous morphine in the management of postoperative pain following abdominal hysterectomy. Side-effects, satisfaction and sedation were also evaluated. Fifty patients (ASA I) between 30 and 65 years of age, scheduled for elective abdominal hysterectomy were randomized to receive intrathecal 0.1 mg of morphine sulfate (ITM) or placebo and intravenous morphine (IVM). Both groups received standard general anesthesia. In the ITM group, 0.1 mg morphine was administered intrathecally just before emergence from anesthesia while an equal volume of sterile saline was administered in the IVM group. Thereafter, all patients received IV morphine via a patient controlled analgesia (PCA) pump, set to deliver a bolus of 1 mg with a lock-out of 7 minutes and maximum dose of 20 mg per 4 hours. Hemodynamics, respiration, PCA demands, VAS, sedation scores, total morphine consumption, satisfaction and side effects were recorded for 24 hours after surgery. There were no significant differences between the groups with respect to satisfaction score. Total morphine consumption was lower in the ITM group; VAS scores at the first 8 hours were lower in the ITM group. Sedation scores at 4, 8, and 12th hours were higher in the ITM group. There was no significant difference in terms of adverse effects. In conclusion, intrathecal morphine (0.1 mg) combined with intravenous PCA is a safe and effective method of providing analgesia after hysterectomy as evidenced by lower pain scores and total morphine consumption and improved patient satisfaction.Öğe Comparison between the effects of rocuronium, vecuronium, and cisatracurium using train-of-four and clinical tests in elderly patients(Brieflands, 2013) Sagir O.; Yucesoy Noyan F.; Koroglu A.; Cicek M.; Ilksen Toprak H.Background: Postoperative residual blockade, longer duration of action for neuromuscular blockade, and slower recovery were relatively common in elderly patients. Objectives: We aimed to investigate the safety of train-of-four ratio and clinical tests in the assessment of patient recovery, and to determine the effects of the rocuronium, vecuronium, and cisatracurium on intubation, extubation and recovery times in elderly patients undergoing abdominal surgery. Patients and Methods: After obtaining institutional approval and informed consent, 60 patients over 60 years old and undergoing elective abdominal operations were included in this double-blind, randomized clinical trial. Following a standard anesthesia induction, 0.6mg kg-1 rocuronium, 0.1mg kg-1 vecuronium, and 0.1mg kg-1 cisatracurium were administered to the patients in Group R, Group V, and Group C, respectively. Train-of-four (TOF) ratios were recorded at 10-minute intervals during and after the operation. Modified Aldrete Score (MAS) and clinical tests were recorded in the recovery room at 10-minute intervals. In addition, intubation and extubation times, duration of recovery room stay, and any complications were recorded. Results: Intubation time was found to be shorter in Group R than that in Groups V and C (P < 0.001). Times to positive visual disturbances and grip strength tests were shorter in Group C than that in Group V (P = 0.016 and P = 0.011, respectively). In Group R and group C, time to TOF ? 0.9 was significantly longer than all positive clinical test times except grip strength (P < 0.05). Conclusions: We hold the opinion that cisatracurium is safer in elderly patients compared to other drugs. We also concluded that the usage of TOF ratio together with clinical tests is suitable for assessment of neuromuscular recovery in these patients. © 2013 Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM); Published by Kowsar Corp.Öğe Comparison of cardiovascular effects and intubating conditions of cisatracurium and rocuronium in patients with coronary artery disease(2000) Torkoz A.; But A.K.; Koroglu A.; Durmus M.; Togal T.; Ersoy M.O.This study was designed to compare the cardiovascular effects and intubation condition of cisatracurium and rocuronium in cardiac surgical patients. Twenty patients scheduled for elective coronary artery bypass surgery were randomly assigned into two equal groups in a double blind fashion. Patients in group R (n=10) were given 0.9 mg/kg rocuronium and patients in group C (n=10) were given 0.15 mg/kg cisatracurium. Tracheal intubation was performed upon completion of maximum depression (% 100) in Train-of-four stimulation. Intubation conditions were rated according to Goldberg scale [1 (excellent) to 4 (intubation not possible)]. Heart rate (HR), systolic and diastolic arterial pressure SAP and DAP), central venous pressure (CVP), mean pulmonary artery pressure (PAPm), pulmonary artery wedge pressure (PAWP), cardiac output (CO), cardiac index (CI), systemic and pulmonary vascular resistances (SVR and PVR) were measured invasively. Measurements were made before induction, 2 min after induction of anesthesia (basal), 1 min after after administration of muscle relaxant, at maximum depression in TOF and 2, 5, 10 min after intubation. Intubation condition were excellent in 60% of patients in the rocuronium group and in 90% of patients in the cisatracurium group, however there were no significant differences between the two groups (p>0.05). Rocuronium produced statistically significant increase in the heart rate at maximum depression in TOF, 2 min after intubation and in systolic blood pressure at 2 min after intubation (p<0.05). Other hemodynamic changes (DBP, CVP, CO, CI, PAPm, PAWP, SVR, PVR) were similar in the groups. As a result, induction with cisatracurium presented a more haemodynamically stable situation than rocuronium, but increases of cardiac rate and blood pressure with rocuronium were within clinically acceptable values.Öğe Remifentanil and acute intermittent porphyria [4](Greenwich Medical Media Ltd, 2002) Durmus M.; Turkoz A.; Togal T.; Koroglu A.; Toprak H.I.; Ersoy M.O.[No abstract available]
