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    The effect of low-dose ketamine on ephedrine requirement following spinal anesthesia in cesarean sections: a randomised controlled trial
    (Drunpp-Sarajevo, 2012) Gulhas, Nurcin; Ozgul, Ulku; Erdil, Feray; Sanli, Mukadder; Nakir, Hamza; Yologlu, Saim; Durmus, Mahmut
    Background: We aimed to assess the effectiveness of subanesthetic doses of ketamine on ephedrine requirement in patients scheduled for Cesarean section under spinal anesthesia. Methods: ASA I-II, 105, patients were enrolled in the study. Spinal anesthesia was achieved with 12.5 mg hyperbaric bupivacaine and 15 mu g fentanyl. Following spinal anesthesia, patients were randomly allocated to three groups. Group Placebo: 2 mL of intravenous physiological saline, Group Ketamine 0.25: 0.25 mg.kg(-1) of intravenous ketamine, and Group Ketamine 0.5: 0.5 mg.kg(-1) of intravenous ketamine was received. Results: The systolic and mean blood pressures were similar in the groups. There were no significant differences between the groups, number of hypotensive attacks, as well as the amount of ephedrine used. The sedation scores in Group Ketamine 0.25 and Group Ketamine 0.5 were significantly higher than Group Placebo (p=0.001) Conclusions: Subanesthetic dose of ketamine is not effective on decreasing ephedrine requirement in Cesarean section under spinal anesthesia.
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    Protective effects of quercetin against sepsis-induced oxidative damage on rat kidneys
    (Bayrakol Medical Publisher, 2022) Duran, Mehmet; Bicakcioglu, Murat; Yilmaz, Nezir; Turk, Bilge Aydin; Dogukan, Mevlut; Nakir, Hamza; Dogan, Zumrut
    Aim: Sepsis is a clinical pathology, characterized by a severe and exaggerated inflammatory response. One of the most frequently damaged organs in sepsis is the kidney. Quercetin has anti-inflammatory, anti-proliferative, and antioxidant effects. In this study. it was aimed to examine the protective effects of quercetin on the kidneys. Material and Methods: In the scope of this study, 31 rats were planned to be used in the experiments. The groups and number of animals were as follows: Group 1:1.5 ml saline, Group 2: 1.5 ml olive oil, Group 3: intestinal ligation and puncture procedure was used to create experimental sepsis method. Group 4:20 mg/kg quercetin was administrated by gavage. Group 5: quercetin was administered in intragastrically at doses of 20 mg/kg. In biochemical analyzes of kidney tissue samples, BUN, creatinine, MDA and GSH values were checked. Cell damage, inflammation and fibrosis were evaluated histopathologically. Results: As a result of this study, tissue GSH levels were significantly different between groups 3 and 4 (p- 0.001). In terms of BUN value, it was found to be significantly higher in group 3 (p= 0.002). In tissue histology, glomerulitis (p, 0.001), tubular cell necrosis (p= 0.001) and mesenchymal matrix increase (p= 0.001) were different between groups 3 and 4. Finally, no fibrosis was observed in any group (p> 0.05). Discussion: Quercetin has protective effects on kidney tissue against organ damage caused by sepsis.
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    Thromboelastographic comparison of the effects of different fluid preloading regimens delivered before spinal anesthesia
    (Drunpp-Sarajevo, 2012) Ozen, Irsat; Togal, Turkan; Aydogan, Mustafa Said; Erdogan, Mehmet Ali; Nakir, Hamza; Gulhas, Nurcin; Toprak, Huseyin Ilksen
    Introduction: Various fluids used for preloading purposes prior to spinal anesthesia. Coagulation disorders can occur due to use of those fluids at large volumes [1]. We aimed to compare the impact of different preloading fluids over coagulation parameters. Method: Sixty-eight patients of ASA I-II physical status who were aged between 18 and 75 years, and scheduled for orthopedic surgery under spinal anesthesia, were included in the study. Prior to the spinal anesthesia, preloading was carried out by RL in Group R (n=16), HES (130/0.4) in Group H (n=16), polygeline in Group P (n=16), and succinylated gelatin 7 ml/kg in Group S (n=16). RL was used as the maintenance fluid in all the groups. Thromboelastography, CBC, PTT, aPTT, fibrinogen values were assessed at baseline and 2 hours. Results: Groups P and S displayed significantly prolonged PTT values. While Groups R and P showed significantly prolonged PTT-INR values, groups R and H exhibited significantly prolonged aPTT values. Groups R, P, and S demonstrated significant decreases in TEG parameters including R, K, CI, and TMA. The increase in a angle was significant in groups R and S. Conclusion: Fluid preloading with HES was not found to affect the coagulation parameters, however, polygeline and succinylated gelatin were observed to cause moderate hypercoagulation. Therefore, we believe that HES may be preferred over succinylated gelatin and polygeline in cases with hypercoagulability.