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Öğe Anaesthesia recommendations for patients suffering from Friedreich's ataxia(Aktiv Druck & Verlag Gmbh, 2017) Ozgul, Ulku; Franca, Marcondes; Wedding, Iselin Marie; Muenster, TinoFriedreich's ataxia (FRDA) is the most common autosomal recessive ataxia in the Caucasian population characterized by ataxia, predominantly sensory neuropathy, cardiomyopathy, and diabetes mellitus. The incidence in Caucasians has been estimated between 1:29,000 to 1:50,000 in different populations. Men and women are affected equally [1,2]. The primary pathology involves degeneration of the dorsal root ganglia, posterior columns, corticospinal, ventral and lateral spinocerebellar tracts, and the dentate nuclei of the cerebellum. FRDA segregates as an autosomal recessive trait, and patients have mutations in the gene FXN that encodes the protein frataxin. The typical mutation found in 96% of the patients is an abnormal expansion of the trinucleotide GAA (guanine, adenine, adenine trinucleotide) in the first intron. Frataxin is a mitochondrial protein and has a role in iron homeostasis and antioxidation [3]. The mutation leads to reduced levels of frataxin, with subsequent accumulation of iron and impaired electron transport in the respiratory chain in the mitochondria. The resulting impairment in mitochondrial function causes pathology in the peripheral and central nervous system, the heart myocardial fibers and the pancreatic islets of Langerhans [4]. Initial symptoms of FRDA typically occur before the age of 25, and the typical presentation includes varying degrees of ataxia in all four limbs, absent lower extremity reflexes, and pyramidal signs. Most patients have an abnormal electrocardiogram due to hypertrophic cardiomyopathy. Other signs are pes cavus, saccadic intrusions, optic atrophy, deafness, diabetes mellitus or glucose intolerance. Death is usually due to cardiac dysfunction, including arrhythmias or heart failure [1,5].Öğe Anaesthetic Management in Electroconvulsive Therapy During Early Pregnancy(Aves, 2014) Ozgul, Ulku; Erdogan, Mehmet Ali; Sanli, Mukadder; Erdil, Feray; Begec, Zekine; Durmus, MahmutThe management of major psychiatric conditions during pregnancy is exceptionally difficult. Pharmacoresistant, life-threatening and severe symptoms such as catatonia and suicidal behavior affect the health and safety of both mother and child. In such cases, electroconvulsive therapy (ECT) may be considered as an alternative to pharmacologic treatment. In this report, we aimed to present anaesthetic management of a patient, who was 13 weeks pregnant and needed ECT due to major depression.Öğe Anaesthetic Management in Obstructive Sleep Apnea Syndrome for Adenotonsillectomy(Aves, 2014) Sanli, Mukadder; Toplu, Yuksel; Ozgul, Ulku; Kayhan, Gulay Erdogan; Gulhas, NurcinThe anaesthetic management of adenotonsillectomy in children with obstructive sleep apnea syndrome was characteristic due to respiratory and cardiac side effects. A detailed physical examination in the preoperative period should be performed, including children's respiratory and cardiac systems. If they have an active infection, surgery should be postponed until the end of medical treatment. Preparation for difficult airway management should be done in the preoperative period. In this case, we presented a report of two children who had obstructive sleep apnea syndrome, with airway management performed at the right lateral position to prevent the pharyngeal collapse and rapid sequence intubation performed using a short-acting muscle relaxant.Öğe Approach to Acute Iron Intoxication: A Case Report(Galenos Yayincilik, 2011) Ozgul, Ulku; Erdogan, Mehmet Ali; Gedik, Ender; Ucar, Muharrem; Aydogan, Mustafa Said; Togal, TurkanIn adults, the main causes of iron poisoning are intake suicide attempts and an overdose of iron during pregnancy. The severity of intoxication depends on the amount of iron. When serum iron level exceeds the iron binding capacity of the body, free radicals occurs, leading to lipid peroxidation and cellular membrane damage. In iron poisoning, especially the liver, heart, kidney, lung, and hematologic systems are affected negatively. Acute iron poisoning can cause serious complications resulting in death. Clinical, laboratory observation and early treatment are important. In this case report, we examined to approach the acute iron poisoning with the occasion of high-dose iron intake for suicide attempt.Öğe Blood Glucose Regulation During Living-Donor Liver Transplant Surgery(Baskent Univ, 2015) Gedik, Ender; Toprak, Huseyin Ilksen; Koca, Erdinc; Sahin, Taylan; Ozgul, Ulku; Ersoy, Mehmet OzcanObjectives: The goal of this study was to compare the effects of 2 different regimens on blood glucose levels of living-donor liver transplant. Materials and Methods: The study participants were randomly allocated to the dextrose in water plus insulin infusion group (group 1, n = 60) or the dextrose in water infusion group (group 2, n = 60) using a sealed envelope technique. Blood glucose levels were measured 3 times during each phase. When the blood glucose level of a patient exceeded the target level, extra insulin was administered via a different intravenous route. The following patient and procedural characteristics were recorded: age, sex, height, weight, body mass index, end-stage liver disease, Model for End-Stage Liver Disease score, total anesthesia time, total surgical time, and number of patients who received an extra bolus of insulin. The following laboratory data were measured pre- and postoperatively: hemoglobin, hematocrit, platelet count, prothrombin time, international normalized ratio, potassium, creatinine, total bilirubin, and albumin. Results: No hypoglycemia was noted. The recipients exhibited statistically significant differences in blood glucose levels during the dissection and neohepatic phases. Blood glucose levels at every time point were significantly different compared with the first dissection time point in group 1. Excluding the first and second anhepatic time points, blood glucose levels were significantly different as compared with the first dissection time point in group 2 (P < .05). Conclusions: We concluded that dextrose with water infusion alone may be more effective and result in safer blood glucose levels as compared with dextrose with water plus insulin infusion for living-donor liver transplant recipients. Exogenous continuous insulin administration may induce hyperglycemic attacks, especially during the neohepatic phase of living-donor liver transplant surgery. Further prospective studies that include homogeneous patient subgroups and diabetic recipients are needed to support the use of dextrose plus water infusion without insulin.Öğe Changes in Melatonin, Cortisol, and Body Temperature, and the Relationship Between Endogenous Melatonin Levels and Analgesia Consumption in Patients Undergoing Bariatric Surgery(Springer, 2018) Altunkaya, Neslihan; Erdogan, Mehmet Ali; Ozgul, Ulku; Sanli, Mukadder; Ucar, Muharrem; Ozhan, Onural; Sumer, FatihBackground Melatonin has analgesic, anti-inflammatory, sedative, and anxiolytic properties. However, the relationship between endogenous melatonin levels and postoperative analgesic requirements has not been well elucidated in patients undergoing bariatric surgery. We studied endogenous melatonin levels, cortisol levels, body temperatures, and the relationship between the level of endogenous melatonin and postoperative morphine consumption. Methods The trial was conducted among 30 patients who were scheduled for laparoscopic bariatric surgery. Their ages were between 18 and 65 years and their BMIs were above 40 kg/m(2). Secretion of melatonin, cortisol, and body temperature was monitored before the anesthetic induction, at 2 h intraoperatively, and at 2, 6, 10, (2:00 A.M.) and 24 h postoperatively. For each patient, morphine consumption was assessed at postoperative visits. The primary outcomes were to measure endogenous melatonin levels and to examine the relationship between these levels and morphine consumption. The secondary outcome was to observe the changes in cortisol and body temperature. Results There was a significant decrease in melatonin levels when preoperative melatonin levels were compared with intraoperative and all postoperative follow-up periods (p < 0.05). When the correlation between plasma melatonin levels and the postoperative morphine consumption of the patients was inspected, there was a significant correlation in all of the follow-up periods (p < 0.05). When preoperative cortisol levels were compared with intraoperative and postoperative cortisol levels, there was a significant difference in the follow-up periods, except two periods (p < 0.05). Body temperatures were similar in all measurement periods. Conclusions Endogenous melatonin secretion was significantly decreased in the intraoperative and postoperative periods. Furthermore, there was a significant inverse correlation between changes in endogenous melatonin levels and morphine consumption.Öğe Changes in melatonin, cortisol, and body temperature, and the relationship between endogenousmelatonin levels and analgesia consumption in patients undergoing bariatric surgery(Sprınger, 233 sprıng st, new york, ny 10013 usa, 2018) Altunkaya, Neslihan; Erdogan, Mehmet Ali; Ozgul, Ulku; Sanli, Mukadder; Ucar, Muharrem; Ozhan, Onural; Sumer, Fatih; Erdogan, Selim; Colak, Cemil; Durmus, MahmutBackground Melatonin has analgesic, anti-inflammatory, sedative, and anxiolytic properties. However, the relationship between endogenous melatonin levels and postoperative analgesic requirements has not been well elucidated in patients undergoing bariatric surgery. We studied endogenous melatonin levels, cortisol levels, body temperatures, and the relationship between the level of endogenous melatonin and postoperative morphine consumption. Methods The trial was conducted among 30 patients who were scheduled for laparoscopic bariatric surgery. Their ages were between 18 and 65 years and their BMIs were above 40 kg/m(2). Secretion of melatonin, cortisol, and body temperature was monitored before the anesthetic induction, at 2 h intraoperatively, and at 2, 6, 10, (2:00 A.M.) and 24 h postoperatively. For each patient, morphine consumption was assessed at postoperative visits. The primary outcomes were to measure endogenous melatonin levels and to examine the relationship between these levels and morphine consumption. The secondary outcome was to observe the changes in cortisol and body temperature. Results There was a significant decrease in melatonin levels when preoperative melatonin levels were compared with intraoperative and all postoperative follow-up periods (p < 0.05). When the correlation between plasma melatonin levels and the postoperative morphine consumption of the patients was inspected, there was a significant correlation in all of the follow-up periods (p < 0.05). When preoperative cortisol levels were compared with intraoperative and postoperative cortisol levels, there was a significant difference in the follow-up periods, except two periods (p < 0.05). Body temperatures were similar in all measurement periods. Conclusions Endogenous melatonin secretion was significantly decreased in the intraoperative and postoperative periods. Furthermore, there was a significant inverse correlation between changes in endogenous melatonin levels and morphine consumption.Öğe Comparison of Antioxidant Effects of Isoflurane and Propofol in Patient Undergoing Right Donor Hepatectomy(Wiley-Blackwell, 2012) Ucar, Muharrem; Ozgul, Ulku; Polat, Alaadin; Toprak, Huseyin I.; Erdogan, Mehmet A.; Aydogan, Mustafa S.; Durmus, Mahmut[Abstract Not Available]Öğe Comparison of effects of propofol and ketamine-propofol mixture (ketofol) on laryngeal mask airway insertion conditions and hemodynamics in elderly patients: a randomized, prospective, double-blind trial(Springer Japan Kk, 2013) Erdogan, Mehmet Ali; Begec, Zekine; Aydogan, Mustafa Said; Ozgul, Ulku; Yucel, Aytac; Colak, Cemil; Durmus, MahmutThe objective of this study was to compare the effects of ketamine-propofol mixture (ketofol) and propofol on ProSeal laryngeal mask airway (PLMA) insertion conditions and hemodynamics in elderly patients. Eighty elderly patients, American Society of Anesthesiologists (ASA) physical status I and II, were randomly divided into two groups to receive either propofol 0.15 ml/kg (n = 40), or ketofol (using a 1:1 single-syringe mixture of 5 mg/ml ketamine and 5 mg/ml propofol) (n = 40) before induction of anesthesia. Sixty seconds after induction, the PLMA was inserted. Heart rate and arterial blood pressure (systolic [S] BP) were recorded prior to the induction of anesthesia, immediately following induction, immediately after PLMA insertion, and 5 and 10 min after PLMA insertion. PLMA insertion conditions were scored according to mouth opening, swallowing, coughing, head and body motion, laryngospasm, and ease of PLMA insertion by the same experienced anesthesiologist, who did not know which agents were used. There were no differences in PLMA insertion conditions between the groups. The number of patients in need of ephedrine (P = 0.043) and the total dose of ephedrine (P = 0.022) were significantly lower, and apnea duration (P < 0.001) was significantly higher in the ketofol group compared with the propofol group. SBP was significantly higher in the ketofol group than in the propofol group immediately after PLMA insertion and 5 min after PLMA insertion. The same PLMA insertion conditions were found with ketofol and propofol. The number of patients in need of ephedrine and the total ephedrine dose were lower and apnea duration was increased in the ketofol group.Öğe Comparison of hemodynamic responses and QTc intervals to tracheal intubation with the McGRATH MAC videolaryngoscope and the Macintosh direct laryngoscope in elderly patients(Wiley, 2019) Colak, Fatih; Ozgul, Ulku; Erdogan, Mehmet A.; Kayhan, Gulay E.; Erdil, Feray A.; Colak, Cemil; Durmus, MahmutOur hypothesis was that intubations with the McGRATH MAC videolaryngoscope in elderly patients would produce less hemodynamic responses and ECG changes than the Macintosh direct laryngoscope. The patients were divided into two groups: patients who were intubated using the McGRATH MAC (Group V, n = 45) and patients who were intubated using the Macintosh direct laryngoscope (Group L, n = 45). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR) were recorded before induction with anesthesia (baseline), immediately after induction and at 1min, 3min, and 5 min after intubation, with simultaneous ECG. When Group L was compared to Group V, there was an increase in the first, third and fitth minutes after intubation in terms of HR. SBP, MAP increased only at 1 min after intubation and DBP increased in the first and third minutes after intubation in Group L. In Group L, there was a significant difference in the HR values immediately after induction and the first minute after intubation compared with the baseline values. There was a difference in the SBP values immediately after induction and at 3 min and 5 min after intubation compared with the baseline values. There was a difference in DBP and MAP values immediately after induction and at 5 min after intubation. When the McGRATH MAC videolaryngoscope was compared with the Macintosh direct laryngoscope in elderly patients, the McGRATH MAC videolaryngoscope decreased the hemodynamic fluctuations due to tracheal intubation.Öğe Comparison of intravenous ibuprofen and acetaminophen for postoperative multimodal pain management in bariatric surgery: A randomized controlled trial(Elsevier Science Inc, 2018) Kayhan, Gulay Erdogan; Sanli, Mukadder; Ozgul, Ulku; Kirteke, Ramazan; Yologlu, SaimStudy objective: Multimodal analgesic strategies are recommended to decrease opioid requirements and opioid-induced respiratory complications in patients undergoing laparoscopic bariatric surgery. Recent studies have demonstrated that intravenous ibuprofen decreases opioid consumption compared with placebo. The primary aim of this study was to compare the effect of intravenous ibuprofen and intravenous acetaminophen on opioid consumption. We also aimed to compare postoperative pain levels and side effects of the drugs. Design: Randomized, double-blinded study. Setting: University hospital. Patients: Eighty patients, aged 18-65 years, (ASA physical status undergoing laparoscopic sleeve gastrectomy or laparoscopic Roux-en-Y gastric bypass surgery were included in this study. Interventions: Patients were randomized to receive 800 mg ibuprofen or 1 g acetaminophen intravenously every 6 h for the first 24 h following surgery; in addition, patient-controlled analgesia with morphine was administered. Measurements: Postoperative morphine consumption in the first 24 h, visual analog scale (VAS) pain scores at rest and with movement, and opioid related side effects were assessed. In addition, time to passage of flatus, surgical complications, lengths of intensive care unit and hospital stay, and laboratory parameters were recorded. Main results: The mean morphine consumption was 23.94 +/- 13.89 mg in iv ibuprofen group and 30.23 +/- 13.76 mg in the acetaminophen group [mean difference: -6.28 (95% CI, -12.70, 0.12); P = 0.055]. The use of intravenous ibuprofen was associated with reduction in pain at rest (AUC, 1- to 24-h, P < 0.001 and 12- to 24-h, P = 0.021) and pain with movement (AUC, 1-24, 6-24, and 12-24 h, P < 0.001). Intravenous ibuprofen was well tolerated with no serious side effects except dizziness. Conclusions: Intravenous ibuprofen did not significantly reduce opioid consumption compared to intravenous acetaminophen; however, it reduced the severity of pain. Intravenous ibuprofen may be a good alternative to intravenous acetaminophen as part of a multimodal postoperative analgesia in patients undergoing bariatric surgery.Öğe Comparison of videolaryngoscope-guided versus standard digital insertion techniques of the ProSeal™ laryngeal mask airway: a prospective randomized study(Bmc, 2019) Ozgul, Ulku; Erdil, Feray Akgul; Erdogan, Mehmet Ali; Begec, Zekine; Colak, Cemil; Yucel, Aytac; Durmus, MahmutBackground: This study were designed to investigate the usefulness of the videolaryngoscope-guided insertion technique compared with the standard digital technique for the insertion success rate and insertion conditions of the Proseal (TM) laryngeal mask airway (PLMA). Methods: Prospective, one hundred and nineteen patients (ASA I-II, aged 18-65 yr) were randomly divided for PLMA insertion using the videolaryngoscope-guided technique or the standard digital technique. The PLMA was inserted according to the manufacturer's instructions in the standard digital technique group. The videolaryngoscope-guided technique was performed a C-MAC (R) videolaryngoscope with D-Blade, under gentle videolaryngoscope guidance, the epiglottis was lifted, and the PLMA was advanced until the tip of the distal cuff reached the oesophagus inlet. The number of insertion attempts, insertion time, oropharyngeal leak pressure, leak volume, fiberoptic bronchoscopic view, peak inspiratory pressure, ease of gastric tube placement, hemodynamic changes, visible blood on PLMA and postoperative airway morbidity were recorded. Results: The first-attempt success rate (the primary outcome) was higher in the videolaryngoscope-guided technique than in the standard digital technique (p = 0.029). The effect size values with 95% confidence interval were 0.19 (0.01-0.36) for the first and second attempts, 0.09 (- 0.08-0.27) for the first and third attempts, and not computed for the second and third attempts by the groups, respectively. Conclusion: Videolaryngoscope-guided insertion technique can be a help in case of difficult positioning of a PLMA and can improve the PLMA performance in some conditions. We suggest that the videolaryngoscope-guided technique may be a useful technique if the digital technique fails. Trial registration: ClinicalTrials.gov NCT03852589 date of registration: February 22th 2019.Öğe Dexmedetomidine ameliorates TNBS-induced colitis by inducing immunomodulator effect(Academic Press Inc Elsevier Science, 2013) Kayhan, Gulay Erdogan; Gul, Mehmet; Kayhan, Basak; Gedik, Ender; Ozgul, Ulku; Kurtoglu, Elcin Latife; Durmus, MahmutBackground: Since sedatives are often administered to immune-compromised and critically ill patients, our understanding of immunomodulation by sedation will be critical. Dexmedetomidine, a selective alpha(2)-adrenergic receptor agonist, is often used for sedation and analgesia especially in intensive care units. There are conflicting and little data concerning both the effect and the mechanism of dexmedetomidine on immune response. In our study, we aimed to investigate the effect of dexmedetomidine on immune system at two different doses (5 mu g.kg(-1) and 30 mu g.kg(-1)) during inflammatory bowel disease by using an experimental model, which resembles both systemic and local inflammation. Methods: The effect of dexmedetomidine on the course of inflammatory bowel disease was investigated by measuring macroscopic and microscopic parameters. We investigated pro-inflammatory Th1, Th2, and Th17 cytokine levels in serum samples to analyze systemic immune response. Following this, local immune response was investigated by measuring cytokine levels in the presence of dexmedetomidine in spleen cell culture. Results: Dexmedetomidine administration led to amelioration of all disease associated pathological manifestations. According to our in vitro and in vivo results, dexmedetomidine shows anti-inflammatory effect by increasing IL-4 and IL-10 levels responsible from anti-inflammatory response via Th2 pathway. Moreover, we showed for the first time in the study that dexmedetomidine administration reduces IL-23, which is responsible from initiation of inflammatory response via Th17 pathway. Conclusions: Dexmedetomidine can have beneficial effect on preoperative or postoperative inflammatory bowel disease patients in intensive care units by down-regulating inflammatory immune response not only in systemic circulation but also in tissue-specific manner. (c) 2013 Elsevier Inc. All rights reserved.Öğe Dexmedetomidine, Remifentanil, and Sevoflurane in the Perioperative Management of a Patient During a Laparoscopic Pheochromocytoma Resection(W B Saunders Co-Elsevier Inc, 2015) Erdogan, Mehmet Ali; Ozkan, Ahmet Selim; Ozgul, Ulku; Colak, Yusuf; Ucar, Muharrem[Abstract Not Available]Öğe 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, MahmutBackground: 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.Öğe The effect of magnesium on emergence agitation in children undergoing adenotonsillectomy under sevoflurane general anesthesia: a prospective randomised clinical trial(Drunpp-Sarajevo, 2012) Yucel, Aytac; Begec, Zekine; Ozgul, Ulku; Aydogan, M. Said; Gulhas, Nurcin; Ersoy, M. OzcanBackground: The aim of this study was to assess the effect of magnesium on the incidence of emergence agitation in preschool-aged children undergoing adenotonsillectomy with sevoflurane anaesthesia. Patients & Methods: 42 children, aged between 3 to 7 years, were randomised into either group M (magnesium, n=26) or group C (saline for controls, n=26). Anesthesia was induced by mask with 8 % sevoflurane in nitrous oxide and oxygen. Magnesium 15 mg.kg(-1) or saline was administered in about 20 minutes after the endotracheal intubation intraoperatively. All patients were ventilated with 60% nitrous oxide and sevoflurane was given at 1-1.5 MAC in oxygen. Mean blood pressure, heart rate, pulse oximetry, eye-opening time, extubation time were recorded in the operating room. In recovery, patients were evaluated using modified Aldrete score, the Pediatric Anesthesia Emergence Delirium (PAED) scale and the Oucher visual analog Pain Scale. Postoperative nause, vomiting, and airway complication and first analgesic application were recorded. Results: Time to eye opening, tracheal extubation, and first analgesic administration were not different between the groups. There were no statistically significant differences in mean arterial pressure and heart rate, pain score and PAED peak scale between the groups (p > 0.05). The modified Aldrete score was significantly lower in the magnesium group (p=0.004). There was no statistically significant difference between the groups regarding side effects. Conclusions: We conclude that the administration of magnesium 15 mg.kg(-1) did not have any significant effect in reducing the incidence of emergence agitation in children undergoing adenotonsillectomy under sevoflurane anaesthesia.Öğe The effect of placement of a support under the shoulders on laryngeal visualization with a C-MAC Miller Video Laryngoscope in children younger than 2 years of age(Wiley, 2019) Gencay, Zeynep Koylu; Begec, Zekine; Ozgul, Ulku; Colak, CemilBackground We aimed to evaluate glottis visualization and time to intubation in children younger than 2 years of age during laryngoscopy performed with a C-MAC Miller Video Laryngoscope in a position determined by placing a folded towel under the shoulders to align the oral-pharyngeal and laryngeal axes in the horizontal plane. Methods Ninety-six children younger than 2 years of age, who were classified by the American Society of Anesthesiologists as having a physical status I or II and who were scheduled for elective surgery necessitating endotracheal intubation under general anesthesia, were included in the study. All patients were intubated with a C-MAC Miller Video Laryngoscope. The children intubated by placing a folded towel under the shoulders were categorized as Group 1 (n = 48), and the children intubated without placement of a folded towel were categorized as Group 2 (n = 48). The percentage of glottis opening and Cormack-Lehane Scores, values of visual analogue scale to determine the ease of using a C-MAC Miller Video Laryngoscope, time to intubation, number of intubation attempts, optimization procedures and complications were recorded for all children. Results There was a statistically significant difference between Group 1 (mean +/- SD; 97.71 +/- 4.24) and Group 2 (mean +/- SD; 94.17 +/- 7.09) in terms of the percentage of glottis opening scores (P = 0.004). The mean difference in the percentage of glottis opening scores (95% confidence interval) between the groups was 3.54 (1.17-5.90). Conclusion We showed that a folded towel placed under the shoulders in children younger than 2 years of age improves glottis visualization provides ease of use of the C-MAC Miller Video Laryngoscope. Therefore, we think that the placement of a folded towel under the shoulders during the use of a C-MAC Miller Video Laryngoscope may be useful for airway management in children younger than 2 years of age.Öğe Effect of the Addition of Ketamine to Sevoflurane Anesthesia on Seizure Duration in Electroconvulsive Therapy(Lippincott Williams & Wilkins, 2015) Erdil, Feray; Ozgul, Ulku; Colak, Cemil; Cumurcu, Birgul; Durmus, MahmutObjectives We evaluated the effects of a subanesthetic dose of ketamine, which was administered as an adjunct to sevoflurane, on duration of seizure activity, hemodynamic profile, and recovery times during electroconvulsive therapy in patients with major depression. Methods Patients were randomly allocated to a group receiving either sevoflurane-ketamine (group SK) or sevoflurane-saline (group SS). Sevoflurane was initiated in both groups at 8% for anesthesia induction until loss of consciousness was achieved, at which point it was discontinued. After loss of consciousness, ketamine was administered to the group SK in the form of a 0.5-mg/kg intravenous bolus. Patients in the group SS received saline in the same manner. Mean arterial pressure (MAP) and heart rate were recorded before anesthetic induction (T1); after anesthetic induction (T2); as well as 0, 1, 3, and 10 minutes after the seizure had ended (T3, T4, T5, and T6, respectively). Motor and electroencephalogram seizure durations were recorded. Results Motor and electroencephalogram seizure durations in the group SS were similar to those observed for the group SK. The heart rate increased significantly during T2 to T6 in both group SS and group SK compared with the baseline. The MAP increased in the group SS during the period between T3 and T6 as well as in the group SK during the same period compared with the baseline. The MAP increased more in the group SK, in comparison with the group SS, during T2 (P < 0.05). Conclusions The addition of ketamine at subanesthetic doses, for the purposes of anesthetic induction with sevoflurane, yielded results similar to those in the control group in terms of both seizure duration and hemodynamic stability.Öğe Effect of transversus abdominis plane block in combination with general anesthesia on perioperative opioid consumption, hemodynamics, and recovery in living liver donors: The prospective, double-blinded, randomized study(Wiley, 2017) Erdogan, Mehmet A.; Ozgul, Ulku; Ucar, Muharrem; Yalin, Mehmet R.; Colak, Yusuf Z.; Colak, Cemil; Toprak, Huseyin I.BackgroundTransversus abdominis plane (TAP) block provides effective postoperative analgesia after abdominal surgeries. It can be also a useful strategy to reduce perioperative opioid consumption, support intraoperative hemodynamic stability, and promote early recovery from anesthesia. The aim of this prospective randomized double-blind study was to assess the effect of subcostal TAP blocks on perioperative opioid consumption, hemodynamic, and recovery time in living liver donors. MethodsThe prospective, double-blinded, randomized controlled study was conducted with 49 living liver donors, aged 18-65years, who were scheduled to undergo right hepatectomy. Patients who received subcostal TAP block in combination with general anesthesia were allocated into Group 1, and patients who received general anesthesia alone were allocated into Group 2. The TAP blocks were performed bilaterally by obtaining an image with real-time ultrasound guidance using 0.5% bupivacaine diluted with saline to reach a total volume of 40mL. The primary outcome measure in our study was perioperative remifentanil consumption. Secondary outcomes were mean blood pressure (MBP), heart rate (HR), mean desflurane requirement, anesthesia recovery time, frequency of emergency vasopressor use, total morphine use, and length of hospital stay. ResultsTotal remifentanil consumption and the anesthesia recovery time were significantly lower in Group 1 compared with Group 2. Postoperative total morphine use and length of hospital stay were also reduced. Changes in the MAP and HR were similar in the both groups. There were no significant differences in HR and MBP between groups at any time. ConclusionsCombining subcostal TAP blocks with general anesthesia significantly reduced perioperative and postoperative opioid consumption, provided shorter anesthesia recovery time, and length of hospital stay in living liver donors.Öğe Effects of Melatonin and ?-Glucan Combination Hepatic Ischemia and Reperfusion in Rats(Wiley-Blackwell, 2012) Aydogan, Mustafa Said; Erdogan, Mehmet Ali; Polat, Alaadin; Yucel, Aytac; Ozgul, Ulku; Parlakpinar, Hakan; Duran, Zeynep Rumeysa[Abstract Not Available]
