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    Comparison of the effects of dexmedetomidineremifentanil and propofol-remifentanil combinations on postoperative cognitive functions in patients undergoing hysteroscopy: A randomized prospective study
    (2019) Atasoy, Idris; Soyalp, Celaleddin; Gulhas, Nurcin
    Aim: In the present study, we aimed to compare Dexmedetomidine-Remifentanil and Propofol-Remifentanil combinations in terms of postoperative cognitive functions in hysteroscopy attempts. Material and Methods: A total of 70 ASA I-II patients who were aged between 18 and 65 years were included in the study following the ethics committee approval. The patients were randomized into two groups (n=35), and standard routine monitoring were applied to them. The sedation depth was evaluated with Ramsey Sedation Score (RSS) before and after the sedation; and cognitive functions of the groups were evaluated with the Minimal Mental State Test (MMST). Propofol 1 mg/kg bolus 25-100 µg/kg/min infusion was administered to Group PR, and Dexmedetomidine 1 µg/kg bolus 0.4-0.7 µg/ kg/h infusion dose was administered to Group DR. Remifentanil 0.25 µg/kg bolus 0.04 µg /kg/min infusion was administered to the groups, and the groups were followed to ensure RSS≥4. Result: In cognitive functions, it was observed that there was significant regression in Group PR in postoperative period compared to the preoperative period (p<0.05). The hemodynamic parameters were lower in Group DR than in Group PR at 5th, 10th and 15th minutes following the hysteroscopy (p<0.05). The Modified Aldrete Score in Group DR were high, and pain scores were lower (p<0.05). Satisfaction with the surgeon, patient and anesthetist scores were higher in Group DR. No respiratory depression was observed (p<0.05). Conclusion: We believe that administering Dexmedetomidine-Remifentanil combination in sedation in hysteroscopy ensures better postoperative cognitive function, recovery conditions, analgesia, and patient and surgeon satisfaction compared to the PropofolRemifentanil combination.
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    Drug-drug interactions in intensive care units and potential clinical consequences of these interactions
    (2019) Oksuz, Ersoy; Bugday, Muhammet Serdar; Soyalp, Celaleddin; Karaaslan, Erol; Oto, Gokhan; Temelli Goceroglu, Rezzan; Berber, Ilhami
    Aim: Drug-drug interactions (DDIs) are an important factor that can lead to serious health problems by increasing or decreasing the effects of drugs. This study aimed to evaluate the frequency of DDIs in the intensive care unit (ICU).Material and Methods: All patients who were hospitalized for more than 24 h in the ICU of our hospital between January and September 2018 and received 2 or more medications were included in this retrospective study. Frequency and severity of the DDIs were detected using the Rx Mediapharma and Lexi-Interact programs.Results: Of the 972 patients enrolled in the study, 2742 incidences of DDIs were detected in 626 patients (64%). Of the different drug pairs administered, 422 had DDIs, and 64 of those had 10 or more DDIs, constituting 67% of all of the DDIs. The most common potential clinical consequences of DDIs were increased risk of bleeding (12.3%), hyperkalemia (8.2%), arrhythmia (7.9%), and CNS depression (6.6%). Conclusion: The results indicated that DDIs in the ICU were very common in our hospital. Moreover, these results indicated that patients should be closely monitored for the prevention of adverse effects, such as electrolyte disturbance, bleeding risk, and arrhythmia of drugs.
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    Drug-drug interactions in intensive care units and potential clinical consequences of these interactions
    (2019) Öksüz, Eray; Buğday, Muhammed Serdar; Soyalp, Celaleddin; Karaaslan, Erol; Oto, Gökhan; Temelli Göçeroğlu, Rezzan; Berber, İlhami
    Abstract: Aim: Drug-drug interactions (DDIs) are an important factor that can lead to serious health problems by increasing or decreasing theeffects of drugs. This study aimed to evaluate the frequency of DDIs in the intensive care unit (ICU).Material and Methods: All patients who were hospitalized for more than 24 h in the ICU of our hospital between January andSeptember 2018 and received 2 or more medications were included in this retrospective study. Frequency and severity of the DDIswere detected using the Rx Mediapharma and Lexi-Interact programs.Results: Of the 972 patients enrolled in the study, 2742 incidences of DDIs were detected in 626 patients (64%). Of the differentdrug pairs administered, 422 had DDIs, and 64 of those had 10 or more DDIs, constituting 67% of all of the DDIs. The most commonpotential clinical consequences of DDIs were increased risk of bleeding (12.3%), hyperkalemia (8.2%), arrhythmia (7.9%), and CNSdepression (6.6%).Conclusion: The results indicated that DDIs in the ICU were very common in our hospital. Moreover, these results indicated thatpatients should be closely monitored for the prevention of adverse effects, such as electrolyte disturbance, bleeding risk, andarrhythmia of drugs.
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    Effects of tracheal intubation without muscle relaxants on postoperative recovery conditions in patients with obstructive sleep apnea: A double-blind randomized controlled study
    (2019) Soyalp, Celaleddin; Tuncdemir, Yunus Emre; Yuzkat, Nureddin; Gulhas, Nurcin
    Aim: We aimed to compare intubation with and without neuromuscular blocking agents with regard to intubation success, hemodynamic parameters, and postoperative recovery in Obstructive sleep apnea patients.Materials and Methods: The study included 60 patients with a STOP-Bang (Snoring, Tiredness during daytime, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, Gender) score of ≥3. The patients were randomly divided into two groups: (I) rocuronium group (Group E) and (II) remifentanil group (Group R). Group R received 4 mcg/kg remifentanil and Group E received 0.6 mg/kg rocuronium and then the patients’ intubation difficulty scale scores and their responses to train-of-four (TOF) nerve stimulation, and postoperative recovery were evaluated in both groups.Results: The median time to recovery of the TOF ratio to 0 following anesthetic induction was significantly higher in Group R compared to Group E (p0.001). The overall incidences of postoperative sore throat and hoarseness were remarkably high (p0.002 and p0.001, respectively). The numbers of patients with relaxed vocal cords and complete jaw relaxation were significantly higher in Group E compared to Group R (p0.001). Conclusion: The results indicated that rocuronium provides better intubation conditions and leads to less peri- and post-operative complications compared to remifentanil.Keywords: Obstructive sleep apnea syndrome; intubation without muscle relaxants; postoperative recovery; stop bang tracheal intubation.