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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 Anaesthetic management of an infant with Conradi's syndrome(Blackwell Publishing Ltd, 2003) Hascalik, M; Togal, T; Doganay, S; Ersoy, MO[Abstract Not Available]Öğe Effectiveness of intravenous ephedrine infusion during spinal anaesthesia for Caesarean section based on maternal hypotension, neonatal acid-base status and lactate levels(Australian Soc Anaesthetists, 2002) Turkoz, A; Togal, T; Gokdeniz, R; Toprak, HI; Ersoy, OMaternal cardiovascular changes and neonatal acid-base status, including lactate levels, were assessed in 30 healthy women undergoing elective caesarean section under spinal anaesthesia. Patients were allocated randomly to receive IV ephedrine infusion (n = 15) (5 mg.min(-1)) immediately after the spinal injection or bolus administration of IV ephedrine (n = 15) (10 mg) in case of development of hypotension. Maternal and neonatal blood pressure, heart rate and acid-base status including lactate levels were compared between the groups. Systolic blood pressure in the bolus group was significantly lower when compared to the infusion group. Nausea was observed in one patient (6%) in the infusion group and nausea and vomiting were observed in 10 patients (66%) in the bolus group. Although umbilical arterial pH values were significantly lower in the bolus group, lactate levels were similar. In conclusion, ephedrine infusion prevented maternal hypotension, reduced the incidence of nausea and vomiting and led to improved umbilical blood pH during spinal anaesthesia for caesarean section.Öğe Effects of fentanyl on the incidence of emergence agitation in children receiving desflurane or sevoflurane anaesthesia(Greenwich Medical Media Ltd, 2004) Demirbilek, S; Togal, T; Cicek, M; Aslan, U; Sizanli, E; Ersoy, MOBackground and objective: In children, emergence agitation frequently complicates sevoflurane and desflurane anaesthesia. The effect of intravenous fentanyl 2.5 mug kg(-1) was examined on the incidence of emergence agitation in children who received desflurane or sevoflurane after midazolam premedication and intravenous thiopental induction. Methods: One hundred and twenty children (2-7 yr) undergoing adenoidectomy or tonsillectomy, or both, were studied. All children were premedicated orally with midazolam 0.5 mg kg(-1). After intravenous induction with thiopental and atracurium to facilitate endotracheal intubation, patients were randomly assigned to one of four groups: Patients in Groups I and 3 received physiological saline solution, whereas patients in Groups 2 and 4 received intravenous fentanyl 2.5 mug kg(-1) during induction. Anaesthesia was maintained with sevoflurane in Groups I and 2 and with desflurane in Groups 3 and 4. After discontinuation of the volatile anaesthetic, the times to tracheal extubation and response to verbal stimuli (emergence time), and emergence behaviours were recorded. Results: The time to tracheal extubation was significantly shorter in Groups 3 (5.2 +/- 1.7 min) and 4 (6.4 +/- 2.1 min) than in Groups 1 (8.1 +/- 2.1 min) (P = 0.0001 and 0.006, respectively) and 2 (8.8 +/- 1.9 min) (P = 0.0001). The emergence time was significantly shorter in Group 3 (10.0 +/- 3.9 min) than in Groups 1 (13.8 +/- 4.9 min) (P = 0.017) and 2 (14.9 +/- 4.1 min) (P = 0.003). The incidence rate of severe agitation was 13% in Groups 1 and 3, and 7 and 10% in Groups 2 and 4, respectively (P > 0.05). Conclusions: After midazolam premedication and intravenous induction of anaesthesia with thiopental, administration of intravenous fentanyl 2.5 mug kg(-1) did not provide any clinically significant benefit on emergence agitation in children who receive sevoflurane or desflurane anaesthesia.Öğe Effects of halotane, sevoflurane and isoflurane anesthesia on neuromusculer blocking effect of rocuromum(Prof Sci Publ, 1999) Togal, T; Türköz, A; Sahin, S; Toprak, HI; Ersoy, MÖ[Abstract Not Available]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 Oral clonidine premedication does not reduce postoperative vomiting in children undergoing strabismus surgery(Blackwell Munksgaard, 2003) Gulhas, N; Turkoz, A; Durmus, M; Togal, T; Gedik, E; Ersoy, MOBackground: We evaluated the effect of oral clonidine on postoperative vomiting (POV) in children undergoing strabismus surgery. Methods: Eighty ASA physical status I children aged 3-12 years were randomly assigned to one of two groups in a double-blinded manner. One hour before surgery, each patient in the clonidine group (n=40) received clonidine 4 mug kg(-1) in apple juice 0.2 ml kg(-1) , and each of the controls (n=40) received apple juice 0.2 ml kg(-1) only. The protocol for general anesthesia was propofol-sevoflurane in N-2 O/O-2 . A paracetamol suppository was administered in each case to prevent postoperative pain. Patient responses during 0-48 h after anesthesia were recorded as complete (no POV, no antiemetic rescue required), retching, vomiting, or rescue antiemetic. Results: There were no significant differences between the clonidine and control groups regarding the number of patients with complete response (21 vs. 18, respectively) retching (10 vs. 14, respectively), vomiting (19 vs. 22, respectively), or rescue antiemetic (9 vs. 12, respectively) during the first 48 h. Conclusion: Oral premedication with clonidine 4 mug kg(-1) did not reduce the rate of POV in the children undergoing strabismus surgery.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 Spinal anaesthesia in full-term infants of 0-6 months(Cambridge Univ Press, 2005) Köroglu, A; Durmus, M; Togal, T; Özpolat, Z; Ersoy, MÖBackground and objective: The aim of the study was to report our experience concerning the effectiveness, complications and safety of spinal anaesthesia, and to determine whether spinal anaesthesia was effective in full-term infants undergoing elective inguinal hernia repair. Methods: Sixty-eight full-term infants aged <6 months were included in the study. Infants were divided into three groups; Group I (<1 month, n = 20), Group II (>1 and <3 months, n = 26), and Group III (3-6 months, n = 22). All spinal blocks were performed under mask inhalation anaesthesia. A dose of bupivacaine 0.596 0.5 mg kg(-1) was used for infants under 5 kg and 0.4 mg kg(-1) for those over 5 kg. Heart rate, mean arterial pressure, respiratory rate and SpO2 were recorded before and after spinal anaesthesia at 5 min intervals. Time to onset of analgesia, time to start of operation, duration of operation, anaesthesia and hospitalization, postoperative analgesic requirement and complications were recorded. Results: Adequate spinal anaesthesia without sedation was better, time to obtain maximum cutaneous analgesia was shorter and need for sedation and postoperative analgesic requirement were significantly lower in Group I. Although heart rate, mean arterial pressure and respiratory rate decreased <20% in all groups following spinal analgesia, the decrease in Group I was lower than the others. Conclusions: Spinal anaesthesia is an effective choice in inguinal hernia repair for full-term infants aged <1 month, providing excellent and reliable surgical conditions. However, this technique is not as useful for infants aged between 1 and 6 months.Öğe The use of magnesium to prevent laryngospasm after tonsillectomy and adenoidectomy: a preliminary study(Blackwell Publishing Ltd, 2003) Gulhas, N; Durmus, M; Demirbilek, S; Togal, T; Ozturk, E; Ersoy, MOBackground : Laryngospasm is the most common cause of upper airway obstruction after tracheal extubation. Magnesium has a central nervous system depressant property, which contributes to the depth of anaesthesia. It also has calcium antagonist properties, which provide muscle relaxation. In this study, we aimed to determine the effect of magnesium on preventing laryngospasm. Methods : After approval of the Ethics Committee and informed parental consent, 40 patients, ASA I-II, aged 3-12 years, who were scheduled for tonsillectomy or/and adenoidectomy, were randomly divided into two groups. Anaesthesia was induced with sevoflurane, lidocaine 1 mg.kg(-1) , alfentanil 10 mug.kg(-1) , vecuronium 0.1 mg.kg(-1) and maintained with sevoflurane 2% and 60% nitrous oxide in oxygen. After intubation, patients in group I received 15 mg.kg(-1) magnesium in 30 ml 0.9% NaCl over 20 min. Patients in group II received 0.9% NaCl alone in the same volume. After reversal of neuromuscular blockade, all patients were extubated at a very deep plane of anaesthesia. The incidence of laryngospasm was determined until the time of discharge from the postanaesthesia care unit. Results : Although laryngospasm was not observed in group I, it was observed in five patients in group II (25%). The incidence of laryngospasm in group II was significantly higher than group I. The plasma magnesium concentrations were significantly higher in group I than group II. Conclusions : We found a significant decrease in the incidence of laryngospasm in paediatric patients receiving magnesium. It is suggested that the use of intravenous magnesium intraoperatively may prevent laryngospasm.
