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Öğe Dextrane 40 followed by cardiac arrest(2000) Turkoz A.; Gulcan O.; But A.K.; Hazar A.; Ersoy O.Anaphylactic reaction due to dextrane 40 is uncommon. A case of anaphylactic reaction followed by cardiac arrest after intravenous dextran 40 infusion in postoperative period is reported. In this case, Cardiopulmonary resuscitation was continued for 116 min after the cardiac arrest and the case was recovered completely. The possible etiology, manifestations, and management of the adverse drug reaction are discussed.Öğe Effect of spinal anaesthesia level on the dosage of sedation(1999) Turkoz A.; Togal T.; Toprak H.I.; Ersoy O.It is sometimes observed that the patients under high spinal anaesthesia (T3-6) alter their wakefulness and that the patients become drowsy without sedative drugs. In these cases, the dosages of the sedative drugs should be decrease if the sedative drugs necessary. We have tested whether sensory level of T8 may affect the susceptibility to the soporific effect of sedatives. ASA grade I, 63 male patients undergoing elective lower extremity surgery were randomized to receive either spinal anaesthesia with sedation (group I), or general anesthesia with sedation (group 2). Patients in group 1 were given a subarachnoid injection of 3.5 mL hyperbaric bupivacine and those patients who had a sensory blockade level of T8 after 10 min. were divided in to three subgroups consisting ten patients (group 1a, 1b, 1c) and the patients in group II were also divided into three subgroups of ten patients (group IIa, IIb, IIc). Propofol, thiopenthone and midazolam were given until patients' sedation score achieve '3' and then stopped. In group Ia patients were given thiopenthone at the rate of 40 mg/kg/hr and in group 1c, the patients were given midazolam 1 mg intravenously, every 30 seconds. In group IIa, b, c infusion of drugs were started as stated above till the sedation score of '3' then general anaesthesia were induced. In group I and group II, the dose of propofol administered until the patients sedation score of '3' was achieved was 78±12.9 (group 1a), 83.8±11.1 mg (group IIa) p>0.05, the dose of thiopenthone was 147.5±35.4 mg (group 1b), 152.0±39.4 mg (group IIb) (p>0.05) and the dose of midazolam was 5.7±1.0 mg (group 1c), 6.4±2.2 mg (group II) (p>0.05). Although all three drugs were used less in group I than in group 2, no significant differences were observed between the groups statistically. In conclusion it is not required to reduce the amount of sedative drugs in the patients having a T8 level spinal anaesthesia.Öğe Glucose-insulin-potassium solution before cardiopulmonary bypass in coronary artery surgery(2000) Turkoz A.; Toprak H.I.; Sari S.; Ozturk E.; Durmus M.; Turkoz R.; Ersoy M.O.Glucose-insulin-potassium (GIK) solution has been advocated for the treatment of ischemic myocardium. This prospective, randomized clinical study was conducted to evaluate whether GIK solutions would cause benefit for the patients in addition to anterograd and retrograd combined blood cardioplegia undergoing coronary artery bypass grafting because of depressed left ventricle and unstable angina. The study group consisted of 33 patients with depressed left ventricle and unstable angina who underwent coronary artery bypass grafting, 2 patients were excluded from the study because of catheter dislocation. In 15 patients GIK solution (500 mL of 30 % dextrose, 70 units insuline, 80 mEq potassium) was given intravenously at 1 mL/kg per hour started with induction of anaesthesia, until the stage of cardiopulmonary bypass (CPB). Sixteen patients received ringer's lactate as the control group. The patients were analysed for hemodynamic changes, blood glucose and potassium levels. Pulmonary capillary wedge pressure, cardiac output, systemic vascular resistance, pulmonary vascular resistance were not different between two groups immediately before and after CPB. Blood glucose levels were not different between the two groups, but in both groups the levels increased after the end of the infusion of GIK solution, on the fifteenth minutes and at the end of the CPB. No differences were determined at the end of operation. There was no difference in serum potassium levels between the two groups, but potassium levels increased significantly during and immediately after CPB and decreased to the basal levels at the end of the operation in both groups. There was no significant difference between the groups in perioperative myocardial infarction, incidence of atrial and ventricular arrhythmias, times of ventilator support, length of stay in the intensive care unit and mortality. In this study, GIK therapy did not produce any additional positive hemodynamic effects and postoperative recovery from depressed left ventricle and urgent coronary artery bypass grafting.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]Öğe Resistance to vecuronium in a patient with testicular feminization (Case report)(1999) Turkoz A.; Ersoy O.A 19 year old patient was diagnosed with testicular feminization. She was scheduled to undergo bilateral inguinal gonadectomy. All the preoperative laboratory tests were found to be normal except the elevated plasma testosterone and low plasma estrogen levels. In the operating room, the patient was intubated after following standard monitorization. Full return of train-of-four-twitches were observed at approximately five minutes after the surgical incisions. The total dose of vecuronium given over 90 minutes was 22 mg until the end of the operation. An investigation after the operation identified that the patients sister also had a similar operation a year earlier and high doses of vecuronium was used. The possible causes were carefully assessed, this case and her sister confirmed a possible interaction between vecuronium and testosterone.Öğe Secondary cross-clamping and blood cardioplegia for refractory ventricular fibrillation after aortic cross-clamp removal [2](2002) Turkoz A.; Toprak H.I.; Ersoy M.O.; Gulcan O.; Turkoz R.[No abstract available]
