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Öğe Bispectral Index Monitoring to Guide End-Tidal Isoflurane Concentration at Three Phases of Operation in Patients With End-Stage Liver Disease Undergoing Orthotopic Liver Transplantation(Elsevier Science Inc, 2011) Toprak, H. I.; Sener, A.; Gedik, E.; Ucar, M.; Karahan, K.; Aydogan, M. S.; Ersoy, M. O.It has been shown that anesthetic requirements during liver transplantation are inversely proportional to the degree of hepatic dysfunction. We investigate alterations during the three phases of requirements for intraoperative isoflurane within the target of 40 to 55 Bispectral Index (BIS) values concerning patients with end-stage liver disease who are undergoing liver transplantation. After faculty ethics committee approval, we studied 50 patients of (age range, 18 to 65 years) who were undergoing liver transplantation. After induction, we used isoflurane with air/oxygen (FiO(2) = 0.5%) for anesthestic maintenance. The isoflurane concentration was set within the range of 40 to 55 BIS values. Remifentanil (0.15 mu g/kg/min) was infused for analgesia and cisatracurium was administered via continuous infusion. After anesthetic induction, we inserted arterial, pulmonary artery, and central venous catheters. The heart rate, mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), body temperature, BIS values, end-tidal isoflurane concentration (ETiso) and end-tidal carbon dioxide concentration (ETCO(2)) were recorded at 30-minute intervals during the dissection and neohepatic phases, at 15-minute intervals during the anhepatic phase. In addition, we calculated the cardiac index during the three phases. There was no difference in heart rates among the operative phases. In contrast, there were significant changes in MAP, MPAP, BIS, ETCO(2) and body temperature values. However, all of these parameters were in physiological ranges and clinically acceptable. The ETiso values were lowest in the anhepatic phase compared to other phases, but the differences were not clinically important. The ETiso values in the dissection and neohepatic phases were compared with the anhepatic phase higher 5% and 8.6% respectively. During liver transplantation, ETiso requirement for the anhepatic phase was lower compared with the other two phases within the range of 40 to 55 BIS values.Öğe Comparison of Antioxidant Effects of Isoflurane and Propofol in Patients Undergoing Donor Hepatectomy(Elsevier Science Inc, 2015) Ucar, M.; Ozgul, U.; Polat, A.; Toprak, H. I.; Erdogan, M. A.; Aydogan, M. S.; Durmus, M.Background. The safety of healthy volunteer donors is one of the most important issues in living-donor liver transplantation. Use of the Pringle maneuver during donor hepatectomy can result in liver ischemia-reperfusion (IR) injury. The objective of this study was to examine the effects of isoflurane and propofol on IR injury caused by the Pringle maneuver during donor hepatectomy. Methods. A total of 70 American Society of Anesthesiology I-II donors aged 18-65 years who underwent hepatectomy were included in the study. The patients were randomly divided into 2 groups: propofol and isoflurane. Plasma superoxide dismutase (SOD), malondialdehyde (MDA), total oxidative status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) were measured before surgery (to) and after surgery (t(1)). Results. There were no statistically significant differences in demographic features, anesthesia, and times of surgery between the groups (P > .05). Plasma TAC levels at to and t(1) were significantly lower in the propofol group than in the isoflurane group (P < .05). OSI at t(1) was significantly higher in the propofol group than in the isoflurane group (P < .05). MDA levels were significantly higher in the propofol group than in the isoflurane group at to (P < .05). MDA levels level were significantly higher in the isoflurane group than in the propofol group at t(1) (P < .05). Conclusions. Propofol may have protective effects against IR injury caused by the Pringle maneuver during donor hepatectomy in living-donor transplantations. However, the effectiveness of propofol for clinical use needs to be investigated further.Öğe Comparison of preoperative and postoperative approaches to ultrasound-guided transversus abdominis plane block for postoperative analgesia in total abdominal hysterectomy(Scientific Publishers India, 2017) Dirican, B.; Erdogan, M.; Ucar, M.; Uzgul, U.; Gulhas, N.; Kayhan, G.; Durmus, M.Background: Transversus Abdominis Plane (TAP) block produces more effective postoperative analgesia and significantly reduces consumption of postoperative opioids after various abdominal surgeries. It can be performed either preoperatively or postoperatively. Furthermore studies investigating the ideal period for TAP block administration are few. The objective of our study was to investigate, which period is more effective for administration of TAP block on postoperative analgesia in patients undergoing total abdominal hysterectomy. Methods: This prospective randomized controlled double-blind study was conducted with 60 patients between the ages of 18-65 and ASA class I-II who were scheduled to undergo total abdominal hysterectomy. Patients who received a TAP block with ultrasound guidance prior to the surgical procedure were referred to as Group 1, the TAP block procedure after surgery made up Group 2. The rest and movement period Visual Analog Score (VAS), sedation score, nausea, vomiting and the need for additional analgesics were recorded at 2, 4, 6, 12 and 24 hours postoperatively. Results: When Group 1 was compared with Group 2, the rest period pain scores were significantly lower in Group 2 at 2 and 4 hours (p< 0.05). In Group 2, the 24-hour morphine consumption was significantly lower than that of Group 1 (p< 0.05). Conclusion: Post-operative administration of an US guided TAP block in total hysterectomy patients significantly decreased pain scores in early periods and also reduced 24 hour morphine consumption when compared with preoperative administration of the block.Öğe Dexpanthenol'ün iskemi-reperfüzyonun neden olduğu karaciğer hasarına koruyucu etkisi(2018) Ucar, M.; Aydogan, MS; Vardi, N.; Parlakpınar, H.Objective. We aimed to investigate the protective and therapeutic effects of dexpanthenol (DXP) on liver injuries induced by ischemia-reperfusion (IR) in an in vivo rat model. Methods. Thirty-two rats were randomly divided into 4 experimental groups (n = 8 in each group: Sham, IR, DXP, and DXP+IR. DXP (500 mg/kg) was intraperitoneally administered for 30 min before 60 min of ischemia, followed by 60 min of reperfusion to rats in the DXP and DXP+IR groups. All rats were euthanized on day 10 to evaluate immunohistopathological changes as well as tissue levels of oxidants and antioxidants. Results. IR decreased total glutathione (tGSH) levels in IR group when compared to the Sham group. DXP supplementation to IR group significantly ameliorated tGSH levels (P < .05). IR also elevated myeloperoxidase production compared to the Sham group, whereas DXP treatment prevented these hazardous effects. However, plasma superoxidedismutase, catalase, and malondialdehyde levels did not differ between the DXP+IR than the IR rats. Histologic tissue damage was reduced in the DXP and DXP+IR group. Conclusion. Liver IR is an inevitable problem during liver surgery. Our results suggested that DXP pretreatment suppressed oxidative stress and increased antioxidant levels in a rat model of liver IR.Öğe Effects of Apocynin on Liver Ischemia-Reperfusion Injury in Rats(Elsevier Science Inc, 2019) Yucel, A.; Aydogan, M. S.; Ucar, M.; Sarici, K. B.; Karaaslan, M. G.Objective. Ischemia-reperfusion (IR) injury is associated with various clinical conditions, such as myocardial infarction, shock, and surgery under vascular occlusion. We aimed to investigate the protective and therapeutic effects of apocynin (AP) on liver injury induced by IR in an in vivo rat model. Methods. Thirty-two rats were randomly divided into 4 experimental groups with n = 8 in each group: sham, IR, AP, and IR + AP. AP (20 mg/kg) was intraperitoneally administered to rats in the AP and IR + AP groups for 30 minutes before 60 minutes of ischemia and followed by 60 minutes of reperfusion. All rats were killed on the same day to evaluate tissue levels of oxidants and antioxidants (catalase, malondialdehyde, myeloperoxidase, superoxidedismutase (SOD), and total glutathione). Results. IR decreased SOD levels in IR group when compared with the sham group. AP supplementation to IR group significantly ameliorated SOD levels (P < .05). Also, IR caused elevation of myeloperoxidase production when compared with the sham group, whereas AP treatment prevented these hazardous effects (P < .05). However, plasma total glutathione, catalase, and malondialdehyde levels did not differ between the AP + IR and the IR rats. Conclusion. The main finding of the present study was that AP may be protective against liver IR injury. Our results suggested that AP pretreatment suppressed oxidative stress and increased antioxidant levels in an rat model of liver IR.Öğe Effects of Isoflurane and Propofol on Hepatic and Renal Functions and Coagulation Profile After Right Hepatectomy in Living Donors(Elsevier Science Inc, 2013) Ozgul, U.; Ucar, M.; Erdogan, M. A.; Aydogan, M. S.; Toprak, H. I.; Colak, C.; Durmus, M.We compared postoperative hepatic and renal functions and coagulation profiles in living donors undergoing right hepatectomy under isofiurane (n = 40) versus propofol (n = 40) anesthesia. After induction, anesthesia was maintained with isoflurane/air-O-2 (group I) or propofol/air-O-2 (group P) in addition to remifentanil and atracurium infusion in both groups. Aspartate aminotransferase, alanine aminotransferase, international normalized ratio (INR), activated partial thromboplastin time (aPTT), albumin, total bilirubin, blood urea nitrogen, creatinine, estimated glomerular filtration rate (GFR), platelet count, and hemoglobin levels were measured in the preoperative period, after end of the operation, and on the first, third, fifth and seventh postoperative days (PODs). INR was significantly increased on POD 3 and aPTT on POD 5 in group I compared with group P (P < .05). Albumin level was significantly lower in Group I on POD 1 and 3 (P < .05). GFR was significantly lower on POD 1 in the group I compared with group P (P < .05). The postoperative coagulation, GFR, and albumin values were superior following administration of propofol than isoflurane in donors who underwent living hepatectomy; however, both approaches were clinically safe, with no significant clinical difference.Öğe Effects of Oral ?- Glucan on Liver Ischemia/Reperfusion Injury in Rats(Elsevier Science Inc, 2013) Aydogan, M. S.; Yucel, A.; Erdogan, M. A.; Polat, A.; Cetin, A.; Ucar, M.; Duran, Z. R.Aim. Ischemia/reperfusion (IR) injury (IRI) in liver transplant patients may negatively affect graft function. Although beta-glucan protects kidneys against IRI, its effect on the liver is unknown. This study sought to investigate beta-glucan effects on oxidative damage to the liver after IRI in rats. Materials and Methods. Thirty-two rats were randomly divided into 4 experimental groups n = 8 in each group: sham, IR, beta-glucan and IR + beta-glucan. beta-Glucan (50 mg kg(-1) . day(-1)) was orally administered for 10 days to rats in the beta-glucan and IR + beta-glucan groups. The rats in the IR and IR + beta-glucan groups were subjected to ischemia and reperfusion (IR) for 60 minutes each. All rats were killed on day 11 to evaluate histological changes as well as tissue levels of oxidants and antioxidants. Results. Malondialdehyde (MDA) levels were significantly higher in the IR than the sham group (P = .001). MDA level was significantly higher in the IR group than in the IR + beta-glucan group (P = .001). The levels of tissue antioxidant markers (superoxide dismutase [SOD], glutathione-peroxidase [GPx], and catalase [CAT]) were significantly lower in the IR group than in the sham group (P < .05). SOD and GPx levels did not differ significantly between the IR and IR + beta-glucan groups. CAT activity was significantly higher in the IR than the IR + beta-glucan group (P = .001). Histological tissue damage was reduced in the IR + beta-glucan than the IR group. Conclusion. Liver IRI is an inevitable problem during liver surgery. Our results suggested that beta-glucan pretreatment suppressed oxidative stress and increased antioxidant levels in an rat model of liver IRI.Öğe Protective and therapeutic effects of molsidomine on radiation induced neural injury in rats(Taylor & Francis Inc, 2017) Durak, M. A.; Parlakpinar, H.; Polat, A.; Vardi, N.; Ekici, K.; Ucar, M.; Ozhan, O.We investigated the protective and therapeutic effects of molsidomine (MOL) in a rat model of whole brain radiotherapy (RT). Forty female rats were divided into five groups of eight: group 1, control; group 2, 15 Gy single dose RT (RT); group 3, 4 mg/kg MOL treated for 5 days (MOL); group 4, 4 mg/kg MOL for 5 days, 10 days after RT treatment (RT + MOL); group 5, 4 mg/kg MOL treatment for 5 days before RT treatment and for 5 days after RT treatment (MOL + RT). All rats were sacrificed on day 16. Neurodegenerative changes in the brain and tissue levels of oxidants and antioxidants were evaluated. The oxidative parameters were increased and antioxidant status was decreased in group RT compared to groups MOL + RT and RT + MOL. Histopathological examination showed that treatment with MOL after RT application and treatment with MOL before RT treatment decreased neuronal degeneration. No difference in neuronal appearance was found between groups RT + MOL and MOL + RT. MOL treatment protected the nervous system of rats and may be a treatment option for preventing RT induced neural injury.Öğe Protective Effect of Dexpanthenol on Ischemia-Reperfusion-Induced Liver Injury(Elsevier Science Inc, 2018) Ucar, M.; Aydogan, M. S.; Vardi, N.; Parlakpinar, H.Objective. We aimed to investigate the protective and therapeutic effects of dexpanthenol (DXP) on liver injuries induced by ischemia-reperfusion (IR) in an in vivo rat model. Methods. Thirty-two rats were randomly divided into 4 experimental groups (n = 8 in each group: Sham, IR, DXP, and DXP+IR. DXP (500 mg/kg) was intraperitoneally administered for 30 min before 60 min of ischemia, followed by 60 min of reperfusion to rats in the DXP and DXP+IR groups. All rats were euthanized on day 10 to evaluate immunohistopathological changes as well as tissue levels of oxidants and antioxidants. Results. IR decreased total glutathione (tGSH) levels in IR group when compared to the Sham group. DXP supplementation to IR group significantly ameliorated tGSH levels (P < .05). IR also elevated myeloperoxidase production compared to the Sham group, whereas DXP treatment prevented these hazardous effects. However, plasma superoxidedismutase, catalase, and malondialdehyde levels did not differ between the DXP+IR than the IR rats. Histologic tissue damage was reduced in the DXP and DXP+IR group. Conclusion. Liver IR is an inevitable problem during liver surgery. Our results suggested that DXP pretreatment suppressed oxidative stress and increased antioxidant levels in a rat model of liver IR.Öğe Recruitment maneuver in a patient with hepatopulmonary syndrome during liver transplantation surgery(Lippincott Williams & Wilkins, 2019) Colak, Y. Z.; Ucar, M.[Abstract Not Available]Öğe Sedation with Propofol and Propofol-Ketamine (Ketofol) in Flexible Bronchoscopy: A Randomized, Double-Blind, Prospective Study(Wolters Kluwer Medknow Publications, 2023) Ulutas, H.; Ucar, M.; Celik, M. R.; Agar, M.; Gulcek, IBackground:The flexible bronchoscopy procedure, which is performed in awake conditions or under local anesthesia, is a difficult and complicated procedure for patients and physicians. Propofol is a fast-acting sedative-hypnotic anesthetic with a rapid return. Ketamine hydrochloride is a fast-acting general anesthetic producing an anesthetic state characterized by deep analgesia, normal pharyngeal, and laryngeal reflexes.Materials and Method:The study was planned in a randomized, prospective, and double-blind design. The drug(s) administered by the anesthesiologist was not known to the bronchoscopist and the patient. A total of 64 cases were included in the study (34/propofol, 30/ketamine-propofol (ketofol) group). Group propofol received 0.1 mL/kg propofol, and group ketofol received 0.1 mL/kg ketofol intravenously over approximately 30 seconds. Vital signs, non-invasive blood pressure, peripheral oxygen saturation, and pulse values of all cases were measured three times and were recorded just before the start of the procedure, after entering the trachea, and after the procedure was terminated. The Visual Analogue Scale (VAS) and The Ramsay scoring were additionally used in the present study.Results:Statistically significant differences were detected between the groups in terms of blood pressure and heart rates. Statistically significant differences were detected between the two groups according to The VAS scoring and additional dose requirement.Conclusion:It must be noted that flexible bronchoscopy procedures, which are performed with local anesthesia by both the patient and the physician with a high degree of difficulty, especially combined drugs to be applied with anesthesia support, are more effective/comfortable/reliable, and have fewer complications and higher tolerability if there are no contraindications.Öğe Trending and Accuracy of Noninvasive Hemoglobin Monitoring During Liver Transplantation Surgery(Wiley-Blackwell, 2015) Toprak, H.; Ucar, M.; Colak, Y.; Ucar, H.[Abstract Not Available]
