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Öğe Accuracy of non-invasive hemoglobin monitoring by pulse CO-oximeter during liver transplantation(Edizioni Minerva Medica, 2017) Erdogan Kayhan, Gulay; Colak, Yusuf Z.; Sanli, Mukadder; Ucar, Muharrem; Toprak, Huseyin I.BACKGROUND: Hemoglobin level monitoring is essential during liver transplantation (LT) due to substantial blood loss. We evaluated the accuracy of non-invasive and continuous hemoglobin monitoring (SpHb) obtained by a transcutaneous spectrophotometry-based technology (Masimo Corporation, Irvine, CA) compared with conventional laboratory Hb measurement (Hb(L)) during LT. Additionally, we made subgroup analyses for distinct surgical phases that have special features and hemodynamic problems and thus may affect the accuracy of SpHb. METHODS: During LT, blood samples were obtained twice for each of the three phases of LT (pre-anhepatic, anhepatic, and neohepatic) and were analyzed by the central laboratory. The HbL measurements were compared with SpHb obtained at the time of the blood draws. RESULTS : A total of 282 data pairs obtained from 53 patients were analyzed. The SpHb values ranged from 6.9 to 17.7 g/dL, and the Hb(L) values ranged from 5.4 to 17.1 g/dL. The correlation coefficient between SpHb and HbL was 0.73 (P< 0.001), and change in SpHb versus change in HbL was 0.76 (P< 0.001). The sensitivity value determined using a 4-quadrant plot was 79%. The bias and precision of SpHb to HbL were 0.86 +/- 1.58 g/dL; the limits of agreement were -2.25 to 3.96 g/dL. The overall correlation between SpHb and Hb(L) remained stable in different phases of surgical procedure. CONCLUSIONS: SpHb was demonstrated to have a clinically acceptable accuracy of hemoglobin measurement in comparison with a standard laboratory device when used during LT. This technology can be useful as a trend monitor during all surgical phases of LT and can supplement HbL to optimize transfusion decisions or to detect occult bleeding.Öğe Anaesthesia Management of a Case with Hereditary Angioedema for Whom Tracheal Dilatation was Planned(Galenos Publ House, 2025) Ucar, Muharrem; Sanli, Mukadder; Akturk, Sezai; Gulcek, Ilham; Erdil, Feray AkgulHereditary angioedema (HAE) causes recurrent angioedema attacks in the oropharynx, larynx, face, and other regions due to bradykinin overproduction as a result of C1 esterase inhibitor deficiency. Surgical interventions requiring general anaesthesia might trigger HAE attacks. Laryngeal angioedema is the most important cause of perioperative mortality. Tracheal dilatation was performed by rigid bronchoscopy in our patient with type 1 HAE, because of tracheal stenosis due to prolonged intubation, which occurred after the attack. The patient was administered 2x500 IU C1 esterase inhibitor approximately 24 hours before rigid bronchoscopy. No complication developed after the first procedure. Two months later, tracheal dilatation was repeated and 2x500 IU C1 esterase inhibitor was administered. While the patient was followed up in the intensive care unit, significant oedema developed in the facial area, especially the tongue and lips, approximately 10 hours after the procedure. Our patient also had stridor due to airway obstruction. The patient was treated with 1000 IU C1 esterase inhibitor and 3 units of fresh frozen plasma (FFP). After FFP, edema started to regress. The patient was discharged after symptoms improved. The patient should be monitored in the intensive care unit for a minimum of 48 hours to monitor for postoperative laryngeal oedema.Öğe Anaesthesia recommendations for Leprosy(Aktiv Druck & Verlag Gmbh, 2020) Ucar, MuharremDisease summary: Leprosy is a chronic infectious disease caused by Mycobacterium leprae and affects the skin and nerves, often seen in developing countries. The prevalence of leprosy is 5.7 per 10,000 population. There are two forms included, tuberculoid and lepromatous leprosy. Pathway of the infectious disease is mainly through nasal droplet infection, contact with infected soil or insect vectors. Leprosy primarily affects the skin and the peripheral nerves, especially the mucosa, the upper respiratory tract, subcutaneous parts of the nerves and the eye. Neuropathy causes insensitiveness and myopathy such as plantar ulceration, foot drop and joint deformities. The autonomic nervous system, cardiovascular system, respiratory system, hepatobiliary system, and renal system are also affected. These manifestations lead to important complications such as baroreflex dysfunction, respiratory dysautonomia, leprous hepatitis, orchitis, glomerulonephritis, amyloidosis. With early diagnosis followed by an appropriate treatment with rifampicin, dapsone and, in case of lepromatous leprosy, additionally with clofazimine, patients can be cured without further disabilities.Öğe Anesthesia Care for Children With Fulminant Liver Failure: Report of Our Experience.(Wiley-Blackwell, 2014) Sahin, Taylan; Koca, Erdinc; Ince, Volkan; Ucar, Muharrem; Toprak, Huseyin Ilksen; Yilmaz, Sezai[Abstract Not Available]Öğe Anesthesia Management in Aortic Dissection in Patients Undergoing Kidney Transplant(Baskent Univ, 2016) Ucar, Muharrem; Erdil, Feray; Sanli, Mukadder; Aydogan, Mustafa Said; Durmus, MahmutKidney transplant is a last resort to increase the life expectancy and quality of life in patients with renal failure. Aortic dissection is a disease that requires emergency intervention; it is characterized by sudden life-threatening back or abdominal pain. In the case described, constant chest pain that increased with respiration was present on exam-ination of a 28-year-old man (85 kg, 173 cm) who presented at our emergency department complaining of severe back pain. He had undergone a kidney transplant in 2004 from his mother (live donor). He was diagnosed with acute Type II aortic dissection and was scheduled for emergent surgery. Because there were no surgical or anesthetic complications, the patient with 79 and 89 minutes aortic cross-clamping and cardiopulmonary bypass durations was sent, intubated, to intensive care unit. When nephrotoxic agents are avoided and blood flow is stabilized, cardiovascular surgery with cardiopulmonary bypass may be performed seamlessly in patients who have undergone a kidney transplant.Öğe Anti-inflammatory Effects and Pharmacokinetics of Bupivacaine in Transversus Abdominis Plane Block for Living Liver Donors: A Prospective Randomized Clinical Trial(Elsevier Science Inc, 2025) Yalin, Mehmet Ridvan; Erdogan, Mehmet Ali; Ucar, Muharrem; Uremis, Muhammed Mehdi; Colak, Yusuf Ziya; Ozdemir, Emine; Ugur, YilmazObjective. Transversus abdominis plane (TAP) blocks have been reported to decrease postoperative pain and opioid use. Local anesthetics modulate the local and systemic inflammatory reaction. Our aim was to examine the effect of TAP block with bupivacaine on the antiinflammatory response in living liver donors. Methods. The randomized prospective clinical study was carried out on 72 living liver donors, aged 18 to 65 scheduled for right hepatectomy. TAP blocks were performed bilaterally with ultrasound guidance using 1.5 mg/kg of 0.5% bupivacaine for group 2. Group 1 patients were the control group. In both groups, blood samples were obtained preoperatively, 30 minutes and 2, 6, and 24 hours after the injection for cytokine measurement. In group 2, to examine the plasma bupivacaine level, blood samples were obtained preoperatively as well as 30 minutes and 1, 2, 6, 12, and 24 hours after injection. The primary outcome was to assess the effect of TAP block on the inflammatory response using cytokine levels. Results. No difference was observed between cytokine levels (tumor necrosis factor-alpha, interleukin [IL]-1 and IL-6) between groups Significant positive correlations were observed between the plasma bupivacaine concentration and IL-1 and IL-6 levels at 2, 6, and 24 hours. Conclusion. Although the TAP block did not affect the levels of cytokines significantly, a significant association was seen between the concentrations of plasma bupivacaine and the levels of IL-1 and IL-6 at 2, 6, and 24 hours. In contrast, the clinical significance of this association is still under investigation.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 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 Comparing 2% lidocaine gel (Dispogel and Cathejell) in cystoscopy(Sage Publications Ltd, 2019) Ucar, Muharrem; Oguz, Fatih; Gecit, Ilhan; Aydogan, Mustafa SaidObjective Cystoscopy is a common urologic procedure. Analgesics are often used to reduce any pain associated with this procedure. The aim of this study was to investigate the efficacy in reducing pain and the cost-effectiveness of two forms of lidocaine gel in patients undergoing cystoscopy. Methods In this double-blind, randomized clinical trial, 77 male patients who were referred for double J removal, urethral dilatation, or cystoscopy were enrolled. The patients were divided into two groups: Dispogel and Cathejell. All patients received 20 mL of intraurethral lidocaine gel 2% and cystoscopy was performed 5 minutes thereafter. The primary outcome was the pain score (visual analogue scale, VAS) during and 5 minutes after cystoscopy. Results There were no statistically significant differences between the VAS scores, blood pressure, and pulse rate in the groups in either observation period. No patient required additional anesthetic agents or sedatives for insufficient pain relief. Conclusion The results of this study show that the analgesic efficacy of Dispogel and Cathejell in the treatment of pain during and after elective cystoscopy was the same, but Dispogel was more cost-effective.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 Femoral and Radial Arterial Pressures for Goal Directed Fluid Therapy in Undergoing Liver Transplantation Recipients(Lippincott Williams & Wilkins, 2016) Ucar, Hacer; Colak, Yusuf Z.; Kitlik, Arzu; Ucar, Muharrem; Ince, Volkan; Toprak, Huseyin I.; Yilmaz, Sezai[Abstract Not Available]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 Difficult Airway Control in a Neonatal Patient with Oropharynx Mass(Medicine Science, 2016) Ozkan, Ahmet Selim; Ucar, Muharrem; Erdogan, Mehmet Ali; Firat, Cemal; Yucel, Aytac; Durmus, MahmutYıl: 2016Cilt: 5Sayı: supplement 1ISSN: 2147-0634Sayfa Aralığı: 155 - 157 Metin Dili: İngilizce Öz: Başlık (İngilizce): Öz (İngilizce): Tracheal intubation using direct laryngoscopy has become an essential part in the anesthesia management of the surgical patient. Big oropharynx mass can cause serious problems depending on their locations. Mass lesions of oropharynx may lead to difficult intubation. In this letter, we present a successful application of airway management with general anesthesia in a neonatal patient with big oropharynx mass.Öğe The effect of addition of ketamine to lidocaine on postoperative pain in rhinoplasties(Tubıtak scıentıfıc & technıcal research councıl turkey, ataturk bulvarı no 221, kavaklıdere, ankara, 00000, turkey, 2016) Sanli, Mukadder; Gulhas, Nurin; Bilen, Bilge Turk; Erdogan Kayhan, Gulay; Ucar, Muharrem; Aytekin, Ahmet Hamdi; Yologlu, SaimBackground/aim: The objective of this study was to examine the effect of addition of subanesthetic doses of ketamine to an epinephrine-lidocaine solution on postoperative pain, analgesic use, and patient comfort during rhinoplasties. Materials and methods: Ninety patients were randomly divided into three groups: Group L, lidocaine with epinephrine; Group K, lidocaine with epinephrine plus ketamine; and Group S (control group), physiological saline solution with epinephrine. The local anesthetic solution was injected as preincisionally with intranasal submucosal infiltration following induction of general anesthesia. We evaluated visual pain score, analgesic demand, Wilson sedation score, and antiemetic demand at 5, 15, and 30 min and 1, 2, 4, 6, 8, 16, and 24 h after the operation. The patient satisfaction score was checked 24 h after the operation. Results: Visual pain score was significantly reduced in Group K in comparison with the other groups and this group did not need any rescue analgesics (P < 0.05). The postoperative patient satisfaction scores were highest in Group K compared with the other groups (P < 0.05). Conclusion: Addition of ketamine solution to lidocaine for infiltration block during rhinoplasty was successful in decreasing pain during postoperative periods and reducing analgesic consumption during the first 24 h after the operation.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 Effect of video laryngoscope on Tp-e interval, QTc and Tp-e/QTc ratio compared with direct laryngoscope in patients with double-lumen tube undergoing thoracic surgery(2024) Kadıoğlu, Mustafa; Ucar, Muharrem; Erdogan, Mehmet Ali; Sanli, Mukadder; Colak, Yusuf Ziya; Erdil, Feray Akgül; Altunkaya, NeslihanAim: QT interval is generally related to the increased risk of polymorphic ventricular tachycardias and ventricular arrythmias. Intubation and laryngoscopy might change in cardiac repolarization and an increase in QT interval length. Video laryngoscopes provide better laryngeal view, higher intubation success, and better correct positioning on double-lumen tube (DLT) intubation. We aimed to compare McGRATH MAC 5 video laryngoscope to direct Macintosh laryngoscope and their effects on Tp-e interval, QTc and Tp-e/QTc ration in those patients requiring intubation having DLT. Materials and Methods: The randomly controlled prospective work is carried out on 94 patients, scheduled for thoracic surgery, aged between 18-65. After anaesthetic induction and before tracheal intubation, all patients airway were evaluated Cormack and Lehane in using a Macintosh laryngoscope and patients having Cormack and Lehane grade-1 or -2a views included in study. The patients who are intubated with video laryngoscope (McGRATH MAC) are allocated into Group V and intubated with direct Macintosh Laryngoscope was allocated into Group L. The primary aim was compared between the two devices on Tp-e interval, QTc and Tp-e/QTc ratio with ECG recordings. The secondary goal was assessment of hemodynamic status and intubation conditions. Results: In Group V, QTc interval, Tp-e intreval and Tp-e/QTc ratio was lower in a significant way than Group L. There has not been a significant difference in terms of hemodynamic assessment among those two groups at all measurement periods. CormackLehane scores, intubation times, DLT types and sizes were similar between two groups. Conclusion: McGRATH MAC video laryngoscope decreased Tp-e interval, QTc and Tp-e/QTc ratio compared to direct Maintosh laryngoscope. Hemodynamic response and intubation parameters are seen as similar to each other in both of the present groups.Öğe Effects of ?- Glucan Liver Ischemia/Reperfusion Injury in Rats(Wiley-Blackwell, 2012) Aydogan, Mustafa Said; Yucel, Aytac; Erdogan, Mehmet Ali; Polat, Alaadin; Cetin, Asli; Ucar, Muharrem; Duran, Zeynep Rumeysa[Abstract Not Available]Öğe The effects of iron deficiency on red blood cell transfusion requirements in non-bleeding critically ill patients(Allied Acad, 2016) Aydogan, Mustafa Said; Ucar, Muharrem; Yucel, Aytac; Karakas, Bugra; Gok, Abdullah; Togal, TurkanIntroduction: Critically ill patients often need blood transfusion, but no reliable predictors of transfusion requirements are available at Intensive Care Unit (ICU) admission. We hypothesized that ICU patients admitted with Iron Deficiency (ID) may be at higher risk for developing anemia, requiring blood transfusion. The aims of this study were to determine the frequency of ID in ICU patients admission and to investigate its relationship with transfusion requirements in ICU patients. Methods: Two hundred ninety-six patients admitted to the general ICU were enrolled in the prospective observational study. We studied 268 patients, after excluding those transfused on or before ICU admission. The patients recorded age, gender, diagnosis, severity scores, presence of sepsis, ICU complications, ICU treatments, and transfusion-free interval. ID was assessed on the basis of several parameters, including hemoglobin, hematocrit, levels of serum iron, transferrin saturation, levels of ferritin, soluble transferrin receptor, C-reactive protein. Results: The mean age was 48 years. Of 268 patients (138 male/130 female), 114 (42.8%) had ID with outcomes of blood samples were used at ICU admission. The overall transfusion rate was 38.8%, being higher in ID patients than in normal iron profile patients (40.3 vs. 18.9%, P= 0.001). After adjusting for severity of illness and hemoglobin level, ID patients remained significantly associated with transfusion, with a hazard ratio of 5.3 (95% CI, 1.8-14.8; P= 0.001). Conclusion: ID is common at ICU admission and is associated with higher transfusion requirements. These findings have important implications for transfusion practices for in ICU patients.Öğe Effects of ketofol and propofol on intubation conditions and hemodynamics without the use of neuromuscular blockers in patients undergoing tympanomastoidectomy(2019) Demiroz Aslan, Duygu; Ucar, Muharrem; Erdogan, Mehmet Ali; Sanli, Mukadder; Gulhas, Nurcin; Çolak, Cemil; Durmus, MahmutAbstract: The effect of ketofol, a mixture of ketamine and propofol in various ratios, on hemodynamic, for intubation without the use of neuromuscular blockers, has not been elucidated in patients undergoing tympanomastoidectomy. We evaluated the effects of ketofol and propofol on intubation conditions and hemodynamic without the use of a neuromuscular blocker. The prospective randomized, double-blinded study was scheduled for tympanoplasty or mastoidectomy. The patients were divided randomly into a propofol group (Group P) and a ketofol group (Group KP). Intubation conditions, changes in hemodynamics, HR, MAP, systolic arterial pressure (SAP), and SpO2 values were recorded before induction, after induction, after intubation, and at 3-min intervals during the first 30 min, 5-min intervals for the next 30 min, and 10-min intervals after that. In the intragroup evaluation, SAP, DAP, MAP and HR values were lower in both groups compared to the baseline values. Hemodynamic values were significantly lower in Group P than in Group KP after intubation compared to baseline. DAP at 12 and 18 min, DAP and MAP at 24 min, SAP, DAP and MAP at 27 min, and SAP and MAP at 30 min after the start of the operation were significantly lower in Group P than in Group KP. The need for ephedrine and the number of patients who required ephedrine were significantly lower in Group KP than in Group P. Ketofol provided appropriate intubation conditions similar to propofol, without the use of a neuromuscular blocker, and contributed to better hemodynamic conditions in patients undergoing tympanomastoidectomy.
