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  • Küçük Resim Yok
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    Akut üst solunum obstrüksiyonunu takiben gelişen negatif basınçlı pulmoner ödem: Olgu sunumu
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2009) Yücel, Aytaç; Öztürk, Erdoğan; Erdil, Feray; Aydoğan, M. Said; Ersoy, M. Özcan
    Öz: Amaç: Kliniğimizin şaşılık biriminde muayeneleri yapılan ilk 776 hastadaki tanı dağılım oranlarını ve bazı klinik özelliklerini değerlendirmek. Materyal ve metod: Şubat 1994 - Mart 1999 arasında İnönü Üniversitesi Göz Hastalıkları Anabilim Dalı Şaşılık biriminde ilk muayeneleri yapılan 776 şaşılık hastası retrospektif olarak incelendi. Bulgular: Hastaların dağılımına bakıldığında en sık ezotropya (%57.5), ikinci sıklıkta ekzotropya (%24.7), daha sonra 4. kranial sinir felci (%4.5), Duane Sendromu (%3), 6. kranial sinir felci (%2.6), Brown Sendromu (%0.9), 3. kranial sinir felci (%0.5), tiroid oftalmopati (%0.26), blow-out kırığı (%0.26), ekstraoküler kas fibrozisi (%0.26), Möbius Sendromu (%0.4), çift elevatör felci (%0.13) saptandı. İnferior oblik adale disfonksiyonu ezotropyalarda (%28.47), ekzotropyalarda (%17.7) oranında görülürken, superior oblik disfonksiyonu ezotropyalarda %4.7, ekzotropyalarda (%5.2) oranında görülmüştür. Ezotropyalar ve ekzotropyaların (%6.93)'ünde disosiye vertikal deviasyon (DVD) izlenmiştir. Refraksiyonları sferik eşdeğer olarak incelendiğinde ezotropyalarda %80.9 oranında (%48.4, >+2.0) ekzotropyalarda ise %31.3 oranında (%21, +0.5-+2.0 D) hipermetropi izlemiştir. Ezotropyalarda şaşılık ambliyopisi ekzotropyalara göre daha sık olarak bulunmuştur (p<0.05). Sonuç: Ana hatlardaki genel benzerlik yanında, ülkemizdeki önceki çalışmalarda farklı olan tanı oranlarına rastlanmış olup, sonuçlar literatür ışığında tartışılmıştır. Başlık (İngilizce): The evaluation of clinical and diagnostic features in strabismus patients Öz (İngilizce): Purpose: This study was performed to evaluate the diagnostic distribution and clinical findings of seven hundred seventy-six patients who were referred for the first time to the Strabismus Unit of our clinic. Materials and Methods: We studied retrospectively seven hundred seventy-six patients inspected for the first time at the Strabismus Unit of Ophthalmology Department, İnönü University School of Medicine, from February 1994 to March 1999. Results: The prevalance of diagnostic subgroups of strabismus patients, in order of decreasing frequency, were; esotropia (57.5%), exotropia (24.7%), 4th nerve palsy (4.5%), Duane's syndrome (3%), 6th nerve palsy (2.6%), Brown syndrome (0.9%,) 3rd nerve palsy (0.5%), thyroid ophthalmopathy (0.26%), orbital fracture (0.26%), extraocular muscle fibrosis (0.26%), Mobius syndrome (0.4%), and double elevator palsy (0.13%). Inferior oblique dysfunction was seen in 28.47% of esotropia and 17.7% of exotropia patients while superior oblique dysfunction was seen in 4.7% of esotropia and 5.2% of exotropia patients. Dissociated vertical deviation was seen in 6.93% of esotropia and exotropia patients. Eighty point one percent of the esotropia patients (48.4 % >+2.0 D as spheric equivalent) and 31.3% of exotropia patients (21% between +0.5 and +2.0 D as spheric equivalent) were hyperopic. Strabismic amblyopia was seen more frequently in esotropia patients than exotropia patients (p <0.05). Conclusion: Our study results showed some common features, and several differences as to the rates of strabismus subgroups compared to the previous reports in literature.
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    Ankilozan spondilitli bir hastada lateral yaklaşımla spinal anestezi uygulaması: Olgu sunumu
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2012) Özgül, Ülkü; Yücel, Aytaç; Kayhan, Erdoğan Gülay; Aslan, Abdulvahap; Ersoy, M. Özcan
    Öz: Ankilozan spondilit, kronik, ağrılı, inflamatuar bir seronegatif otoimmün spondiloartropatidir. Anestezistler için ankilozan spondilitte hem hava yolunun yönetimi hem de nöroaksiyel blok uygulamalarında zorluklar olabilir. Total kalça protezi operasyonu geçirecek ankilozan spondilitli hastaya lateral yaklaşımla başarılı spinal anestezi uygulamasını sunmayı amaçladık.
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    Application of medical data mining on the prediction of apache II score
    (Medicine Science | International Medical Journal, 2015) Çolak, Cemil; Aydoğan, Mustafa Said; Arslan, Ahmet Kadir; Yücel, Aytaç
    The Acute Physiology and Chronic Health Evaluation (APACHE II) is a beneficial tool for the estimation of risk and the comparison of the patients who received care with similar risk properties. Machine learning based systems can assist clinicians in the early diagnosis of diseases. This research aimed at predicting the APACHE II score using Support Vector Machine (SVM) from Medical Data Mining (MDM). The records of 280 patients from intensive care unit included the dataset containing the target variable (the APACHE II score), and 23 demographical/clinical predictor variables. Genetic algorithm based feature selection and 10-fold cross validation method were employed. SVM with radial basis (RBF) was constructed. The performance of the proposed approach was assessed using root mean squared error (RMSE), mean absolute error (MAE), correlation (R) and coefficient of determination (R2). Mean age of the individuals was 51±23 years. 153 (54.6%) were females, and 127 (45.4%) were males. The proposed approach yielded the values of 1.037 for RMSE, 0.727 for MAE, 0.993 for R and 0.986 for R2, respectively. The results demonstrated that the proposed approach had an excellent predictive performance of the APACHE II score. Additionally, ensemble approaches such as bagging, boosting, voting etc. can improve markedly the performance of the prediction and classification tasks.
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    Application of Medical Data Mining on the Prediction of APACHE II Score
    (2015) Çolak, Cemil; Aydoğan, Mustafa Said; Arslan, Ahmet Kadir; Yücel, Aytaç
    The Acute Physiology and Chronic Health Evaluation (APACHE II) is a beneficial tool for the estimation of risk and the comparison of the patients who received care with similar risk properties. Machine learning based systems can assist clinicians in the early diagnosis of diseases. This research aimed at predicting the APACHE II score using Support Vector Machine (SVM) from Medical Data Mining (MDM). The records of 280 patients from intensive care unit included the dataset containing the target variable (the APACHE II score), and 23 demographical/clinical predictor variables. Genetic algorithm based feature selection and 10-fold cross validation method were employed. SVM with radial basis (RBF) was constructed. The performance of the proposed approach was assessed using root mean squared error (RMSE), mean absolute error (MAE), correlation (R) and coefficient of determination (R2). Mean age of the individuals was 51±23 years. 153 (54.6%) were females, and 127 (45.4%) were males. The proposed approach yielded the values of 1.037 for RMSE, 0.727 for MAE, 0.993 for R and 0.986 for R, respectively. The results demonstrated that the proposed approach had an excellent predictive performance of the APACHE II score. Additionally, ensemble approaches such as bagging, boosting, voting etc. can improve markedly the performance of the prediction and classification tasks.
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    Application of medical data mining on the prediction of apache ıı score
    (Medicine Science | International Medical Journal, 2015) Çolak, Cemil; Aydogan, Mustafa Said; Arslan, Ahmet Kadir; Yücel, Aytaç
    The Acute Physiology and Chronic Health Evaluation (APACHE II) is a beneficial tool for the estimation of risk and the comparison of the patients who received care with similar risk properties. Machine learning based systems can assist clinicians in the early diagnosis of diseases. This research aimed at predicting the APACHE II score using Support Vector Machine (SVM) from Medical Data Mining (MDM). The records of 280 patients from intensive care unit included the dataset containing the target variable (the APACHE II score), and 23 demographical/clinical predictor variables. Genetic algorithm based feature selection and 10-fold cross validation method were employed. SVM with radial basis (RBF) was constructed. The performance of the proposed approach was assessed using root mean squared error (RMSE), mean absolute error (MAE), correlation (R) and coefficient of determination (R2 ). Mean age of the individuals was 51±23 years. 153 (54.6%) were females, and 127 (45.4%) were males. The proposed approach yielded the values of 1.037 for RMSE, 0.727 for MAE, 0.993 for R and 0.986 for R2 , respectively. The results demonstrated that the proposed approach had an excellent predictive performance of the APACHE II score. Additionally, ensemble approaches such as bagging, boosting, voting etc. can improve markedly the performance of the prediction and classification tasks.
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    Beckwith-Wiedemann Sendromlu Olguya Anestezik Yaklaşım: Olgu sunumu
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2011) Erdoğan, M. Ali; Yücel, Aytaç; Bucak, Nizamettin; Şanlı, Mukadder; Begeç, Zekine; Ersoy, M. Özcan
    Beckwith-Wiedemann sendromu; eksofalos, makroglossi, hipoglisemi, organomegali, omfalosel ve gigantizim gibi çeşitli anomalileri içerir. Beckwith-Wiedemann sendromlu olgular sıklıkla infant dönemde cerrahiye gereksinim duyarlar. Anestezi yönetimindeki temel problemler sıklıkla; zor hava yolu ve hipoglisemidir. Makroglossinin maske ventilasyonu ve entübasyonu zorlaştırabileceği akılda tutularak indüksiyondan önce zor hava yolu hazırlığı yapılmalıdır. Dikkatli intraoperatif glukoz takibi hipogliseminin neden olacağı nörolojik sekelleri önlemede oldukça önemlidir. Bu sunuda laringeal maskenin potansiyel zor hava yolu anatomisine sahip Beckwith-Wiedemann sendromlu olguda endotrakael tüpe alternatif olarak kullanılabileceğine değindik.
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    The Case of a Diplopia and Visual Impairment Developing Patient after Spinal Anaesthesia
    (Turgut Özal Tıp Merkezi Dergisi, 2015) Aydoğan, Mustafa Said; Miniksar, Ökkeş Hakan; Özkan, Ahmet Selim; Kaçmaz, Osman; Yücel, Aytaç; Durmuş, Mahmut
    Yıl: 2015Cilt: 22Sayı: 1ISSN: 1300-1744Sayfa Aralığı: 74 - 75 Metin Dili: İngilizce Öz: Başlık ( ): Spinal Anestezi Sonrası Diplopi ve Görme Bozukluğu Gelişen Bir Hasta Olgusu Öz ( ):
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    Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2010) Begeç, Zekine; Durmuş, Mahmut; Erdil, Feray; Öztürk, Erdoğan; Yücel, Aytaç; Ersoy, M. Özcan
    Kaudal anestezi uygulanan çocuklarda laringeal maske (LMA) çıkarılması için gerekli sevofluran minimum alveolar konsantrasyonunu (MAK) değerlendiren bir çalışma bulunmamaktadır. Çalışmanın amacı kaudal anestezi uygulanmış çocuklarda LMA çıkarılması için gerekli sevofluran MAK’ını belirlemektir. Materyal ve Metod: Genel anestezi ile ürolojik cerrahiye giden (<2 saat) 56 çocuk çalışmaya alındı. Sevofluran indüksiyonundan sonra LMA yerleştirilen çocuklar kaudal anestezi yapılan ve yapılmayan grup olarak ayrıldı. Cerrahi işlemin sonunda LMA; grupları bilmeyen bir anestezist tarafından, end-tidal sevofluran konsantrasyonu önceden belirlenen % 0.2’lik konsantrasyonlarla azaltılarak çıkartıldı. LMA çıkarılması sırasında veya çıkarıldıktan sonra 1 dakika içinde, öksürük, diş sıkma, amaçlı hareket, nefes tutma veya laringospazm eşlik etmiyorsa LMA çıkarılması başarılı olarak kabul edildi. Bulgular: Çocuklarda LMA çıkarılması için gerekli sevofluran MAK’ı kaudal anestezi uygulanan grupta %1.60, kaudal anestezi uygulanmayan grupta %1.72 idi. Sonuç: İki ay-8 yaş arası çocuklarda kaudal anestezi; LMA çıkarılması için gerekli sevofluran MAK’ını azaltmadı. Kaudal bloğun infant ve çocuklarda LMA çıkarılması için gerekli sevofluran MAK’ına etkisini araştıran ileri çalışmalara ihtiyaç olduğu kanaatine varıldı.
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    Çocuklarda proseal laringeal maske: 428 olgunun geriye dönük incelenmesi
    (2011) Begeç, Zekine; Erdoğan, M. Ali; Yücel, Aytaç; Özgül, Ülkü; Gülhaş, Nurçin; Ersoy, M. Özcan
    Amaç: ProSeal Laringeal Maske (PLMA) klasik LMA temelinde geliştirilen supraglottik bir hava yolu aracıdır. Bu çalışmada Mayıs 2009 ile Haziran 2011 tarihleri arasında çocuk cerrahisi ameliyatlarında genel anestezi indüksiyonu sonrası PLMA uygulanan 428 pediyatrik hasta, anestezi kayıtları gözden geçirilerek geriye dönük olarak değerlendirildi. Gereç ve Yöntem: Çalışmaya alınan hastaların demografik özellikleri, ASA skorları, cerrahi girişim türü ve anestezi süresi, uygulanan premedikasyon, indüksiyon ajanları, hastaların pozisyonları, yerleştirilen PLMA numarası ve hangi yöntemle yerleştirildiği, girişim sayısı, uygulayıcıların anestezi tecrübeleri ve karşılaşılan komplikasyonlar kaydedildi. Bulgular: Anestezi indüksiyonu 355 hastada intravenöz, 73 hastada inhalasyon ajanlarıyla sağlanmıştır. Hastaların 411’ine birinci denemede, 14’üne ikinci denemede PLMA yerleştirilmiştir. PLMA uygulanan hastaların 342’si supin pozisyonda, 86’sı litotomi pozisyonunda operasyon geçirmiştir. 355 hastada dijital teknik ile PLMA takılırken, 73 hastada introduser kullanılmıştır. PLMA yerleştirildikten sonra 4 hastada laringospazm, üç hastada bronkospazm, bir hastada mide distansiyonu, iki hastada hıçkırık gelişmiştir. İki hasta PLMA yerleştirildikten sonra kusmuştur. PLMA çıkarıldıktan sonra üç hastada laringospazm gelişmiş, iki hastada PLMA’da kan bulaşı tesbit edilmiştir. Sonuç: Çocuklarda, PLMA başarılı yerleştirme oranı yüksek, komplikasyon oranı düşük, klasik LMA’ya göre daha yüksek kaçak basınçlarına izin veren, özefagusu glottisden ayıran etkili bir havayolu aracıdır.
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    Çocuklarda ProSeal Laringeal Maske: 428 Olgunun Geriye Dönük İncelenmesi
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2011) Begeç, Zekine; Erdoğan, M. Ali; Yücel, Aytaç; Özgül, Ülkü; Gülhaş, Nurçin; Ersoy, M. Özcan
    ProSeal Laringeal Maske (PLMA) klasik LMA temelinde geliştirilen supraglottik bir hava yolu aracıdır. Bu çalışmada Mayıs 2009 ile Haziran 2011 tarihleri arasında çocuk cerrahisi ameliyatlarında genel anestezi indüksiyonu sonrası PLMA uygulanan 428 pediyatrik hasta, anestezi kayıtları gözden geçirilerek geriye dönük olarak değerlendirildi. Gereç ve Yöntem: Çalışmaya alınan hastaların demografik özellikleri, ASA skorları, cerrahi girişim türü ve anestezi süresi, uygulanan premedikasyon, indüksiyon ajanları, hastaların pozisyonları, yerleştirilen PLMA numarası ve hangi yöntemle yerleştirildiği, girişim sayısı, uygulayıcıların anestezi tecrübeleri ve karşılaşılan komplikasyonlar kaydedildi. Bulgular: Anestezi indüksiyonu 355 hastada intravenöz, 73 hastada inhalasyon ajanlarıyla sağlanmıştır. Hastaların 411’ine birinci denemede, 14’üne ikinci denemede PLMA yerleştirilmiştir. PLMA uygulanan hastaların 342’si supin pozisyonda, 86’sı litotomi pozisyonunda operasyon geçirmiştir. 355 hastada dijital teknik ile PLMA takılırken, 73 hastada introduser kullanılmıştır. PLMA yerleştirildikten sonra 4 hastada laringospazm, üç hastada bronkospazm, bir hastada mide distansiyonu, iki hastada hıçkırık gelişmiştir. İki hasta PLMA yerleştirildikten sonra kusmuştur. PLMA çıkarıldıktan sonra üç hastada laringospazm gelişmiş, iki hastada PLMA’da kan bulaşı tesbit edilmiştir. Sonuç: Çocuklarda, PLMA başarılı yerleştirme oranı yüksek, komplikasyon oranı düşük, klasik LMA’ya göre daha yüksek kaçak basınçlarına izin veren, özefagusu glottisden ayıran etkili bir havayolu aracıdır.
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    Cornelia De lange sondromlu iki olguda anestezi yönetimimiz
    (Anestezi Dergisi, 2012) Özgül, Ülkü; Begeç, Zekine; Yücel, Aytaç; Erdoğan, M. Ali; Bucak, Nizamettin; Ersoy, M. Özcan
    Yıl: 2012Cilt: 20Sayı: 2ISSN: 1300-0578Sayfa Aralığı: 106 - 109 Metin Dili: Türkçe Öz: Cornelia de Lange sendromu mezenkimin hipoplazisine sekonder geliştiği düşünülen gelişme geriliği, mental retardasyon, hirşutizm, kardiyak, gastrointestinal ve kas-iskelet sisteminin majör anomalileri ile dismorfik yüz görüntüsünün eşlik etti¤i nadir görülen bir sendromdur. Cornelia de Lange sendromu tanısı almış hastaların anestezi yönetiminde zor trakeal entübasyon, aspirasyon ve ilaçlara aşırı duyarlılık gibi problemlerle karşılaşılabilir. Biz bu olgu sunusunda Cornelia de Lange sendromunda anestezik yaklaşımı ve literatür bilgilerini gözden geçirmek istedik. Başlık (İngilizce): Anesthetic management of two patients with cornelia De lange syndrome Öz (İngilizce): Cornelia de Lange syndrome is a rarely encountered disorder that is thought to progress secondary to hypoplasia of mesenchyma. Growth and mental retardation, hirsutism, major malformations of cardiac, gastrointestinal, and musculoskeletal systems with dysmorphic facial features are accompanied with this syndrome. Anesthetic management of these patients may encounter problems such as difficult tracheal intubation, aspiration and hypersensitivity to drugs. We want to review the anesthetic management and literature of the Cornelia de Lange Syndrome in this case presentation.
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    The effect of dexmedetomidine on middle ear pressure
    (Otolaryngol Head Neck Surg, 2007) Fırat, Yezdan; Kızılay, Ahmet; Akarçay, Mustafa; Yücel, Aytaç; But, Abdulkadir; Yoloğlu, Saim
    Dexmedetomidine is a preferred anesthetic agent in otological surgery because it provides controlled hypotension and good surgical field visibility. The aim of this study was to evaluate the influence of this novel agent on middle ear pressure. STUDY DESIGN AND SETTING: This prospective clinical trial was performed in 60 patients who were scheduled for elective surgery. They received dexmedetomidine or saline infusion for 20 minutes before induction of anesthesia. Tympanometric measurements were recorded for both ears at preoperative, intraoperative, and postoperative states. RESULTS: Mean difference of tympanometric peak pressure from baseline was statistically significant between dexmedetomidine and control group at the 30th minute of operation (24.8 daPa, P 0.003 for right ear; 20.5 daPa, P 0.02 for left ear) and at the end of the operation (25.8 daPa, P 0.01 for right ear; 28.1 daPa, P 0.004 for left ear). CONCLUSIONS: Dexmedetomidine anesthesia raises the tympanometric parameters, but they never exceed the limits of normal. © 2007 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved.
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    Effect of preoperative iron deficiency in liver transplant recipients on length of intensive care ünit stay
    (Transplantation Proceedings, 2013) Aydoğan, Mustafa Said; Özgül, Ülkü; Erdoğan, Mehmet Ali; Yücel, Aytaç; Toprak, Hüseyin İlksen; Durmuş, Mahmut; Çolak, Cemil
    Liver transplant (LT) recipients often display iron deficiency preoperatively, which significantly increases the quantity of blood that needs to be transfused intraoperatively, A risk factor for a prolonged intensive care unit (ICU) stay. The aim of this retrospective study was to determine whether there was a clinically significant association between iron deficiency and the length of ICU stay, among 153 patients scheduled for OLT from September 2011 to June 2012. Patients were divided into 2 groups according to their baseline iron status: iron- deficient (ID) and non-ID (normal iron profile) cohorts. Iron deficiency was assessed on the basis of several parameters; transferrin saturation as well as serum iron, ferritin, soluble transferrin receptor, and C-reactive protein levels. We retrospectively analyzed the data regarding demographic and clinical features, preoperative laboratory values, intraoperative transfusions, and length of ICU stay. Patient demographic features and preoperative values were similar between the groups. Preoperative iron deficiency, which was diagnosed in 72 patients (58.6%), was associated with a greater intraoperative use of fresh frozen plasma and red blood cell transfusions (P .0001). The median length of ICU stay after LT was longer among the ID versus the non-ID group (5 and 3 days per patient, respectively; P .0001). Therefore, we have suggested that preoperative iron deficiency may be a prognostic factor for the length of ICU stay after LT.
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    Effects of 2 different doses of pregabalin on morphine consumption and pain after abdominal hysterectomy a randomized double blind clinical trial
    (Current Therapeutic Research, 2011) Yücel, Aytaç; Öztürk, Erdoğan; Aydoğan, Mustafa Said; Durmuş, Mahmut; Çolak, Cemil; Ersoy, Mehmet Özcan
    Pain relief after surgical procedures continues to be a major medical challenge. Alleviation of pain has been given a high priority by medical professionals and health authorities. Improvement in perioperative analgesia is not only desirable for humanitarian reasons but also essential for its potential to reduce postoperative morbidity and mortality.1,2 Unsatisfactory analgesia increases discomfort of the patient and prolongs hospital stay.3 This means an increase in the incidence of complications and treatment costs.3 Moreover, it may lead to development of chronic pain as an adverse effect, one of the most devastating problems related to this issue if acute pain cannot be treated as required.4 Postoperative pain is not purely nociceptive in nature and may consist of inflammatory, neurogenic, and visceral components.5 Sensitization of the dorsal horn neurons has been demonstrated in acute pain models and may also play a role in the development of chronic pain after surgery.6 By reducing the hyperexcitability of dorsal horn neurons induced by tissue damage, gabapentin and pregabalin may have roles in the treatment of postoperative pain.7,8 Pregabalin is the pharmacologically active S-enantiomer of 3-aminomethyl-5- methyl-hexanoic acid.9 It is a structural analogue of -aminobutyric acid, one of the key inhibitory neurotransmitters in the brain. Its mode of action is believed to be mediated by the -2--1 subunit protein of voltage-gated calcium channels, resulting in its anxiolytic, anticonvulsant, and antinociceptive effects.10 Pregabalin is rapidly absorbed with peak blood concentrations occurring within 1 hour. The average bioavailability exceeds 90% and is independent of dose, which may produce a more predictable patient response. The elimination half-life of pregabalin ranges between 5.5 and 6.7 hours and is independent of dose.9,11 Due to these specific properties of pregabalin, preoperative single dose administration is effective in postoperative pain therapy with no need for long-term treatment.12 Although opioids continue to have an important role in postoperative pain management, they have side effects.13,14 For this reason, multimodal analgesia was suggested to improve postoperative analgesia and to reduce opioid-related side effects.15 An antineuropathic pain drug like pregabalin, as a part of multimodal analgesia, can be useful for optimization of postoperative analgesia.7,8,12,16 Early preclinical studies suggesting analgesic efficacy after tissue injury led to the development of gabapentin and pregabalin as treatments for postoperative pain.17,18 Preoperative administration of 600 mg pregabalin, but not 300 mg, significantly reduced opioid usage in patients after laparoscopic hysterectomy.7 In addition, a study reported that 75 and 150 mg doses of pregabalin did not reduce postoperative
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    Effects of 2 different doses of pregabalin on morphine consumption and pain after abdominal hysterectomy a randomized double blind clinical trial
    (Current Therapeutic Research, 2011) Yücel, Aytaç; Aydoğan, Mustafa Said; Durmuş, Mahmut; Çolak, Cemil; Ersoy, Mehmet Özcan; Öztürk, Erdoğan
    Background: Pregabalin has a similar pharmacologic profile to that of its developmental predecessor gabapentin but has shown greater analgesic activity in rodent models of neuropathic pain. Objective: The objective of the study was to compare the effects of 2 different doses of pregabalin and placebo on postoperative pain and morphine consumption. Methods: Ninety patients who underwent abdominal hysterectomy were included in the study and randomly divided into 3 groups in a doubled-blinded manner. They were given 150 mg of pregabalin (group P300, n 30), 300 mg of pregabalin (group P600, n 30), or placebo capsules (group C, n 30) 4 hours before the induction of anesthesia; they received a second dose of the drug 12 hours postoperatively. Morphine consumption, nausea, and vomiting, visual analogue scalepain intensity (VAS-PI), sedation scores, and dissatisfaction scores were recorded in the postanesthesia care unit (PACU) and at 2, 4, 6, and 24 hours after operation. Results: Morphine consumption at 24 hours was 40.80 (3.42) mg, 33.79 (5.77) mg, and 46.97 (6.67) mg in groups P300, P600, and C, respectively (P 0.001). VAS-PI scores at movement and at rest in the PACU and at 2, 4, and 6 hours decreased in group P600 (P 0.01). In the PACU and at 2, 4, and 6 hours, the sedation scores were increased in group P600 compared with the scores in group C (P 0.001, P 0.001, P 0.01, P 0.006, respectively). Patient satisfaction was higher in group P600 than in group C for all time points (P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, respectively). There were no statistically significant differences between the groups for side effects such as nausea, vomiting, and dizziness (P 0.58). Conclusions: Pregabalin at a total dose of 600 mg, administered before operation and at 12 hours postoperatively after abdominal hysterectomy, reduced morphine consumption and pain intensity and increased patient satisfaction. No significant differences in side effects were observed between the study groups. (Curr Ther Res Clin Exp. 2011;72:173-183) © 2011 Elsevier HS Journals, Inc. All rights reserved.
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    Effects of dexmedetomidine and midazolam on motor coordination and analgesia a comparative analysis
    (Current Therapeutic Research, 2013) Aydoğan, Mustafa Said; Parlakpınar, Hakan; Erdoğan, Mehmet Ali; Yücel, Aytaç; Uçar, Muharrem; Sağır, Mustafa; Çolak, Cemil
    Objective: We compared the effects of 2 sedative drugs, dexmedetomidine and midazolam, on motor performance and analgesic efficacy in a rat model. Materials and methods: Rats were randomly divided into the following 4 groups on the basis of the treatment received. The first group received 83 mg/kg/min midazolam; the second, 1 mg/kg/min dexmedetomidine; the third, 83 mg/kg/min morphine; and the fourth was a control group. The rats were measured motor coordination and pain reflexes by using rotarod, accelerod, hot plate, and tail flick tests. Results: At all the tested speeds, the midazolam-injected rats remained on the rotarod longer than did the dexmedetomidine-injected rats. Furthermore, in the 10-minute accelerod test, the midazolaminjected rats remained for a longer duration than did the dexmedetomidine-injected rats. The latency time for the hot plate test was significantly higher at 10 minutes and 20 minutes in the dexmedetomidine group than in the midazolam group. Further, the latency time at 10 minutes for the tail flick test was greater in the dexmedetomidine group than in the midazolam group. Conclusions: In this rat model, midazolam results in faster recovery of motor coordination performance when compared with dexmedetomidine.
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    Effects of dexmedetomidine and midazolam on motor coordination and analgesia a comparative analysis
    (Current Therapeutic Research, 2013) Aydoğan, Mustafa Said; Parlakpınar, Hakan; Erdoğan, Mehmet Ali; Yücel, Aytaç; Uçar, Muharrem; Sağır, Mustafa; Çolak, Cemil
    Objective: We compared the effects of 2 sedative drugs, dexmedetomidine and midazolam, on motor performance and analgesic efficacy in a rat model. Materials and methods: Rats were randomly divided into the following 4 groups on the basis of the treatment received. The first group received 83 mg/kg/min midazolam; the second, 1 mg/kg/min dexmedetomidine; the third, 83 mg/kg/min morphine; and the fourth was a control group. The rats were measured motor coordination and pain reflexes by using rotarod, accelerod, hot plate, and tail flick tests. Results: At all the tested speeds, the midazolam-injected rats remained on the rotarod longer than did the dexmedetomidine-injected rats. Furthermore, in the 10-minute accelerod test, the midazolaminjected rats remained for a longer duration than did the dexmedetomidine-injected rats. The latency time for the hot plate test was significantly higher at 10 minutes and 20 minutes in the dexmedetomidine group than in the midazolam group. Further, the latency time at 10 minutes for the tail flick test was greater in the dexmedetomidine group than in the midazolam group. Conclusions: In this rat model, midazolam results in faster recovery of motor coordination performance when compared with dexmedetomidine.
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    Effects of enteral and total parenteral nutrition on length of stay in intensive care unit in postoperative period
    (2018) Toğal, Türkan; Karakaş, Buğra; Yücel, Aytaç; Karademir, Ali; Paşahan, Ramazan; Aydoğan, Mustafa Said
    Abstract: Patients post-operatively followed in intensive care units in are known to have high morbidity and mortality rates. The aim of the present study was to compare the effects of enteral versus total parenteral nutrition for length of ICU stay in postoperative patients. Nutritional support for patients were divided into two groups; enteral nutrition (Group E) total parenteral administered (Group P). Demographic findings, APACHE II score and serum albumin levels were determined in the preoperative period in both groups of patients. In both groups were recorded type of operation and blood transfusion during the operation. Gas, fecal discharge time in the postoperative period, of patients in groups and, postoperative day 7th, serum albumin, and serum C-reactive protein (CRP), length of stay intensive care unit and mortality rates were determined. Abdominal cramps, the tension in the abdomen, nausea and diarrhea in patients in group E were accepted as complications of enteral nutrition. In this study were included group E 89, group P 82 patients. Between groups were similar demographic features, APACHE II score and serum albumin levels. Both groups was not significant difference operation type, operation time and blood transfusion. Postoperative gas discharge and fecal discharge were significantly difference earlier period in Group E (p <0.05). In terms of the serum albumin and CRP levels were not significant difference between groups postoperative day 7th. Gastrointestinal complications was detected in Group E 58.5% and in Group P 28.9%. Both groups showed two patients mortality in postoperative period. The median length of ICU stay was shorter Group E versus Group P in postoperative period (p <0.05). In the postoperative period the implementation of enteral nutrition was associated with the decreased length of ICU stay and recovered earlier gastrointestinal function. We thought that enteral nutrition support can be used safely and priority postoperative patients in ICU.
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    The effects of secondhand smoke on postoperative pain and fentanyl consumption
    (Journal of Anesthesia, 2013) Aydoğan, Mustafa Said; Öztürk, Erdoğan; Erdoğan, Mehmet Ali; Yücel, Aytaç; Durmuş, Mahmut; Ersoy, Mehmet Özcan; Çolak, Cemil
    Background Although the need for increased postoperative analgesia in smokers has been described, the effect of secondhand smoke on postoperative analgesia requirements has not been studied. We examined the effects of secondhand smoke on fentanyl consumption and postoperative pain. Methods In this study, 101 patients (American Society of Anesthesiology physical status I and II) who underwent abdominal hysterectomy were divided into 3 groups according to history of exposure to cigarette smoke as per medical records which was retrospectively confirmed by measurement of serum cotinine: smokers (n = 28), nonsmokers (n = 31), and secondhand smokers (n = 32). All patients received propofol–remifentanil total intravenous anesthesia and used fentanyl patient controlled analgesia for postoperative pain. The fentanyl consumption visual analogue scale-pain intensity (VAS-PI) score and side effects were recorded in the postanesthesia care unit (PACU) and at 2, 4, 6, and 24 h after surgery. Results Fentanyl consumption at all the evaluation time points was significantly higher in secondhand smokers than in nonsmokers (P\0.05). However, fentanyl consumption in secondhand smokers was lower than that in smokers in the PACU and at 24 h (P\0.05). VAS-PI scores during movement and at rest in the PACU and at 4, 6, and 24 h after surgery were higher in secondhand smokers than in nonsmokers (P\0.05). There were no statistically significant differences between the groups with regard to side effects such as nausea, vomiting, and dizziness (P[0.05). Conclusion Secondhand smoking was associated with increased postoperative fentanyl consumption, and increased VAS-PI scores. These findings may be beneficial for managing postoperative pain in secondhand smokers.
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    The effects of secondhand smoke on postoperative pain and fentanyl consumption
    (Journal of Anesthesia, 2013) Aydoğan, Mustafa Said; Öztürk, Erdoğan; Erdoğan, Mehmet Ali; Yücel, Aytaç; Durmuş, Mahmut; Ersoy, Mehmet Özcan; Çolak, Cemil
    Background Although the need for increased postoperative analgesia in smokers has been described, the effect of secondhand smoke on postoperative analgesia requirements has not been studied. We examined the effects of secondhand smoke on fentanyl consumption and postoperative pain. Methods In this study, 101 patients (American Society of Anesthesiology physical status I and II) who underwent abdominal hysterectomy were divided into 3 groups according to history of exposure to cigarette smoke as per medical records which was retrospectively confirmed by measurement of serum cotinine: smokers (n = 28), nonsmokers (n = 31), and secondhand smokers (n = 32). All patients received propofol–remifentanil total intravenous anesthesia and used fentanyl patient controlled analgesia for postoperative pain. The fentanyl consumption visual analogue scale-pain intensity (VAS-PI) score and side effects were recorded in the postanesthesia care unit (PACU) and at 2, 4, 6, and 24 h after surgery. Results Fentanyl consumption at all the evaluation time points was significantly higher in secondhand smokers than in nonsmokers (P\0.05). However, fentanyl consumption in secondhand smokers was lower than that in smokers in the PACU and at 24 h (P\0.05). VAS-PI scores during movement and at rest in the PACU and at 4, 6, and 24 h after surgery were higher in secondhand smokers than in nonsmokers (P\0.05). There were no statistically significant differences between the groups with regard to side effects such as nausea, vomiting, and dizziness (P[0.05). Conclusion Secondhand smoking was associated with increased postoperative fentanyl consumption, and increased VAS-PI scores. These findings may be beneficial for managing postoperative pain in secondhand smokers.