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Öğe The antimicrobial effects of ketamine combined with propofol: An in vitro study(Elsevier Science Inc, 2013) Begec, Zekine; Yucel, Aytac; Yakupogullari, Yusuf; Erdogan, Mehmet Ali; Duman, Yucel; Durmus, Mahmut; Ersoy, M. OzcanBackground and objectives: Ketamine and propofol are the general anesthetics that also have antimicrobial and microbial growth-promoting effects, respectively. Although these agents are frequently applied together during clinical use, there is no data about their total effect on microbial growth when combined. In this study, we investigated some organisms' growth in a ketamine and propofol mixture. Method: We used standard strains including Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans in this study. Time-growth analysis was performed to assess microbial growth rates in 1% propofol. Antimicrobial activity of ketamine, alone and in propofol was studied with microdilution method. Results: In propofol, studied strains grew from 103-104 cfu/mL to ?AO cfu/mL concentrations within 8-16 hours depending on the type of organism. Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) (for candida, minimal fungicidal concentration) of ketamine were determined as follows (MIC, MBC): E.coli 312.5, 312.5 pg/mL; S.aureus 19.5, 156 pg/mL; P.aeruginosa 312.5, 625 pg/mL; and C.albicans 156, 156 pg/ml. In ketamine+propofol mixture, ketamine exhibited antimicrobial activity to E.coli, P.aeruginosa and C.albicans as MBCs at 1250, 625 and 625 pg/mL, respectively. Growth of S. aureus was not inhibited in this mixture (ketamine concentration=1250 pg/mL). Conclusion: Ketamine has sustained its antimicrobial activity in a dose-dependent manner against some organisms in propofol, which is a strong microbial growth-promoting solution. Combined use of ketamine and propofol in routine clinical application may reduce the risk of infection caused by accidental contamination. However, one must keep in mind that ketamine cannot reduce all pathogenic threats in propofol mixture. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe ASSESSMENT OF PSYCHOLOGICAL RESPONSES AND RELATED FACTORS OF DISCHARGED PATIENTS WHO HAVE BEEN HOSPITALIZED WITH COVID-19(Medicinska Naklada, 2021) Cansel, Neslihan; Tetik, Burcu Kayhan; Demi, Gulsu Hilal; Kurt, Osman; Evren, Bahri; Yucel, AytacBackground: COVID-19 is the biggest pandemic of the last century. While a large number of cases and mortality rates direct the research to the clinic and prognosis of the disease, the mental health of these patients has recently become a matter of concern. This study aims to predict psychiatric morbidity and possible associated markers in COVID-19 survivors. Subjects and methods: A total of 102 survivors with COVID-19 infection participated in this study. A questionnaire was applied to the participants to evaluate demographic variables, history of comorbid diseases, smoking, loss of a relative due to COVID-19, and environmental attitudes after the discharge. Length of hospitalization, lung findings, intensive care history and treatments were recorded. Psychiatric morbidities were evaluated with General Anxiety Disorder-7, Patient Health Questionnaire-9 and The Results: Anxiety was found in 20.6%, depression in 13.7% based on moderate and above levels, 21.6% had significant PTSD. Female gender, history of psychiatric and comorbid diseases, smoking, perceived discrimination, and lack of long-lasting immunity posed a risk in terms of psychological response. There was a negative correlation between age and depression scores. No relation was found between the duration of hospitalization, presence of lung involvement, receiving intensive care treatment, losing a relative due to COVID-19 and psychological response. Conclusions: On patients treated for COVID-19 infection, psychological response continue after discharge. Mental health support and efforts to reduce stigma among infected subjects can reduce the psychological impact caused by the pandemic.Öğe Comparison of effects of propofol and ketamine-propofol mixture (ketofol) on laryngeal mask airway insertion conditions and hemodynamics in elderly patients: a randomized, prospective, double-blind trial(Springer Japan Kk, 2013) Erdogan, Mehmet Ali; Begec, Zekine; Aydogan, Mustafa Said; Ozgul, Ulku; Yucel, Aytac; Colak, Cemil; Durmus, MahmutThe objective of this study was to compare the effects of ketamine-propofol mixture (ketofol) and propofol on ProSeal laryngeal mask airway (PLMA) insertion conditions and hemodynamics in elderly patients. Eighty elderly patients, American Society of Anesthesiologists (ASA) physical status I and II, were randomly divided into two groups to receive either propofol 0.15 ml/kg (n = 40), or ketofol (using a 1:1 single-syringe mixture of 5 mg/ml ketamine and 5 mg/ml propofol) (n = 40) before induction of anesthesia. Sixty seconds after induction, the PLMA was inserted. Heart rate and arterial blood pressure (systolic [S] BP) were recorded prior to the induction of anesthesia, immediately following induction, immediately after PLMA insertion, and 5 and 10 min after PLMA insertion. PLMA insertion conditions were scored according to mouth opening, swallowing, coughing, head and body motion, laryngospasm, and ease of PLMA insertion by the same experienced anesthesiologist, who did not know which agents were used. There were no differences in PLMA insertion conditions between the groups. The number of patients in need of ephedrine (P = 0.043) and the total dose of ephedrine (P = 0.022) were significantly lower, and apnea duration (P < 0.001) was significantly higher in the ketofol group compared with the propofol group. SBP was significantly higher in the ketofol group than in the propofol group immediately after PLMA insertion and 5 min after PLMA insertion. The same PLMA insertion conditions were found with ketofol and propofol. The number of patients in need of ephedrine and the total ephedrine dose were lower and apnea duration was increased in the ketofol group.Öğe Comparison of videolaryngoscope-guided versus standard digital insertion techniques of the ProSeal™ laryngeal mask airway: a prospective randomized study(Bmc, 2019) Ozgul, Ulku; Erdil, Feray Akgul; Erdogan, Mehmet Ali; Begec, Zekine; Colak, Cemil; Yucel, Aytac; Durmus, MahmutBackground: This study were designed to investigate the usefulness of the videolaryngoscope-guided insertion technique compared with the standard digital technique for the insertion success rate and insertion conditions of the Proseal (TM) laryngeal mask airway (PLMA). Methods: Prospective, one hundred and nineteen patients (ASA I-II, aged 18-65 yr) were randomly divided for PLMA insertion using the videolaryngoscope-guided technique or the standard digital technique. The PLMA was inserted according to the manufacturer's instructions in the standard digital technique group. The videolaryngoscope-guided technique was performed a C-MAC (R) videolaryngoscope with D-Blade, under gentle videolaryngoscope guidance, the epiglottis was lifted, and the PLMA was advanced until the tip of the distal cuff reached the oesophagus inlet. The number of insertion attempts, insertion time, oropharyngeal leak pressure, leak volume, fiberoptic bronchoscopic view, peak inspiratory pressure, ease of gastric tube placement, hemodynamic changes, visible blood on PLMA and postoperative airway morbidity were recorded. Results: The first-attempt success rate (the primary outcome) was higher in the videolaryngoscope-guided technique than in the standard digital technique (p = 0.029). The effect size values with 95% confidence interval were 0.19 (0.01-0.36) for the first and second attempts, 0.09 (- 0.08-0.27) for the first and third attempts, and not computed for the second and third attempts by the groups, respectively. Conclusion: Videolaryngoscope-guided insertion technique can be a help in case of difficult positioning of a PLMA and can improve the PLMA performance in some conditions. We suggest that the videolaryngoscope-guided technique may be a useful technique if the digital technique fails. Trial registration: ClinicalTrials.gov NCT03852589 date of registration: February 22th 2019.Öğe Controlled Hypotension with Remifentanil, Nitroglycerine, and Esmolol on Blood Loss during Living Donor Hepatectomy(Wiley-Blackwell, 2011) Aslan, Sibel; Yucel, Aytac; Toprak, Huseyin I.; Gedik, Ender; Koc, Elif; Ersoy, Mehmet O.[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 magnesium on emergence agitation in children undergoing adenotonsillectomy under sevoflurane general anesthesia: a prospective randomised clinical trial(Drunpp-Sarajevo, 2012) Yucel, Aytac; Begec, Zekine; Ozgul, Ulku; Aydogan, M. Said; Gulhas, Nurcin; Ersoy, M. OzcanBackground: The aim of this study was to assess the effect of magnesium on the incidence of emergence agitation in preschool-aged children undergoing adenotonsillectomy with sevoflurane anaesthesia. Patients & Methods: 42 children, aged between 3 to 7 years, were randomised into either group M (magnesium, n=26) or group C (saline for controls, n=26). Anesthesia was induced by mask with 8 % sevoflurane in nitrous oxide and oxygen. Magnesium 15 mg.kg(-1) or saline was administered in about 20 minutes after the endotracheal intubation intraoperatively. All patients were ventilated with 60% nitrous oxide and sevoflurane was given at 1-1.5 MAC in oxygen. Mean blood pressure, heart rate, pulse oximetry, eye-opening time, extubation time were recorded in the operating room. In recovery, patients were evaluated using modified Aldrete score, the Pediatric Anesthesia Emergence Delirium (PAED) scale and the Oucher visual analog Pain Scale. Postoperative nause, vomiting, and airway complication and first analgesic application were recorded. Results: Time to eye opening, tracheal extubation, and first analgesic administration were not different between the groups. There were no statistically significant differences in mean arterial pressure and heart rate, pain score and PAED peak scale between the groups (p > 0.05). The modified Aldrete score was significantly lower in the magnesium group (p=0.004). There was no statistically significant difference between the groups regarding side effects. Conclusions: We conclude that the administration of magnesium 15 mg.kg(-1) did not have any significant effect in reducing the incidence of emergence agitation in children undergoing adenotonsillectomy under sevoflurane anaesthesia.Öğe Effects of 2 Different Doses of Pregabalin on Morphine Consumption and Pain After Abdominal Hysterectomy: A Randomized, Double-Blind Clinical Trial(Elsevier, 2011) Yucel, Aytac; Ozturk, Erdogan; Aydogan, M. Said; Durmus, Mahmut; Colak, Cemil; Ersoy, M. OzcanBACKGROUND: 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 scale-pain 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) (C) 2011 Elsevier HS Journals, Inc. All rights reserved.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 dexmedetomidine on liver ischemia-reperfusion injury in rats(Academic Press Inc Elsevier Science, 2013) Sahin, Taylan; Begec, Zekine; Toprak, Huseyin I.; Polat, Alaadin; Vardi, Nigar; Yucel, Aytac; Durmus, MahmutBackground: Ischemia-reperfusion (IR) injury of the liver may cause various types of damage to hepatic tissues. It can affect the prognosis of patients and the success of an operation. Dexmedetomidine is a selective alpha(2) receptor agonist. We investigated whether dexmedetomidine provides protection against IR-induced liver injury in rats. Methods: Forty rats were divided equally into four groups. In group 1, the liver was manipulated after the laparotomy, and no occlusion of the vessels of the liver was performed. In group 2, once the abdomen was opened, 60 min of ischemia and 60 min of reperfusion were applied according to the segmental hepatic ischemia model. In group 3, 10 mu g/kg of dexmedetomidine was injected into the peritoneal cavity 30 min before ischemia. In group 4, 100 mu g/kg of dexmedetomidine was injected into the peritoneal cavity 30 min before ischemia. Further procedures in groups 3 and 4 were the same as those of group 2. After the experiment was completed, the rats were killed. Liver tissues were removed and stored until biochemical and histologic assessments were performed. Results: The malondialdehyde level in group 2 was higher than that of groups 1, 3, and 4 (P = 0.001, P = 0.000, and P = 0.000, respectively). Superoxide dismutase, catalase, and glutathione levels in group 2 were lower than those in group 1 (P = 0.001, P = 0.027, and P = 0.014, respectively). Superoxide dismutase and catalase levels in group 4 were higher than those in group 2 (P = 0.002 and P = 0.000, respectively). GSH levels in groups 3 and 4 were higher than those in group 2 (P = 0.049 and P = 0.006, respectively). A lower glutathione peroxidase level was detected in groups 2 and 3 than that in group 1 (P = 000). Group 4 demonstrated an increase in glutathione peroxidase levels compared with group 3 (P = 0.014). The histologic injury scores in groups 2-4 were higher than those in group 1 (P = 0.003, P = 0.002, and P = 0.001, respectively). However, the histologic injury scores were lower in groups 3 and 4 than those in group 2 (P = 0.003 and P = 0.002, respectively). Conclusions: This study showed that dexmedetomidine may protect the liver against IR injury in rats. (C) 2013 Elsevier Inc. All rights reserved.Öğe The Effects of Dexmedetomidine on Liver Ischemia-Reperfusion Injury in Rats(Wiley-Blackwell, 2012) Sahin, Taylan; Begec, Zekine; Toprak, Huseyin I.; Polat, Alaadin; Vardi, Nigar; Yucel, Aytac; Durmus, Mahmut[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 Melatonin and ?-Glucan Combination Hepatic Ischemia and Reperfusion in Rats(Wiley-Blackwell, 2012) Aydogan, Mustafa Said; Erdogan, Mehmet Ali; Polat, Alaadin; Yucel, Aytac; Ozgul, Ulku; Parlakpinar, Hakan; Duran, Zeynep Rumeysa[Abstract Not Available]Öğe Effects of propofol and dexmedetomidine on motor coordination and analgesia: A comparative analysis(Dustri-Verlag Dr Karl Feistle, 2012) Yucel, Aytac; Aydogan, M. Said; Parlakpinar, Hakan; Erdogan, M. Ali; Kurt, Ahmet; Ucar, Muharrem; Durmus, MahmutObjective: The objective of this study was to compare the effects of two drugs on motor performance and analgesic efficacy in a rat model. Material and methods: Rats were randomly divided into four groups as follows: propofol (600 mu g/kg/min), dexmedetomidine (1 mu g/kg/min), morphine (83 mu g/kg/min) and control. The rats were placed on a rotating rod and tested at the slowest speed (5 rpm) and then at increasing increments from 5, 10, 15, 20, 25, 30, 35 to 40 rpm. The speed was set up again from 1 to 79 rpm within 4 and 10 min for the accelerod test, respectively. Pain reflexes in response to a thermal stimulus were measured at 0, 10, 20 and 60 min after the drug injection using the hot-plate test. Results: Dexmedetomidine injected rats showed an increased length of time compared to the propofol group at 20 rpm, 25 rpm, 35 rpm and 40 rpm speeds during the rotarod test. The latency times for the hot-plate test increased significantly for the propofol, at 0, 10 and 20 min compared to the control. At 10 min the latency times of the propofol group were longer than the dexmedetomidine group. Conclusions: For long-term analgesic benefit, propofol treatment seems to be better than the dexmedetomidine group. Dexmedetomidine may be preferable in day-case surgery and sedation applications in intensive care units as it provided a faster onset of recovery of motor coordination performance.Öğe Effects of sample temperature and storage time on arterial blood gases values(Drunpp-Sarajevo, 2012) Aydogan, Mustafa Said; Yucel, Aytac; Erdogan, Mehmet Ali; Sanli, Mukadder; Konur, Huseyin; Ozgul, Ulku; Togal, TurkanBackground: Arterial blood gas analysis is vital during diagnosis and treatment monitorization of mechanically ventilated patients. Work overload delays blood gas analysis lead to false results. Therefore syringes and the blood samples is recommended to kept cool or cold environment. The aim of this study is to investigate the effect of refrigerator-cooled syringes on blood gas analysis. Methods: We prepared 12 heparinized polypropylene plastic syringes for blood gas analysis for each patients before the study. Syringes divided in tree group as kept at room temperature (Group Room, n=4), or stored in the refrigerator for 30 minutes (Group Refrigerator, n=4), or stored in the refrigerator for 30 minutes but blood samples stored at room temperature (Group Refrigerator and Room, n=4). 40 for each patient's blood samples on mechanical ventilation were analyzed immediately as reference value (T-0). Samples analyzed at 15, 30, 45 and 60 minutes. Results: Patients characteristics and mechanical ventilation parameters were similar in the three groups. In terms of impact of sample temperature and storage time on arterial blood gas analysis; pH, pCO(2), and pO(2) values were not differ significantly among the groups (Table 2, P>0.05). There was significant difference in 60 minutes SpO(2) value among the groups (Table 2, P<0.05). Conclusion: Storage of syringes at room temperature or cooling in refrigerator was not affect arterial blood gas analysis results immediately before obtaining of blood samples. Blood gas analysis with plastic syringes at room temperature can provide safe results up to 60 minutes.Öğe The effects of secondhand smoke on postoperative pain and fentanyl consumption(Springer Japan Kk, 2013) Aydogan, Mustafa Said; Ozturk, Erdogan; Erdogan, Mehmet Ali; Yucel, Aytac; Durmus, Mahmut; Ersoy, Mehmet Ozcan; Colak, CemilAlthough 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. 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. 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). 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.Öğe Efficacy of Intravenous Ibuprofen and Intravenous Paracetamol in Multimodal Pain Management of Postoperative Pain After Percutaneous Nephrolithotomy(Elsevier Science Inc, 2022) Ucar, Muharrem; Erdogan, Mehmet Ali; Sanli, Mukadder; Colak, Yusuf Ziya; Aydogan, Mustafa Said; Yucel, Aytac; Ozgul, UlkuPurpose: Many different techniques, including multimodal analgesia, have been used for the management of postoperative pain after Percutaneous nephrolithotomy (PCNL). Ketorolac, intravenous (IV) paracetamol, rofecoxib, and IV ibuprofen have been used as a part of a multimodal analgesic approach in different surgical procedures. However, the efficacy of IV ibuprofen has not been well elucidated in adult patients undergoing elective PCNL. The aim of the study was to examine the efficacy of IV ibuprofen compared to IV paracetamol after elective PCNL. Design: This was a prospective randomized clinic study. Methods: The study was conducted with 50 patients scheduled for PNCL between the ages of 18 and 65. IV ibuprofen 800 mg infusion was used for Group I, and 1 g IV paracetamol infusion Group P. IV tramadol infusion was administered with a Patient Controlled Analgesia device for postoperative analgesia. The primary outcome was 24-hour tramadol consumption. Secondary outcomes were pain intensity and side effects of the drugs. All outcomes were recorded in the 30th minute in the PACU and in 2, 4, 6, 12, 24 hours postoperatively. Findings: Total postoperative tramadol consumption was significantly lower in Group I compared with Group P (P = .031). There was also a significant decrease in the cumulative tramadol consumption between the two groups in the 2nd and 24th hours (P < .012). In all measurement periods, pain intensity, sedation score, nausea and vomiting, itching, additional analgesia, and satisfaction with pain management were similar between the two groups. Conclusion: IV ibuprofen, used as a part of multimodal tramadol-based analgesia reduced tramadol consumption compared with IV paracetamol in the first 24 hours postoperatively after elective PCNL. The IV ibuprofen-tramadol combination seems appeared superior to a paracetamol-tramadol combination. (C) 2021 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.Öğe The Hemodynamic Effects of Dexmedetomidine and Esmolol in Electroconvulsive Therapy A Retrospective Comparison(Lippincott Williams & Wilkins, 2013) Aydogan, Mustafa Said; Yucel, Aytac; Begec, Zekine; Colak, Yusuf Ziya; Durmus, MahmutAim: Acute hemodynamic responses, including transient hypertension and tachycardia, to electroconvulsive therapy (ECT) predispose vulnerable patients to significant cardiovascular complications. Many drugs have been used in an attempt to attenuate these responses. To date, no comparative study of the acute hemodynamic effects of dexmedetomidine and esmolol in ECT has been published. Hence, this retrospective study aimed to compare the effects of dexmedetomidine and esmolol on acute hemodynamic responses in patients undergoing ECT. Materials and Methods: The anesthesia records for 66 patients who underwent a total of 198 ECT treatments performed between July 2009 and January 2010 were analyzed retrospectively. For each case, 1 seizure with 1-mg/kg propofol as control (group C), 1 seizure with 1-mu g/kg dexmedetomidine combined with propofol (group D; total volume, 30 mL for 10 minutes), and 1 seizure with 1-mg/kg esmolol combined with propofol were compared (group E; total volume, 30 mL for 10 minutes). Anesthesia was induced with 1-mg/kg propofol, and then intravenous succinylcholine, 0.5-mg/kg, was administered. Heart rates and systolic and mean blood pressures were recorded at baseline (T-0) and 1, 3, and 10 minutes after the seizure (T-1, T-2, and T-3, respectively). The electroencephalographic (EEG) tracing motor seizure duration, and recovery times (spontaneous breathing, eye opening, and obeying commands) were recorded. Results: The baseline hemodynamic measurements were similar between the groups. Heart rates at T-1, T-2, and T-3 were lower in group D than those in groups E and C (P < 0.05). Systolic blood pressures at T-1, T-2, and T-3 were lower in group D than those in groups C (P < 0.05). In addition, systolic blood pressure at T-3 was lower in group D than that in group E (P < 0.05). The mean blood pressure at T3 was significantly lower in group D than those in groups E and C (P <0.05). The electroencephalographic tracing, motor seizure durations, and recovery times were similar between the groups. Conclusion: Dexmedetomidine administration before anesthesia induction reduced the acute hemodynamic response compared with esmolol administration in the early period of ECT. Therefore, dexmedetomidine may be effective in preventing acute hemodynamic responses to ECT.Öğe Management of the crush syndrome in critical patients: 10 cases(2017) Karakas, Bugra; Aydogan, Mustafa Said; Yucel, Aytac; Yucel, Neslihan; Kacmaz, Osman; Sari, Mirac SefaAbstract Introduction: Crush trauma may be life threating in extremities. Crush syndrome leads to a systemic disorder through muscle cytolysis and the spread of metabolic substance into the circulatory system. In the present study, we summarized the follow-up and treatment of 10 cases with intensive care unit (ICU) crush injury. Meterials and Methods: We have analyzed the clinical data of 10 patients with crush injury who were under treatment in the intensive care unit of our clinic. Age, sex, diagnosis, APACHE II score, sepsis, intensive care complications, treatment parameters in intensive care and arterial blood gases parameters, routine blood biochemistry, alanine aminotransferase, lactate dehydrogenase, creatine kinase, creatinine, existence of blood urea nitrogen, urinary protein and severity score of the patients have been recorded. Patients have been closely monitored for symptoms of crush injury, changes, crush area, urination and dangerous complications. Results: The mean age of 10 patients (10 male) was 41.3 ± 8.7 years. APACHE II score was 21,7. 8 out of 10 patients had traumatic shock, one showed acute renal failure and one presented with multiple organ dysfunction syndrome (MODS). In 3 patients presenting the criteria for crush syndrome, the symptoms of extremity distension and sensory function disorder were regulated with rapid surgical operation and hemodialysis, and urination increased, even in some patients, it reached the normal level. Serologic parameters were regulated in most of the patients after application. Amputation was applied to 5 (50%) patients in our group for serious infection and crush. 2 (20%) patients died, one because of MODS and one because of acute renal failure. Conclusion: Early and aggressive resuscitation, emergency treatment and close monitoring of serious complications are of great importance for saving the lives of the patients with crush syndrome under intensive careÖğe Pain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolam(Wiley-Blackwell, 2013) Aydogan, Mustafa S.; Korkmaz, Mehmet F.; Ozgul, Ulku; Erdogan, Mehmet A.; Yucel, Aytac; Karaman, Abdurrahman; Togal, TurkanBackground The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the early postoperative period in adolescents who underwent scoliosis surgery. Methods We performed a prospective, randomized trial in an intensive care unit (ICU) in a tertiary care center. In this study, 42 patients (American Society of Anesthesiology physical status I and II) who underwent scoliosis surgery were divided into two groups according to sedation protocols: group dexmedetomidine (DEX) (n=22) and group midazolam (MDZ) (n=20). Adolescents (1218years) requiring mechanical ventilation underwent a continuous infusion of either dexmedetomidine (group DEX; starting dose, 0.4g center dot kg1 center dot h1) or midazolam (group MDZ; starting dose, 0.1mg center dot kg1 center dot h1) with intermittent fentanyl, as needed. The efficacy of sedation was assessed using the Richmond Agitation Sedation Scale (RASS). Quality of pain relief was measured using the Numeric Visual Analog Scale (NVAS). Delirium was determined in patients in the RASS range of 2 to +1 using the Confusion Assessment Method for the ICU (CAM-ICU). Fentanyl consumption, incidence of delirium, NVAS scores, and hemodynamics were recorded postoperatively at 2, 4, 6, and 24h in the ICU. Results The NVAS pain scores and fentanyl consumption at all the evaluation time points were significantly higher in group MDZ than those in group DEX (P<0.05). Further, total fentanyl consumption in group MDZ was significantly higher than that in group DEX (P<0.05). Delirium was significantly higher in the group MDZ than that in group DEX (31.3% vs 12.5%) when analyzed as the endpoint of CAM-ICU (P<0.05). The heart rate was significantly lower in group DEX compared with that in group MDZ at all the evaluation time points (P<0.05). Conclusion Dexmedetomidine was associated with the decreased postoperative fentanyl consumption, NVAS scores, and a decreased incidence of delirium. These findings may be beneficial for managing sedation protocols in adolescents who have undergone scoliosis surgery.
