-
[show abstract]
[hide abstract]
ABSTRACT: Objectives: Ultrasound-guided supraclavicular and infraclavicular blocks are commonly used for upper extremity surgery. The primary aims of our study were to compare block success, block onset times and performance times; secondary aims were to compare the number of needle advancements, and incidence of adverse events of ultrasound-guided supraclavicular or infraclavicular blocks. Methods: 110 patients were randomized into two groups: supraclavicular (Group S) and infraclavicular (Group I). All the patients were given a mixture of 20 ml 0.5% levobupivacaine and 10 ml 2% lidocaine as local anesthetics. The sensory score of the seven terminal nerves was assessed every 10 min for 30 min. Results: Block success (Group I: 92.7%; Gorup S: 83.6%) and block onset time (Group I: 12.5±4.8; Group S: 11.6±3.9 min) were similar between the groups. Block performance time was shorter in Group I, than Group S (194.4±65; 226.3±59 sec, P<0.05). The number of needle advancements were lower in Group I than Group S (p<0.05). The Group I patients had a significantly improved block of the median and ulnar nerves than Group S, and Group S patients had a better block of the medial cutaneous nerve, than Group I (p<0.05). Horner syndrome was observed in 9 patients (16.3%) and paresthesia in one patient (1.8%) in Group S. Conclusion: Similar block features were observed with infraclavicular and supraclavicular approaches, but infraclavicular block may be preferable to supraclavicular block due to the lower incidence of transient adverse events.
Agri: Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology 10/2012; 24(4):159-64.
-
Agri: Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology 10/2012; 24(4):194-5.
-
[show abstract]
[hide abstract]
ABSTRACT: In this study we aimed to analyze the effect of perioperative magnesium sulphate (MgSO(4)) on minimal alveolar concentration (MAC) of desflurane using bispectral index (BIS) monitoring.
Sixty patients undergoing abdominal surgery under general anesthesia were randomized into two groups: Mg - receiving perioperative MgSO(4) supplementation and C - control. Anesthesia was titrated to maintain the BIS value between 45-55.
MAC values, tachycardia and hypertension during intubation was found to be lower in group Mg compared to group C (p<0.001). Time to extubation, verbal cooperation and eye opening was longer in patients receiving infusion of MgSO(4) (p<0.001).
We concluded that perioperative MgSO(4) infusion may be used as an adjunct as it decreases MAC of desflurane and suppresses the hemodynamic response to intubation.
Magnesium research: official organ of the International Society for the Development of Research on Magnesium 11/2011; 24(4):181-8. · 1.52 Impact Factor
-
Agri: Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology 07/2011; 23(3):134-5.
-
[show abstract]
[hide abstract]
ABSTRACT: In this study we investigated the effects of intravenously administered dexmedetomidine on the duration of hyperbaric ropivacaine in spinal anesthesia, and the side effects.
In a prospective, double-blind study, sixty ASA I-II patients were randomized to two groups of 30 individuals. All patients were administered hyperbaric ropivacaine (22.5 mg) for spinal anesthesia. Intravenous dexmedetomidine was administered in group I for 60 min, physiological saline at the same amount and duration was infused in group II.
Measurements of mean blood pressure before and after the procedure revealed significant decreases in group I compared with group II after 20, 25, and 30 min. The times for two dermatomes regression of the blockade and complete resolution of motor blockade were significantly prolonged in group I. The sedation score in the dexmedetomidine group was significantly increased compared with controls. Atropine requirement was found to be significantly higher in group I than in group II.
Our results show that intravenously administered dexmedetomidine prolonged the duration of spinal anesthesia, provided sufficient sedation, and had few side effects. Therefore, dexmedetomidine is appropriate during spinal anesthesia, if the anesthesiologist is alert for development of bradycardia.
Journal of Anesthesia 05/2010; 24(4):544-8. · 0.83 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Bilateral brachial plexus block is rarely performed due to the risk of systemic toxicity of local anesthetics. Therefore, general anesthesia is generally preferred in bilateral extremity operations. However, usage of ultrasound allows easy visualization of the structures of the vessels and the nerves. In this case report, we present a 28-year-old man who was scheduled for bilateral hand surgery with ultrasound-guided bilateral infraclavicular block after he refused general anesthesia. After visualization of the axillary artery and the cords of the brachial plexus with linear ultrasound probe, the mixture of local anesthetics, which was prepared as 20 ml for each extremity (10 ml 2% lidocaine (with 5 microg x ml(-1) adrenaline) + 10 ml 7.5% levobupivacaine), was injected using triple injection method. During block performance, no complication developed. In conclusion, we think that infraclavicular block can be safely performed bilaterally with ultrasound guidance, which allows a reduction in the dose of local anesthetic.
Agri: Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology 01/2010; 22(1):41-3.
-
Journal of Anesthesia 11/2009; 23(4):643-4. · 0.83 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study aimed to evaluate the effects of different inflating gases used for ProSeal LMA (PLMA) cuff inflation on cuff pressure, oropharyngeal structure, and the incidence of sore throat. Eighty patients (American Society of Anesthesiologists; ASA I-II) were randomly divided into two groups. PLMA cuff inflation was achieved with appropriate volumes of 50% N2O + 50% O2 in group I and room air in group II, respectively. When the PLMA was removed, oropharyngeal examination was carried out immediately, using a rigid optical telescope. Patients were asked about sore throat symptoms postoperatively. Cuff pressures were significantly lower in group I, except at the initial pressure measurement. Cuff pressure was positively correlated with the length of the operation in group II, and negatively correlated in group I. PLMA cuff inflation with room air led to increased cuff pressure during the operation, possibly due to the diffusion of N2O into the cuff. We consider that a PLMA cuff inflated with an N2O-O2 mixture is convenient, especially in operations in which N2O has been used.
Journal of Anesthesia 12/2008; 22(4):467-70. · 0.83 Impact Factor
-
Pediatric Anesthesia 12/2008; 18(11):1127-8. · 2.10 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of the study was to describe the effects of influenza associated with community-acquired pneumonia (CAP) on the outcome of patients in an area characterized by endemic avian influenza.
Sixty patients diagnosed with CAP and requiring hospitalization were studied for the presence of influenza. Based on the presence or absence of influenza, patients were divided into two groups: group 1 were CAP patients positive for influenza and group 2 included CAP patients negative for influenza. Laboratory investigations, CXR findings and prognosis were compared.
Nasopharyngeal swabs or deep tracheal aspirates were tested for viral aetiology, and seven patients were positive for influenza AH3; one was positive for influenza AH1; seven were positive for influenza B; and one was positive for parainfluenza. Group 1 patients (n = 16) had a mean age of 56 years and group 2 patients (n = 45) had a mean age of 55 years. Significant increases in creatinine kinase and lymphopaenia were seen in group 1 patients. On CXR, interstitial infiltration was more marked in group 1. There was significantly higher mortality in group 1 than in group 2.
CAP associated with influenza had a different clinical picture and outcome compared with patients without evidence of influenza.
Respirology 06/2008; 13(3):444-6. · 2.42 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study was to prospectively analyze intensive care unit patients with fibre-optic bronchoscopy-assisted percutaneous dilatational tracheostomy by guidewire dilating forceps (GWDF; Griggs percutaneous tracheostomy).
Prospective study.
A tertiary care centre.
Fifty-two critically ill patients (32 men and 20 women), aged 16 to 84 years (mean +/- SD 42 +/- 1.6 years) who required endotracheal intubation for longer than 15 days were consecutively selected to undergo tracheostomy by the GWDF technique. The diagnoses of the patients and intraoperative and postoperative complications were recorded.
The patients were mechanically ventilated for an average of 14.8 +/- 1.2 days. The duration of the GWDF technique was 4.9 +/- 1.7/min. Intraoperative complications occurred in 10 (19.2%) patients: hemorrhage in 3 cases, puncture of the tracheal tube in 2 cases, difficult cannulation in 2 cases, difficult dilatation in 1 case, false passage in 1 case, and inadvertent extubation in 1 case. Postoperative complications occurred in three (5.7%) patients, stomal cellulitis in one case, subcutaneous emphysema in one case, and difficult recannulation in the remaining case.
Fibre-optic bronchoscopy-assisted percutaneous dilatational tracheostomy by GWDF is a simple and fast technique for inserting a tracheal cannula.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 03/2008; 37(1):76-80. · 0.71 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Melkersson Rosenthal Syndrome (MRS) is a rare disorder characterized by relapsing facial paralysis, persistent or recurrent orofacial edema, and lingua plicata. It may cause difficult airway, drug allergy, and angioedema. In our anesthetic management of two patients with MRS, preanesthetic immunological blood examination and skin tests for hypersensitivity to anesthetic drugs were applied. Because the principal goal is to avoid all factors that may stimulate, an allergic reaction, anesthetic drugs known to trigger urticaria were avoided. Body and operating room temperatures, changes of which may trigger allergic reactions, were kept constant during the perioperative period. Emergency precautions were taken for probable angioedema. MRS is a rare syndrome, and if its manifestations are misunderstood as simple facial paralysis, it may be overlooked by anesthesiologists. Anesthesiologists must be careful of several problems in patients with MRS.
Journal of Anesthesia 02/2008; 22(3):294-6. · 0.83 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Cases of botulism in a family in eastern Anatolia were studied. In late September 2005, an outbreak of botulism developed in our region, first in 2 patients, a teenage boy and his mother, in whom the disease culminated in respiratory insufficiency and death. An additional 8 cases of botulism were identified later; most of them presented to our medical centre the next d. These patients with milder symptoms recovered gradually. All the patients received anti-botulinum toxin. The investigation of the source of the outbreak showed an unexpected vehicle for botulism infection in the these patients, süzme (condensed) yoghurt buried under soil. Type A botulinal toxin was detected in the yoghurt sample. The clinical diagnosis was also confirmed by a mouse bioassay performed with the serum samples of the patients. The most common symptoms were dry mouth, difficulty in speaking and swallowing, and change in voice quality. The 10 identified patients with botulism constitutes the largest-ever outbreak of botulism reported in Turkey to date. The present study shows the importance of considering a diagnosis of botulism soon after patients present with acute cranial nerve dysfunction and of promptly treating suspected cases with antitoxin.
Scandinavian Journal of Infectious Diseases 02/2007; 39(2):108-14. · 1.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The effects of desflurane and sevoflurane on QT interval and QT dispersion have been investigated in a prospective, double-blind, randomized study of patients undergoing noncardiac surgery.
Sixty American Society of Anaesthesiologists physical status I-II adult patients were randomly assigned to two groups. Anaesthesia was induced with inhalation of desflurane (desflurane group) or sevoflurane (sevoflurane group) in increasing concentrations to 3 minimal alveolar concentration level. The maintenance of anaesthesia was provided with 2 minimal alveolar concentration agents in both groups until the end of the study. Electrocardiogram, heart rate and blood pressure were recorded as follows: before premedication, before induction, 1 and 3 min after the induction of anaesthesia, after the administration of vecuronium and after the tracheal intubation. The induction times and the complications were recorded.
The QTc interval was significantly more prolonged with desflurane than with sevoflurane at the first and third minute after the induction, and at the third minute after the administration of vecuronium. There were no significant differences in the QT dispersion between the two groups. Heart rate and blood pressure were found to be significantly higher in the desflurane group.
The QTc interval was more prolonged with desflurane than sevoflurane, and QT dispersion was normal with both agents.
Acta cardiologica 11/2005; 60(5):459-64. · 0.61 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Sore throat is a common postoperative complaint. We investigated whether preemptive benzydamine hydrochloride (BH) treatment could prevent sore throat due to a laryngeal mask airway (LMA) cuff inflated with air. One-hundred ASA status I-II patients who underwent general anesthesia were randomly divided into two groups. In the first group, four puffs of BH were applied to the pharynx 30 min before the operation and 5 min before the induction of anesthesia. Distilled water with a similar bottle was applied with the same protocol in the second group. Anesthetic induction was provided with propofol and fentanyl. The pressure of the LMA cuff inflated with room air was measured after the first adjustment and after 30, 60, and 90 min of inflation in both groups. At the end of operation, the LMA was removed after the recovery of spontaneous breathing. After the operation, patients were asked about sore throat symptoms at the first, second, and fourth hours. There were no significant differences between groups for cuff pressures, cuff volumes, analgesic doses, or operation times. However, sore throat symptoms were significantly less severe for the BH group during both resting and swallowing. In conclusion, preemptive topical BH may decrease the incidence of sore throat due to LMA use.
Anesthesia & Analgesia 10/2004; 99(3):710-2, table of contents. · 3.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: zet Sistemik lokal anestezik toksistesi riski nedeniyle bilateral brakiyal pleksus bloğu nadiren uygulanır. Bu nedenle, bilateral eks-tremite operasyonlarında çoğunlukla genel anestezi tercih edilir. Bununla birlikte, ultrason kullanımı damar ve sinir yapıları-nın rahatlıkla görüntülenebilmesine olanak verir. Biz bu yazımızda, bilateral el yaralanması nedeniyle ameliyat edilecek olan, fakat genel anestezi istemeyen 28 yaşında bir erkek hastada, ultrason yardımıyla bilateral infraklavikuler blok uygulamasını sunmayı amaçladık. Lineer ultrason probu ile aksiller arter ve brakiyal pleksusun kordları görüntülendikten sonra her bir eks-tremite için 20' şer ml lokal anestezik karışımı (10 ml %2 lidokain (5 μg. ml -1 adrenalin içerecek şekilde) + 10 ml %7.5 levobu-pivakain) üçlü enjeksiyon yöntemi ile enjekte edildi. Blok sırasında herhangi bir komplikasyon gelişmedi. Sonuç olarak, inf-raklavikuler bloğun, ultrason yardımı ile lokal anestezik dozu azaltılarak güvenle bilateral uygulanabileceğini düşünmekteyiz. Anahtar sözcükler: Bilateral infraklavikuler blok; ultrason. Summary Bilateral brachial plexus block is rarely performed due to the risk of systemic toxicity of local anesthetics. Therefore, general anesthesia is generally preferred in bilateral extremity operations. However, usage of ultrasound allows easy visualization of the structures of the vessels and the nerves. In this case report, we present a 28-year-old man who was scheduled for bilateral hand surgery with ultrasound-guided bilateral infraclavicular block after he refused general anesthesia. After visualization of the axillary artery and the cords of the brachial plexus with linear ultrasound probe, the mixture of local anesthetics, which was prepared as 20 ml for each extremity (10 ml 2% lidocaine (with 5 μg. ml -1 adrenaline) + 10 ml 7.5% levobupivacaine), was injected using triple injection method. During block performance, no complication developed. In conclusion, we think that infraclavicular block can be safely performed bilaterally with ultrasound guidance, which allows a reduction in the dose of local anesthetic.
-
[show abstract]
[hide abstract]
ABSTRACT: The present study was undertaken to compare the effects of laryngeal mask anesthesia (LMA) and spinal anesthesia on mood states in patients undergoing hemorrhoidectomy. A total of 46 patients who underwent hemorrhoidectomy for grade III and IV hemorrhoids were included in this study. LMA with fentanyl plus propofol was given to 23 patients, and spinal anesthesia with bupivacaine was administered to 23 patients. Mood changes were assessed preoperatively and 2 h postoperatively with the Profile of Mood States (POMS), which consists of 65 questions that are designed to measure 6 identifiable mood states (tension, depression, anger, vigor, fatigue, and confusion). No significant differences were noted between the 2 groups in terms of baseline POMS global and subscale scores, except for scores regarding vigor. No significant mood changes were observed after hemorrhoidectomy in patients who were given LMA; however, an increase in total POMS score was reported in patients given spinal anesthesia. These findings suggest that mood score is affected by spinal anesthesia but not by LMA in patients who are about to undergo hemorrhoidectomy.
Advances in Therapy 24(1):171-7. · 2.11 Impact Factor
