Ebru Kelsaka - Academia.edu (original) (raw)

Papers by Ebru Kelsaka

Central core disease is a rare neuromuscular disorder associated with leg weakness. It is a famil... more Central core disease is a rare neuromuscular disorder associated with leg weakness. It is a familial disease with autosomal dominant inheritance. Central core disease has been reported to be associated with malignant hyperthermia. A 25-year-old woman with central core disease was scheduled to be operated for lumbar disc hernia at L4-5 and L5-S1 interspaces. Oral dantrolene was administered prophylactically. Spinal anesthesia was performed with a 25 G Whitacre spinal needle at the L3-4 interspace. No complication was observed during the intraoperative and postoperative periods. We present a case with central core disease who was operated under spinal anesthesia with oral prophylactic dantrolene. Girifl: Santral kor hastal›¤› bacaklarda güçsüzlük ile seyreden nadir görülen bir nöromüsküler hastal›kt›r. Otozomal dominant geçifllidir. Santral kor hastal›¤›n›n malign hipertermi ile iliflkili olabilecei rapor edilmifltir. 25 yafl›nda santral kor hastal›¤› olan kad›n hastan›n L4-5 ve L5-S1...

The aim of this study was to evaluate the histopathologic healing of penicillin G induced traumat... more The aim of this study was to evaluate the histopathologic healing of penicillin G induced traumatic sciatic nerve injury with tenoxicam. 22-gauge sharp edged needle was inserted into the sciatic nerve and 0.1 ml (25000 Ü) crystallized penicillin G was injected. Rats were randomly divided into four groups. 1 ml intraperitoneal 0.09% NaCl solution was administered daily for one week

TURKISH JOURNAL OF MEDICAL SCIENCES, 2015

To compare the postoperative analgesic efficacy and side effects of paracetamol and tramadol in p... more To compare the postoperative analgesic efficacy and side effects of paracetamol and tramadol in patients undergoing lumbar disc surgery. Group P (paracetamol group) was given 1 g of paracetamol intravenously 30 min before the end of the operation and 1 g each day at 6-h intervals. Group T (tramadol group) was given 1.5 mg/kg of tramadol as a loading dose and patient-controlled analgesia for 1 day. Hemodynamic parameters, modified Aldrete score, Ramsay sedation scale score, patient satisfaction scale (PSS) score, visual analog scale (VAS) score, nausea/vomiting scale score, and additional analgesic needs/times were recorded. PSS scores were significantly higher in Group T (P < 0.05). The total analgesic consumption was significantly higher in Group P. There were no significant differences in the VAS scores at any time points. Twenty-one patients in Group P and 8 patients in Group T needed additional analgesia (P < 0.05). The first additional analgesic time was earlier in Group P, and pain was more evident at the 15th minute and at hours 2 and 6 (P < 0.05). Paracetamol alone was not able to provide effective analgesia. Tramadol was more effective in the treatment of postoperative pain after lumbar disc surgery.

Regional Anesthesia and Pain Medicine, 2006

Background and Objectives: Perioperative hypothermia is a common problem in anesthesia practice. ... more Background and Objectives: Perioperative hypothermia is a common problem in anesthesia practice. Regional anesthesia, like general anesthesia, influences the thermoregulatory process. The aim of our study was to compare the efficacy of ondansetron and meperidine in the prevention of shivering during and after spinal anesthesia.

Pediatric Anesthesia, 2004

The aim of this study was to determine whether tissue coring occurs with 22-G hollow needle and 2... more The aim of this study was to determine whether tissue coring occurs with 22-G hollow needle and 22-G caudal block needle during caudal injection in children, as well as evaluating the nature of the coring material if it did occur. Seventy children were randomly allocated to two groups and caudal block was performed with either 22-G hollow (group I) or 22-G caudal block (group II) needle under general anesthesia. The needles and guides were washed with 0.5 ml of 70% ethanol in a sterile tube and were evaluated by a pathologist blinded to the type of needle used, for the type and number of cells. Nucleated cells, which have no mitotic activity, were present in 8.5% in each study group and bloody material was present in 8.5 and 2.8%, in group I and II, respectively. Non-nucleated epidermal cells were detected in 94.2 and 97.1% of the patients in group I and II, respectively. However, cells with mitotic activity from the stratum basale were not detected in any slides. The incidence of transporting nucleated epidermal cells with no mitotic activity from stratum spinosum during puncture for caudal block is low and no differences exist between different types of needle used. However, it may also suggest that transporting nucleated cells with mitotic activity from the stratum basale may be possible during caudal puncture.

Pediatric Anesthesia, 2007

... What is the ideal glucose regime in children undergoing extensive hepatic resection? Ebru Kel... more ... What is the ideal glucose regime in children undergoing extensive hepatic resection? Ebru Kelsaka,; Deniz Karakaya,; Sibel Baris,; Serap Karacalar,; Suat Ayyıldız. Article first published online: 17 APR 2007. DOI: 10.1111/j.1460-9592.2006.02125.x. Issue. Pediatric Anesthesia. ...

Pediatric Anesthesia, 2003

Background: The aim of this study was to evaluate the intensity and effectiveness of 0.75 mlAEkg ... more Background: The aim of this study was to evaluate the intensity and effectiveness of 0.75 mlAEkg )1 bupivacaine 0.25% with the addition of fentanyl or midazolam for caudal block in children undergoing inguinal herniorrhaphy. Methods: Seventy-five children were allocated randomly to three groups to receive a caudal block with either 0.25% bupivacaine with fentanyl 1 lgAEkg )1 (group BF) or with midazolam 50 lgAEkg )1 (group BM) or bupivacaine alone (group B) after induction of anaesthesia. Haemodynamic parameters, degree of pain, additional analgesic requirements and side-effects were evaluated. Results: The mean systolic arterial pressure at 10, 20, 30 min after caudal block was higher in group B compared with groups BF and BM. Mean intraoperative heart rate was lower in group BF than the other groups. Adequate analgesia was obtained in all patients (100%) in group BF, 23 patients (92%) in group BM and 21 patients (84%) in group B (P > 0.05). The time to recovery to an Aldrete score of 10 was significantly shorter in group B than group BM (P < 0.05). Although not significant, it was also shorter in group B than group BF. There was no difference in additional analgesic requirements between the groups in the first 24 h. Sedation score was higher in the midazolam group at 60 and 90 min postoperatively than the other groups. Conclusions: Caudal block with 0.75 mlAEkg )1 0.25% bupivacaine and 50 lgAEkg )1 midazolam or 1 lgAEkg )1 fentanyl provides no further analgesic advantages to bupivacaine alone when administered immediately after induction of anaesthesia in children undergoing unilateral inguinal herniorrhaphy.

Medical Principles and Practice, 2011

Our purpose was to study whether or not intravenous (IV) administration of lidocaine reduces prop... more Our purpose was to study whether or not intravenous (IV) administration of lidocaine reduces propofol dose requirement as intramuscular (IM) lidocaine in a placebo-controlled manner. Seventy-five adult patients with American Society of Anesthesiologists physical status I and II, aged 20-60 years who were scheduled for surgery under general anaesthesia were included in the study. The patients were randomly allocated to 3 groups: IM: intramuscular administration; IV: intravenous administration and C: control. There were 25 patients in each group. The patients in group IM received lidocaine 1.5 mg · kg(-1) administered into the deltoid muscle 10 min before anaesthesia induction. In group IV, the patients received IV lidocaine 1.5 mg · kg(-1), 2 min before anaesthesia induction. Group C patients served as control group who received only propofol injection. Hypnosis after propofol administration was measured with response to verbal commands. There were no statistical differences between group IM (100.8 ± 26.1 mg) and group IV (110.8 ± 30.1 mg) regarding the induction dose of propofol (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). In group C, the required propofol dose (151.2 ± 27.4 mg) for anaesthesia induction was significantly higher than in the other groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). No side effect was observed in any patients. In this study, both IV and IM lidocaine administration were effective in reducing the hypnotic dose of propofol without any side effects. In addition, IV lidocaine may be more comfortable for awake patients.

Journal of Neurosurgical Anesthesiology, 2003

Subdural hematoma is a rare complication of spinal anesthesia. This patient underwent bilateral i... more Subdural hematoma is a rare complication of spinal anesthesia. This patient underwent bilateral inguinal herniorrhaphy under spinal anesthesia 40 days prior to admission. Two days after spinal anesthesia, the patient described a typical postdural puncture headache. Oral analgesics, fluid therapy, and lying flat were recommended. Because of prolonged headache, computed tomography scan was performed and demonstrated chronic subdural hematoma in the left fronto-temporo-parietal region. After surgical drainage, the patient fully recovered. Prolonged headache should be regarded as a warning sign of subdural hematoma.

Journal of Clinical Anesthesia, 2012

To determine the optimal remifentanil dose required to provide acceptable intubating conditions f... more To determine the optimal remifentanil dose required to provide acceptable intubating conditions following induction of anesthesia with propofol without using neuromuscular blockade. Dose-response study. Operating room of a university hospital. 50 ASA physical status 1 men, aged between 20 and 40 years, who were scheduled for general anesthesia. Intubating conditions were evaluated according to the scoring system described by Viby-Mogensen et al. Successful intubation was defined as excellent or good. For induction of anesthesia, an intravenous (IV) bolus dose of propofol 2.0 mg/kg was given over 30 seconds followed by the administration of predetermined IV remifentanil over 30 seconds; intubation was performed 90 seconds after completion of the remifentanil administration. The dose of remifentanil used for each patient was determined by the response of the previously tested patients, using the modified Dixon&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s up-and-down method (using 0.2 μg/kg as a step size). The first patient was tested with remifentanil 1.0 μg/kg. If intubation failed, the remifentanil dose was increased by 0.2 μg/kg; if intubation was successful, the dose was decreased by 0.2 μg/kg. Mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation were recorded during the study period. According to probit analysis, the effective dose of remifentanil in 50% (ED(50)) and 95% (ED(95)) of patients were 1.40 μg/kg and 2.40 μg/kg, respectively. Preintubation and postinduction HR and MAP values were lower than preinduction values (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The optimal bolus dose of remifentanil for acceptable intubating conditions was 2.40 μg/kg (95% confidence interval, 1.90-9.0 μg/kg) in 95% of patients during induction of anesthesia with propofol 2.0 mg/kg without neuromuscular blocking agents.

Journal of Clinical Anesthesia, 2006

The aim of the study was to compare the effect of pretreatment with remifentanil 1 microg/kg and ... more The aim of the study was to compare the effect of pretreatment with remifentanil 1 microg/kg and the effect of gender on the incidence of myoclonus after anesthesia induction with etomidate. This was a randomized, double-blind study. The study was conducted at a university hospital. Sixty patients were pretreated in a randomized double-blinded fashion with remifentanil 1 microg/kg or placebo. Two minutes after remifentanil or placebo injection, etomidate 0.3 mg/kg was given. Myoclonus was recorded with a scale of 0 to 3. The grade of sedation (none, mild, moderate, severe), nausea, pruritus, and apnea were recorded after injection of both drugs. The incidence of myoclonus was significantly lower in the remifentanil group (6.7%) than in the placebo group (70%) (P &lt; 0.001). None of the patients experienced sedation, apnea, nausea, or pruritus after injection of both drugs. In the placebo group, male patients were associated with significantly increased incidence of myoclonus after etomidate administration. Pretreatment with remifentanil 1 microg/kg reduced myoclonus after etomidate induction without side effects such as sedation, apnea, nausea, or pruritus. Men experience increased incidence of myoclonus than women after etomidate administration.

Journal of Cardiothoracic and Vascular Anesthesia, 2011

The present study aimed to compare 2 different doses of remifentanil infusion on hemodynamics, re... more The present study aimed to compare 2 different doses of remifentanil infusion on hemodynamics, recovery period, and complications in children undergoing diagnostic pediatric cardiac catheterization.

European Journal of Anaesthesiology, 2008

Although the association of tissue coring and development of epidermoid tumour has been proposed,... more Although the association of tissue coring and development of epidermoid tumour has been proposed, the extent and frequency of such coring is still controversial and the viability of carried cells has not been substantiated. In the present study, we used an experimental model without needle removal to investigate the incidence of tissue coring using two different needle types. We inserted 22-G caudal (n = 34) or 22-G hollow (n = 25) needles to the tumour-free areas of fresh modified mastectomy specimens. The specimen was stretched and needles were inserted perpendicular to the skin and forced to penetrate the full thickness of the specimen. Without removing the needle, the needle cavity was then washed with 2 mL of RPMI 1640 with L-Glutamine and the washings were collected in a 15-mL falcon tube. The tubes were sealed and labelled and processed to obtain cytologic preparations. The slides were evaluated under a light microscope. A high rate of epithelial cell transportation was noted. All the carried cells were stratum corneum cells with no nucleus. No nucleated cells were seen. The incidence of carried cells was 64.7% and 72.0% in the caudal and hollow needle groups, respectively (P &gt; 0.05). Only cells from the outermost layer, stratum corneum, which is made of dead flat skin cells, were transported with needle puncture. The risk of epidermoid tumour development after regional anaesthesia must therefore be low. The incidence of transporting non-nucleated stratum corneum cells was similar between hollow and caudal needles.

Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2002

P Pu ur rp po os se e: : To report a case of awake tracheal intubation through the intubating lar... more P Pu ur rp po os se e: : To report a case of awake tracheal intubation through the intubating laryngeal mask airway (ILMA) in a patient with halo traction.

… of Experimental and …, 2009

... Norepinephrine, Cortisol and Glucose Concentrations Cengiz KAYA*, Ebru KELSAKA* *, Binnur SAR... more ... Norepinephrine, Cortisol and Glucose Concentrations Cengiz KAYA*, Ebru KELSAKA* *, Binnur SARIHASAN* * *, ... sonra ölçüldü. Kontrol grubunda; kalp at›mh›z› ve ortalama kan bas›nc› preoperatif de¤erlere göre entü-basyon ve ekstübasyondan sonra yükseldi. ...

Journal of Experimental and Clinical Medicine, 2013

Central core disease is a rare neuromuscular disorder associated with leg weakness. It is a famil... more Central core disease is a rare neuromuscular disorder associated with leg weakness. It is a familial disease with autosomal dominant inheritance. Central core disease has been reported to be associated with malignant hyperthermia. A 25-year-old woman with central core disease was scheduled to be operated for lumbar disc hernia at L4-5 and L5-S1 interspaces. Oral dantrolene was administered prophylactically. Spinal anesthesia was performed with a 25 G Whitacre spinal needle at the L3-4 interspace. No complication was observed during the intraoperative and postoperative periods. We present a case with central core disease who was operated under spinal anesthesia with oral prophylactic dantrolene. Girifl: Santral kor hastal›¤› bacaklarda güçsüzlük ile seyreden nadir görülen bir nöromüsküler hastal›kt›r. Otozomal dominant geçifllidir. Santral kor hastal›¤›n›n malign hipertermi ile iliflkili olabilecei rapor edilmifltir. 25 yafl›nda santral kor hastal›¤› olan kad›n hastan›n L4-5 ve L5-S1...

The aim of this study was to evaluate the histopathologic healing of penicillin G induced traumat... more The aim of this study was to evaluate the histopathologic healing of penicillin G induced traumatic sciatic nerve injury with tenoxicam. 22-gauge sharp edged needle was inserted into the sciatic nerve and 0.1 ml (25000 Ü) crystallized penicillin G was injected. Rats were randomly divided into four groups. 1 ml intraperitoneal 0.09% NaCl solution was administered daily for one week

TURKISH JOURNAL OF MEDICAL SCIENCES, 2015

To compare the postoperative analgesic efficacy and side effects of paracetamol and tramadol in p... more To compare the postoperative analgesic efficacy and side effects of paracetamol and tramadol in patients undergoing lumbar disc surgery. Group P (paracetamol group) was given 1 g of paracetamol intravenously 30 min before the end of the operation and 1 g each day at 6-h intervals. Group T (tramadol group) was given 1.5 mg/kg of tramadol as a loading dose and patient-controlled analgesia for 1 day. Hemodynamic parameters, modified Aldrete score, Ramsay sedation scale score, patient satisfaction scale (PSS) score, visual analog scale (VAS) score, nausea/vomiting scale score, and additional analgesic needs/times were recorded. PSS scores were significantly higher in Group T (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The total analgesic consumption was significantly higher in Group P. There were no significant differences in the VAS scores at any time points. Twenty-one patients in Group P and 8 patients in Group T needed additional analgesia (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The first additional analgesic time was earlier in Group P, and pain was more evident at the 15th minute and at hours 2 and 6 (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Paracetamol alone was not able to provide effective analgesia. Tramadol was more effective in the treatment of postoperative pain after lumbar disc surgery.

Regional Anesthesia and Pain Medicine, 2006

Background and Objectives: Perioperative hypothermia is a common problem in anesthesia practice. ... more Background and Objectives: Perioperative hypothermia is a common problem in anesthesia practice. Regional anesthesia, like general anesthesia, influences the thermoregulatory process. The aim of our study was to compare the efficacy of ondansetron and meperidine in the prevention of shivering during and after spinal anesthesia.

Pediatric Anesthesia, 2004

The aim of this study was to determine whether tissue coring occurs with 22-G hollow needle and 2... more The aim of this study was to determine whether tissue coring occurs with 22-G hollow needle and 22-G caudal block needle during caudal injection in children, as well as evaluating the nature of the coring material if it did occur. Seventy children were randomly allocated to two groups and caudal block was performed with either 22-G hollow (group I) or 22-G caudal block (group II) needle under general anesthesia. The needles and guides were washed with 0.5 ml of 70% ethanol in a sterile tube and were evaluated by a pathologist blinded to the type of needle used, for the type and number of cells. Nucleated cells, which have no mitotic activity, were present in 8.5% in each study group and bloody material was present in 8.5 and 2.8%, in group I and II, respectively. Non-nucleated epidermal cells were detected in 94.2 and 97.1% of the patients in group I and II, respectively. However, cells with mitotic activity from the stratum basale were not detected in any slides. The incidence of transporting nucleated epidermal cells with no mitotic activity from stratum spinosum during puncture for caudal block is low and no differences exist between different types of needle used. However, it may also suggest that transporting nucleated cells with mitotic activity from the stratum basale may be possible during caudal puncture.

Pediatric Anesthesia, 2007

... What is the ideal glucose regime in children undergoing extensive hepatic resection? Ebru Kel... more ... What is the ideal glucose regime in children undergoing extensive hepatic resection? Ebru Kelsaka,; Deniz Karakaya,; Sibel Baris,; Serap Karacalar,; Suat Ayyıldız. Article first published online: 17 APR 2007. DOI: 10.1111/j.1460-9592.2006.02125.x. Issue. Pediatric Anesthesia. ...

Pediatric Anesthesia, 2003

Background: The aim of this study was to evaluate the intensity and effectiveness of 0.75 mlAEkg ... more Background: The aim of this study was to evaluate the intensity and effectiveness of 0.75 mlAEkg )1 bupivacaine 0.25% with the addition of fentanyl or midazolam for caudal block in children undergoing inguinal herniorrhaphy. Methods: Seventy-five children were allocated randomly to three groups to receive a caudal block with either 0.25% bupivacaine with fentanyl 1 lgAEkg )1 (group BF) or with midazolam 50 lgAEkg )1 (group BM) or bupivacaine alone (group B) after induction of anaesthesia. Haemodynamic parameters, degree of pain, additional analgesic requirements and side-effects were evaluated. Results: The mean systolic arterial pressure at 10, 20, 30 min after caudal block was higher in group B compared with groups BF and BM. Mean intraoperative heart rate was lower in group BF than the other groups. Adequate analgesia was obtained in all patients (100%) in group BF, 23 patients (92%) in group BM and 21 patients (84%) in group B (P > 0.05). The time to recovery to an Aldrete score of 10 was significantly shorter in group B than group BM (P < 0.05). Although not significant, it was also shorter in group B than group BF. There was no difference in additional analgesic requirements between the groups in the first 24 h. Sedation score was higher in the midazolam group at 60 and 90 min postoperatively than the other groups. Conclusions: Caudal block with 0.75 mlAEkg )1 0.25% bupivacaine and 50 lgAEkg )1 midazolam or 1 lgAEkg )1 fentanyl provides no further analgesic advantages to bupivacaine alone when administered immediately after induction of anaesthesia in children undergoing unilateral inguinal herniorrhaphy.

Medical Principles and Practice, 2011

Our purpose was to study whether or not intravenous (IV) administration of lidocaine reduces prop... more Our purpose was to study whether or not intravenous (IV) administration of lidocaine reduces propofol dose requirement as intramuscular (IM) lidocaine in a placebo-controlled manner. Seventy-five adult patients with American Society of Anesthesiologists physical status I and II, aged 20-60 years who were scheduled for surgery under general anaesthesia were included in the study. The patients were randomly allocated to 3 groups: IM: intramuscular administration; IV: intravenous administration and C: control. There were 25 patients in each group. The patients in group IM received lidocaine 1.5 mg · kg(-1) administered into the deltoid muscle 10 min before anaesthesia induction. In group IV, the patients received IV lidocaine 1.5 mg · kg(-1), 2 min before anaesthesia induction. Group C patients served as control group who received only propofol injection. Hypnosis after propofol administration was measured with response to verbal commands. There were no statistical differences between group IM (100.8 ± 26.1 mg) and group IV (110.8 ± 30.1 mg) regarding the induction dose of propofol (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). In group C, the required propofol dose (151.2 ± 27.4 mg) for anaesthesia induction was significantly higher than in the other groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). No side effect was observed in any patients. In this study, both IV and IM lidocaine administration were effective in reducing the hypnotic dose of propofol without any side effects. In addition, IV lidocaine may be more comfortable for awake patients.

Journal of Neurosurgical Anesthesiology, 2003

Subdural hematoma is a rare complication of spinal anesthesia. This patient underwent bilateral i... more Subdural hematoma is a rare complication of spinal anesthesia. This patient underwent bilateral inguinal herniorrhaphy under spinal anesthesia 40 days prior to admission. Two days after spinal anesthesia, the patient described a typical postdural puncture headache. Oral analgesics, fluid therapy, and lying flat were recommended. Because of prolonged headache, computed tomography scan was performed and demonstrated chronic subdural hematoma in the left fronto-temporo-parietal region. After surgical drainage, the patient fully recovered. Prolonged headache should be regarded as a warning sign of subdural hematoma.

Journal of Clinical Anesthesia, 2012

To determine the optimal remifentanil dose required to provide acceptable intubating conditions f... more To determine the optimal remifentanil dose required to provide acceptable intubating conditions following induction of anesthesia with propofol without using neuromuscular blockade. Dose-response study. Operating room of a university hospital. 50 ASA physical status 1 men, aged between 20 and 40 years, who were scheduled for general anesthesia. Intubating conditions were evaluated according to the scoring system described by Viby-Mogensen et al. Successful intubation was defined as excellent or good. For induction of anesthesia, an intravenous (IV) bolus dose of propofol 2.0 mg/kg was given over 30 seconds followed by the administration of predetermined IV remifentanil over 30 seconds; intubation was performed 90 seconds after completion of the remifentanil administration. The dose of remifentanil used for each patient was determined by the response of the previously tested patients, using the modified Dixon&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s up-and-down method (using 0.2 μg/kg as a step size). The first patient was tested with remifentanil 1.0 μg/kg. If intubation failed, the remifentanil dose was increased by 0.2 μg/kg; if intubation was successful, the dose was decreased by 0.2 μg/kg. Mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation were recorded during the study period. According to probit analysis, the effective dose of remifentanil in 50% (ED(50)) and 95% (ED(95)) of patients were 1.40 μg/kg and 2.40 μg/kg, respectively. Preintubation and postinduction HR and MAP values were lower than preinduction values (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The optimal bolus dose of remifentanil for acceptable intubating conditions was 2.40 μg/kg (95% confidence interval, 1.90-9.0 μg/kg) in 95% of patients during induction of anesthesia with propofol 2.0 mg/kg without neuromuscular blocking agents.

Journal of Clinical Anesthesia, 2006

The aim of the study was to compare the effect of pretreatment with remifentanil 1 microg/kg and ... more The aim of the study was to compare the effect of pretreatment with remifentanil 1 microg/kg and the effect of gender on the incidence of myoclonus after anesthesia induction with etomidate. This was a randomized, double-blind study. The study was conducted at a university hospital. Sixty patients were pretreated in a randomized double-blinded fashion with remifentanil 1 microg/kg or placebo. Two minutes after remifentanil or placebo injection, etomidate 0.3 mg/kg was given. Myoclonus was recorded with a scale of 0 to 3. The grade of sedation (none, mild, moderate, severe), nausea, pruritus, and apnea were recorded after injection of both drugs. The incidence of myoclonus was significantly lower in the remifentanil group (6.7%) than in the placebo group (70%) (P &lt; 0.001). None of the patients experienced sedation, apnea, nausea, or pruritus after injection of both drugs. In the placebo group, male patients were associated with significantly increased incidence of myoclonus after etomidate administration. Pretreatment with remifentanil 1 microg/kg reduced myoclonus after etomidate induction without side effects such as sedation, apnea, nausea, or pruritus. Men experience increased incidence of myoclonus than women after etomidate administration.

Journal of Cardiothoracic and Vascular Anesthesia, 2011

The present study aimed to compare 2 different doses of remifentanil infusion on hemodynamics, re... more The present study aimed to compare 2 different doses of remifentanil infusion on hemodynamics, recovery period, and complications in children undergoing diagnostic pediatric cardiac catheterization.

European Journal of Anaesthesiology, 2008

Although the association of tissue coring and development of epidermoid tumour has been proposed,... more Although the association of tissue coring and development of epidermoid tumour has been proposed, the extent and frequency of such coring is still controversial and the viability of carried cells has not been substantiated. In the present study, we used an experimental model without needle removal to investigate the incidence of tissue coring using two different needle types. We inserted 22-G caudal (n = 34) or 22-G hollow (n = 25) needles to the tumour-free areas of fresh modified mastectomy specimens. The specimen was stretched and needles were inserted perpendicular to the skin and forced to penetrate the full thickness of the specimen. Without removing the needle, the needle cavity was then washed with 2 mL of RPMI 1640 with L-Glutamine and the washings were collected in a 15-mL falcon tube. The tubes were sealed and labelled and processed to obtain cytologic preparations. The slides were evaluated under a light microscope. A high rate of epithelial cell transportation was noted. All the carried cells were stratum corneum cells with no nucleus. No nucleated cells were seen. The incidence of carried cells was 64.7% and 72.0% in the caudal and hollow needle groups, respectively (P &gt; 0.05). Only cells from the outermost layer, stratum corneum, which is made of dead flat skin cells, were transported with needle puncture. The risk of epidermoid tumour development after regional anaesthesia must therefore be low. The incidence of transporting non-nucleated stratum corneum cells was similar between hollow and caudal needles.

Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2002

P Pu ur rp po os se e: : To report a case of awake tracheal intubation through the intubating lar... more P Pu ur rp po os se e: : To report a case of awake tracheal intubation through the intubating laryngeal mask airway (ILMA) in a patient with halo traction.

… of Experimental and …, 2009

... Norepinephrine, Cortisol and Glucose Concentrations Cengiz KAYA*, Ebru KELSAKA* *, Binnur SAR... more ... Norepinephrine, Cortisol and Glucose Concentrations Cengiz KAYA*, Ebru KELSAKA* *, Binnur SARIHASAN* * *, ... sonra ölçüldü. Kontrol grubunda; kalp at›mh›z› ve ortalama kan bas›nc› preoperatif de¤erlere göre entü-basyon ve ekstübasyondan sonra yükseldi. ...

Journal of Experimental and Clinical Medicine, 2013