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Papers by Ferdi Menda

Objective: In this single-blind, observational prospective trial we aimed to determine and compar... more Objective: In this single-blind, observational prospective trial we aimed to determine and compare the effect of premedication with hydroxyzine plus midazolam and midazolam alone on the incidence of Oculocardiac Reflex (OCR).Methods: Forty-five patients divided into three groups retrospectively after surgery; according to the oral premedication before surgerys. Group M received 0.5mg/kg midazolam alone, Group H received 0.5 mg/kg hydroxyzine plus 0.5 mg/kg midazolam, and Group HM received 1mg/kg hydroxyzine plus 0.5 mg/kg midazolam. The observational part of the study was carried out prospectively during surgery. The Ramsay Sedation Scale (RSS), the heart rates (HR1: after induction of anesthesia; HR2: before retraction of orbital muscle; and HR3: right after retraction of orbital muscle), the muscles with OCR and the incidence of OCR (20% decrease of the HR right after the traction) were recorded and compared between the three groups. Results: The mean HR1, HR2 and HR3 values were ...

Journal of Anesthesiology and Reanimation Specialists’ Society, 2020

Covid-19 pandemisi olarak adlandırılan virüs salgını, 2019 yılı Aralık ayında Çin'in Wuhan kentin... more Covid-19 pandemisi olarak adlandırılan virüs salgını, 2019 yılı Aralık ayında Çin'in Wuhan kentinden tüm dünyaya yayılmıştır. Hastalar ve hastalığı taşıyan asemptomatik vakalar nedeniyle, sağlık çalışanları açısından risk oluşturmaktadır. Özellikle ameliyathaneler, aerosol oluşturan işlemler ve olası temas açısından en riskli çalışma alanlarındandır. Bu nedenle perioperatif dönem işleyiş protokollerinin oluşturulması önem göstermektedir. Bu derlemede, pandemi döneminde özellik arzeden; preoperatif hasta hazırlığı, ameliyathane organizasyonu ve kişisel korunma ekipmanlarını içeren "preoperatif hasta hazırlığı ve ameliyathane işleyiş protokolümüz" sunulmuştur. Yöntem: Bu amaçla mevcut protokoller ve literatür taraması yapılmış ve güncel bilgiler ışığında oluşturulan protokol; preoperatif hasta hazırlığı, ameliyathane işleyişinin düzenlenmesi, ameliyat bitiminde ameliyathane temizliği olmak üzere 3 alt başlık içermektedir. Bulgular: Oluşturulan protokol 15 Mart-10 Mayıs 2020 tarihleri arasında kullanılmıştır. Kurumumuzun iç işleyişine uygun olarak oluşturulan protokollerimiz eşliğinde perioperatif yönetim titizlikle uygulandığında, hasta ve çalışan güvenliği yanında, işleyişin aksamadığı görülmüştür. Sonuç: Klinik protokoller ışığında preoperatif dönemde COVID-19 şüpheli-enfekte hastalar belirlenerek, perioperatif riskler azaltılabilir ve hastanın, sağlık çalışanlarının ve diğer hastaların güvenliği arttırılabilir.

Acta Orthopaedica et Traumatologica Turcica, 2017

The aim of this study was to compared the effectiveness of intraarticular levobupivacain with lev... more The aim of this study was to compared the effectiveness of intraarticular levobupivacain with levobupivacain and magnesium sulfate. Methods: In this prospective randomized double blinded study, 96 patients (67 male, 29 female; age range: 18e65 years) with ASA (American Society of Anesthesiologist) score I and II, who had undergone arthroscopic meniscectomy operation, were divided to 3 groups that had postoperative analgesia with intra-articular saline injection (control group), levobupivacain injection (L group) or levobupivacain and magnesium sulfate injection (LM group). Patients were compared with postoperative VAS (Visual Analog Score) score during rest and activity, opioid analgesic need, non-opioid analgesic need and other medication needs. Results: Postoperative VAS scores during rest and activation at early postoperative period were significantly lower at LM group when compared with L group and lower than control group at all time periods. Opioid analgesic need, non-opioid analgesic need and other medication needs for non-pain symptoms were lower at LM group when compared with L and control groups at all time periods. Conclusion: intraarticular magnesium sulfate plus Levobupivacain injection is a safe and effective method for post operative pain management after arthroscopic meniscectomy.

Aesthetic Plastic Surgery, 2016

Introduction Postoperative Nausea and Vomiting is one of the most common problems after implement... more Introduction Postoperative Nausea and Vomiting is one of the most common problems after implementation of general anesthesia. The incidence can reach 80% in high-risk patients, depending on the type of surgery. In our study, we aimed to compare dexamethasone-dimenhydrinate and dexamethasone-ondansetron combinations in prevention of nausea and vomiting in postoperative patients. Method Sixty 18-65-year-olds ASAI-II females who underwent rhinoplasty were included in the study. Patients were randomly included in two groups: Dexamethasonedimenhydrinate group (group DD) and dexamethasoneondansetron group (group DO). All patients received

The journal of obstetrics and gynaecology research, Jan 20, 2016

To examine whether tramadol wound infiltration decreased postoperative pain following cesarean se... more To examine whether tramadol wound infiltration decreased postoperative pain following cesarean section (CS) under general anesthesia or reduced the need for analgesics in the immediate postoperative period.

Korean Journal of Anesthesiology, 2015

Propofol has gained wide acceptance among anesthesiologists due to its favorable induction charac... more Propofol has gained wide acceptance among anesthesiologists due to its favorable induction characteristics, including its rapid onset time and fast elimination half-life. However, intravenous (i.v.) propofol injections are painful, making the induction of anesthesia uncomfortable for the patient and anesthesiologist [1-4]. Several pharmacological interventions have been described to reduce or prevent propofol injection pain [3], including cooling or diluting the propofol solution, or applying propofol in tandem with local anesthetics, ondansetron, ketamine, magnesium sulfate, non-steroidal anti-inflammatory drugs, or opioids [5-12]. Fentanyl given just before propofol diminishes propofol injection pain, but it is unclear whether fentanyl has this effect when used in a mixture with propofol [4]. We compared the effects of injection with saline followed by injection with a fentanyl-propofol mixture, injection with fentanyl followed by Clinical Research Article Background: Propofol injection pain is a common problem that can be very distressing for patients. We compared the effects of injection with saline followed by injection with a fentanyl-propofol mixture, injection with fentanyl followed by a propofol injection, and injection with saline followed by propofol alone on propofol injection pain. Methods: The patients were assigned randomly to one of three groups. A rubber tourniquet was placed on the forearm to produce venous occlusion for 1 min. Before anesthesia induction, group C (control, n = 50) and group M (fentanylpropofol mixture, n = 50) received 5 ml of isotonic saline, while group F (fentanyl, n = 50) received 2 μg/kg of fentanyl. After the tourniquet was released, groups C and F received 5 ml of propofol and group M received 5 ml of a mixture containing 20 ml of propofol and 4 ml of fentanyl. At 10 s after the study drugs were given, a standard question about the comfort of the injection was asked of the patient. We used a verbal rating scale to evaluate propofol injection pain. Statistical analyses were performed with Student's t-tests and Fisher's exact tests; P < 0.05 was considered to indicate statistical significance. Results: The demographic data were similar among the groups. In group M, the number of patients reporting propofol injection pain was significantly lower than in groups F and C (both P < 0.001). No patient in group F or M experienced severe pain, whereas 24 patients (48%) had severe pain in group C (both P < 0.001). Conclusions: This study shows that a fentanyl-propofol mixture was more effective than fentanyl pretreatment or a placebo in preventing propofol injection pain.

Turkiye Klinikleri Journal of Medical Sciences, 2005

Yeditepe Medical Journal, 2012

Yeditepe Medical Journal, 2014

Yeditepe Medical Journal, 2010

Yeditepe Medical Journal, 2013

European Journal of Anaesthesiology, 2014

Background and Goal of Study: Hypotension af ter regional anaesthesia for caesarean section (CS) ... more Background and Goal of Study: Hypotension af ter regional anaesthesia for caesarean section (CS) remains a common clinical problem. The aim of this study was to evaluate the ef fectiveness of intermit tent pneumatic compression system (IPCS) in lower ex tremities for preventing maternal hypotension af ter spinal anaesthesia (SA). Materials and methods: During 3 months patients scheduled for elective CS were randomised to have an IPCS on their legs before SA (G2) or not (G1: control). Exclusion criteria: age < 18 ys, non-elective CS, BMI > 40, gravidity hypertension, high-risk patients, sepsis, insulin-dependent diabetes mellitus, spinal block level > T5, ongoing epidural anaesthesia and multiple gravidities. Crystalloid cohydration with 500 ml saline solution IV was given. SA was performed with a 25G needle in the interspace L2/L3 in lef t side decubitus with hyperbaric bupivacaine 0.5% adjusted to height. Hypotension was defined as 30% decrease from initial systolic arterial pressure (SAP) or SAP lower than 90 mmHg. A prophylactic variable rate regimen of phenylephrine (P) infusion was titrated and rescue boluses were administered for maintenance of SAP using algorithms. Predelivery we recorded: demographics, oxygen saturation (SpO2), heart rate and basal blood pressure values and post-SA (systolic, mean and diastolic arterial pressure) every 2 min, umbilical cord blood gas values (UCBGV), APGAR scores af ter 1 min/5 min, P total doses, P boluses needed and final haemoglobin values. Data are presented as percentages, mean values ± standard deviation. Results: A total of 26 patients were included (G1: 16, G2:10). Demographics, heart rates, UCBGV, APGAR scores, neonatal outcomes and haemoglobin values were not dif ferent among groups. Total phenylephrine consumption was 0.451±1.77 µg/kg/min in G1 and 0.370±0.10 µg/kg/min in G2 (p=0.241). 43.8% of the patients in G1 needed P rescue boluses versus 40% in G2 (p=0.588). The mean arterial pressure af ter SA was 85.8±13.89 mmHg in G1 versus 90.6±13.64 mmHg in G2 (p=0.404). IPCS was well tolerated. Conclusion(s): An intermit tent pneumatic compression system on legs is an easy, noninvasive and nonpharmacological ef fective prophylactic method for preventing maternal hypotension af ter spinal anaesthesia for elective caesarean section. Our preliminary results point out a trend towards a reduction of vasoconstrictor requirements without side-ef fects. A bigger sample size will probably show a statistical significance among groups.

Minerva anestesiologica, 2012

Ketamine is an analgesic suitable for the induction of anesthesia during Caesarean delivery. This... more Ketamine is an analgesic suitable for the induction of anesthesia during Caesarean delivery. This double blind, randomized trial examined the effect of intravenous ketamine used before the induction of general anesthesia on morphine consumption, immediate and long term postoperative pain after Cesarean delivery. One hundred and forty term pregnant women undergoing elective Cesarean delivery were randomized into four groups (N.=35 each), placebo (0.9% normal saline), ketamine 0.25, 0.5, or 1 mg kg(-1) intravenously. In all patients 2-2.5 mg kg(-1) propofol was used for the induction of anesthesia, 0.6 mg kg(-1) rocuronium to facilitate the tracheal intubation and 50% oxygen in N2O and sevoflurane (end-tidal concentration of 1.2-1.3 %) for the maintenance of anesthesia. Postoperative analgesia was provided with intravenous morphine chloride patient-controlled analgesia (PCA) and rescue analgesia with intramuscular diclofenac sodium in the postoperative period. Apgar scores of the neon...

Turkish Journal of Anesthesia and Reanimation, 2014

Amaç: Proseal laringeal maske ile ilişkili postoperatif boğaz ağrısı, ses kısıklığı ve disfaji se... more Amaç: Proseal laringeal maske ile ilişkili postoperatif boğaz ağrısı, ses kısıklığı ve disfaji semptomlarını flurbiprofen pastilin azalttığı varsayımını gösterebilmek. Yöntemler: Laringeal Maske (LMA) ile genel anestezi uygulanacak 80 American Society of Anesthesiologists (ASA) I-II hasta çalışmaya alındı. Prospektif, randomize, plasebo kontrollü, klinik ve tek merkezli (üniversite hastanesi) bir çalışma idi. Anestezi indüksiyonundan 45 dakika önce Grup F'ye 8,75 mg flurbiprofen içeren pastil (Strefen ®), grup P'ye plasebo pastil verildi. LMA çıkarıldıktan 30 dakika sonra ve sonrasında 4, 12 ve 24. saatlerde postoperatif boğaz ağrısı, ses kısıklığı ve disfaji 4 puanlık bir skala ile değerlendirildi.Veriler Student's t test, Fisher's exact ve Mann-Whitney U testleri ile değerlendirildi. p<0,05 anlamlı kabul edildi. Bulgular: 8,75 mg flurbiprofen pastil erken dönem (30. dakika) postoperatif boğaz ağrısı ve disfaji şiddetini azaltmaktadır. Grup F'de 4. saat disfaji şiddeti ve 12. saat ses kısıklığı da anlamlı şekilde azalmıştır. Boğaz ağrısı, disfaji ve ses kısıklığı insidansında gruplar arasında fark yoktur. Sonuç: Preoperatif flurbiprofen pastil erken dönem postoperatif boğaz ağrısı ve disfaji şiddetini azaltmaktadır.

European Journal of Anaesthesiology, 2011

Background and aim Anaesthesia with sevoflurane leads to a high prevalence of emergence agitation... more Background and aim Anaesthesia with sevoflurane leads to a high prevalence of emergence agitation in paediatric patients. This study investigates the effects of combining hydroxyzine and midazolam on sevoflurane-induced emergence agitation in paediatric patients undergoing infraumbilical surgery with a caudal block. Patients and methods Eighty-four children 1-7 years of age undergoing general anaesthesia with sevoflurane and caudal block were assigned to two groups. Children in group M (n ¼ 42) were premedicated with 0.5 mg kg À1 oral midazolam and children in group MH (n ¼ 42) were premedicated with 0.5 mg kg À1 oral midazolam and 1 mg kg À1 hydroxyzine given 30 min before anaesthesia induction. A caudal epidural block was performed following anaesthesia induction. Induction quality, parental separation scores and emergence agitation were evaluated. Emergence agitation was evaluated with the PAED score (Paediatric Anesthesia Emergence Delirium) every 5 min during the first 30 min after admission to recovery room. Induction quality and parental separation were assessed with 4-point scores. Postoperative pain was evaluated with the 10-point Children's and Infants' Postoperative Pain Scale. Results Median parental separation (3 vs. 2; P ¼ 0.01), induction quality (2 vs. 2; P ¼ 0.03) and sedation scores (3 vs. 2; P ¼ 0.003) were significantly better in the MH group compared to the M group. Median PAED score of group M (15) was higher than that of group MH (11; P < 0.001) and the number of children with PAED scores more than 16 was also higher in group M (n ¼ 16) compared to group MH (n ¼ 2; P < 0.001). None of the children had a pain score more than 3 throughout the study period. Conclusion The incidence of sevoflurane-induced emergence agitation was significantly lower in children premedicated with a midazolam and hydroxyzine combination compared to those premedicated with midazolam only. Furthermore, the midazolam and hydroxyzine combination provided better premedication quality than midazolam alone.

European Journal of Anaesthesiology, 2012

Anesthesia & Analgesia, 2008

BACKGROUND: The aim of our study was to evaluate the pulmonary effects of noninvasive ventilation... more BACKGROUND: The aim of our study was to evaluate the pulmonary effects of noninvasive ventilation (NIV) with or without recruitment maneuver (RM) after open heart surgery. METHODS: One-hundred patients undergoing coronary artery bypass surgery were randomized into four groups after the operation: 1) RM with sustained inflation during mechanical ventilation postoperatively (RM group, n ϭ 25); 2) RM combined with NIV applied for 1/2-h periods every 6 h in the first postoperative day after tracheal extubation (RM-NIV group, n ϭ 25); 3) NIV after tracheal extubation (NIV group, n ϭ 25); and 4) a control group consisting of patients receiving neither RM nor NIV (control group, n ϭ 25). Pulmonary function tests, oxygenation index, and atelectasis on chest radiograph were evaluated and compared among the groups. RESULTS: RM provided higher arterial oxygen levels during mechanical ventilation and after tracheal extubation compared to other interventions. Oxygenation was better in the RM-NIV and NIV groups than in the control group (P ϭ 0.02 and P ϭ 0.008, respectively) at the end of the study. The postoperative atelectasis score of the control group (median: 1) was higher than those of the RM (1; P ϭ 0.03), RM-NIV (0; P Ͻ 0.01) and NIV (0; P Ͻ 0.01) groups. Pulmonary function of the NIV groups on postoperative day 2 was better than in the other groups, whereas the tests were similar among the groups on postoperative day 7. CONCLUSIONS: NIV associated with RM provided better oxygenation both during and after the mechanical ventilation period. NIV either alone or in combination with RM provided lower atelectasis scores and better early pulmonary function tests compared to the control group, without a significant difference regarding the duration of mechanical ventilation, intensive care unit stay, and the length of hospitalization. NIV combined with RM is recommended after open heart surgery to prevent postoperative atelectasis and hypoxemia.

Journal of Anesthesia, 2013

Lower urinary tract (LUT) discomfort is a common complaint after transurethral resection of the p... more Lower urinary tract (LUT) discomfort is a common complaint after transurethral resection of the prostate (TURP), and it may lead to agitation and restlessnes. We have evaluated the efficacy of morphine for preventing TURP-related LUT discomfort symptoms. This was a prospective randomised study including 60 patients (American Society of Anesthesiologists class I and II) who were scheduled to undergo TURP. The patients were divided into two equally sized groups (group M: morphine, group C: control). A standartized anesthesia method was used. Group M patients received morphine 0.04 mg/kg intravenous (iv) in 100 ml of normal saline followed by an infusion of morphine for 24 h (0.01 mg/kg/h); group C patients received 100 ml normal saline 20 min before the expected extubation time, followed by a normal saline infusion which looked identical to that of the morphine infusion. The incidences and severity of LUT discomfort, postoperative pain, sedation level, postoperative nausea and vomiting (PONV) and respiratory depression were recorded at 0, 1, 2, 6, 12 and 24 h postoperatively. The incidence of LUT discomfort was lower in group M patients at all time points during the study (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;lt; 0.05) except for 2 h postoperatively, and the severity of LUT discomfort was also lower this group at 0, 12 and 24 h postoperatively (p = 0.001, p = 0.04 and p = 0.02, respectively). Pain (numeric rating scale) scores were lower in group M patients at 0 (p = 0.003) and 6 h (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;lt; 0.001). The need for rescue analgesic was lower in group M patients (19 patients in group C, 10 patients in group M; p = 0.04). The incidence of PONV was higher in group M patients (p = 0.03). The incidence of pruritus, respiratory depression and over-sedation were similar among the groups. Based on these results, we conclude that morphine effectively reduces LUT discomfort after TURP at a cost of postoperative nausea and vomiting.