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Papers by Onur Ozlu
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2018
Şiddetli nefes darlığı ve genel durum bozukluğu ile acil servise başvuran 70 yaşındaki erkek hast... more Şiddetli nefes darlığı ve genel durum bozukluğu ile acil servise başvuran 70 yaşındaki erkek hastanın kontrastlı gögüş tomografisinde sağ ve sol ana pulmoner arterlerde, segmental ve subsegmental dallarda masif tromboemboli ile uyumlu dolma defektleri saptandı. Solunum yetmezliği nedeni ile mekanik ventilatör desteği sağlanan hastada kardiyak arest gelişmesine bağlı 55 dk. resusitasyon uygulanmasıyla eşzamanlı rekombinan doku plazminojen aktivatörü alteplaz ile trombolitik tedavi uygulandı. Spontan dolaşımı düzelen hasta 2 gün yoğun bakım ünitesinde gözlendikten sonra kardiyoloji servisine nakledildi. Akut masif pulmoner emboli tanısı alan ve hemodinamisi stabil olmayan hastalarda alteplaz ile erken sistemik trombolitik tedavi yaşam kurtarıcıdır.
İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 2019
Diffuse alveolar hemorrhage (DAH) is a medical emergency which can cause acute respiratory failur... more Diffuse alveolar hemorrhage (DAH) is a medical emergency which can cause acute respiratory failure. The diagnosis and treatment of DAH should be carried out as soon as possible. DAH has various causes such as vasculitis, infections, pesticides intoxication, barotrauma, diffuse alveolar damage, pulmonary embolism and may be associated with the use of anticoagulants (1). Warfarin therapy is a rare cause of DAH (1). We aimed to present a 69 year-old male patient who developed diffuse alveolar hemorrhage as a complication of warfarin therapy used for valve replacement. After diagnosis of DAH, warfarin treatment was discontinued and fresh frozen plasma, metilprednisolone, vitamin K were administered during mechanical ventilation therapy. The patient was responded well and INR decreased to therapeutic value. DAH should be remembered during warfarine therapy to avoid challenging situations.
Journal of Clinical Anesthesia, 2019
Korean Journal of Anesthesiology, 2012
A 37-year-old woman diagnosed with sickle cell anemia (SCA), beta (+) thalassemia, Crohn's diseas... more A 37-year-old woman diagnosed with sickle cell anemia (SCA), beta (+) thalassemia, Crohn's disease, and liver dysfunction was scheduled for laparoscopic cholecystectomy (LC) due to acute cholecystitis with gall bladder. Regional anesthesia was performed. An epidural catheter was inserted into the 9-10 thoracal epidural space and then 15 ml of 0.5% bupivacaine was injected through the catheter. The level of sensorial analgesia tested with pinprick test reached up to T4. Here we describe the first case of the combination of sickle cell anemia (SCA), beta (+) thalassemia, and Crohn's disease successful anesthetic management with attention to hemodynamics, particularly with regards to liver dysfunction.
Background: Respiratory functions and gas exchange deteriorates in patients with COPD. In our stu... more Background: Respiratory functions and gas exchange deteriorates in patients with COPD. In our study, we aimed to investigate if there is any relationship between the washout time of sevoflurane and chronic obstructive pulmonary disease (COPD). Method: Sixty patients, American Society of Anesthesiology (ASA) 1-3 status; aged between 18-60 years old who underwent general anesthesia for an operation were enrolled in our study. Patients were divided into two groups: Group N (non-COPD n = 33), group COPD (patients with COPD, n = 33). Two patients were excluded from the study, a total of 31 patients in Group COPD. Pre-operative respiratory function tests were performed and standard monitoring was provided in the operation room. Both groups received propofol 2 mg/kg, fentanyl 1.5-2 mcg/kg and rocuronium 0.6 mg/kg intravenously, and an oxygen-air mixture of 50%/50% with a tidal volume of 6 ml/kg (ideal body weight) and sevoflurane of 1 MAC. Remifentanil was administered at 0.05-0.1 mcg/ kg/...
Turkish journal of anaesthesiology and reanimation, 2017
Turkish journal of anaesthesiology and reanimation, 2015
To compare sugammadex and neostigmine regarding the efficacy in reversing rocuronium-induced neur... more To compare sugammadex and neostigmine regarding the efficacy in reversing rocuronium-induced neuromuscular block, the incidence of post-operative respiratory complications and costs in patients undergoing surgery for the treatment of obstructive sleep apnoea (OSA). After obtaining ethical approval and patient consent, 74 patients in ASA physical status I or II were randomised into two groups to receive 2-mg kg(-1) sugammadex (Group S) or 0.04-mg kg(-1) neostigmine+0.5-mg atropine (Group N). Groups were compared regarding time to TOF (train-of-four) 0.9, operating room time, post-anaesthesia care unit (PACU) stay, post-operative respiratory complications, costs related to neuromuscular block reversal, anaesthesia care and complication treatment. Patient demographics, anaesthesia, surgical data and total rocuronium doses were similar between groups. Time to TOF 0.9 was shorter for group S [Group N: 8 (5-18) min; Group S: 2 (1.5-6) min (p<0.001)]. Operating room time [Group S: 72.4±...
Turkish Journal of Anesthesia and Reanimation, 2016
Objective: Rocuronium is a non-depolarising, intermediate-acting, monoquaternary amino steroid an... more Objective: Rocuronium is a non-depolarising, intermediate-acting, monoquaternary amino steroid and was brought into clinical use as a potentially ideal muscle relaxant. Post-operative residual curarisation (PORC) results from the prolonged effects of non-depolarising neuromuscular blocking agents. This is a common problem and seriously affects patient safety. No recent study has investigated the effects of sugammadex on smokers, which is often used to restore neuromuscular block and avoid PORC. This study compares the severity of the effects of sugammadex used for antagonising rocuronium bromide and antagonism durations in smokers and non-smokers. Methods: This randomised, prospective study included 40 patients scheduled for elective surgery and belonging to classes I and II based the American Society of Anesthesiologists classification, who were either smokers for at least 10 years or non-smokers. Patients underwent routine and neuromuscular monitoring. At induction, 2 mg kg −1 propofol and 1 mcg kg −1 intravenous fentanyl were applied. After the loss of eyelash reflex, 0.6 mg kg −1 intravenous rocuronium was administered. Patients were intubated at train of four (TOF) 2. Anaesthesia was continued with 50% O 2 +50% air and 2% sevoflurane. Rocuronium, 0.15 mg kg −1 , was administered at TOF 2 during the operation. At the end of the operation, 2 mg kg −1 sugammadex was administered. The times until TOF 0.7, 0.8 and 0.9 were recorded. Results: Intubation time was 132.8±46.4 s for smokers and 127.6±32.7 s for non-smokers. After sugammadex administration, the time to TOF 0.7 was 153.3±54.7 s in smokers and 125±67.2 s in non-smokers. The times were 178.4±58.8 and 146.6±72.6 s for TOF 0.8 and 200.8±55.8 s and 170.4±77.8 s for TOF 0.9 in smokers and non-smokers, respectively. Conclusion: Although not statistically significant, the time to reach each TOF was longer for smokers. Larger populations and different perspectives are needed to find if sugammadex use is affected by smoking, which has negative effects on the body.
Turkiye Klinikleri Journal of Anesthesiology Reanimation, 2011
Propofol, tiyopental, sevofluran ve desfluran ile anestezi uygulamalarının; rokuronyum ile entüba... more Propofol, tiyopental, sevofluran ve desfluran ile anestezi uygulamalarının; rokuronyum ile entübasyon süresi, entübasyon kalitesi, klinik etki ve düzelme sürelerine etkilerini akselerometrik metod kullanarak karşılaştırmak amaçlandı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Etik komite onayı alınan, ASA I-II, 18-65 yaş arası 80 genel cerrahi olgusu rastgele dört eşit gruba ayrıldı. Grup PS (n= 20) ve Grup PD'de (n= 20) propofol 2 mg/kg ile Grup TS (n= 20) ve Grup TD'de (n= 20) tiyopental 5 mg/kg ile anestezi indüksiyonundan sonra rokuronyum 0.6 mg/kg, iv uygulandı. Grup PS ve Grup TS'de %2 sevoflurane; Grup PD ve Grup TD'de %6-7,5 desflurane ile anestezi idamesi gerçekleştirildi. Bütün olgularda indüksiyondan hemen sonra akselerometri cihazının (TOF-Watch SX, Organon®, Ireland) otomatik kalibrasyonu yapıldı. Rokuronyumdan sonra, tekli uyarıda %95 depresyon (T5) geliştiğinde endotrakeal entübasyon gerçekleştirildi. Entübasyon süresi ve Goldberg Skalası ile entübasyon kalitesi kaydedildi. Tekli uyarıda %25 (T25) düzelme anı, TOF %90 (TOF 0,90) yanıt alınma zamanı kaydedildi. T5 ile T25 arası, klinik etki süresi; T25 ile TOF 0,90 arası, düzelme süresi olarak hesaplandı. B Bu ul lg gu ul la ar r: : Demografik veriler ile cerrahi ve anestezi süreleri tüm gruplarda benzerdi (p> 0,05). Entübasyon süresi (T5) ve kalitesi ile klinik etki ve düzelme sürelerinde gruplar arasında fark gözlenmedi (p> 0,05). S So on nu uç ç: : Çalışmamızda; rokuronyumum etki sürelerinde propofol ve tiyopental ile sevofluran ve desfluran anestezilerinin farklı etkiye sahip olmadıkları sonucuna ulaşılmıştır. A An na ah ht ta ar r K Ke el li im me el le er r: : Rokuronyum; propofol; tiyopental; sevofluran; dezfloran;X entübasyon, intratrakea A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : It was aimed to compare the effects of propofol, thiopenthal, sevoflurane and desflurane on intubation time, intubation quality, clinical effect and recovery time with rocuronium by using the accelerometric method. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : After approval of the ethics committee 80, ASA I-II general surgery patients, aged 18-65 years were randomly allocated to one of four equal groups. Anesthesia was induced with either propofol 2.0 mg/kg or tiopental sodium 5 mg/kg and sevoflurane 2.0% (Group PS and TS) or desflurane 6.0-7.5% (Group PD and TD) was used for maintenance. The accelerometer (TOF-Watch SX, Organon®, Ireland) was calibrated after the anesthetic induction. Following administration of rocuronium, endotracheal intubation was performed with 95% depression (T5) in a single stimulus. Intubation time and quality by Goldberg Scale were determined. In a single stimulus 25% recovery time (T25) and TOF 90% response time (TOF 0.90) were recorded. The differences between T5;T25 and T25; TOF 0.90 were determined as clinical effect duration and recovery time respectively. R Re es su ul lt ts s: : Demographic features and the duration of the surgery and anesthesia were similar between the groups (p>0.05). Intubation time (T5), intubation quality, clinical effect and recovery time were not different between the groups (p>0.05). C Co on nc cl lu us si io on n: : Anesthesia with propophol or thiopental with either sevoflurane or desflurane have similar effect on the duration of rocuronium.
Turkiye Klinikleri Anesteziyoloji Reanimasyon Dergisi, 2008
Turkiye Klinikleri Journal of Anesthesiology Reanimation, 2009
Malignant hyperthermia is a rare genetic disorder characterized by a hypermetabolic response to a... more Malignant hyperthermia is a rare genetic disorder characterized by a hypermetabolic response to all commanly used inhalational anesthetics and depolarizing muscle relaxants. A malignant hyperthermia crisis can develop at any point during anesthesia and in the early postoperative period. Approximately two hours after the induction of anesthesia the patient undergoing cleft palate operation developed an unexplained tachicardia and a body temperature over 39oC. Malignant hyperthermia was suspected and respectively blood gas analysis revealed metabolic and respiratory acidosis. Although creatine kinase is the most sensitive indicator of muscular damage, our patient never developed high levels of creatine kinase as suggestive of rhabdomyolysis which made it difficult to predict malignant hyperthermia susceptibility. But in such cleft palate cases, we think that suspecting clinical signs of malignant hyperthermia would allow fast diagnosis and treatment.
Middle East journal of anaesthesiology, 2012
Propofol injection pain is a frequent and a well-known complaint distressing for the patients. Al... more Propofol injection pain is a frequent and a well-known complaint distressing for the patients. Although the ethiology of this pain remains obscure, the ideal method for the prevention of propofol injection pain is still controversial. Local anesthetics, opioids, nonsteroidal anti-inflammatory drugs, ketamine, metoclopramide, droperidol have been tested. We aimed to conduct a study comparing various drugs with saline, lidocaine and together at the same time. In this randomized, double-blind, prospective trial a total of 250 patients (ASA I-II) undergoing elective surgery with general anesthesia were randomly allocated into five groups. After premedication of 3 mg midazolam im, patients received either 2 mL (0.02 mg) of remifentanil (n = 50, Group R), 2mL (40 mg) of lidocaine (n = 50, Group L), 2 mL (10 mg) of metoclopramide (n = 50, Group M), or 2mL (100 microg/kg) of ketamine (n = 50, Group K) and 2 mL of saline. Pain intensity was evaluated through the use of a verbal rating scale,...
Journal of Anesthesiology, 2014
Objective. To present the conscious sedation and the regional anesthesia technique, consisting of... more Objective. To present the conscious sedation and the regional anesthesia technique, consisting of scalp block and superficial cervical plexus block, used in our institution for patients undergoing deep brain stimulation (DBS) for the treatment of Parkinson’s disease (PD).Methods. The study included 26 consecutive patients. A standardized anesthesia protocol was used and clinical data were collected prospectively.Results. Conscious sedation and regional anesthesia were used in all cases. The dexmedetomidine loading dose was 1 μg kg−1and mean infusion rate was 0.26 μg kg−1 h−1(0.21) [mean total dexmedetomidine dose: 154.68 μg (64.65)]. Propofol was used to facilitate regional anesthesia. Mean propofol dose was 1.68 mg kg (0.84) [mean total propofol dose: 117.72 mg (59.11)]. Scalp block and superficial cervical plexus block were used for regional anesthesia. Anesthesia related complications were minor. Postoperative pain was evaluated; mean visual analog scale pain scores were 0 at the...
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2013
Elli yaşındaki kadın olguda nefes darlığı ve göğüs ağrısı yakınmalarına neden olan sağ hemidiyafr... more Elli yaşındaki kadın olguda nefes darlığı ve göğüs ağrısı yakınmalarına neden olan sağ hemidiyafragma elevasyonu saptanmış ve diyafragma pilikasyonu amacıyla sağ torakotomi yapılmıştır. Sol çift lümenli endobronşiyal entübasyon tüpü ile entübe edilen olguda ameliyat sırasında mediastinal amfizem gelişmiş ve sol ana bronş membranöz kısmında rüptür saptanmıştır. Bronşiyal rüptürün primer olarak tamir edildiği olgu postoperatif 8. günde sorunsuz olarak taburcu edilmiştir. Sonuç: Çift lümenli endobronşiyal entübasyon tüpleri ile yapılan entübasyonlarda tüp ucu vokal kordları geçer geçmez stilenin çıkarılması rüptür riskini azaltacaktır. Bu olgularda perioperatif tanı ve erken primer tamir ile olumlu sonuçlar alınmaktadır.
Konuralp Tıp Dergisi, 2020
Objective: Trigeminocardiac reflex is a reflex characterized by hypotension, bradycardia, gastric... more Objective: Trigeminocardiac reflex is a reflex characterized by hypotension, bradycardia, gastric hypermotility or asystole that develops as a result of stimulation of the trigeminal nerve. In our retrospective study, in septorhinoplasty operations performed under general anesthesia, trigeminocardiac reflex development was investigated primarily during the periods where the reflex was surgically stimulated. Secondly, the effect of different inhalation anesthetic agents on the emergence of this reflex was investigated. Methods: Anesthesia notes and Datex Ohmeda icentral central monitor records of septorhinoplasty cases operated between 01 / January / 2016-30 / November / 2016 were retrospectively examined and detected through the Hospital Information Management System software. Induction, application of local anesthesia, surgical incision, initiation of incision suturing and 5 minutes after extubation were recorded from the records. It was determined that two different inhalation anesthetics were administered in 60 patients who met the criteria, and analyzes were performed in 2 separate groups as group sevoflurane and group desflurane, and the development of QT, QTc and Trigeminocardiac reflex was investigated. Results: Although there was no difference between the groups, when the basal values were compared with the other periods, it was found that the development of TKR and QT and QTc experts were mostly observed in the periods of local anesthesia, surgical incision and incision suturing. (p <0.001). Conclusions: We think that the inhalation anesthetic agents used mostly in the sevoflurane group play a facilitating role in the development of TKR, especially by creating a cumulative effect during periods when the trigeminal nerve is maximally stimulated.
BMC Anesthesiology, 2014
Background: Perioperative hemodynamic fluctuations are seen more often in hypertensive patients t... more Background: Perioperative hemodynamic fluctuations are seen more often in hypertensive patients than in normotensive patients. The purpose of our study was to investigate the perioperative hemodynamic effects of dexmedetomidine and midazolam used for premedication in hypertensive patients relative to each other and in comparison to normotensive patients. Methods: One-hundred-forty female, normotensive or hypertensive patients undergoing myomectomies or hysterectomies. They were randomly enrolled into the subgroups: Group ND (normotensive-dexmedetomidine); Group HD (hypertensive-dexmedetomine); Group NM (normotensive-midazolam); Group HM (hypertensive-midazolam). Dexmedetomidine was administered at a concentration of 0.5 μg.kg −1 , and midazolam was administered at a concentration of 0.025 μg.kg −1 via intravenous (IV) infusion before the induction of anaesthesia. Haemodynamic parameters were recorded at several times (T beginning , T preop5 min , T preop 10 min , T induction , T intubation , T intubation 5 min , T initial surgery , T surgery 15 min , T surgery 30 min , T extubation , T extubation 5 min). Propofol amount for induction, time between induction and initial surgery, demand of antihypertensive therapy, rescue atropine were recorded. Quantitative clinical and demographic characteristics were compared using One Way ANOVA. The values were compared using One-way Analysis of Variance. Additionally periodic variations were examined by One way Repeated Measures Analysis of Variance for groups separately. Results: SBP was significantly different between normotensive and hypertensive groups at the following time points: T preop 5 min , T preop 10 min , T induction , T intubation , T intubation 5 min and T initial surgery. MBP was significantly different in the hypertensive groups at T induction , T intubation , T intubation 5 min, T initial surgery , T surgery 15 min , T surgery 30 min, T extubation and T extubation 5 min. The perioperative requirements for antihypertensive drugs were significantly higher in Group HM. Conclusion: In the hypertensive patients, dexmedetomidine premedication provides better hemodynamic stability compared with midazolam, and because it decreases the antihypertensive requirements, its use might be beneficial.
![Research paper thumbnail of [The effectiveness of preemptive analgesic techniques on postoperative analgesia in patients undergoing open septorhinoplasty]](https://attachments.academia-assets.com/82866285/thumbnails/1.jpg)
](Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology, 2016
A comparison was made of effects of preincisional intravenous (IV) dexketoprofen trometamol and a... more A comparison was made of effects of preincisional intravenous (IV) dexketoprofen trometamol and acetaminophen on postoperative pain, analgesic requirement, hemodynamic parameters, postoperative tramadol consumption, and patient satisfaction in patients undergoing elective septorhinoplasty. Sixty patients scheduled for elective septorhinoplasty under general anesthesia were divided into 3 groups. Groups were similar with respect to gender, mean age, body weight, mean duration of surgery and anesthesia (p>0.05). Group D (n=20) received 50 mg IV dexketoprofen trometamol, while Group A (n=20) received 1 gr IV acetaminophen before surgical incision. Group K (n=20) received no analgesic. Postoperative analgesia was maintained with IV tramadol infusion, with the aid of patient-controlled analgesia pump. Visual analogue scale (VAS), total tramadol consumption, and patient satisfaction were recorded at 15 and 30 minutes postoperatively, as well as 1, 2, 6, 12, and 24 hours postoperatively...
![Research paper thumbnail of [The effectiveness of preemptive analgesic techniques on postoperative analgesia in patients undergoing open septorhinoplasty]](https://attachments.academia-assets.com/82866277/thumbnails/1.jpg)
](Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology, 2016
A comparison was made of effects of preincisional intravenous (IV) dexketoprofen trometamol and a... more A comparison was made of effects of preincisional intravenous (IV) dexketoprofen trometamol and acetaminophen on postoperative pain, analgesic requirement, hemodynamic parameters, postoperative tramadol consumption, and patient satisfaction in patients undergoing elective septorhinoplasty. Sixty patients scheduled for elective septorhinoplasty under general anesthesia were divided into 3 groups. Groups were similar with respect to gender, mean age, body weight, mean duration of surgery and anesthesia (p>0.05). Group D (n=20) received 50 mg IV dexketoprofen trometamol, while Group A (n=20) received 1 gr IV acetaminophen before surgical incision. Group K (n=20) received no analgesic. Postoperative analgesia was maintained with IV tramadol infusion, with the aid of patient-controlled analgesia pump. Visual analogue scale (VAS), total tramadol consumption, and patient satisfaction were recorded at 15 and 30 minutes postoperatively, as well as 1, 2, 6, 12, and 24 hours postoperatively...
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2018
Şiddetli nefes darlığı ve genel durum bozukluğu ile acil servise başvuran 70 yaşındaki erkek hast... more Şiddetli nefes darlığı ve genel durum bozukluğu ile acil servise başvuran 70 yaşındaki erkek hastanın kontrastlı gögüş tomografisinde sağ ve sol ana pulmoner arterlerde, segmental ve subsegmental dallarda masif tromboemboli ile uyumlu dolma defektleri saptandı. Solunum yetmezliği nedeni ile mekanik ventilatör desteği sağlanan hastada kardiyak arest gelişmesine bağlı 55 dk. resusitasyon uygulanmasıyla eşzamanlı rekombinan doku plazminojen aktivatörü alteplaz ile trombolitik tedavi uygulandı. Spontan dolaşımı düzelen hasta 2 gün yoğun bakım ünitesinde gözlendikten sonra kardiyoloji servisine nakledildi. Akut masif pulmoner emboli tanısı alan ve hemodinamisi stabil olmayan hastalarda alteplaz ile erken sistemik trombolitik tedavi yaşam kurtarıcıdır.
İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 2019
Diffuse alveolar hemorrhage (DAH) is a medical emergency which can cause acute respiratory failur... more Diffuse alveolar hemorrhage (DAH) is a medical emergency which can cause acute respiratory failure. The diagnosis and treatment of DAH should be carried out as soon as possible. DAH has various causes such as vasculitis, infections, pesticides intoxication, barotrauma, diffuse alveolar damage, pulmonary embolism and may be associated with the use of anticoagulants (1). Warfarin therapy is a rare cause of DAH (1). We aimed to present a 69 year-old male patient who developed diffuse alveolar hemorrhage as a complication of warfarin therapy used for valve replacement. After diagnosis of DAH, warfarin treatment was discontinued and fresh frozen plasma, metilprednisolone, vitamin K were administered during mechanical ventilation therapy. The patient was responded well and INR decreased to therapeutic value. DAH should be remembered during warfarine therapy to avoid challenging situations.
Journal of Clinical Anesthesia, 2019
Korean Journal of Anesthesiology, 2012
A 37-year-old woman diagnosed with sickle cell anemia (SCA), beta (+) thalassemia, Crohn's diseas... more A 37-year-old woman diagnosed with sickle cell anemia (SCA), beta (+) thalassemia, Crohn's disease, and liver dysfunction was scheduled for laparoscopic cholecystectomy (LC) due to acute cholecystitis with gall bladder. Regional anesthesia was performed. An epidural catheter was inserted into the 9-10 thoracal epidural space and then 15 ml of 0.5% bupivacaine was injected through the catheter. The level of sensorial analgesia tested with pinprick test reached up to T4. Here we describe the first case of the combination of sickle cell anemia (SCA), beta (+) thalassemia, and Crohn's disease successful anesthetic management with attention to hemodynamics, particularly with regards to liver dysfunction.
Background: Respiratory functions and gas exchange deteriorates in patients with COPD. In our stu... more Background: Respiratory functions and gas exchange deteriorates in patients with COPD. In our study, we aimed to investigate if there is any relationship between the washout time of sevoflurane and chronic obstructive pulmonary disease (COPD). Method: Sixty patients, American Society of Anesthesiology (ASA) 1-3 status; aged between 18-60 years old who underwent general anesthesia for an operation were enrolled in our study. Patients were divided into two groups: Group N (non-COPD n = 33), group COPD (patients with COPD, n = 33). Two patients were excluded from the study, a total of 31 patients in Group COPD. Pre-operative respiratory function tests were performed and standard monitoring was provided in the operation room. Both groups received propofol 2 mg/kg, fentanyl 1.5-2 mcg/kg and rocuronium 0.6 mg/kg intravenously, and an oxygen-air mixture of 50%/50% with a tidal volume of 6 ml/kg (ideal body weight) and sevoflurane of 1 MAC. Remifentanil was administered at 0.05-0.1 mcg/ kg/...
Turkish journal of anaesthesiology and reanimation, 2017
Turkish journal of anaesthesiology and reanimation, 2015
To compare sugammadex and neostigmine regarding the efficacy in reversing rocuronium-induced neur... more To compare sugammadex and neostigmine regarding the efficacy in reversing rocuronium-induced neuromuscular block, the incidence of post-operative respiratory complications and costs in patients undergoing surgery for the treatment of obstructive sleep apnoea (OSA). After obtaining ethical approval and patient consent, 74 patients in ASA physical status I or II were randomised into two groups to receive 2-mg kg(-1) sugammadex (Group S) or 0.04-mg kg(-1) neostigmine+0.5-mg atropine (Group N). Groups were compared regarding time to TOF (train-of-four) 0.9, operating room time, post-anaesthesia care unit (PACU) stay, post-operative respiratory complications, costs related to neuromuscular block reversal, anaesthesia care and complication treatment. Patient demographics, anaesthesia, surgical data and total rocuronium doses were similar between groups. Time to TOF 0.9 was shorter for group S [Group N: 8 (5-18) min; Group S: 2 (1.5-6) min (p<0.001)]. Operating room time [Group S: 72.4±...
Turkish Journal of Anesthesia and Reanimation, 2016
Objective: Rocuronium is a non-depolarising, intermediate-acting, monoquaternary amino steroid an... more Objective: Rocuronium is a non-depolarising, intermediate-acting, monoquaternary amino steroid and was brought into clinical use as a potentially ideal muscle relaxant. Post-operative residual curarisation (PORC) results from the prolonged effects of non-depolarising neuromuscular blocking agents. This is a common problem and seriously affects patient safety. No recent study has investigated the effects of sugammadex on smokers, which is often used to restore neuromuscular block and avoid PORC. This study compares the severity of the effects of sugammadex used for antagonising rocuronium bromide and antagonism durations in smokers and non-smokers. Methods: This randomised, prospective study included 40 patients scheduled for elective surgery and belonging to classes I and II based the American Society of Anesthesiologists classification, who were either smokers for at least 10 years or non-smokers. Patients underwent routine and neuromuscular monitoring. At induction, 2 mg kg −1 propofol and 1 mcg kg −1 intravenous fentanyl were applied. After the loss of eyelash reflex, 0.6 mg kg −1 intravenous rocuronium was administered. Patients were intubated at train of four (TOF) 2. Anaesthesia was continued with 50% O 2 +50% air and 2% sevoflurane. Rocuronium, 0.15 mg kg −1 , was administered at TOF 2 during the operation. At the end of the operation, 2 mg kg −1 sugammadex was administered. The times until TOF 0.7, 0.8 and 0.9 were recorded. Results: Intubation time was 132.8±46.4 s for smokers and 127.6±32.7 s for non-smokers. After sugammadex administration, the time to TOF 0.7 was 153.3±54.7 s in smokers and 125±67.2 s in non-smokers. The times were 178.4±58.8 and 146.6±72.6 s for TOF 0.8 and 200.8±55.8 s and 170.4±77.8 s for TOF 0.9 in smokers and non-smokers, respectively. Conclusion: Although not statistically significant, the time to reach each TOF was longer for smokers. Larger populations and different perspectives are needed to find if sugammadex use is affected by smoking, which has negative effects on the body.
Turkiye Klinikleri Journal of Anesthesiology Reanimation, 2011
Propofol, tiyopental, sevofluran ve desfluran ile anestezi uygulamalarının; rokuronyum ile entüba... more Propofol, tiyopental, sevofluran ve desfluran ile anestezi uygulamalarının; rokuronyum ile entübasyon süresi, entübasyon kalitesi, klinik etki ve düzelme sürelerine etkilerini akselerometrik metod kullanarak karşılaştırmak amaçlandı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Etik komite onayı alınan, ASA I-II, 18-65 yaş arası 80 genel cerrahi olgusu rastgele dört eşit gruba ayrıldı. Grup PS (n= 20) ve Grup PD'de (n= 20) propofol 2 mg/kg ile Grup TS (n= 20) ve Grup TD'de (n= 20) tiyopental 5 mg/kg ile anestezi indüksiyonundan sonra rokuronyum 0.6 mg/kg, iv uygulandı. Grup PS ve Grup TS'de %2 sevoflurane; Grup PD ve Grup TD'de %6-7,5 desflurane ile anestezi idamesi gerçekleştirildi. Bütün olgularda indüksiyondan hemen sonra akselerometri cihazının (TOF-Watch SX, Organon®, Ireland) otomatik kalibrasyonu yapıldı. Rokuronyumdan sonra, tekli uyarıda %95 depresyon (T5) geliştiğinde endotrakeal entübasyon gerçekleştirildi. Entübasyon süresi ve Goldberg Skalası ile entübasyon kalitesi kaydedildi. Tekli uyarıda %25 (T25) düzelme anı, TOF %90 (TOF 0,90) yanıt alınma zamanı kaydedildi. T5 ile T25 arası, klinik etki süresi; T25 ile TOF 0,90 arası, düzelme süresi olarak hesaplandı. B Bu ul lg gu ul la ar r: : Demografik veriler ile cerrahi ve anestezi süreleri tüm gruplarda benzerdi (p> 0,05). Entübasyon süresi (T5) ve kalitesi ile klinik etki ve düzelme sürelerinde gruplar arasında fark gözlenmedi (p> 0,05). S So on nu uç ç: : Çalışmamızda; rokuronyumum etki sürelerinde propofol ve tiyopental ile sevofluran ve desfluran anestezilerinin farklı etkiye sahip olmadıkları sonucuna ulaşılmıştır. A An na ah ht ta ar r K Ke el li im me el le er r: : Rokuronyum; propofol; tiyopental; sevofluran; dezfloran;X entübasyon, intratrakea A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : It was aimed to compare the effects of propofol, thiopenthal, sevoflurane and desflurane on intubation time, intubation quality, clinical effect and recovery time with rocuronium by using the accelerometric method. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : After approval of the ethics committee 80, ASA I-II general surgery patients, aged 18-65 years were randomly allocated to one of four equal groups. Anesthesia was induced with either propofol 2.0 mg/kg or tiopental sodium 5 mg/kg and sevoflurane 2.0% (Group PS and TS) or desflurane 6.0-7.5% (Group PD and TD) was used for maintenance. The accelerometer (TOF-Watch SX, Organon®, Ireland) was calibrated after the anesthetic induction. Following administration of rocuronium, endotracheal intubation was performed with 95% depression (T5) in a single stimulus. Intubation time and quality by Goldberg Scale were determined. In a single stimulus 25% recovery time (T25) and TOF 90% response time (TOF 0.90) were recorded. The differences between T5;T25 and T25; TOF 0.90 were determined as clinical effect duration and recovery time respectively. R Re es su ul lt ts s: : Demographic features and the duration of the surgery and anesthesia were similar between the groups (p>0.05). Intubation time (T5), intubation quality, clinical effect and recovery time were not different between the groups (p>0.05). C Co on nc cl lu us si io on n: : Anesthesia with propophol or thiopental with either sevoflurane or desflurane have similar effect on the duration of rocuronium.
Turkiye Klinikleri Anesteziyoloji Reanimasyon Dergisi, 2008
Turkiye Klinikleri Journal of Anesthesiology Reanimation, 2009
Malignant hyperthermia is a rare genetic disorder characterized by a hypermetabolic response to a... more Malignant hyperthermia is a rare genetic disorder characterized by a hypermetabolic response to all commanly used inhalational anesthetics and depolarizing muscle relaxants. A malignant hyperthermia crisis can develop at any point during anesthesia and in the early postoperative period. Approximately two hours after the induction of anesthesia the patient undergoing cleft palate operation developed an unexplained tachicardia and a body temperature over 39oC. Malignant hyperthermia was suspected and respectively blood gas analysis revealed metabolic and respiratory acidosis. Although creatine kinase is the most sensitive indicator of muscular damage, our patient never developed high levels of creatine kinase as suggestive of rhabdomyolysis which made it difficult to predict malignant hyperthermia susceptibility. But in such cleft palate cases, we think that suspecting clinical signs of malignant hyperthermia would allow fast diagnosis and treatment.
Middle East journal of anaesthesiology, 2012
Propofol injection pain is a frequent and a well-known complaint distressing for the patients. Al... more Propofol injection pain is a frequent and a well-known complaint distressing for the patients. Although the ethiology of this pain remains obscure, the ideal method for the prevention of propofol injection pain is still controversial. Local anesthetics, opioids, nonsteroidal anti-inflammatory drugs, ketamine, metoclopramide, droperidol have been tested. We aimed to conduct a study comparing various drugs with saline, lidocaine and together at the same time. In this randomized, double-blind, prospective trial a total of 250 patients (ASA I-II) undergoing elective surgery with general anesthesia were randomly allocated into five groups. After premedication of 3 mg midazolam im, patients received either 2 mL (0.02 mg) of remifentanil (n = 50, Group R), 2mL (40 mg) of lidocaine (n = 50, Group L), 2 mL (10 mg) of metoclopramide (n = 50, Group M), or 2mL (100 microg/kg) of ketamine (n = 50, Group K) and 2 mL of saline. Pain intensity was evaluated through the use of a verbal rating scale,...
Journal of Anesthesiology, 2014
Objective. To present the conscious sedation and the regional anesthesia technique, consisting of... more Objective. To present the conscious sedation and the regional anesthesia technique, consisting of scalp block and superficial cervical plexus block, used in our institution for patients undergoing deep brain stimulation (DBS) for the treatment of Parkinson’s disease (PD).Methods. The study included 26 consecutive patients. A standardized anesthesia protocol was used and clinical data were collected prospectively.Results. Conscious sedation and regional anesthesia were used in all cases. The dexmedetomidine loading dose was 1 μg kg−1and mean infusion rate was 0.26 μg kg−1 h−1(0.21) [mean total dexmedetomidine dose: 154.68 μg (64.65)]. Propofol was used to facilitate regional anesthesia. Mean propofol dose was 1.68 mg kg (0.84) [mean total propofol dose: 117.72 mg (59.11)]. Scalp block and superficial cervical plexus block were used for regional anesthesia. Anesthesia related complications were minor. Postoperative pain was evaluated; mean visual analog scale pain scores were 0 at the...
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2013
Elli yaşındaki kadın olguda nefes darlığı ve göğüs ağrısı yakınmalarına neden olan sağ hemidiyafr... more Elli yaşındaki kadın olguda nefes darlığı ve göğüs ağrısı yakınmalarına neden olan sağ hemidiyafragma elevasyonu saptanmış ve diyafragma pilikasyonu amacıyla sağ torakotomi yapılmıştır. Sol çift lümenli endobronşiyal entübasyon tüpü ile entübe edilen olguda ameliyat sırasında mediastinal amfizem gelişmiş ve sol ana bronş membranöz kısmında rüptür saptanmıştır. Bronşiyal rüptürün primer olarak tamir edildiği olgu postoperatif 8. günde sorunsuz olarak taburcu edilmiştir. Sonuç: Çift lümenli endobronşiyal entübasyon tüpleri ile yapılan entübasyonlarda tüp ucu vokal kordları geçer geçmez stilenin çıkarılması rüptür riskini azaltacaktır. Bu olgularda perioperatif tanı ve erken primer tamir ile olumlu sonuçlar alınmaktadır.
Konuralp Tıp Dergisi, 2020
Objective: Trigeminocardiac reflex is a reflex characterized by hypotension, bradycardia, gastric... more Objective: Trigeminocardiac reflex is a reflex characterized by hypotension, bradycardia, gastric hypermotility or asystole that develops as a result of stimulation of the trigeminal nerve. In our retrospective study, in septorhinoplasty operations performed under general anesthesia, trigeminocardiac reflex development was investigated primarily during the periods where the reflex was surgically stimulated. Secondly, the effect of different inhalation anesthetic agents on the emergence of this reflex was investigated. Methods: Anesthesia notes and Datex Ohmeda icentral central monitor records of septorhinoplasty cases operated between 01 / January / 2016-30 / November / 2016 were retrospectively examined and detected through the Hospital Information Management System software. Induction, application of local anesthesia, surgical incision, initiation of incision suturing and 5 minutes after extubation were recorded from the records. It was determined that two different inhalation anesthetics were administered in 60 patients who met the criteria, and analyzes were performed in 2 separate groups as group sevoflurane and group desflurane, and the development of QT, QTc and Trigeminocardiac reflex was investigated. Results: Although there was no difference between the groups, when the basal values were compared with the other periods, it was found that the development of TKR and QT and QTc experts were mostly observed in the periods of local anesthesia, surgical incision and incision suturing. (p <0.001). Conclusions: We think that the inhalation anesthetic agents used mostly in the sevoflurane group play a facilitating role in the development of TKR, especially by creating a cumulative effect during periods when the trigeminal nerve is maximally stimulated.
BMC Anesthesiology, 2014
Background: Perioperative hemodynamic fluctuations are seen more often in hypertensive patients t... more Background: Perioperative hemodynamic fluctuations are seen more often in hypertensive patients than in normotensive patients. The purpose of our study was to investigate the perioperative hemodynamic effects of dexmedetomidine and midazolam used for premedication in hypertensive patients relative to each other and in comparison to normotensive patients. Methods: One-hundred-forty female, normotensive or hypertensive patients undergoing myomectomies or hysterectomies. They were randomly enrolled into the subgroups: Group ND (normotensive-dexmedetomidine); Group HD (hypertensive-dexmedetomine); Group NM (normotensive-midazolam); Group HM (hypertensive-midazolam). Dexmedetomidine was administered at a concentration of 0.5 μg.kg −1 , and midazolam was administered at a concentration of 0.025 μg.kg −1 via intravenous (IV) infusion before the induction of anaesthesia. Haemodynamic parameters were recorded at several times (T beginning , T preop5 min , T preop 10 min , T induction , T intubation , T intubation 5 min , T initial surgery , T surgery 15 min , T surgery 30 min , T extubation , T extubation 5 min). Propofol amount for induction, time between induction and initial surgery, demand of antihypertensive therapy, rescue atropine were recorded. Quantitative clinical and demographic characteristics were compared using One Way ANOVA. The values were compared using One-way Analysis of Variance. Additionally periodic variations were examined by One way Repeated Measures Analysis of Variance for groups separately. Results: SBP was significantly different between normotensive and hypertensive groups at the following time points: T preop 5 min , T preop 10 min , T induction , T intubation , T intubation 5 min and T initial surgery. MBP was significantly different in the hypertensive groups at T induction , T intubation , T intubation 5 min, T initial surgery , T surgery 15 min , T surgery 30 min, T extubation and T extubation 5 min. The perioperative requirements for antihypertensive drugs were significantly higher in Group HM. Conclusion: In the hypertensive patients, dexmedetomidine premedication provides better hemodynamic stability compared with midazolam, and because it decreases the antihypertensive requirements, its use might be beneficial.
Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology, 2016
A comparison was made of effects of preincisional intravenous (IV) dexketoprofen trometamol and a... more A comparison was made of effects of preincisional intravenous (IV) dexketoprofen trometamol and acetaminophen on postoperative pain, analgesic requirement, hemodynamic parameters, postoperative tramadol consumption, and patient satisfaction in patients undergoing elective septorhinoplasty. Sixty patients scheduled for elective septorhinoplasty under general anesthesia were divided into 3 groups. Groups were similar with respect to gender, mean age, body weight, mean duration of surgery and anesthesia (p>0.05). Group D (n=20) received 50 mg IV dexketoprofen trometamol, while Group A (n=20) received 1 gr IV acetaminophen before surgical incision. Group K (n=20) received no analgesic. Postoperative analgesia was maintained with IV tramadol infusion, with the aid of patient-controlled analgesia pump. Visual analogue scale (VAS), total tramadol consumption, and patient satisfaction were recorded at 15 and 30 minutes postoperatively, as well as 1, 2, 6, 12, and 24 hours postoperatively...
Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology, 2016
A comparison was made of effects of preincisional intravenous (IV) dexketoprofen trometamol and a... more A comparison was made of effects of preincisional intravenous (IV) dexketoprofen trometamol and acetaminophen on postoperative pain, analgesic requirement, hemodynamic parameters, postoperative tramadol consumption, and patient satisfaction in patients undergoing elective septorhinoplasty. Sixty patients scheduled for elective septorhinoplasty under general anesthesia were divided into 3 groups. Groups were similar with respect to gender, mean age, body weight, mean duration of surgery and anesthesia (p>0.05). Group D (n=20) received 50 mg IV dexketoprofen trometamol, while Group A (n=20) received 1 gr IV acetaminophen before surgical incision. Group K (n=20) received no analgesic. Postoperative analgesia was maintained with IV tramadol infusion, with the aid of patient-controlled analgesia pump. Visual analogue scale (VAS), total tramadol consumption, and patient satisfaction were recorded at 15 and 30 minutes postoperatively, as well as 1, 2, 6, 12, and 24 hours postoperatively...