Sibel Tetiker - Academia.edu (original) (raw)

Papers by Sibel Tetiker

TEZ6545Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2007.Kaynakça (s.53-58) var.vii, 59 s. ; 2... more TEZ6545Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2007.Kaynakça (s.53-58) var.vii, 59 s. ; 29 cm.Konjenital kalp cerrahisi uygulanan pediyatrik olgularda, operasyon odasında ekstübasyon ve etkin bir postoperatif analjezi sağlanması, maliyeti düşürme ve komplikasyonları azaltma çabasının önemli basamaklarıdır. Çalışmamızda masada ekstübe edilen konjenital kalp cerrahisi hastalarında intravenöz deksmedetomidin uygulamasının postoperatif ağrı tedavisi ve morfin tüketimi üzerine olan etkileri araştırıldı. Fakülte etik kurul ve ebeveyn onayları alınarak, konjenital kalp hastalıkları nedeniyle düzeltme cerrahi uygulanacak 1-15 yaş arası toplam 53 olgu çalışma kapsamına alındı. Operasyon öncesi ketamin (2 mg/kg, iv) ile premedike edilen olgularda, sevofluran anestezisi ile anestezi idamesi sağlandı. Cerrahi insizyon ile birlikte tüm olgulara peroperatif analjezi için morfin (0,1 mg/kg, iv) uygulandı. Olgular rasgele seçimle 3 gruba ayrıldılar. I. Grup olgularda operasyon başlamadan ön...

Cukurova Medical Journal, Sep 30, 2021

Amac: HELLP (Hemolysis, elevated liver enzymes, and low platelets) sendromu gebeligin ciddi kompl... more Amac: HELLP (Hemolysis, elevated liver enzymes, and low platelets) sendromu gebeligin ciddi komplikasyonlarindan birisidir. Literaturde HELLP sendromunun tedavisinde kortikosteroid kullanimi ile ilgili celiskili bilgiler bulunmaktadir. Bu calismanin amaci deksametazon tedavisinin maternal sonuclar uzerindeki etkisinin arastirilmasidir. Yontemler: Calismaya HELLP sendromu tanisi ile yogun bakim unitesinde izlenen 20 hasta dahil edilmistir. Hasta yasi, gestasyonel yas, Mississipi sinflandirmasi, APACHE II skoru, hematolojik ve biyokimyasal olcumler, mortalite ve yogun bakim yatis gunu gibi parametreler analiz edilmistir. Bulgular: Hastalardan ikisi coklu organ yetmezligine bagli olarak olmustur. Iki intrauterine ve bir premature bebek olumu gerceklesmistir. On iki hastaya deksametazon tedavisi verilmis (Grup 1), 8 hasta ise kortikosteroid tedavisi almamistir. Gruplar arasinda yogun bakim yatis suresi, transfuzyon gereksinimi ve mortalite acisindan anamli fark saptanmamistir. Deksameta...

Journal of Surgery and Medicine, 2021

Journal of Critical Care, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Mersin Üniversitesi Sağlık Bilimleri Dergisi, 2019

Amac: Sugammadeks; genel anestezi uygulamalarinda steroid yapida kas gevseticilerin etkisini farm... more Amac: Sugammadeks; genel anestezi uygulamalarinda steroid yapida kas gevseticilerin etkisini farmakolojik olarak ortadan kaldiran ve yan etkileri az gorulen bir ajandir. Ancak maliyeti yuksek oldugu, iki yas altinda kullanimi konusunda yeterli veri bulunmadigi, diger ilac ve besinlerle etkilesimi tam olarak bilinmedigi icin kullanimi kisitlidir. Bu calisma ile sugammadeks kullanilan hastalarin cesitli parametreleri incelenmis olup, sonuclarimizi paylasmayi ve yeni calismalara isik tutmayi amacladik. Yontem: Retrospektif olan bu calismada, dosya taramasi yapilarak genel anestezi altinda ameliyata alinan ve sugammadeks kullanilan hastalarin cinsiyetleri, branslara gore sayilari, yas araliklari, sugammadeks kullanim endikasyonlari elektronik ortama aktarilmis, sayilar % dagilim olarak ifade edilmistir. Kullanilan sugammadeks dozlari miligram/kilogram, anestezi risk degerlerinin ortalamasi rakamsal olarak ifade edilmistir. Bulgular: Farkli branslarda sugammadeks kullanilan 1381 hasta calismaya dahil edildi. Hastalarin 506’si kadin, 875’i erkekti. 22 hasta 2 yas ve alti, 65 hasta 3-7 yas arasi, 135 hasta 8-18 yas arasi, 874 hasta 19-65 yas arasi, 253 hasta 66 yas ve uzerindeydi. 317 hasta ASA (American Society of Anesthesiologists, anestezi risk siniflamasi)-I, 636 hasta ASA-II, 300 hasta ASA-III, 128 hasta ASA-IV risk grubunda idi. Ortalama ASA degeri 2.20 idi. Sugammadeks zor entubasyon (n=55), obesite cerrahisi (n=110), vertebral cerrahi (n=274), atropin ve neostigmin ile yetersiz dekurarizasyon (n=30), ameliyat iptali veya hizli uyandirma gerektiren durum (n=100), 80 yas uzeri (n=26), konjental malformasyon (mukopolisakkaridoz tip 3, vajinal agenezi=Rokitansky Mayer Hauser Kustner sendromu, doudenal atrezili down sendromu) (n=3), neostigmin kullaniminin kontrendike olmasi (n=783) nedeniyle kullanilmisti. Ameliyat sureleri en kisa 15 dakika, en uzun 420 dakika idi. Sugammadeks kullanim dozu 2.0-4.0 miligram/kilogram arasindaydi. Hastalarda anaflaksi veya benzeri herhangi bir yan etkiye rastlanmadi. Sonuc: Bu calismanin sonuclari sugammadeksin; cinsiyet ayirdetmeden, yas farki gozetmeden, ASA risk faktoru dusuk veya yuksek, tum branslarin kisa veya uzun sureli ameliyatlarinda 2.0-4.0 mg/kg doz araliginda guvenle kullanilabilecek bir ilac oldugunu gostermektedir.

Transplantation, 2017

Introduction. The number of organ donors in Italy is increasing, but with still disappointing liv... more Introduction. The number of organ donors in Italy is increasing, but with still disappointing living donation activity and relatively frequent objection by potential deceased donors' relatives to organ recovery. Few studies have assessed health care students' knowledge and attitude on donation. Methods. We administered a questionnaire to medical (MS) and nursing students (NS) at University of Modena and Reggio Emilia, Italy, and 749 students (406 MS and 343 NS) completed the questionnaire. Results. Although 95% of students were in favor of donation, only 21.9% of NS and 24.9% of MS were registered as donors. One quarter of students reported family disagreement. MS appeared more confident with personnel involved in donation. Overall, 60% of students knew the term donation after brain death but only 40% were aware of the criteria used to define it. Barely 27.1% of NS and 15.3% of MS believed they had received sufficient information in lessons. Backward logistic regression demonstrated that students whose families agree with them and who knew the definition of donation after brain death were more likely to express the disposition of registering, and those who showed distrust in the declaration of brain death were half as likely to register as donors. Discussion. Students expressed a lack of knowledge, controversial attitudes on donation, and strong need for education; increased awareness may help increase donation rates. The majority of educational institutions in Italy do not directly address training on organ donation and transplantation for health care students; an integrated curriculum favoring interpersonal discussion including practical aspects is urgently required.

Journal of Clinical Anesthesia, 2016

Study objective: Preoperative anxiety can be associated with poor postoperative clinical outcomes... more Study objective: Preoperative anxiety can be associated with poor postoperative clinical outcomes. We aimed to assess whether preoperative maternal anxiety level of obstetric patients scheduled for elective cesarean surgery has an effect on clinical outcome of the newborn. Design: A prospective observational study. Setting: Operating room. Patients: Sixty pregnant women with American Society of Anesthesiologists physical status 1 and 2 scheduled for elective cesarean surgery were enrolled. Interventions: All patients received spinal anesthesia with hyperbaric bupivacaine 12.5 mg. Measurements: We performed a State-Trait Anxiety Inventory questionnaire to evaluate preoperative maternal anxiety. We used the Apgar scoring system to assess the physical condition of the newborn. Hemodynamic measurements (heart rate, systolic and diastolic blood pressure) were recorded at baseline, skin incision, childbirth, and 10, 15, and 30 minutes after skin incision. The use of ephedrine, nausea, and vomiting were recorded as well. Main results: Average preoperative maternal state anxiety score was 41.1 ± 4.6, and trait anxiety score was 50.9 ± 5.7. Average Apgar scores of newborns were 7.6 ± 0.8 and 9.2 ± 0.6, at first minute and fifth minute, respectively. We found no significant relationship between the anxiety scores and Apgar scores at first and fifth minute. Forty-two patients required ephedrine, 5 patients had nausea, and 5 patients had vomiting. Conclusions: We concluded that there was no relationship between preoperative maternal anxiety scores and Apgar scores at the first and fifth minute.

European Journal of Anaesthesiology, 2008

Background and objective: We have investigated whether, after major abdominal surgery, the additi... more Background and objective: We have investigated whether, after major abdominal surgery, the addition of remifentanil to tramadol for intravenous patient-controlled analgesia improved analgesia and lowered pain scores, compared to a patient-controlled analgesia containing only tramadol. Methods: Sixty-two patients were allocated randomly to receive an intravenous patient-controlled analgesia with tramadol alone (T), or tramadol plus remifentanil (TR), in a double-blind randomized study. Whenever patients complained of pain, they were allowed to use bolus doses of tramadol (0.2 mg kg 21) or tramadol (0.2 mg kg 21) plus remifentanil (0.2 mg kg 21) mixture every 10 min without a time limit and background infusion. Discomfort, sedation, pain scores, total and bolus patient-controlled analgesia tramadol consumption, and side-effects were recorded for up to 24 h after the start of patient-controlled analgesia. Results: Pain scores at rest were statistically significantly lower in the TR group at 6, 12 and 24 h than in T group (P , 0.05). Pain scores at movement and patient comfort scores were also found to be significantly lower in the TR group at 2, 6, 12 and 24 h than in the T group (P , 0.05). Although the TR group consumed less tramadol, there were no statistically significant differences in the cumulative tramadol consumptions between the groups at any time. However, the number of patients requiring rescue analgesia and average supplementary doses used was significantly higher in the T group than in the TR group (P , 0.05). Conclusions: After major abdominal surgery, adding remifentanil (0.2 mg kg 21) to tramadol (0.2 mg kg 21), with 10-min lockout times, for patient-controlled analgesia offered better postoperative pain relief and patient comfort, without causing any sedation or respiratory depression.

European Journal of Anaesthesiology, 2007

Anesthesia & Analgesia, 2008

We designed this prospective, randomized, double-blind study to compare the analgesic effectivene... more We designed this prospective, randomized, double-blind study to compare the analgesic effectiveness and side effects of IV patient-controlled morphine, pethidine, and tramadol for postoperative pain management. One-hundred-twenty-six ASA physical status I or II patients undergoing abdominal hysterectomy were randomly allocated to receive IV-patient controlled morphine (M), pethidine (P), or tramadol (T) for postoperative analgesia. The cumulative analgesic consumption over 24 h was 25.7 +/- 9.5 mg for morphine, 266 +/- 90 mg for pethidine, and 320 +/- 10 mg for tramadol. The average supplementary fentanyl dose used was significantly higher in group T than in groups M and P (P &amp;lt; 0.05). In conclusion, morphine, pethidine, and tramadol resulted in equivalent pain scores and side effects, but tramadol group T required more rescue analgesic doses of fentanyl.

Journal of Opioid Management, 2018

Objective: In this study, the authors investigated the effect of the addition of remifentanil to ... more Objective: In this study, the authors investigated the effect of the addition of remifentanil to tramadol or morphine for patient-controlled analgesia (PCA).Design: Prospective, randomized, double-blind, controlled study.Setting: University Hospital.Patients, participants: The authors randomly allocated 133 patients undergoing major abdominal surgery to receive IV PCA with tramadol alone, tramadol plus remifentanil, morphine alone or morphine plus remifentanil.Interventions: Bolus doses of tramadol (0.2 mg/kg), tramadol (0.2 mg/kg) plus remifentanil (0.2 μg/kg), morphine (0.02 mg/kg), or morphine (0.02 mg/kg) plus remifentanil (0.2 μg/kg) were available every 10 minutes without time limit or background infusion.Main outcome measure(s): Discomfort, sedation, pain scores, side effects, and total and bolus tramadol and morphine consumption were recorded for up to 24 hours after the start of PCA.Results: Pain scores at rest and movement were greater with tramadol alone than in the other...