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Öğe Airway management with supraglottic airway device at pierre robin sequence(Oxford Univ Press, 2012) Copuroglu, Elif; Colak, Alkin; Sagiroglu, Gonul; Copuroglu, Cem; Gunday, Isil[Abstract Not Available]Öğe Anaesthesia Management of a Child with West Syndrome(Aves, 2014) Sahin, Sevtap Hekimoglu; Copuroglu, Elif; Ugur, Huseyin; Sagiroglu, Gonul; Colak, AlkinWest syndrome (WS) is an epileptic encephalopathy usually occurring during the first year of life and is characterized by severe electroencephalography (EEG) derangement. Most of these patients may develop cerebral palsy, facial malformations, and skeletal deformities. The anaesthesiologist should make the preoperative assessment carefully due to epileptic seizures and should consider the possibility of difficult intubation because of coexisting anatomic malformations during the anaesthesia management of patients with WS. This report presents a case of general anaesthesia management in a left femoral fixation operation in an 11-year-old, 18 kg male patient.Öğe Comparison of Different Anesthetic Techniques on Postoperative Outcomes in Elderly Patients with Hip Fracture(Ortadogu Ad Pres & Publ Co, 2012) Sahin, Sevtap Hekimoglu; Heybeli, Nurettin; Colak, Alkin; Arar, Cavidan; Alan, Kudret; Copuroglu, Cem; Yilmaz, BarisObjective: Determining the type of anesthesia is a complex medical decision that depends on many factors including co-morbidity, age, type of surgery performed, and the risk of the anesthetic techniques. This study evaluated the effects of anesthesia type on postoperative mortality and morbidity in hip fractures. Material and Methods: One hundred eighty-five patients older than 60 years who were operated for hip fracture between 2005-2009 were retrospectively analyzed. Patients received general anesthesia (n=67), spinal anesthesia (n=67), or epidural anesthesia (n=51). The clinical features of the patients were obtained from the hospital records. Morbidity outcomes were assessed on postoperative day 7. Mortality rates were calculated on postoperative day 7 and postoperative day 30. Results: There were no significant differences between the three groups with regard to intraoperative blood loss, intraoperative blood transfusion, smoking status, length of stay in hospital, American Society of Anesthesiology (ASA) physical status, and Charlson Comorbidity Index (CCI) (p=0.393, p=0.088, p=0.369, p=0.228, p=0.491, p=0.371 respectively). Similarly, no difference was detected between the three groups regarding patient mortality rates for day 7 and 30 (p=0.738, p=0.805 respectively). Conclusion: No technique was superior to the others. Due to the similar mortality rates among the groups, we suggest that the proper anesthetic technique selected according to the clinical features of the patient combined with adequate monitorization would yield successful results with all three techniques.Öğe COMPARISON OF RISK INDEXES USED IN DETERMINING THE POSTOPERATIVE RESPIRATORY INSUFFICIENCY RISK(Nobel Ilac, 2013) Kavalci, Gulsum; Arar, Cavidan; Colak, Alkin; Turan, Nesrin; Kavalci, CemilObjective: Postoperative respiratory failure is an important complication of anesthesia. In this study, we aimed to compare the effectiveness of respiratory failure risk index and pneumonia risk index in determining postoperative respiratory failure. Material and Method: 3000 patients were included in our study. We calculated the patients' scores of respiration insufficiency risk indexes and postoperative pneumonia risk indexes in preoperative period. The factors that could play a role in intensive care unit requirement have been inquired through multiple variability regression analysis. Results: Through multiple variability regression analysis we concluded that; intensive care unit requirement and postoperative pulmonary complications were effected by age, gender, low albumin levels, high urea levels, functional state, chronic obstructive lung disease, having more than 4 unit blood transfusion, peripheric vessel surgery, extremity surgery, brain surgery, spinal column surgery and urgent surgery (p<0.05). Respiration insufficiency risk index and postoperative pneumonia risk index scores had similar effects in determining the intensive care unit requirement and postoperative pulmonary complications. Conclusion: We conclude that respiration insufficiency risk index and postoperative pneumonia risk index have similiar effects in determining the intensive care unit requirement and postoperative pulmonary complications.Öğe Comparison of temporal artery, nasopharyngeal, and axillary temperature measurement during anesthesia in children(Elsevier Science Inc, 2012) Sahin, Sevtap Hekimoglu; Duran, Ridvan; Sut, Necdet; Colak, Alkin; Acunas, Betul; Aksu, BurhanStudy Objective: To evaluate the accuracy and precision of a new, noninvasive infrared thermometer applied to the temporal artery. Design: Prospective randomized study. Setting: Trakya University Hospital. Patients: 60 ASA physical status 1 and 2 children undergoing surgery. Interventions: During anesthesia, temperature measurements were recorded with three different techniques: temporal artery, nasopharynx, and axillary temperature. Measurements: Temperatures measured from the nasopharynx, temporal artery, and the axilla were recorded at 15-minute intervals for the first hour, then at 30-minute intervals until the completion of surgery. During each measurement, heart rate and midarterial pressure were recorded. Main Results: There were no statistically significant differences between temperatures recorded at the temporal artery and nasopharynx at 15, 30, 45, 60, 90, and 120 minutes, and the completion of surgery. Axillary temperatures were statistically lower than those recorded at the nasopharynx and the temporal artery (P < 0.001). Bland-Altman plots showed a correlation of temperature measurements between the temporal artery and nasopharyngeal methods. The axillary method had a lower correlation with the temporal artery and the nasopharyngeal methods. Conclusions: The temporal artery thermometer is a substitute for the nasopharyngeal thermometer for core temperature measurement during anesthesia in children. (C) 2012 Elsevier Inc. All rights reserved.Öğe Comparison of the Analgesic Effect of Pericapsular Nerve Group Block and Lumbar Erector Spinae Plane Block in Elective Hip Surgery(Mdpi, 2024) Kucuk, Onur; Sag, Fatih; Eyrice, Ali; Karadayi, Selman; Alagoz, Ali; Colak, AlkinBackground and Objectives: The aim of this study was to compare the effectiveness of pericapsular nerve group (PENG) and lumbar erector spinae plane (L-ESP) blocks, both administered with a high volume (40 mL) of local anesthetic (LA), for multimodal postoperative analgesia in patients undergoing hip surgery. Materials and Methods: This was a prospective, double-blind, randomized study that included 75 adult patients who were divided into three equal groups: control, PENG, and L-ESP. The study compared pain intensity, morphine consumption, time to first morphine request, and postoperative satisfaction between the control group, which received standard multimodal analgesia, and the block groups, which received PENG or L-ESP block in addition to multimodal analgesia. The numerical rating scale (NRS) was used to measure pain intensity. Results: The results showed that the block groups had lower pain intensity scores and morphine consumption, a longer time to the first morphine request, and higher postoperative satisfaction compared to the control group. The median maximum NRS score during the first 12 h was four in the control group, two in the PENG group, and three in the L-ESP group. The control group (21.52 +/- 9.63 mg) consumed more morphine than the two block groups (PENG, 11.20 +/- 7.55 mg; L-ESP, 12.88 +/- 8.87 mg) and requested morphine 6.8 h earlier and 5 h earlier than the PENG and L-ESP groups, respectively. The control group (median 3) had the lowest Likert satisfaction scores, while the PENG group (median 4) had the lowest NRS scores (L-ESP, median 4). Conclusions: The application of PENG or L-ESP blocks with high-volume LA in patients undergoing hip surgery reduces the need for postoperative analgesia and improves the quality of multimodal analgesia.Öğe Continuous spinal anesthesia application in a patient with high cardiac risk(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2007) Colak, Alkin; Inal, Mehmet Turan; Arar, Cavidan; Oguzhan, Nihal; Pamukcu, ZaferRegional techniques are preferred to general anesthesia in lower-extremity surgery. Especially in elderly patients with high cardiac risk, the main objective is to supply sufficient anesthesia preserving hemodynamic stability. A 63-year-old female patient in whom emergency right leg amputation above the knee was planned, was treated for myocardial infarction without ST elevation 6 days ago. She had type 2 diabetes mellitus for 15 years, and hypertension for 10 years. She underwent a coronary bypass operation for two vessels and mitral annuloplasty two years ago and right leg amputation below the knee two months ago. An intrathecal cathater was placed at the right lateral position from L3-4 intervertebral space through the cathater by the needle technique. After cerebrospinal fluid flow was observed, we administered 2,5 mg 0.5% bupivacaine. Anesthesia was maintained by performing 2.5 mg of bupivacain every five minutes at a total dose of 7.5 mg until adequate sensory block was reached. The patient was given a supine positione after the sensory block reached T-10 level. The patient was hemodynamically stable during-the-operation and did not require additional drug from the catheter. The patient was sent to the ward after removing spinal cathater at the end of a one hour operation. In conclusion, especially in old patients with high cardiac risk, we think that continuous spinal anesthesia should be the method of choice for anesthesia in lower-extremity surgery.Öğe The Effect of Cerebral Oxygen Saturation Changes on Early Postoperative Neuropsychological Function in Patients Undergoing Cranial Surgery(Turkish Neurosurgical Soc, 2023) Hekimoglu Sahin, Sevtap; Copuroglu, Elif; Delen, Emre; Tutunculer, Banu; Sut, Necdet; Colak, Alkin; Sagiroglu, GonulAIM: To compare the incidence of postoperative neuropsychological dysfunction in patients managed with cerebral saturation monitoring versus traditional approaches.MATERIAL and METHODS: A hundred patients undergoing elective intracranial surgery were divided into two groups to receive intraoperative management via cerebral saturation monitoring (Group O) or the conventional approach (Group C). The postoperative neuropsychological function was evaluated by the antisaccadic eye movement test (ASEM) and the Mini-Mental State Examination (MMSE). These tests were performed preoperatively and postoperatively on the first, second, and fifth days. The time for the modified Aldrete score to reach 9 (MAS 9), adverse effects, and pain using a Visual Analog Scale (VAS) scores were recorded.RESULTS: Patient characteristics and surgery data were not statistically different. The MAS 9 of group O was significantly lower than that of group C (p<0.001). The MMSE at the postoperative 1, 2, and 5 days were significantly higher in Group O compared to Group C (p<0.001). ASEM was similar between groups. Group O was subdivided according to the type of surgery applied with diagnosis, and there were no statistically significant between-group differences in terms of areas under the curve for the cerebral regional oxygen saturation. There was no between-group difference regarding the mean arterial pressure at any time perioperatively. The heart rate at 80, 90, 100, and 110 min intraoperatively was significantly higher in group C than in Group O.CONCLUSION: Intraoperative cerebral oxygenation monitoring can reduce patient mortality and morbidity by allowing early postoperative neurological evaluation to detect potential neurocognitive deficits.Öğe The effect of hyperbaric oxygen treatment on aspiration pneumonia(Springer, 2011) Sahin, Sevtap Hekimoglu; Kanter, Mehmet; Ayvaz, Suleyman; Colak, Alkin; Aksu, Burhan; Guzel, Ahmet; Basaran, Umit NusretWe have studied whether hyperbaric oxygen (HBO) prevents different pulmonary aspiration materials-induced lung injury in rats. The experiments were designed in 60 Sprague-Dawley rats, ranging in weight from 250 to 300 g, randomly allotted into one of six groups (n = 10): saline control, Biosorb Energy Plus (BIO), hydrochloric acid (HCl), saline + HBO treated, BIO + HBO treated, and HCl + HBO treated. Saline, BIO, HCl were injected into the lungs in a volume of 2 ml/kg. A total of seven HBO sessions were performed at 2,4 atm 100% oxygen for 90 min at 6-h intervals. Seven days later, rats were sacrificed, and both lungs in all groups were examined biochemically and histopathologically. Our findings show that HBO inhibits the inflammatory response reducing significantly (P < 0.05) peribronchial inflammatory cell infiltration, alveolar septal infiltration, alveolar edema, alveolar exudate, alveolar histiocytes, interstitial fibrosis, granuloma, and necrosis formation in different pulmonary aspiration models. Pulmonar aspiration significantly increased the tissue HP content, malondialdehyde (MDA) levels and decreased (P < 0.05) the antioxidant enzyme (SOD, GSH-Px) activities. HBO treatment significantly (P < 0.05) decreased the elevated tissue HP content, and MDA levels and prevented inhibition of SOD, and GSH-Px (P < 0.05) enzymes in the tissues. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase, TUNEL and arise in the expression of surfactant protein D in lung tissue of different pulmonary aspiration models with HBO therapy. It was concluded that HBO treatment might be beneficial in lung injury, therefore, shows potential for clinical use.Öğe The effect of methylene blue treatment on aspiration pneumonia(Academic Press Inc Elsevier Science, 2015) Kanter, Mehmet; Sahin, Sevtap Hekimoglu; Basaran, Umit Nusret; Ayvaz, Suleyman; Aksu, Burhan; Erboga, Mustafa; Colak, AlkinBackground: The study aimed to examine whether methylene blue (MB) prevents different pulmonary aspiration materials-induced lung injury in rats. Methods: The experiments were designed in 60 Sprague-Dawley rats, ranging in weight from 250-300 g, randomly allotted into one of six groups (n = 10): saline control, Biosorb Energy Plus (BIO), hydrochloric acid (HCl), saline + MB treated, BIO + MB treated, and HCl + MB treated. Saline, BIO, and HCl were injected into the lungs in a volume of 2 mL/kg. After surgical procedure, MB was administered intraperitoneally for 7 days at a daily dose of 2 mg/kg per day. Seven days later, rats were killed, and both lungs in all groups were examined biochemically and histopathologically. Results: Our findings show that MB inhibits the inflammatory response reducing significantly (P < 0.05) peribronchial inflammatory cell infiltration, alveolar septal infiltration, alveolar edema, alveolar exudate, alveolar histiocytes, interstitial fibrosis, granuloma, and necrosis formation in different pulmonary aspiration models. Pulmonary aspiration significantly increased the tissue hydroxyproline content, malondialdehyde levels, and decreased (P < 0.05) the antioxidant enzyme (superoxide dismutase and glutathione peroxidase) activities. MB treatment significantly (P < 0.05) decreased the elevated tissue hydroxyproline content and malondialdehyde levels and prevented the inhibition of superoxide dismutase and glutathione peroxidase (P < 0.05) enzymes in the tissues. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase (iNOS), terminal deoxynucleotidyl transferase dUTP nick end labeling, and arise in the expression of surfactant protein D in lung tissue of different pulmonary aspiration models with MB therapy. Conclusions: MB treatment might be beneficial in lung injury and therefore shows potential for clinical use. (C) 2015 Elsevier Inc. All rights reserved.Öğe Effects of Bupivacaine Versus Levobupivacaine on Pulmonary Function in Patients With Chronic Obstructive Pulmonary Disease Undergoing Urologic Surgery: A Randomized, Double-Blind, Controlled Trial(Elsevier Science Inc, 2011) Sahin, Sevtap Hekimoglu; Inal, Mehmet; Alagol, Aysin; Colak, Alkin; Arar, Cavidan; Basmergen, Tughan; Gunday, IsilBACKGROUND: There are limited data to determine the impact of subarachnoid blockade with local anesthetics on perioperative pulmonary function. The effects of local anesthetics used in spinal anesthesia are very important in terms of respiratory function in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVE: The aim of this study was to evaluate the effects of bupivacaine versus levobupivacaine on pulmonary function in patients with COPD undergoing urologic surgery. METHODS: Patients were randomized into 2 groups: group B (n = 25) received 3 mL of hyperbaric 0.5% bupivacaine; group L (n = 25) received 3 mL of isobaric 0.5% levobupivacaine. Both agents were administered intrathecally. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow rate (PEER), vital capacity (VC), and FEV1/FVC ratio were measured using spirometry 10 and 30 minutes after spinal anesthesia and 30 minutes after completion of the operation. An arterial blood gas test was performed before and after spinal anesthesia. RESULTS: Fifty male patients aged 40 to 80 years completed the study. There were no differences in the results of preoperative and postoperative FVC, FEV1, PEFR, VC, FEV1/FVC ratio, and arterial blood gas between the bupivacaine (n = 25) and levobupivacaine (n = 25) groups. However, patients who took bupivacaine showed a significant decrease in intraoperative PEFR at 30 minutes compared with baseline, a result not seen in patients who took levobupivacaine (P = 0.036 and P = 0.282, respectively). CONCLUSIONS: In 50 patients with moderate COPD undergoing urologic surgery, hyperbaric bupivacaine caused a decrease in intraoperative PEFR compared with baseline because of higher level block; however, the effects of hyperbaric bupivacaine and isobaric levobupivacaine on pulmonary function in these patients showed equally effective potencies for spinal anesthesia. (Curr Ther Res Clin Exp. 2011; 72:164-172) (C) 2011 Elsevier HS Journals, Inc. All rights reserved.Öğe Fat embolism associated with anesthesia induction with propofol-lidocaine combination(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Sahin, Sevtap Hekimoglu; Memis, Dilek; Colak, AlkinFat embolism syndrome has been described following traumatic, surgical, and atraumatic conditions. Long-bone fractures are probably the most common cause of this syndrome. Fat embolic events are often clinically insignificant and difficult to recognize since clinical manifestations vary and there is no routine laboratory or radiographic means of diagnosis. Propofol is widely used for the induction and maintenance of anesthesia. Addition of lidocaine to propofol may result in a coalescence of oil droplets, forming a separate layer. The risk of propofol and lidocaine combination to cause fat embolism depends on the dose of lidocaine and the duration between its preparation and administration. We presented a patient who developed fat embolism following anesthesia induction during surgery for a lower extremity fracture due to a traffic accident. The occurrence of fat embolism was attributed to propofol-lidocaine use. The diagnosis of fat embolism was based on clinical manifestations, radiographic and laboratory findings, and elimination of other causes associated with arterial hypoxemia.Öğe A Fatal Complication of Acupuncture in a Patient with Romatoid Arthritis: Necrotizing Fasciitis(Galenos Yayincilik, 2011) Colak, Alkin; Memis, Dilek; Kandulu, Hseyin; Top, Husamettin; Kargi, MuratAcupuncture is used for some conditions as an alternative to medication or surgical intervention. Acupuncture is a relatively safe procedure but fatal and near fatal complications have been reported in the international literature. We report a case where fatal necrotizing fasciitis developed in a patient who had acupuncture treatment for romatoid arthritis of the knee.Öğe Investigation of the availability of tongue movements in Mallampati classification(Saudi Med J, 2011) Colak, Alkin; Yilmaz, Ali; Sut, Necdet; Memis, Dilek; Ulucam, Enis; Cigali, Bulent S.; Bozer, CuneytObjectives: To investigate the relation of Mallampati classification with a new alternative method suggested for use in the estimation of tongue movements. Method: This study was conducted in the Department of Anesthesiology, Faculty of Medicine, Trakya University, Edirne, Turkey from April to October 2009. Two hundred and thirty patients were enrolled in this study. The modified Mallampati score (MMS) was devised by an anesthetist. To define tongue movements, horizontal and vertical lines were utilized. Horizontal lines passing through the mid points of the upper lip and mandible, and vertical lines passing through the right and left infraorbitale points were constituted on each subject. Subjects were asked to elevate, depress, and abduct (right-left) the tip of the tongue. The scores corresponding with the movements of the tongue were determined. Results: Depression of the tip of the tongue (DTT) and elevation of the tip of the tongue (ETT) levels were significantly different between MMS 1, MMS 2, and MMS 3, MMS 4 groups (p=0.001). The risk of being MMS 3 or MMS 4 for the groups that cannot reach the borderline for the DTT or ETT are 5.5 times and 5.4 times higher consequently than the groups that can reach the borderline. Conclusion: This new method can be combined with MMS classification, which requires clinical experience and knowledge in predicting difficult intubation.Öğe Is music the food of the anesthesia in children?(Bmj Publishing Group, 2022) Sahin, Sevtap Hekimoglu; Duran, Ridvan; Basaran, Umit Nusret; Sut, Necdet; Colak, Alkin; Duran, SedefBackground The noise in an operating room may have a detrimental effect on human cognitive functions, and it may cause perioperative anxiety with prolonged exposure. The aim of this study was to investigate the effects of music therapy and use of earplugs and normal noise level in the operating room under general anesthesia of pediatric patients on hemodynamic parameters and postoperative emergence delirium. Methods One hundred and five pediatric patients were involved in this study. The patients were randomly divided into three groups. Group N was exposed to the ambient operating room noise, group S received earplugs from an independent anesthesiologist, and group M used a CD player. The preoperative anxiety levels of children were evaluated with the Modified Yale Preoperative Anxiety Scale (M-YPAS). Mean arterial pressure (MAP) and heart rate were recorded at 30-minute periods until the completion of surgery, end of surgery and postoperatively. During each measurement, noise level recordings were performed using sonometer. Pediatric Anesthesia Emergency Delirium (PAED) score was evaluated after postoperative extubation. Results M-YPAS was similar between groups. The MAP at 30 and 60 min intraoperatively, at end of surgery, and at 5, 10, and 15 min postoperatively was significantly lower in group S than in group N. There were no differences in heart rate among the groups. Postoperative PAED score was not significantly different among the groups. Conclusions The music therapy was not more effective than silence and operating noise room in reducing PAED score postoperatively in pediatric patients.Öğe Lateral Trendelenburg with the injected side down after the block improves the efficacy of the axillary approach to brachial plexus block(Springer Japan Kk, 2014) Sevdi, M. Salih; Gunday, Isil; Arar, Cavidan; Colak, Alkin; Turan, NesrinWe hypothesized that, after axillary block, positioning the patient in a lateral position with the injected side down and simultaneously in a 20A degrees Trendelenburg position will increase the success rate and quality of the block. Fifty patients with chronic renal failure (ASA 2-3) scheduled for arteriovenous fistula surgery were included in this study. In all patients, 30-40 ml of 0.25 % levobupivacaine were injected into the axillary sheath. The block was performed as three injections (multiple injection technique) with the arm in 90A degrees abduction and 90A degrees flexion in the supine position. Patients were randomly allocated to two groups. Group I (n = 25) patients were kept in the supine position after the block. Group II (n = 25) patients were positioned laterally after the block with the injected arm down and in a 20A degrees Trendelenburg position. Sensory and motor block were evaluated at 2, 4, 6, 8, 10, 15, 20, and 25 min after the administration of the block. Thus, the patients in group II were evaluated in a lateral position during the first 30 min. Throughout the surgery and the recovery period, sensory and motor block were evaluated at 30-min intervals. There were no significant intergroup differences in the effects on radial, ulnar, median, and musculoskeletal nerve blockade. Thirty minutes after the injection, the patients in group II had higher levels of sensory axillary nerve blockade. Subscapular and thoracodorsal nerve motor block were not detected in group I, while 84 % of the patients in group II experienced blockade of both of these nerves (p < 0.01). We conclude that, for patients undergoing an axillary block, positioning the patient laterally with the injected side down and in a 20A degrees Trendelenburg position increases the success rate and quality of the block.Öğe Modified 45-degree head-up tilt increases success rate of lumbar puncture in patients undergoing spinal anesthesia(Springer Japan Kk, 2014) Sahin, Sevtap Hekimoglu; Colak, Alkin; Arar, Cavidan; Yildirim, Ilker; Sut, Necdet; Turan, AlparslanLumbar puncture (LP) is one of the most common procedures performed in medicine. The aim of this prospective study is to determine the success rate of LP in lateral decubitus with 45-degree head-up tilt position, and compare it with traditional positions like sitting and lateral decubitus. Three hundred and thirty patients between 25 and 85 years of age who had undergone abdominal, urologic, and lower limb extremities surgeries were enrolled and 300 patients were divided into three different groups. The LP was performed with a 25-G atraumatic needle, either in the standard sitting position (group S, n = 100), lateral decubitus, knee-chest position (group L, n = 100) or lateral decubitus, knee-chest position with a 45-degree head-up tilt (group M, n = 100). The free flow of clear cerebrospinal fluid (CSF) upon first attempt was considered to be evidence of a successful LP. Total LP success rate was significantly higher in group M (85 %) than in groups S and L (70 and 65 %, respectively) (p = 0.004). When the significance between the groups was evaluated according to age, the increase in the LP success rate was not significant for a parts per thousand currency sign65 and > 65 age groups. There were no differences among the three groups in terms of bloody CSF (p = 0.229) and the number of attempts before dural puncture (p = 0.052). The lateral decubitus in knee-chest position with a 45-degree head-up tilt may be the preferred position for spinal anesthesia in young and elderly patients, due to the high success rate.Öğe Post-Operative Malignant Hyperthermia in a Child after Colon Interposition(Aves, 2015) Sahin, Sevtap Hekimoglu; Inan, Mustafa; Aksu, Burhan; Oner, Naci; Colak, Alkin; Guzel, AhmetMalignant hyperthermia (MH) is a rare and potentially life threatening fatal complication of anaesthesia. We present a 2-year-old boy with late onset MH after colon interposition to replace the oesophagus under sevoflurane anaesthesia. The patient was treated with intravenous dantrolene sodium as well as cooling and controlled ventilation. Despite treatment, the patient developed cardiopulmonary arrest at 21 hours after the operation and died. It should be kept in mind that post-operative MH may develop during these types of operations with ischaemia-reperfusion injuries.Öğe Preventive effects of hyperbaric oxygen treatment on glycerol-induced myoglobinuric acute renal failure in rats(Springer, 2012) Ayvaz, Suleyman; Aksu, Burhan; Kanter, Mehmet; Uzun, Hafize; Erboga, Mustafa; Colak, Alkin; Basaran, Umit NusretMyoglobinuric acute renal failure (ARF) is a uremic syndrome caused by traumatic or non-traumatic skeletal muscle breakdown and intracellular elements that are released into the bloodstream. We hypothesized that hyperbaric oxygen (HBO) therapy could be beneficial in the treatment of myoglobinuric ARF caused by rhabdomyolysis. A total of 32 rats were used in the study. The rats were divided into four groups: control, control+hyperbaric oxygen (control+HBO), ARF, and ARF+hyperbaric oxygen (ARF+HBO). Glycerol (8 ml/kg) was injected into the hind legs of each of the rats in ARF and ARF+HBO groups. 2.5 atmospheric absolute HBO was applied to the rats in the control+HBO and ARF+HBO groups for 90 min on two consecutive days. Plasma urea, creatinine, sodium, potassium, calcium, aspartate aminotransferase, alanine aminotransferase, lactic dehydrogenase, creatinine kinase and urine creatinine and sodium were examined. Creatinine clearance and fractional sodium excretion could then be calculated. Superoxide dismutase, catalase, glutathione and malondialdehyde (MDA) levels were assessed in renal tissue. Tissue samples were evaluated by Hematoxylin-eosin, PCNA and TUNEL staining histopathologically. MDA levels were found to be significantly decreased whereas SOD and CAT were twofold higher in the ARF+HBO group compared to the ARF group. Renal function tests were ameliorated by HBO therapy. Semiquantitative evaluation of histopathological findings indicated that necrosis and cast formation was decreased by HBO therapy and TUNEL staining showed that apoptosis was inhibited. PCNA staining showed that HBO therapy did not increase regeneration. Ultimately, we conclude that, in accordance with our hypothesis, HBO could be beneficial in the treatment of myoglobinuric ARF.Öğe Pulmonary Embolism During Hepatoblastoma Resection(Aves, 2020) Colak, Alkin; Basaran, Umit Nusret; Copuroglu, Elif; Sag, Fatih; Cakici, Zafer; Kiray, GuvenAlthough hepatoblastoma is rare, it is the most malignant tumour of childhood. Treatment is usually done by surgical resection and chemotherapy. The mortality and morbidity have decreased due to improvements in the treatments. In this process, hepatic resection has a risk of pulmonary embolism, and this condition could be fatal. In this case, a 9-month-old patient who was treated with chemotherapy and then underwent hepatectomy was presented. We used non-invasive methods such as the perfusion index (PI), the plethysmographic variability index (PVI) (Massimo Radical 7) and non-invasive total haemoglobin measurement (SpHb) rather than invasive measurements. During closure of the surgical skin incision, the end-tidal CO2 (ETCO2) value dropped, after which arrhythmia and bradycardia resulted in cardiac arrest. Cardiopulmonary resuscitation (CPR) was initiated. However, the patient did not respond to CPR. We concluded that heparin may be administered to reduce the risk of thrombosis in patients undergoing liver surgery.
