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Öğe Anesthesia management of a patient having hyperparathyroidism and mandibular fracture(Anestezi Dergisi, 2017) Çopuro?lu E.; Sa?iro?lu G.; Sezer A.; Çolak A.; Günday I.Hyperparathyroidism is a disease involving multiple systems, mainly as diabetes, hypertension and chronic renal failure. Surgical removal of the parathyroid tissue is the gold standard in the treatment of hyperparathyroidism. Preparation for the anesthesia and maintenance of the aiiway in these patients is vital. The increased risk of osteoporosis-related fracture lead to a variety of difficulties preoperative!)'. In this study we aim to present the anesthesia management of a patient having hyperparathyroidism and mandibular fracture.Öğe Case report (Olgu Sunumu): Total intravenous anesthesia management of a patient with Stevens - Johnson syndrome(2009) Şahin S.H.; Sevdi S.; Günday I.Stevens-Johnson syndrome is a disorder of the skin and mucous membranes with severe bullous forms manifesting systemic toxic effects. Various etiologies particularly numerous medications and infectious agents have been implicated. Anaesthetic management of this syndrome must be accomplished with a minimal applicable dose of the anaesthetic agent, in addition any traumatic process must be avoided, other drugs must be carefully given, and the patient must be observed carefully. The patient was diagnosed as Stevens-Johnson syndrome three months ago following drug administration for the treatment of upper respiratory tract infection. In this case report, we aimed to present anaesthetic management of a 32 year-old woman with Stevens Johnson Syndrome who underwent cervical conisation under general anesthesia because of cervical cancer.Öğe Cisatracurium given by intermittent bolus or infusion methods for muscle relaxation in ICU(2001) Memiş D.; Öztürk N.; Karamanlio?lu B.; Turan A.; Turan N.; Günday I.We aimed to compare in our study, cisatracurium continuous infusion or intermittent IV bolus in 28 patients who needed musculer relaxation for at least 10 h in ICU, the patients were randomly divided into two equal groups and monitored by TOF. In group I; IV bolus cisatracurium 0.2 mg/kg was given. After the T95 (beginning time for effect) achieved, time for the next incremental muscle relaxant was noted. Recovery time after last given dosege was noted, time achieved to T70 (recovery index), and amount of muscle relaxant administered for the study was noted. In group II; After the T95 achieved (beginning time for effect) 2 ?g/kg/min cisatracurium infusion was started. At the end of the procedure, recovery time after the end of cisatracurium infusion, time achieved to T70 (recovery index) and amount of muscle relaxant applied for the study was noted. The study time was 15±3.8 and 18.3±4.8 in group I and II respectively (p>0.05). In Group I through study time cisatracurium dose 4.42±1.6 ?g/kg, in Group II was applied as 3.07±0.9 ?g/kg/min IV (p<0.01). Recovery times were 87.64±11.5 minutes in Group I, and 38.38±5.4 minutes in Group II (p<0.01).Öğe Comparison of sufentanil and remifentanil during monitored anesthesia care(2003) Turan A.; Erk Köse H.; Karamanlio?lu B.; Süt N.; Günday I.In our study we aimed to compare remifentanil and sufentanil in monitored anesthesia care of septoplasty operations for consumption of propofol, analgesia, sedation and side effects. 50 patients scheduled for septoplasty operations were randomily divided into two groups of 25 patients in each received standardised premedication. Induction of sedation was done by 0.8 mg kg-1 propofol. Continoued by 2 mg kg-1 hr-1 and adjusted according to sedation scale. In Group 0.05 ?g kg-1 dk-1 remifentanil, in group II 0.25 ?g kg-1 hr-1 sufentanil infusion was started and adjusted according to scores of visuel rating scale. Intraoperative mean blood pressure, heart rate, SpO2 and visuel rating scale were evaluated and recorded at 5., 10., 20., 30., 40., and 50. mins. At the end of surgery study drugs were ended and total propofol, remifentanil, sufentanil consumptions were recorded. Alderete scores were evaluated 3 times at 15. min. interval after the termination of study drug. Intraoperative surgeon evaluation was done by 4 point scale. Postoperative 1., 2., 4., 6., 12. and 24. hrs mean blood pressure, heart rate, SpO2 and pain was evaluated by visual analog scale (VAS). When VAS scores were 4 or above 75 mg intramuscular diclophenac was given, first analgesic requirement time and total diclophenac consumptions were recorded. Total propofol consumptions were significantly high in group I when compared with group II (p<0.05). Aldrete scores in 15. min was lower in group II (p<0.05). Postoperative VAS values at 2. and 4. hrs were found to be higher in group I (p<0.05). First analgesic requirement time was significantly prolonged in group II (p<0.05), while there was on significant diffference in total diclophenac consumption. Respiratory depression and headache was encountered more in group I and difference was significant (p<0.05). Sufentanil infusion can be an alternative to remifentanil infusion in monitored anesthesia care.Öğe The effect of normal and low hematocrit levels on cognitive functions during cardiopulmonary bypass(2008) Çolak A.; Arar C.; Turan E.; Söker A.; Kargi M.; Günday I.; Turan N.The frequency of postoperative cognitive disfunction (PCD) is 60-80 % in the early postoperative period. The frequency of PCD after coronary artery bypass grefting (CABG) surgery can change associated with a lot of factors such as using or not using cardiopulmonary bypass pump, cerebral embolism, systemic inflamation, the body temparature and cerebral hemodynami. The aim of our study is to examine the effects of low hematocrit levels (< 20 %) on mini mental state test (MMST) during cardiopulmonary bypass. Patients between the age of 50-77 years, in the ASA I-II group who would undergo CABG surgery were included to the study. They didn't have any neurological and neuropsychiatrical problems and were not using any psychotic agents. The MMST was performed to the patients who would undergo CABG surgery, on the day before the operation and on the postopertive sixth day. After the induction of anesthesia 1-2 units whole blood was collected from the patients. The MMST values of the subjects who had the hematocrit levels of 15-19 % (Group I, n=100) and the hematocrit levels of 20-25 % (Group II, n=100) during the cardiopulmonary bypass were compared. Demografic features, durations of the operation, x-clamp and intubation, the length of intensive care unit stays and the hematocrit levels at the time of MMST were similar in all subjects. On the postoperative sixth day, there was no statistical difference in the MMST values of the subjects who had low hematocrit levels during cardiopulmonary bypass. In conclusion, we think that the low hematocrit levels during cardiopulmonary bypass have no egative effects on MMST however using different tests may change the outcome.Öğe The effects of albumin levels on recovery characteristics and duration of hospitalisation in geriatric emergency patients(2005) Arar C.; Alagöl A.; Kaya G.; Günday I.; Turan N.Aim: Some studies suggest that, preoperative albumin levels are associated with delayed postoperative recovery and increased morbidity and mortality in patients undergoing elective surgery. Advance age also appears to be associated with postoperative outcomes. Materials and Methods: In this retrospective study, we assessed the effects of albumin concentrations on recovery, length of hospitalization and patient's status at discharge time, in 40 geriatric patients who underwent emergent abdominal surgery under general anaesthesia. Patients were divided into two groups based on preoperative albumin concentrations Group I albumin >3.5 g dL-1; (n=20) or Group II albumin <3.5 g dL-1, (n=20). Only those patients who received similar anaesthetic plans were enrolled studied, Recovery criteria (time to: spontaneous eye opening, extubation. response to verbal stimuli, orientation) complications, length of hospitalization and patient's status at discharge time were determined. Results: There were no preoperative differences between groups (p>0 05). Hypoalbuminemic patients were more likely to have delayed wound healing and more likely die. Conclusion: We conclude that hypoalbuminemia may be marker of morbiditiy and mortality in elderly patients undergoing emergent abdominal surgery.Öğe Retrospective analysis of therapeutic bronchoscopic interventions under total intravenous anesthesia(2010) Hekimoglu Sahin S.; Çolak A.; Karlikaya C.; Arar C.; Günday I.; SüT N.; Karakoca Y.Endobronchial obstruction is an important reason of morbidity and mortality in lung cancer patients. Therapeutic bronchoscopic interventions provide significant improvement in quality of life and possible survival benefit. In this study, we aimed to present our experiences related with general anesthesia for therapeutic bronchoscopic intervention. The study included 10 patients who underwent total intravenous anesthesia (TIVA) for therapeutic bronchoscope interventions on cases with bronchogenic carcinoma between 2007 and 2008. Remifentanil and propofol were, used for anesthetic induction and then maintenance of anesthesia with TIVA was decided in consideration of the data recorded and manual ventilation was applied with the aid of the rotating side-arm of the rigid bronchoscope (RB) following the instillation of lhe RB without any muscle relaxant. Mean arterial blood pressure (MAP), heart rate, peripheral oxygen saturation (SpO2), arterial blood gas and pulmonary function test were retrospectively evaluated The values of MAP in the induction period were significantly lower from the preoperative values. The values of SpO2, were re significantly higher in the induction period than the preoperative period (p <0.05). Since spontaneous assisted ventilation can be applied more safely with facilitated control of anesthetic depth, it is thought that using TIVA with remifentanil and propofol could be a preferred therapeutic method for bronchoscope interventions.Öğe Tracheal resection after tracheal stenosis: Case report(2008) Inal M.T.; Hekimo?lu Şahin S.; Kaya G.; Günday I.After endotracheal intubation or tracheostomy, airway damage may be occurred and serious respiratory distress may be seen in the patient. In this case report, we discussed the anesthetic care during tracheal resection in a patient with severe respiratory distress after tracheostomy. © Medical Journal of Trakya University. Published by Ekin Medical Publishing. All rights reserved.
