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    Cardiac and Liver Marker Alterations After Laparoscopic Gynaecologic Operations
    (Aves, 2015) Sinikoglu, Nadir Sitki; Gumus, Funda; Sanli, Nalan; Totoz, Tolga; Alagol, Aysin; Turan, Nesrin
    Objective: In our study, we aimed to investigate the effect of laparoscopic procedures in which the abdominal cavity at a Trendelenburg position of 15 degrees was insufflated with CO 2 on cardiac and liver markers. Methods: Forty patients scheduled for laparoscopic gynaecological surgery were included in the study. Venous blood samples were taken the day before operation and 6 hours after surgery, and later, lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase-MB (CK-MB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), myoglobin (MY) and d-dimer (d-D) were measured. Results: There was no statistically significant difference in the values of preoperative and postoperative ALT (16.8 +/- 9.4 and 17.8 +/- 9.3; p= 0.579), AST (19.4 +/- 7 and 20.9 +/- 7.6; p=0.361) and ALP (65.2 +/- 16.2 and 63.3 +/- 16.9; p=0.609), but LDH (385.1 +/- 117.3 and 460.6 +/- 156.3; p=0.003), CK (113.8 +/- 138.5 and 247.9 +/- 283.5; p=0.0001), CK-MB (22.8 +/- 13.3 and 28.7 +/- 16; p= 0.011), MY (28.1 +/- 12.9 and 138.8 +/- 129; p=0.0001) and d-D (509.5 +/- 815: 1026 +/- 1054; p=0.0001) increased significantly. Conclusion: After laparoscopic operations in the Trendelenburg position, postoperative serum ALT, AST and ALP levels, remained unchanged, when compared to preoperative values, but LDH, CK, CK-MB, myoglobin and d-dimer values increased significantly.
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    Reinsertion of the Stylet does not affect Incidence of Post Dural Puncture Headaches (PDPH) after Spinal Anesthesia
    (Elsevier Science Inc, 2013) Sinikoglu, Nadir S.; Yeter, Hacer; Gumus, Funda; Belli, Enver; Alagol, Aysin; Turan, Nesrin
    Background and objectives: This study was conducted to investigate the effects of reinsertion of the stylet after a spinal anesthesia procedure on the Post Dural Puncture Headache (PDPH). Methods: We have enrolled into this study 630 patients who were undergoing elective operations with spinal anesthesia and randomized them to Group A (stylet replacement before needle removal) and Group B (needle removal without stylet replacement). These patients were observed for the duration of 24 hours in the hospital and they were checked for PDPH on the 3rd and the 7th day of the study. Results: Overall, the PDPH incidence was at 10.8% (68 patients). Thirty-three of these patients (10.5%) who were in Group A (stylet replacement before needle removal) and the other 35 patients (11.1%) who were in Group B (needle removal without stylet replacement) experienced PDPH. There was no significant difference between the two groups with respect to the PDPH. Conclusions: In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.