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    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]
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    Comparison of different tests to determine difficult intubation in pediatric patients
    (Elsevier Science Inc, 2014) Inal, Mehmet Turan; Memis, Dilek; Sahin, Sevtap Hekimoglu; Gunday, Isil
    Background: The difficulties with airway management is the main reason for pediatric anesthesia-related morbidity and mortality. Objective: To assess the value of modified Mallampati test, Upper-Lip-Bite test, thyromental distance and the ratio of height to thyromental distance to predict difficult intubation in pediatric patients. Design: Prospective analysis. Measurements and results: Data were collected from 5 to 11 years old 250 pediatric patients requiring tracheal intubation. The Cormack and Lehane classification was used to evaluate difficult laryngoscopy. Sensitivity, specificity, positive predictive value and AUC values for each test were measured. Results: The sensitivity and specificity of modified Mallampati test were 76.92% and 95.54%, while those for ULBT were 69.23% and 97.32%. The optimal cutoff point for the ratio of height to thyromental distance and thyromental distance for predicting difficult laryngoscopy was 23.5 (sensitivity, 57.69%; specificity, 86.61%) and 5.5 cm (sensitivity, 61.54%; specificity, 99.11%). The modified Mallampati was the most sensitive of the tests. The ratio of height to thyromental distance was the least sensitive test. Conclusion: These results suggested that the modified Mallampati and Upper-Lip-Bite tests may be useful in pediatric patients for predicting difficult intubation. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.
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    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, Isil
    BACKGROUND: 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.
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    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, Nesrin
    We 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.
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    Tracheal resection after tracheal stenosis
    (Aves Yayincilik, Ibrahim Kara, 2008) Inal, Mehmet Turan; Sahin, Sevtap Hekimoglu; Kaya, Gaye; Gunday, Isil
    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.
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    Using temporomandibular joint mobility to predict difficult tracheal intubation
    (Springer Tokyo, 2011) Sahin, Sevtap Hekimoglu; Yilmaz, Ali; Gunday, Isil; Kargi, Murat; Sut, Necdet; Taskinalp, Oguz; Ulucam, Enis
    The aim of this prospective study was to determine the reliability of temporomandibular joint (TMJ) mobility measurements for predicting difficult intubation. To evaluate the accuracy in predicting difficult intubation by TMJ mobility measurement, 762 patients requiring general anesthesia with tracheal intubation for elective surgery were enrolled in this prospective, observational, single-blind study. Maximum mouth opening, right-left jaw excursion, and degrees of protraction were determined with a digital inclinometer. Incisor gap was measured using a vernier caliper during full mouth opening. After induction of anesthesia using a standard protocol, the patient's grade of laryngeal view by Cormack-Lehane classification was documented by an anesthesiologist. We found that the degrees of protraction and incisor gap in the easy intubation group were significantly higher than those in the difficult intubation group. The incisor gap was found to be more sensitive (88.37%) and more specific (95.71%) than protraction degrees (58.14% and 59.76%, respectively). The results revealed that measurements of the incisor gap and degrees of protraction may be useful routine screening tests for preoperative prediction of difficult intubation.