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Öğe Comparison of dexmedetomidine and lidocaine in the prevention of rocuronium injection pain(2004) Kaya G.; Memiş D.; Turan A.; Karamanlio?lu B.; Şeker Ş.; Pamukçu Z.In our study, we aimed to compare the efficacy of dexmedetomidine which is an ?-adrenergic receptor agonist and an analgesic,in the prevention of rocuronium injection pain with lidocaine. Following the ethical committee approval and written informed consent, 90 patients (ASA I-II) were randomly divided into three groups. All groups received standard premedication. The patients were monitored and then a tourniquet was applied on the medication-receiving arm and inflated up to 70 mmHg. Group S (n=30) received 1 mL saline, Group L (n=30) received 20 mg lidocaine and Group D (n=30) received, 0.25 mgkg-1 dexmedetomidine intravenously. The tournique was deflated after 20 seconds. Following deflation 1/8 of the total rocuronium dose of 0.9 mg kg-1 was injected and the patients were asked immediately if they had any pain with injection and pain scores were recorded. Then anaesthesia induction was performed and the remaining dose of rocuronim was intevenously injected. Anaesthesia was continued with sevoflurane 1-2 % in 50 % N 2O/O2 mixture. Group L pain scores were lower than Groups S and D with statistical significance (p<0.05, p<0.01, p<0.001). No statistically significant difference was determined between Group D and Group S (p<0.05), although the scores were lower in Group D. In conclusion, it was revealed that lidocaine is effective in preventing pain with rocuronium injection, whereas dexmedetomidine had no significant effect.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 Effects of dexmedetomidine infusion on hemodynamic responses in craniotomies(2006) Alagöl A.; Kaya G.; Çolak A.; Karaçayir Y.; Pamukçu Z.; Turan F.N.Aim: The effectiveness of dexmedetomidine infusion on preventing hemodynamic response to intubation, skull pins and surgical incision in craniotomies was evaluated. Materials and Methods: Fourty ASA I-II patients undergoing craniotomy because of supratentorial tumors were randomised into: study group (n=20) received 1 ?g kg h-1 dexmedetomidine, and control group (n=20) received 0.9% NaCl infusion, 5 min. prior to induction. After intubation was performed at 10th minute, infusion rates were reduced to 50% in both groups. Control group received 1 ?g kg-1 fentanyl; dexmedetomidine group received 0.9% NaCl intravenously before skull pins. Same drugs were administered to the both groups for premedication, induction and maintenance. Results: Heart rate, systolic and diastolic arterial pressures reduced at 5th minute of infusion compared to initial values in dexmedetomidine group (p<0.001). Systolic and diastolic arterial pressures reduced after induction in both groups (p<0.001). In control group, the three haemodynamic parameters were higher after intubation compared to before intubation (p<0.001); were higher at 1 (p<0.001) and 5 minutes (p<0.05) after skull pins compared to before intubation; heart rate, systolic and diastolic (p<0.05) arterial pressures were higher after surgical incision compared to before intubation (p<0.001). In dexmedetomidine group, intubation and surgical incision did not cause significant haemodynamic response; systolic (p<0.001) and diastolic (p<0.05) arterial pressures were lower at 5 th minute than 1st minute of skull pins. Six patients in control and no patients in dexmedetomidine group needed fentanyl after surgical incision (p<0.001). Conclusion: Dexmedetomidine infusion started before induction is effective for preventing haemodynamic responses to intubation, skull pins and surgical incision in craniotomies.Öğe Emla Cream Application for Epidural Puncture(2004) Kaya G.; Turan A.; Memiş D.; Karamanlio?lu B.; Pamukçu Z.; Turan N.Emla cream is frequently used for topical anaesthesia for injections, catheterisation, minor surgery and spinal puncture. We aimed to evaluate the efficacy of cutectic mixture of local anaesthetics on pain scores, patients satisfaction and compare it with lignocaine infiltration for insertion of 16 G Toughy needles. After Ethics Commitee approval and written informed consent, 60 ASA I-II patients undergoing for elective lower extremity and lower abdominal surgery were included to the study. The patients were randomly allocated to two groups: Group I received placebo cream and intradermal-subdermal 2 mL lidocaine % 2 infiltration, Group II received EMLA cream. One hour prior to the insertion of epidural catheter; plasebo cream in Group I and EMLA cream in Group II were applied to L2-3 and L3-4 levels. During the insertion of the epidurale catheter, 10 cm visual analog pain scales and after the insertion of the catheter, anaesthesia quality, and patient satisfaction were determined. Groups were comparable for age, weight and gender parity. There were no significant difference in pain scores during epidural needle insertion, anaesthesia quality and patient satisfaction between Group I and II (p>0.05). The time required for plasement of the catheter was significantly longer in group I (p<0.05). We conclude that application of EMLA cream is a simple and effective method to provide adequate analgesia for epidural needle insertion and can be an alternative method to lidocaine infiltration.Öğe Horner's syndrome following uncomplicated internal jugular vein catheterization: A case report(2008) Hekimo?lu Şahin S.; Kaya G.; Koyuncu O.; Pamukçu Z.Percutaneous cannulation of the internal jugular vein is widely used for central venous cannulations. Horner's syndrome may develop as a rare complication of internal jugular vein cannulation. We presented a 47-year-old female patient who developed Horner's syndrome one day after uncomplicated internal jugular venous cannulation, which was accompanied by miosis, ptosis, and anisocoria. The symptoms improved within a week. ©Medical Journal of Trakya University. Published by Ekin Medical Publishing. All rights reserved.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.Öğe The use of carbohydrate drink before general anesthesia(2008) Alagöl A.; Kaya G.; Akalin E.; Turan N.; Pamukçu Z.Limiting of oral intake for 8h preoperatively for minimalizing the aspiration risk can cause hunger, dry mouth and. Carbohydrete drink is suggeted drink twice: in the night before and in the morning before the operation to eliminate feeling hungery. In this placebo-controlled study, we investigated the efficacy of carbohydrete drink taking once (immediately before the operation) and compared with taking twice. After measuring body weight and triceps, and fasting since 24.oo pm, 45 (15 in each) ASA I-II patients undergoing abdominal surgery were administered 5 mg of methylene blue before, anesthesia. Groups I and II received 400 mL carbohydrate drink 2 hours before the operation; Group II received 800 mL the night before as well. Group III was control. Premedication, induction and maintenance were same in three groups. Feeling thirsty, dry mouth and taste were asked before/after carbohydrate drink. Gastric volume and pH was measured once, haemodynamics recorded 10 min interval, intraoperatively. Colour of cuff was recorded after extubation. Levels of blood glucose, insuline and albumine; minimental test, anxiety and depression scores were evaluated before/after carbohydrate drink and 12h after extubation. Body mass index and triceps were measured aat postoperative 12th h. In Group I and II, frequent of thirsty, unpleased taste and dry mouth and, anxiety scores were lower (p<0.05); blood glucose levels before induction; systolic and diastolic arterial pressures after induction were higher than Group III (p<0.05). The results suggest that, carbohydrate drink provided good conditions, regarding to hunger and thirst, blood glucose, anxiety and haemodynamics when administered in the morning of operation, aand could be an alternative to administration at the night before plus at the operative morning.
