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Öğe Adding Dexmedetomidine to Lidocaine for Intravenous Regional Anesthesia(2004) Memiş D.; Turan A.; Karamanlio?lu B.; Pamukçu Z.; Kurt I.Dexmedetomidine is approximately 8 times more selective toward the ?-2-adrenoceptors than clonidine. It decreases anesthetic requirements by up to 90% and induces analgesia in patients. We designed this study to evaluate the effect of dexmedetomidine when added to lidocaine in IV regional anesthesia (IVRA). We investigated onset and duration of sensory and motor blocks, the quality of the anesthesia, intraoperative-postoperative hemodynamic variables, and intraoperative-postoperative pain and sedation. Thirty patients undergoing hand surgery were randomly assigned to 2 groups to receive IVRA. They received 40 mL of 0.5% lidocaine and either 1 mL of isotonic saline (group L, n = 15) or 0.5 ?g/kg dexmedetomidine (group LD, n = 15). Sensory and motor block onset and recovery times and anesthesia quality were noted. Before and after the tourniquet application at 5, 10, 15, 20, and 40 min, hemodynamic variables, tourniquet pain and sedation, and analgesic use were recorded. After the tourniquet deflation, at 30 min, and 2, 4, 6, 12, and 24 h, hemodynamic variables, pain and sedation values, time to first analgesic requirement, analgesic use, and side effects were noted. Shortened sensory and motor block onset times, prolonged sensory and motor block recovery times, prolonged tolerance for the tourniquet, and improved quality of anesthesia were found in group LD. Visual analog scale scores were significantly less in group LD in the intraoperative period and 30 min, and 2, 4, and 6 h after tourniquet release. Intra-postoperative analgesic requirements were significantly less in group LD. Time to first analgesic requirements was significantly longer in group LD in the postoperative period. We conclude that the addition of 0.5 ?g/kg dexmedetomidine to lidocaine for IVRA improves quality of anesthesia and perioperative analgesia without causing side effects.Öğe Alternative application site of transdermal nitroglycerin and the reduction of pain on propofol injection [6](2003) Turan A.; Karamanlio?lu B.; Memiş D.; Pamukçu Z.[No abstract available]Öğe Alternative Approach to Airway Control of Short Surgical Procedures; (PAXpress) Pharyngeal Airway(2003) Turan A.; Memiş D.; Karamanlio?lu B.; Pamukçu Z.We aimed to compare PAXpress pharyngeal airway, which is presented to use as an alternative to laringeal mask and cuffed oropharyngeal airway, in short surgical procedures for haemodynamic response, oxygenation, placement easiness and side effects. Our study was done on 60 ASA I-II status, aged between 18-65 patients sheuduled for elective short surgical procedures. Following standard premedication patients were monitored for mean arterial pressure, heart rate and peripheric oxygen saturation. All patients were ventilated by mask following standard anesthesia induction and end-tidal CO2 pressures were monitored, inspiratory and expiratory anaesthetic concentration were observed. Patients were randomily divided into three groups, to Group I (n=20) Pharyngeal, Group II (n=20) Laryngeal mask, Group III (n=20) cuffed oropharyngeal airway was applied, number of trial and time were recorded. Anesthesia was maintained by % 50 O2/N2O and % 2 sevoflurane, muscle relaxation was fasciliated by mivacurium. Mean arterial blood pressure, heart rate, peripheric oxygen saturation and end-tidal CO 2 pressure measurements in all the groups were recorded at begining, 1., 2., 4. minutes after device placement and immediately after removal. Intraoperative complications, additional manoeuvres made for ventilation, desaturation (SpO2 <% 95) and number of arithmia's were recorded. In postoperative period blood contamination on removed airway, nausea and vomiting, coughing and throat pain were recorded in 1. hours and late period at 24. hours. There was no difference between groups, when compared for airway placement time, haemodynamic parameter values at all the measurement times, number of desaturation, end-tidale CO2 pressure values and intraoperative side effects. Intraoperative additional manoeuvre need in Group III. (% 30) was significantly high (p<0.05) when compared with Group I. (% 5) and Group II. (% 5), there was no difference between Groups I and II. When blood contamination on applied airway devices were compared; was significantly lower in Group II. (% 5) when compared with Group I (% 35) and III (% 20), difference between Groups I and III was insignificant. There was no difference between three groups according to other postoperative complications. As a result, all three devices are safe and sufficient in airway management of short surgical procedures. Pharyngeal airway can be an alternative to laryngeal mask and cuffed oropharyngeal airway in short surgical procedures.Öğe Anaphylactic reaction to lansoprazole(2007) Memiş D.; Hekimo?lu S.; Karaçayir Y.; Vatan I.; Yandim T.Lansoprazole is a substituted benzimidazole that has gained widespread use in the treatment of acidic and peptic ulcer disease. Adverse events with the drug are rare and involve mainly the gastrointestinal and central nervous systems. Skin inflammation, urticaria, pruritus, alopecia, and dry skin have been reported in 0.5-1.5 % of patients. We report a case of a 56-year-old man with peptic ulcers who developed periorbital edema, edema of the skin, generalized pruritis and urticaria, a swollen tonque, increase sweating and loss of conciousness. These findings suggest that the chemically related lansoprazole can, as a group, cause anaphylactic reactions; however, the rate is comparatively low. Since anaphylaxis is a potentially serious reaction, more precise information is needed regarding its frequency, and healthcare professionals need to be aware of this possibility when prescribing these agents.Öğe Anaphylactic reaction with cisatracurium (case report)(2002) Turan A.; Memiş D.; Pamukoçu Z.Anaphylactic reaction associated with cisatracurium is seen rarely. These incident challenge existing views of a substantially reduced anaphylactoid potential of cisatracurium relative to other muscle relaxants. We aimed to present anaphylactic reaction due to cisatracurium with help of literature knowledge. A 36 years-old man with mandibula fracture scheduled for mandibula reconstruction with no history of allergy was taken to the operation room. After anaesthesia induction with 2 mg/kg propofol and 0.1 mg/kg iv cisatracurium patient developed anaphylactic reaction and was resuscitated successfully. After treatment in intensive care unit patient was operated successfulby under local anaesthesia.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 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 Comparison of patient controlled sedation versus continuous infusion of propofol for sedation during spinal and epidural anaesthesia(2000) Güreler C.; Memiş D.; Pamukçu Z.In our study we aimed to compare continuous infusion and patient controlled sedation (PCS) as an adjunct to spinal and epidural anaesthesia. Totally 50 patients in ASA I-II groups; aged between 19-76 years were divided in two groups; Group I (n=25) with continuous infusion and patients who applied PCS were Group II (n=25). 15 patients were performed epidural block and 35 patients spinal block. Group I received 3 mg/kg/hour propofol; group II received bolus doses of propofol 0.5 mg/kg and lock out time 5 minute with PCS. We measured mean arterial pressure (MAP), heart rate (HR), peripheric oxygen saturation (SpO2) and sedation levels; anxiety scores before sedation, on the 15th minute of sedation, at the and of operation and on the 15th and 30th minute after operation. In our results, when sedation started there were statistically significant decreases in MAP and HR on both groups. When we compared hemodynamic parameters before sedation at the end of operation and at the post-operative period, there was no significant difference. During sedation there were statistically significant decreases in SpO2 values only in Group I. Peroperatif sedation levels of Group I were greater than Group II. At the end of operation the sedation levels of Group I were significantly high. Mean duration of the procedures were similar in Group I and Group II. Total doses of propofol was significantly higher in Group I when compared with Group II. Recovery times were significantly shorter in Group II than Group I. Preoperative anxiety scores of both groups were high. At the end of operation and on the 30th minute postoperative anxiety scores of both groups were low. There were no difference between Group I and Group II. In Group I we observed hypotension at one patient, bradycardia at 3 patients and desaturation at 8 patients. As a result; POCS provided sufficient sedation and hemodynamic parameters were more stable. Lesser drug usage, rapid recovery and patients preference were other advantages.Öğe Comparison of TruView EVO2 laryngoscope with Macintosh laryngoscope on patients undergoing caesarean section(Nobelmedicus, 2016) İnal M.T.; Memiş D.; Yandım T.; Ersöz Ş.Objective: A significant part of developing complications from anaesthesia during caesarean section is related to airway management. The goal of this study was to determine the efficiency of the TruView EVO2 laryngoscope compared with the Macintosh laryngoscope on patients undergoing caesarean section. Material and Method: One hundred patients requiring endotracheal intubation for caesarean delivery were divided into two groups: Group T, using the TruView EVO2 laryngoscope (n=50), and Group M, using the Macintosh laryngoscope (n=50). The view of the glottis evaluating Cormack-Lehane classification, the intubation time, the success rate, the number of intubation attempts, the blood on blade, minor laceration, dental/airway trauma, and the lowest peripheral oxygen saturation during intubation attempts were noted. Results: The view with the TruView EVO2 laryngoscope was better than the view with the Macintosh laryngoscope, using the Cormack-Lehane classification (p<0.05) for evaluation. The intubation time was 6.0±1.9 sec in group M and 13.8±3.3 sec in group T (p<0.001). The success rate was 100% in all groups. The number of intubation attempts was 46/2/2 in group T and 45/3/2 in group M (p>0.05). Blood on blade was detected in five patients in group T and in four patients in group M. Minor laceration was detected in four patients in group T and in three patients in group M. No statistically difference was detected in the incidence of complications. The lowest peripheral oxygen saturation during intubation attempts was 99.14±0.67 in group T and 99.00±0.72 in group M (p>0.05). Conclusion: The TruView EVO2 laryngoscope provides better laryngeal views and similar peripheral oxygen saturations and complication rates when compared with the Macintosh laryngoscope; thus, it can be used for intubation in obstetric patients. © 2016, Nobelmedicus. All rights reserved.Öğe Dexmedetomidine reduces rocuronium dose requirement in sevoflurane anaesthesia(2008) Memiş D.; Turan A.; Karamanlio?lu B.; Şeker S.; Pamukçu Z.Background: We evaluated the effect of dexmedetomidine infusion on rocuronium dose requirement, haemodynamic parameters, and the recovery of neuromuscular blockade during sevoflurane anaesthesia in patients. Material: This randomized study was conducted on 40 ASA I-II patients. Neuromuscular block was measured by stimulation of the ulnar nerve and acceleromyograph of adductor pollicis muscle. After tracheal intubation; patients received either 1.0 ?/kg over 10 min followed by a maintenance 0.2 ?g/kg/h of dexmedetomidine (Group D)(n=20) or the same volume saline infusion (Group C)(n=20). After this, 0.6 mg/kg rocuronium was given to all patients. The incremental doses of rocuronium (0.15 mg/kg) were repeated to maintain muscle relaxation at the level of with T1 just positive or maximum up to 10% of its control. The variables recorded were times to recovery of T1 to 25%, 75%, and 90% of control and total dose of rocuronium used during surgery. Heart rate, and mean arterial pressure were recorded. The extubation criteria were adequate recovery of neuromuscular function as judged by TOF ratio >0.95. Results: There were significant decreases in heart rate, and mean arterial pressure in group D 15 min after intubation. The times to T1 of 25% was also significantly longer in the dexmedetomidine group (54±13 vs 35±6.7 min, respectively, p=0.001). There were no significant variables in recovery time between groups (T1 25-75%, 14.5±6.8 vs 12±5 min, respectively, p=0.193). The time required to a 90%T1 recovery was significantly longer in the dexmedetomidine group (86±29.2 vs 58±15.3 min, respectively, p=0.005). The total dose requirement of rocuronium was significantly lower in the dexmedetomidine group (61.5±4.65 vs 74±5.21 mg respectively, p=0.001). Conclusion: We concluded that dexmedetomidine infusion reduced rocuronium dose requirement, decreased hemodynamic parameters during sevoflurane anaesthesia. © 2008 Elsevier Ltd. All rights reserved.Öğe Effect of intraperitoneal bupivacaine and bupivacaine+meperidine infiltration on postoperative pain in total abdominal histerectomy(2002) Memiş D.; Turan A.; Karamanlio?lu B.; Güler T.; Süt N.; Pamukçu Z.We aimed to evaluate; intraperitoneal application of bupivacaine and bupivacaine+meperidine combinations effects on postoperative vital parameters and pain in total abdominal histerectomy. Our study is done on 28 patients scheduled for abdominal hysterectomy. In Group I (n=14) 20 mL bupivacaine % 0.5, to Group II (n=14) 20 mL bupivacaiae % 0.5+50 mg meperidine was given into peritoneal cavity according to infiltration rules. Postoperative pain was evaluated, 30 min, and 2,4,6,12,24 hours after excubation with, VAS while patients were laying and seated. Side effects were noted. When patients were laying at 30. mi and 2. hours (p<0.01) and while seated 30 min, VAS values were found to be statistically significantly low in Group II when compared with Group 1 (p<0.01). Consumption of meperidine was found 56.67±10.11 mg in Group I, and 50 mg in Group II, there was significant difference between them (p<0.01). First analgesic time found 30 min in Group I and 155±81.7 min in Group II, difference was found between groups (pÖğe The Effect of Intravenous Pantoprazole and Ranitidine for Improving Preoperative Gastric Fluid Properties in Adults Undergoing Elective Surgery(2003) Memiş D.; Turan A.; Karamanlioglu B.; Saral P.; Türe M.; Pamukçu Z.We studied pantoprazole, a new potent and fast-acting proton pump inhibitor. Its effects on preoperative gastric fluid volume and pH have not yet been determined. In this randomized, controlled trial, we examined the effects of preoperative IV pantoprazole or ranitidine on gastric pH and volume. Ninety patients (ASA status I and II, scheduled for elective surgery) were studied. One hour before surgery, patients in Group I (n = 30) were given IV saline 5 mL, those in Group II (n = 30) were given 40 mg of pantoprazole IV, and those in Group III (n = 30) were given 50 mg of ranitidine IV. A nasogastric tube was inserted immediately after anesthesia induction. Gastric contents were aspirated, and volume and pH were recorded. The pH values determined in Group I were 3.73 ± 0.82; in Group II, they were 5.30 ± 1.84; and in Group III, they were 4.80 ± 1.40. There was no statistical difference between Groups 2 and 3, but there was a significant difference between Group I and Groups 2 and 3 (P < 0.0005). The volume of the gastric contents was 28. 67 ± 10.98 mL in Group I, 15.20 ± 15.52 mL in Group II, and 7.77 ± 11.17 mL in Group III. There was no statistical difference between Groups 2 and 3, but there was a statistically significant difference between Group I and Groups 2 and 3 (P < 0.0005). The proportion of patients considered "at risk" of significant lung injury should aspiration occur was 20% of Group I, 10% of Group II, and 3.3% of Group III. When statistically evaluated, there was no difference among groups. We concluded that the administration of IV pantoprazole and ranitidine 1 h before surgery is effective in reducing gastric pH and volume.Öğe Effects of lornoxicam on the physiology of severe sepsis.(2004) Memiş D.; Karamanlioglu B.; Turan A.; Koyuncu O.; Pamukçu Z.INTRODUCTION: The purpose of the present study was to evaluate the effects of intravenous lornoxicam on haemodynamic and biochemical parameters, serum cytokine levels and patient outcomes in severe sepsis. METHODS: A total of 40 patients with severe sepsis were included, and were randomly assigned (20 per group) to receive either lornoxicam (8 mg administered intravenously every 12 hours for six doses) or placebo. For both groups the following were recorded: haemodynamic parameters (heart rate, mean arterial pressure), nasopharyngeal body temperature, arterial blood gas changes (pH, partial oxygen tension, partial carbon dioxide tension), plasma cytokine levels (IL-1beta, IL-2 receptor, IL-6, IL-8, tumour necrosis factor-alpha), biochemical parameters (lactate, leucocytes, trombocytes, creatinine, total bilirubin, serum glutamate oxalate transaminase), length of stay in the intensive care unit, duration of mechanical ventilation and mortality. All measurements were obtained at baseline (before the start of the study) and at 24, 48 and 72 hours from the start of lornoxicam/placebo administration. RESULTS: No significant differences were found between the intravenous lornoxicam and placebo groups in major cytokines, duration of ventilation and length of intensive care unit stay, and inspired fractional oxygen/arterial oxygen tension ratio (P > 0.05). CONCLUSION: In these patients with severe sepsis, we found intravenous lornoxicam to exert no effect on haemodynamic and biochemical parameters, cytokine levels, or patient outcomes. Because of the small number of patients included in the study and the short period of observation, these findings require confirmation by larger clinical trials of intravenous lornoxicam, administered in a dose titrated manner.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 Factors affecting acute renal failure in intensive care unit and effect of these factors on mortality(Turkiye Klinikleri, 2015) Uzundere O.; Memiş D.; İnal M.T.; Gültekin A.; Turan F.N.Objective: Early detecting acute renal failure is important by the aspect of determination of the disease's severity and grade of the organ dysfunction. The Acute Dialysis Quality Initiative workgroup designed a classification system for acute kidney injury (AKI) named as the RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease). The aim of our study is to assess acute renal failure development in intensive care units patients, factors affecting it and the effect of the factors over mortality via using RIFLE score. Material and Methods: The age, height, weight, gender, diagnosis, comorbid diseases, admission reason to the intensive care, intensive care stay, the APACHE II score, SOFA score, RIFLE score, biochemical parameters (albumin, prealbumin, urea, creatinine, cholesterol, HCO3 level), triceps thickness and waist circumference measurement were all recorded. Patients were grouped into AKI and non-AKI. The AKI group was assessed by RIFLE score due to hourly urine output and creatinine rise separated into three groups as R=Risk, I=Injury, F=Failure. Results: 502 patients were enrolled to the study. 39,2% of the patients was in the acute kidney injury group while 60.8% was in nonacute kidney injury group. The renal failure development is related with high age, short body height, excessive weight, existence of chronic disease and long intensive care units hospitalization period. Conclusion: In conclusion, patients with high age, excessive weight, chronic diseases, high urea, creatinine, HCO3 levels, low cholesterol, albumine and prealbumine levels are prone to renal failure. © 2015 by Türkiye Klinikleri.Öğe Fat embolism associated with anesthesia induction with propofol-lidocaine combination: A case report(2008) Hekimo?lu Şahin S.; Memiş D.; Çolak A.Fat 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. ©Medical Journal of Trakya University. Published by Ekin Medical Publishing. All rights reserved.Öğe Hypernatremia due to hypertonic solution usage during cyst hydatic surgery (case report)(2002) Memiş D.; Tükenmez B.; Pamukçu Z.Hydatic cyst, is a disease in human body made by a parasite echinococcus granulosus and % 60-80 percent settles in liver. This pathologic situation can only treated by surgical metods. One of treatment method is, ending the viability of the cyst via injecting a scolosidal substance into the cyst. For this purpose, different agents are being used, one of the most common substance which is being used is hypertonic sodium chlorid solution. It has been reported that sudden hypernatremia caused by injection of hypertonic saline solution is followed by reversible or irreversible coma. In this case report; we aimed to present hypernatremia and death which occured due to the use of hypertonic sodium chlorid solution in surgical approach of a hydatic cyst which has ruptured into the peritoneal cavity.Öğe Prevention of propofol injection pain in patients using transdermal nitroglycerine(2002) Turan A.; Karamanlio?lu B.; Memiş D.; Pamukçu Z.In our study, we aimed to compare two different dosages of transdermal nitroglycerine with placebo in prevention of propofol injection pain. 150 patients from ASA II class who were to undergo various elective operations and who use transdermal nitroglycerine were assigned randomly in to three groups. In Gronp I pre-emptied transdermal nitroglycerine tape, in Group II transdermal nitroglycerine TTS 5 tape and in Group III transdermal nitroglycerine TTS 10 tape was applied 2 hours before the propofol injection, over the dorsum of the hand at the tip of intravenous cannula. After application of first 5 mL of propofol with a speed of 10 mg/5 sec, patients reaction and side effects were assessed. There was no propofol injection pain in 58% of group II patients and in 64% of group III patients, while different degrees of pain was seen in all the patients in placebo group. In 2% of group III patients and 10% of group II patients moderate to severe pain was seen, while moderate to severe pain was seen in 96% of patients in placebo group. There was no statistical difference between TNG- TTS 5 and TNG- TTS 10 dosages in reducing propofol pain, when compared with placebo significant difference was found. Propofol injection pain in patients using transdermal nitroglycerine used patients was significantly reduced when compared with placebo. Transdermal nitroglycerine can be useful in preventing propofol injection pain.Öğe The prognostic value of atrial and brain natriuretic peptides, troponin I and C-reactive protein in patients with sepsis(2008) Yucel T.; Memiş D.; Karamanlioglu B.; Süt N.; Yuksel M.Aim: To investigate the plasma levels of atrial and brain natriuretic peptides (ANP and BNP), cardiac troponin I (cTnI) and C-reactive protein (CRP) as prognostic factors for survival in patients with sepsis. Method: Evaluation of serum levels of ANP, BNP, cTnI and CRP of patients an admission to an intensive care unit, two days later, and on the day of discharge from the intensive care unit or on the day of death. Results: ANP levels were significantly higher in the nonsurviving patients (day 1: 70.00±49.54 pg/mL; day 2: 138.85±143.15 pg/mL; and died/discharged day: 375.70±262.66 pg/mL) than surviving patients (day 1: 23.96±29.93 pg/mL; day 2: 10.06±6.03 pg/ML; died/discharged. day: 6.68±100.98 pg/mL, P<0.001). The BNP levels were significantly higher in the nonsurvivors (day 1: 254.78±308.62 pg/mL; day 2: 383.22±307.19 pg/mL; and died/discharged day: 696.47±340.33 pg/mL), than survivors (day 1: 13.72±12.95 pg/mL; day 2: 7.20±5.85 pg/mL; died/discharged day: 4.51±4.64 pg/mL, P<0.001). The cTnI levels were significantly higher in the nonsurviving patients (day 2: 0.16±0.38 ?g/L; died/discharged day: 0.78±2.48 ?g/L) than surviving patients (day 2: 0.04±0.07 ?g/L; died/discharged day: 0.02±0.01 ?g/L, P<0.05). The CRP levels were significantly higher in the nonsurvivors (day 2: 119.3±71.5 mg/L; and died/discharged day: 145.7±74.7 mg/L) than sumavors (day 2: 57.0±29.7 mg/L; died/discharged day: 26.8±24.0 mg/L, P<0,05). There were no significont differences between nonsurvivors and survivors for cTnI and CRP on day 1. Conclusion: With the exception of cTnI and CRP on day 1, all of the parameters were significantly powerful to determine nonsurvivors on all days. Among these variables, BNP was the most powerful diagnostic parameter for the prediction of nonsurvivors on all days. © 2008 Pulsus Group Inc. All rights reserved.
