Yazar "Memis D." seçeneğine göre listele
Listeleniyor 1 - 12 / 12
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe The addition of haloperidol, propofol, or midazolam to sufentanil for intravenous sedation in the intensive care unit using bispectral index(Weston Medical Publishing, 2008) Tukenmez B.; Memis D.; Pamukcu Z.Aim: Inadequate sedative techniques may adversely affect morbidity and mortality in the intensive care unit (ICU), and the search for the ideal sedative agent continues. Combinations of hypnotics and opiates have are commonly used for sedation. In this study, the authors aimed to assess whether or not the addition of a haloperidol, propofol, or midazolam infusion decreased the sufentanil requirements by using bispectral index (BIS). Material and Methods: The study involved 60 patients in the ICU. All patients received 0.5 ?g/kg sufentanil IV bolus. Immediately after, group S received 0.25 ?g/kg sufentanil infusion, group SH received sufentanil infusion + haloperidol 3 mg/h infusion, group SP received sufentanil infusion + propofol 25 ?g/kg/min infusion, and group SM received sufentanil infusion + midazolam 0.04 mg/kg/h infusion, for 6 hours. Average BIS values 61-80 and Ramsay Sedation Score 2-5 were kept at a range of by decreasing or increasing sufentanil levels in all groups and hourly sufentanil consumption was determined. Hemodynamic and biochemical parameters and arterial blood gases were determined at baseline and were repeated in study hours. Results: There was no significant difference in hemodynamic and biochemical parameters and arterial blood gases among the groups. Propofol, midazolam, haloperidol infusion, when added to sufentanil infusion, decreased the consumption of sufentanil in all the measured times (p < 0.001). Conclusions: The authors aimed to determine the effects of haloperidol, propofol, or midazolam infusion when added to sufentanil infusion in a short period of time. The authors found that propofol, midazolam, and haloperidol infusion decreased the sufentanil requirements in ICU patients.Öğe Analgesic effects of lornoxicam after total abdominal hysterectomy(Weston Medical Publishing, 2007) Sapolya O.; Karamanlhoglu B.; Memis D.The authors investigated, in a randomized, placebo-controlled, double-blinded study, the efficacy and safety of lornoxicam on pain after abdominal hysterectomy and on tramadol consumption in patients. Fifty patients were randomized to receive either oral placebo or lornoxicam 8 mg one hour before surgery. Anesthesia was induced with propofol and maintained with sevoflurane in 50 percent N2O/O2 with a fresh gas flow of 2 L/min (50 percent N2O in O2) and fentanyl (2 ?g/kg). All patients received patient-controlled analgesia with tramadol with loading dose of 50 mg; incremental dose of 20 mg; lock out interval of 10 minute; and four-hour limit 300 mg. The incremental dose was increased to 30 mg if analgesia was inadequate after one hour. Patients were studied at one, two, four, eight, 12, and 24 hours for visual analogue (VAS) pain scores, heart rate, mean arterial pressure, penferic oxygen saturation, sedation, tramadol consumption, and length of hospitalization. VAS scores at one hour were significantly lower in the lornoxicam group (p < 0.001). The tramadol consumption at one, two, four, eight, and 12 hours was significantly lower in the lornoxicam group when compared with the placebo group (p < 0.001, p = 0.008, p = 0.029, p = 0.034, p = 0.042, respectively). Sedation scores were similar at all the measured times in the groups. Length of hospitalization was significantly shorter in lornoxicam group (4.8 ± 0.4 day) than placebo group (5.2 ± 0.5 day) (p = 0.005). There was difference in the incidence of nausea between the groups (p = 0.047). The number of patients and the doses of antiemetics given during the first 24 hours after surgery in lornoxicam group were less than those in placebo group (p = 0.003, p = 0.034, respectively). In conclusion, a single oral dose of lornoxicam given preoperatively enhanced the analgesic effect of tramadol, decreasing tramadol consumption and side effects, and shortened the length of hospitalization.Öğe A comparison of esmolol alfentanyl, fentanyl and lidocaine for attenuation cardiovascular response to laryngoscopy and tracheal intubation(1999) Memis D.; Alpaydin T.; Pamukcu Z.; Turan N.This study was designed to compare the efficacy of esmolol, alfentanyl, fentanyl and lidocaine for cardiovascular responses to laryngoscopy and tracheal intubation. Fifty ASA physical status class I-II patients undergoing elective surgery were included in a randomized study consisting of 5 groups with each group receiving a designated drug: Group A received esmolol (0.8 mg/kg), Group B alfentanyl (10 ?g/kg), Group C fentanyl (2 ?g/kg), Group D lidocaine (1.5 mg/kg) and Group E saline (10 mL) as control. Heart rate, mean arterial pressure (MAP) and peripheric oxygen saturation values were recorded after injection of the drugs, immediately before laryngoscopy and after tracheal intubation. HR, MAP and SpO2 values were not significantly different after injection the drugs in all groups (p>0.05). HR values after tracheal intubation were significantly higher in C, D, E groups (p<0.05) but no difference in A and B groups (p>0.05). MAP values after tracheal intubation were significantly higher in all groups (p<0.05). SpO2 values were similar in all groups (p>0.05). As a result of our study, we conclude that esmolol (0.8 mg/kg) and alfentanyl (10 g/kg) are safe and effective for controlling the increase of HR during laryngoscopy and tracheal intubation.Öğe A comparison of oral midazolam, oral tramadol, and intranasal sufentanil premedication in pediatric patients(Weston Medical Publishing, 2007) Bayrak F.; Gunday I.; Memis D.; Turan A.Background: This study was designed to evaluate the efficacy and safety of oral midazolam, tramadol drops, and intranasal sufentanil for premedication of pediatric patients. Methods: Sixty children, three to 10 years of age, who were designated as American Society of Anesthesiologists physical status I and who were undergoing adenotonsillectomy as inpatients were randomized to receive a dosage of 0.5 mg/kg (total of 4 mL) midazolam in cherry juice (n = 20, Group M), 3 mg/kg tramadol drops (n = 20, Group T), or 2 ?g/kg intranasal sufentanil (n = 20, Group S). Clinical responses (sedation, anxiolysis, cooperation) and adverse effects (respiratory, hemodynamic, etc.) were recorded. Safety was assessed by continuous oxygen saturation monitoring and observation. Vital signs (blood pressure, pulse, oxygen saturation, respiratory rate) were recorded before drug administration (baseline) and then every 10 minutes until the induction of anesthesia. Results: Mean blood pressure decreased significantly after five minutes of intranasal sufentanil administration relative to Groups M (p < 0.01) and T (p < 0.05), whereas heart rate remained unchanged. Oxygen saturation and respiratory rate decreased significantly after 20 and 30 minutes of intranasal sufentanil administration relative to Groups M and T (p < 0.05). Anxiety scores showed rates of 45 percent in Group M, 5 percent in Group T, and 40 percent in Group S. Anxiety scores in Groups M and S were better than those of Group T (p < 0.01). Cooperation scores for face-mask acceptance showed rates of 85 percent in Group M, 45 percent in Group T, and 85 percent in Group S (p < 0.01). Conclusion: Intranasal sufentanil and oral midazolam are more appropriate premedication options than tramadol drops in children.Öğe The comparison of the effects of bupivacaine+morphine and bupivacaine+clonidine in vertebral surgery(2000) Alagol A.; Evis M.; Memis D.; Yalniz E.; Pamukcu Z.In this study, for postoperative pain management of 40 patients who were operated for lumbal scoliosis, spondylolystesis and spondylolysis, a catheter was placed into the epidural space, during intraoperative period. By this way bupivacaine+morphine or bupivacaine+clonidine were administered and compared for analgesic, haemodynamic and side effects. In all patients premedication, induction and maintenence of anesthesia were similar. After awakening and neurologic examination, in group I, patients received bupivacaine % 0.125+morphine 2 mg; in group II; bupivacaine % 0.125+1 mcg/kg clonidine; in 10 ml volume of % 0.9 NaCl, via the catheter. Pain (NRS), haemodynamic, respiratory and side effects were noted at: the begining of the postoperative period (0. min.), 30. min. and 1., 2., 6., 12. and 24. hours respectively. 2 mg of morphine was applied from the catheter when needed and total morphine requirements were noted. Data were evaluated statistically; while NRS and haemodynamic results were lower in group II, respiratory values were equal. Analgesia time and side effects were higher in group I. In conclusion, as both combinations were effective and safe in postoperative pain management via an epidural catheter, bupivacaine+clonidine may be an alternative to morphine+bupivacaine.Öğe Comparison of the effects of rocuronium, mivacurium and cisatracurium on hemodynamic parameters, intubation conditions and neuro-muscle junction in paediatric patients(2000) Sogut N.; Memis D.; Alpaydin T.; Pamukcu Z.In our study our aim was to evaluate the effects of non-depolarizing muscle relaxants rocuronium (R), mivacurium (M) and cisatracurium (C) on nerve-muscle function, intubation conditions and haemodynamic parameters in paediatric patients under sevoflurane anaesthesia. Our study is performed on 60 ASA I-II class patients ages ranging between 1-7 years planned for elective surgery patients were randomized into 3 groups (n=20) according to the muscle relaxants planned to be used. All patients received 0.015 mg/kg atropin and 0.06 mg/kg midazolam İM for premedication. HR, MAP and SpO2 values were recorded before muscle relaxant administration as baseline, immediately after muscle relaxant administration, immediately after intubation, 5 and 10 minutes after intubation. In all groups anaesthesia induction was provided with 50% O2 + 50% N2O with 5% sevoflurane following induction patients received either of R 0.6 mg/kg, M 0.2 mg/kg or C 0.1 mg/kg. At equal times T 95, T 25, T 25-75 and T 70 parameters were recorded by TOF-Guard monitore. Endotracheal intubation quality was evaluated with Clarke and Mirakhur evaluation scale. In comparison of intubation scores no significant statistical difference was found between R, M and C groups. In comparison of muscle relaxation T 95 values were recorded shorter in R group than in M and C groups. T 25 values was found to be significantly shorter in M group when compared to the other groups. T 25-75 value was also noticed to be significantly short in M group. In comparison of T 70 value between groups it was found to be significantly shorter in M group than R and C group. This value was found longer in C group. As a result we have concluded that rocuronium having short duration of onset is the agent to be preferred in induction and emergency states, short clinical effects and recovery time mivacurium the agent to be preferred in short durational operations. Since clinical effect time is long cisatracurium can be preferred in long durational operations.Öğe Effect of alfentanil and remifentanil infusions on hemodynamic and postoperative parameters in isoflurane anesthesia(1997) Memis D.; Alagol A.; Karamanlioglu B.; Alpaydin T.; Pamukcu Z.In our study, effects of alfentanil or remifentanil infusations on pre, per and postoperative hemodynamic parameters, early postoperative recovery criterias and on pain control was evaluated in patients undergoing TAH+BSO. Study was performed in patients with ASA I-III classification of 40 patients. Patients were divided into two groups: alfentanil (Group A) and remifentanil (Group R). In group A, anaesthesia was induced with alfentanil 20 ?g/kg continued with, 0.5 ?g/kg/min infusion, in Group R patients anaesthesia was induced with 1 ?g/kg remifentanil, continued with 0.1 ?g/kg/min infusion in isoflurane anaesthesia. SAP, DAP and HR were noted before induction and 1 min later, just after intubation, and 3 min later, when skin closure was beginned, at extubation, 15, 30, 45, 60, 90, 120 minutes after extubation. Recovery criterias were determined postoperatively, intensity of pain was determined by 'verbal pain score', sedation was evaluated with sedation scale. SAP, DAP and HR decreased 1 min. after induction of anesthesia, difference was not significant in other times (p>0.05). Spontan eye opening was earlier in Group R (p>0.05), postoperative pain management was better in Group A (p<0.05), there was no significant difference in sedation scores (p>0.05). As a result, alfentanil and remifentanil had similar hemodynamic stability, in postoperative pain management alfentanil, in early recovery criteria and side effects remifentanil was more advantageous when compared.Öğe The effect of tramadol or clonidine added to intraperitoneal bupivacaine on postoperative pain in total abdominal hysterectomy.(2005) Memis D.; Turan A.; Karamanlioglu B.; Tükenmez B.; Pamukçu Z.Recent studies suggest that intraperitoneal application of local anesthetics is useful in abdominal surgery. Tramadol and clonidine have specific effects on peripheral nerves when used alone. We aimed to evaluate the effects of intraperitoneal application of bupivacaine and the combinations of bupivacaine plus tramadol and bupivacaine plus clonidine on postoperative pain in total abdominal hysterectomy. After standard anesthetic procedure during closure of the abdomen, Group 1 (n = 20) was given 20 mL bupivacaine 0.5 percent, Group 2 (n = 20) was given 20 mL bupivacaine 0.5 percent plus 100 mg tramadol, and Group 3 (n = 20) was given 20 mL bupivacaine 0.5 percent plus 1 microg per kg clonidine, all into the peritoneal cavity. Postoperative pain was evaluated with the visual analog scale (VAS) at 30 minutes, and two, four, six, 12, and 24 hours after extubation. While patients were supine and seated, mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO2) values were noted. When VAS scores were 4 to 7, 0.5 mg per kg of meperidine was given intramuscularly (IM); above 7, 1 mg per kg of meperidine was given IM; and when VAS scores were 2 to 4, 500 mg acetaminophen was given orally. For evaluating quality of analgesia, rescue analgesic dose, analgesia time, and side effects were noted. The groups were similar in respect to SpO2; however, when Group 1 was compared to Groups 2 and 3 at 30 minutes, and two, four, and six hours, MAP and HR measurements were found to be significantly higher (p < 0.05). VAS values in sitting and supine positions at 30 minutes and two hours were significantly lower in Group 2 (p < 0.05) when compared to Group 1. VAS values for Group 3 at 30 minutes, and two and four hours in the supine position, and at 30 minutes and two hours in the sitting position, were found to be significantly lower than those in Group 1 (p < 0.05). There were no significant differences between Groups 2 and 3. The mean dosage of meperidine used was 76.7+/-10.5 mg in Group 1, 63.9+/-8.4 mg in Group 2, and 70 +/-5.2 mg in Group 3. When Group 1 was compared to Group 2, there were significant differences found (p < 0.05). First analgesic requirement time was found to be 30 (range, 30 to 30) minutes in Group 1, 120 (range, 30 to 240) minutes in Group 2, and 110 (range, 30 to 240) minutes in Group 3. There were significant differences found when Groups 2 and 3 were compared to Group 1 (p < 0.05). We concluded that the combinations of bupivacaine plus tramadol and bupivacaine plus clonidine administered intraperitoneally in total abdominal hysterectomy operations provide more effective analgesia than bupivacaine alone during the early postoperative period.Öğe Epidural administration of clonidine+bupivacaine and tramadol+bupivacaine combinations during vertebral surgery and assessment of its effect on postoperative analgesia and hemodynamics(2000) Memis D.; Muhittin M.; Alagol A.; Pamukcu Z.This study was applied on 30 cases to assess the effect of combinations of clonidine+bupivacaine and tramadol+bupivacaine on vital signs. Patients were allocated randomly to one of two groups. Group 1 (n=15) received doses of 1 ?g/kg clonidine+4 mL 0.5 % bupivacaine and Group II (n=15) doses of 75 mg tramadol+4 mL 0.5 % bupivacaine. Mean arterial pressure, heart rate, SpO2, respiratory rate, pain and sedation scores, analgesia onset and side effects were recorded for 24 hours. Statistically there was no difference in mean arterial pressure, heart rate, SpO2, respiratory rate, and sedation scores between Group I and II (p>0.05). Within 1/2. hours, postoperatively there was no difference in VAS between Group I and II (p>0.05). While within the 2,4,6 hours postoperatively there was significant decrease in VAS of Group I (p<0.05). Postoperatively within 12 and 24 hours there were no significant differences detected between two groups (p>0.05). Postoperative onset of analgesia was 6.11±3.19 hours in group I, 4.50±2.09 hours in group II. The difference between two groups was significant (p<0.05). Significant increase in side effects founded in group II was more than group I (p<0.05). We conclude that epidural administrations of clonidine+bupivacaine combination is safe and provide effective analgesia, produces no hemodynamic disturbances, and has no effect on respiratory parameters.Öğe Indomethacin-induced pancreatitis: A case report(2005) Memis D.; Akalin E.; Yücel T.Context: There are no previous reports of acute pancreatitis associated with the use of indomethacin in the general population. Drugs of all types are related to the etiology of pancreatitis in approximately 1.4-2.0% of cases. Case report: We report the case of a 56-year-old man who presented with acute pancreatitis after a period of indomethacin therapy. Other causes of the disease were ruled out. Due to multiorgan failure, he was in the intensive care unit for 44 days. He made a full recovery. The indomethacin was discontinued. Conclusions: We report indomethacin as the probable cause of acute pancreatitis in a patient without any known predisposing factors. To our knowledge, this is the rare description of a case of indomethacin-induced pancreatitis. However, the link is difficult to establish and further evidence is required to prove the association.Öğe Neuroleptic malignant syndrome: A case report(2006) Memis D.; Bayrak F.; Tokatlioglu D.[No abstract available]Öğe
