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Öğe The addition of sufentanil, tramadol or clonidine to lignocaine for intravenous regional anaesthesia(Australian Soc Anaesthetists, 2004) Alayurt, S; Memis, D; Pamukcu, ZThis study was designed to evaluate the effect of sufentanil, tramadol or clonidine added to lignocaine for intravenous regional anaesthesia. We investigated the onset and duration of sensory and motor block, the quality of the anaesthesia, intraoperative and postoperative haemodynamics, intraoperative and postoperative pain and sedation. Sixty patients undergoing ambulatory hand surgery received intravenous regional anaesthesia using 35 ml of 0.5% lignocaine and either 5 ml saline (Group L, n = 15); sufentanil 25 mug (Group LS, n = 15); tramadol 100 mg (Group LT, n = 15) or clonidine 1 mug.kg(-1) (Group LC, n = 15). Before and after the tourniquet application, haemodynamic data, tourniquet pain, sedation scores and analgesic use were recorded. After tourniquet deflation, haemodynamic data, pain and sedation, time to first analgesic requirement and analgesic use were noted. There were no differences among groups in intraoperative haemodynamic data, the time to recovery of sensory block, the onset and the recovery of motor block, sedation scores or postoperative pain. Compared to the other groups, in Group L the onset of sensory block was longer, the time to initial tourniquet pain was shorter and the intraoperative tourniquet pain scores and use of the opioid were higher (P < 0.05). The quality of anaesthesia in Groups LS, LT and L C was better than in Group L (P < 0.05). In conclusion, the addition of sulfentanil, tramadol or clonidine to lignocaine shortened the onset of the sensory block, delayed the onset time of the tourniquet pain and reduced the intraoperative consumption of opioid, but did not affect postoperative pain.Öğe Analgesic effects of rofecoxib in ear-nose-throat surgery(Lippincott Williams & Wilkins, 2002) Turan, A; Emet, S; Karamanlioglu, B; Memis, D; Turan, N; Pamukcu, ZIn this study we evaluated the analgesic efficacy and the opioid-sparing effect of rofecoxib in ear-nose-throat surgery patients. Patients undergoing nasal septal or sinus surgery were randomized to receive either oral placebo or rofecoxib 50 mg 1 h before surgery. All patients received propofol 0.8 mg/kg, fentanyl 1 mug/kg, and local anesthesia at the operative site. Sedation was maintained by a continuous infusion of propofol adjusted to maintain sedation at a 2-3 level on the Ramsey scale. Additional fentanyl 0.5-1 mug/kg was administered at the patient's request or if the verbal rating scale score was >4. Patient sedation and pain scores were obtained at 5, 15, 30 45, and 60 min during surgery and 30 min and 2, 4, 6, 12, and 24 h after completion of the procedure. During the postoperative period, diclofenac 75 mg IM was administered for analgesia at the patient's request or if the visual analog scale (VAS) rating for pain was more than 4. VAS pain scores, intraoperative fentanyl, and postoperative diclofenac requirements were significantly smaller in the rofecoxib group compared with the placebo group (P < 0.001). The times to first analgesic request were also significantly less in the rofecoxib group. We conclude that the preoperative administration of oral rofecoxib provided a significant analgesic benefit and decreased the need for opioids in patients undergoing nasal septal and nasal sinus surgery.Öğe Comparison of the maternal and neonatal effects of sevoflurane, isoflurane and halothane for elective cesarean section(Prof Sci Publ, 1999) Alpaydin, T; Karamanlioglu, B; Pamukcu, Z[Abstract Not Available]Öğe Effect of preoperative oral use of erythromycin and nizatidine on gastric pH and volume(Sage Publications Ltd, 2002) Memis, D; Turan, A; Karamanlioglu, B; Guler, T; Yurdakoc, A; Pamukcu, Z; Turan, NThis randomized controlled trial examined the effects of preoperative oral erythromycin or nizatidine on gastric pH and volume. Sixty patients, ASA I and 2 status scheduled for elective surgery were studied. All subjects received oral study medication with 10 ml of water 60 minutes prior to surgery. Patients in Group I (it = 20) were given erythromycin 200 mg, in Group 2 (n = 20) nizatidine 300 mg, and in Group 3 (n = 20) placebo capsule. A nasogastric tube was inserted immediately after anaesthesia induction. Gastric content was aspirated, and volume and pH recorded. pH values determined in Group I were 5.6+/-1.87, in Group 2, 5.65+/-1.92 and in Group 3, 3.5+/-1.93. There was no statistical difference between Groups I and 2, but there was a statistically significant difference between Group 3 and Groups I and 2 (P<0.001). The volume of gastric content was 10.25+/-6.65 ml in Group 1, 10.3+/-6.29 ml in Group 2, and 20.25+/-16.72 ml in Group 3. Again, there was no statistical difference between Groups I and 2, but there was a statistically significant difference between Group 3 and Groups I and 2 (P<0.05). The proportion of patients considered at risk of significant lung injury should aspiration occur was 10% of Group 1, 5% of Group 2 and 20% of Group 3 (not statistically different). We conclude that oral erythromycin and nizatidine given one hour prior to surgery are effective in reducing gastric pH and volume.Öğe Genotoxicity of waste anaesthetic gases(Australian Soc Anaesthetists, 2002) Bozkurt, G; Memis, D; Karabogaz, G; Pamukcu, Z; Ture, M; Karamanlioglu, B; Gunday, IBackground and aim: The possibility of a potential mutagenic or carcinogenic action of chronic exposure to low concentrations of inhalational anaesthetics has been previously studied, with conflicting results. The purpose of this study was to assess whether occupational exposure to waste anaesthetic gases increases genotoxic risk. We examined peripheral lymphocytes from anaesthetists for both sister chromatid exchange (SCE) and for cells with high-frequency SCEs (HFCs). Method: A group of 16 non-smoking anaesthetists with occupational exposure to anaesthetic gases and a sex- and age-matched group matched 16 non-smoking matched physicians without occupational exposure to anaesthetic gases were studied. The participants were also selected on the basis of similar responses to a questionnaire assessing risk of genotoxicity relating to other aspects of life. Result: SCEs, and HFC percentages obtained from the exposed anaesthetists (6.6 +/- 2.4 and 12.2 +/- 15.9) were greater but not statistically significantly so than in the reference group (5.2 +/- 1.6 and 5.9 +/- 10.0). Conclusion: This study does not support the existence of an association between occupational exposure to waste anaesthetic gases and an increase in SCEs in lymphocytes. The nature of our anaesthesia practice suggests exposure was likely to be low. It should be noted that some anaesthetic gases produce lesions that can be efficiently repaired in mitogen-stimulated lymphocytes in vitro but not in circulating lymphocytes.Öğe The influence of methylene levels during severe sepsis blue infusion on cytokine(Australian Soc Anaesthetists, 2002) Memis, D; Karamanlioglu, B; Yuksel, M; Gemlik, I; Pamukcu, ZThe aim of our study was to assess the effect of methylene blue infusion on plasma levels of cytokines in severe sepsis. In a prospective, randomized, double-blind, placebo-controlled study, patients received either methylene blue 0.5 mg.kg(-1).h(-1) (MB group, n=15) or similar volume of isotonic saline (control group, n=15) IV for 6 hours. Plasma concentrations of tumour necrosis factor-alpha, interleukin-1, interleukin-2 receptor, interleukin-6, interleukin-8 were measured by sensitive immunoassays at basal (15 min before start of the study), immediately after, and at 24 and 48 hours after methylene blue infusion. We evaluated haemodynamic parameters (mean arterial pressure, heart rate), blood gases, methaemoglobin levels, and biochemical parameters at the same time. Methylene blue administration had no significant effect on plasma cytokine levels, blood gases and biochemical parameters. When compared to placebo infusion in controls, methylene blue administration resulted in significantly higher mean arterial pressure (85+/-14 mmHg vs 74.1+/-10.3 mmHg; P<0.01), and methaemoglobin levels (1.06+/-0.22% vs 0.9+/-0.05%; P<0.05). Furthermore, comparison with baseline levels revealed significantly increased both mean arterial pressure (85+/-14 mmHg and 74.1+/-10.2 mmHg, P<0.05) and methaemoglobin levels (1.06+/-0.22% and 0.88+/-0.06%; P<0.05) in MB group. There was no difference in mortality rates between the groups. We found that methylene blue infusion did not change cytokine levels or outcome in severe sepsis. The administration of methylene blue, however, resulted in a transient increase in arterial pressure. Because of the limited size of the present study, and the short period of observation, our findings need to be confirmed by larger clinical trials of methylene blue infused in a dose-titrated manner.Öğe Intraarticular analgesia after arthroscopic knee surgery: comparison of neostigmine, clonidine, tenoxicam, morphine and bupivacaine(Springer, 2005) Alagol, A; Calpur, OU; Usar, PS; Turan, N; Pamukcu, ZWe conducted a randomized, placebo-controlled, double blinded study to compare the analgesic effects of intraarticular neostigmine, morphine, tenoxicam, clonidine and bupivacaine in 150 patients undergoing arthroscopic knee surgery. General anaesthesia protocol was same in all patients. At the end of the surgical procedure, patients were randomized into six intraarticular groups equally. Group N received 500 mu g neostigmine, Group M received 2 mg morphine, Group T received 20 mg tenoxicam, Group C received 1 mu g kg(-1) clonidine, Group B received 100 mg bupivacaine and Group S received saline 20 ml. Visual analog scale scores 0, 30 and 60 min and 2, 4, 6, 12, 24, 48 and 72 h, time to first analgesic need, analgesic consumption at 48 h and 72 h and side effects were noted. Demographic and operational parameters were similar in six groups. All study groups provided analgesia when compared with saline group (P<0.05). Duration of analgesia in Group N and C was longer than other groups (P<0.001). Analgesic consumptions of Group N, C and T were lower than other groups (P<0.01). Pain scores during 2 h postoperatively were lower in all study groups than the control group (P<0.001). In Group B, median pain scores were higher than Groups N and C at 0 min and 30 min postoperatively (P<0.001). Side effects were not significantly different among the six groups. We conclude that the most effective drugs that are administered intraarticularly are neostigmine and clonidine among the five drugs we studied. Tenoxicam provided longer analgesia when compared with morphine and bupivacaine, postoperatively.Öğe The prevention of pain from injection of rocuronium by magnesium sulphate, lignocaine, sodium bicarbonate and Alfentanil(Sage Publications Ltd, 2003) Turan, A; Memis, D; Karamanlioglu, B; Sut, N; Pamukcu, ZWe compared the efficacy of magnesium sulphate, lignocaine, sodium bicarbonate or alfentanil in minimizing pain due to injection of rocuronium in 250 patients. After tourniquet application on the forearm, the patients were given saline, magnesium sulphate, lignocaine, sodium bicarbonate 8.4% or alfentanil, diluted into a 3 ml solution. The occlusion was released after 20 seconds, and rocuronium was injected over 10 to 15 seconds. The patients were observed and asked immediately if they had pain in the arm and the response was assessed. Reactions such as discomfort and pain, withdrawal of the hand and screaming after the administering of the rocuronium were recorded as side-effects and patients were reassessed at 24 hours postoperatively. We concluded that magnesium sulphate, lignocaine, sodium bicarbonate or alfentanil decreased the level of rocuronium injection pain. Of these drugs, magnesium sulphate, lignocaine and sodium bicarbonate were the most effective while alfentanil was the least effective.Öğe The value of nizatidine and famotidine in prophylaxis of aspiration pneumonia in caesarean section(Prof Sci Publ, 1999) Zoroglu, F; Karamanlioglu, B; Ünal, C; Pamukcu, Z[Abstract Not Available]
