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Öğe Anaesthesia Management of a Child with West Syndrome(Aves, 2014) Sahin, Sevtap Hekimoglu; Copuroglu, Elif; Ugur, Huseyin; Sagiroglu, Gonul; Colak, AlkinWest syndrome (WS) is an epileptic encephalopathy usually occurring during the first year of life and is characterized by severe electroencephalography (EEG) derangement. Most of these patients may develop cerebral palsy, facial malformations, and skeletal deformities. The anaesthesiologist should make the preoperative assessment carefully due to epileptic seizures and should consider the possibility of difficult intubation because of coexisting anatomic malformations during the anaesthesia management of patients with WS. This report presents a case of general anaesthesia management in a left femoral fixation operation in an 11-year-old, 18 kg male patient.Öğe Caudal ropivacaine and bupivacaine for postoperative analgesia in infants undergoing lower abdominal surgery(Professional Medical Publications, 2015) Cinar, Surhan Ozer; Isil, Canan Tulay; Sahin, Sevtap Hekimoglu; Paksoy, InciObjective: To compare the postoperative analgesic efficacy of ropivacaine 0.175% and bupivacaine 0.175% injected caudally into infants for lower abdominal surgery. Methods: Eighty infants, aged 3-12 months, ASA I-II scheduled to undergo lower abdominal surgery were randomly allocated to one of the two groups: Group R received 1ml.kg(-1) 0.175% ropivacaine and Group B received 1ml.kg(-1) 0.175% bupivacaine via caudal route. Postoperative analgesia, sedation and motor block were evaluated with modified objective pain scale, three-point scale and modified Bromage scale respectively. Postoperative measurements including mean arterial pressure (MAP), heart rate (FIR), pain (OPS), sedation and motor block score were recorded for four hours in the postoperative recovery room. Parents were contacted by telephone after 24 hours to question duration of analgesia and side effects. Results: No significant differences were found among the groups in demographic data, MAP, FIR, OPS and sedation scores during four hours postoperatively. The duration of analgesia was 527.5 +/- 150.62 minutes in Group R, 692.77 +/- 139.01 minutes in Group B (p=0.004). Twelve (30%) patients in Group R, 16 (40%) patients in groupB needed rescue analgesics (p=0.348). Rescue analgesics were administered (1 time/2 times) (9/3) (22.5/7.5%) in Group R and 16/0 (40/0%) in Group B, where no statistically significant difference was determined between the groups (p=0.071). Motor blockade was observed in 7 (17.5%) patients in Group R, and 8 (20%) patients in Group B (p=0.774). Conclusion: This study indicated, that a concentration of 0.175% ropivacaine and 0.175% bupivacaine administered to the infants via caudal route both provided effective and similar postoperative pain relief in infants, who underwent lower abdominal surgery.Öğe Comparison of Different Anesthetic Techniques on Postoperative Outcomes in Elderly Patients with Hip Fracture(Ortadogu Ad Pres & Publ Co, 2012) Sahin, Sevtap Hekimoglu; Heybeli, Nurettin; Colak, Alkin; Arar, Cavidan; Alan, Kudret; Copuroglu, Cem; Yilmaz, BarisObjective: Determining the type of anesthesia is a complex medical decision that depends on many factors including co-morbidity, age, type of surgery performed, and the risk of the anesthetic techniques. This study evaluated the effects of anesthesia type on postoperative mortality and morbidity in hip fractures. Material and Methods: One hundred eighty-five patients older than 60 years who were operated for hip fracture between 2005-2009 were retrospectively analyzed. Patients received general anesthesia (n=67), spinal anesthesia (n=67), or epidural anesthesia (n=51). The clinical features of the patients were obtained from the hospital records. Morbidity outcomes were assessed on postoperative day 7. Mortality rates were calculated on postoperative day 7 and postoperative day 30. Results: There were no significant differences between the three groups with regard to intraoperative blood loss, intraoperative blood transfusion, smoking status, length of stay in hospital, American Society of Anesthesiology (ASA) physical status, and Charlson Comorbidity Index (CCI) (p=0.393, p=0.088, p=0.369, p=0.228, p=0.491, p=0.371 respectively). Similarly, no difference was detected between the three groups regarding patient mortality rates for day 7 and 30 (p=0.738, p=0.805 respectively). Conclusion: No technique was superior to the others. Due to the similar mortality rates among the groups, we suggest that the proper anesthetic technique selected according to the clinical features of the patient combined with adequate monitorization would yield successful results with all three techniques.Öğe Comparison of different tests to determine difficult intubation in pediatric patients(Elsevier Science Inc, 2014) Inal, Mehmet Turan; Memis, Dilek; Sahin, Sevtap Hekimoglu; Gunday, IsilBackground: 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.Öğe Comparison of temporal artery, nasopharyngeal, and axillary temperature measurement during anesthesia in children(Elsevier Science Inc, 2012) Sahin, Sevtap Hekimoglu; Duran, Ridvan; Sut, Necdet; Colak, Alkin; Acunas, Betul; Aksu, BurhanStudy Objective: To evaluate the accuracy and precision of a new, noninvasive infrared thermometer applied to the temporal artery. Design: Prospective randomized study. Setting: Trakya University Hospital. Patients: 60 ASA physical status 1 and 2 children undergoing surgery. Interventions: During anesthesia, temperature measurements were recorded with three different techniques: temporal artery, nasopharynx, and axillary temperature. Measurements: Temperatures measured from the nasopharynx, temporal artery, and the axilla were recorded at 15-minute intervals for the first hour, then at 30-minute intervals until the completion of surgery. During each measurement, heart rate and midarterial pressure were recorded. Main Results: There were no statistically significant differences between temperatures recorded at the temporal artery and nasopharynx at 15, 30, 45, 60, 90, and 120 minutes, and the completion of surgery. Axillary temperatures were statistically lower than those recorded at the nasopharynx and the temporal artery (P < 0.001). Bland-Altman plots showed a correlation of temperature measurements between the temporal artery and nasopharyngeal methods. The axillary method had a lower correlation with the temporal artery and the nasopharyngeal methods. Conclusions: The temporal artery thermometer is a substitute for the nasopharyngeal thermometer for core temperature measurement during anesthesia in children. (C) 2012 Elsevier Inc. All rights reserved.Öğe Duodenal necrosis during nasogastric tube feeding: A case report(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2007) Memis, Dilek; Sahin, Sevtap Hekimoglu; Sezer, AtakanA case of duodenal necrosis during nasogastric tube feeding in a 45-year-old male patient hospitalized in intensive care unit with a diagnosis of acute respiratory distress syndrome is reported with a review of literature. Abdominal distension developed after several days of uneventful nasogastric tube feeding. At laparotomy patchy necrosis of the duedonum was found without signs of bowel obstruction or impaired mesenteric perfusion. In this case, the large doses of fentanyl, midazolam and dopamine given for sedation, were suspected to be a major contributing factor to the development of the necrosis by impairing mucosal per-fusion.Öğe The effect of hyperbaric oxygen treatment on aspiration pneumonia(Springer, 2011) Sahin, Sevtap Hekimoglu; Kanter, Mehmet; Ayvaz, Suleyman; Colak, Alkin; Aksu, Burhan; Guzel, Ahmet; Basaran, Umit NusretWe have studied whether hyperbaric oxygen (HBO) prevents different pulmonary aspiration materials-induced lung injury in rats. The experiments were designed in 60 Sprague-Dawley rats, ranging in weight from 250 to 300 g, randomly allotted into one of six groups (n = 10): saline control, Biosorb Energy Plus (BIO), hydrochloric acid (HCl), saline + HBO treated, BIO + HBO treated, and HCl + HBO treated. Saline, BIO, HCl were injected into the lungs in a volume of 2 ml/kg. A total of seven HBO sessions were performed at 2,4 atm 100% oxygen for 90 min at 6-h intervals. Seven days later, rats were sacrificed, and both lungs in all groups were examined biochemically and histopathologically. Our findings show that HBO inhibits the inflammatory response reducing significantly (P < 0.05) peribronchial inflammatory cell infiltration, alveolar septal infiltration, alveolar edema, alveolar exudate, alveolar histiocytes, interstitial fibrosis, granuloma, and necrosis formation in different pulmonary aspiration models. Pulmonar aspiration significantly increased the tissue HP content, malondialdehyde (MDA) levels and decreased (P < 0.05) the antioxidant enzyme (SOD, GSH-Px) activities. HBO treatment significantly (P < 0.05) decreased the elevated tissue HP content, and MDA levels and prevented inhibition of SOD, and GSH-Px (P < 0.05) enzymes in the tissues. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase, TUNEL and arise in the expression of surfactant protein D in lung tissue of different pulmonary aspiration models with HBO therapy. It was concluded that HBO treatment might be beneficial in lung injury, therefore, shows potential for clinical use.Öğe The effect of methylene blue treatment on aspiration pneumonia(Academic Press Inc Elsevier Science, 2015) Kanter, Mehmet; Sahin, Sevtap Hekimoglu; Basaran, Umit Nusret; Ayvaz, Suleyman; Aksu, Burhan; Erboga, Mustafa; Colak, AlkinBackground: The study aimed to examine whether methylene blue (MB) prevents different pulmonary aspiration materials-induced lung injury in rats. Methods: The experiments were designed in 60 Sprague-Dawley rats, ranging in weight from 250-300 g, randomly allotted into one of six groups (n = 10): saline control, Biosorb Energy Plus (BIO), hydrochloric acid (HCl), saline + MB treated, BIO + MB treated, and HCl + MB treated. Saline, BIO, and HCl were injected into the lungs in a volume of 2 mL/kg. After surgical procedure, MB was administered intraperitoneally for 7 days at a daily dose of 2 mg/kg per day. Seven days later, rats were killed, and both lungs in all groups were examined biochemically and histopathologically. Results: Our findings show that MB inhibits the inflammatory response reducing significantly (P < 0.05) peribronchial inflammatory cell infiltration, alveolar septal infiltration, alveolar edema, alveolar exudate, alveolar histiocytes, interstitial fibrosis, granuloma, and necrosis formation in different pulmonary aspiration models. Pulmonary aspiration significantly increased the tissue hydroxyproline content, malondialdehyde levels, and decreased (P < 0.05) the antioxidant enzyme (superoxide dismutase and glutathione peroxidase) activities. MB treatment significantly (P < 0.05) decreased the elevated tissue hydroxyproline content and malondialdehyde levels and prevented the inhibition of superoxide dismutase and glutathione peroxidase (P < 0.05) enzymes in the tissues. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase (iNOS), terminal deoxynucleotidyl transferase dUTP nick end labeling, and arise in the expression of surfactant protein D in lung tissue of different pulmonary aspiration models with MB therapy. Conclusions: MB treatment might be beneficial in lung injury and therefore shows potential for clinical use. (C) 2015 Elsevier Inc. All rights reserved.Öğe Effect of Preoperative Anxiety on Depth of Anaesthesia and In Vitro Fertilization Success(Galenos Publ House, 2023) Sahin, Sevtap Hekimoglu; Copuroglu, Elif; Altinpulluk, Ece Yamak; Sut, Necdet; Karamanlioglu, Beyhan; Elter, Koray; Yaman, OzgeObjective: Infertility anxiety may have a harmful effect on embryo quality and fertilization during in vitro fertilization (IVF). Monitoring brain function gives real-time information about the depth of anaesthesia of a patient. This study examined the effect of preoperative anxiety on the depth of anaesthesia and IVF success. Methods: One hundred thirty-one patients who had undergone oocyte retrieval were divided into two groups according to the Beck Anxiety Inventory (BAI): the low-anxious Group L (n = 71) and high-anxious Group H (n = 60). Hemodynamic stability, intraoperative total propofol and fentanyl consumption, good quality embryo (GQE) rate, and fertilization rate were recorded. Results: Fertilization and GQE rates were not significant between groups L and H. Total propofol consumption was significantly higher in group H than in group L. Heart rate (HR) preoperatively and postoperatively and systolic arterial pressure (SAP) preoperatively and diastolic arterial pressure (DAP) postoperatively were significantly increased in group H than in group L. The time for the modified Aldrete score to reach 9 (MAS 9) in group H was significantly higher than that in group L. The effect of variables that were found significantly in the univariate analysis (Propofol, HRpreop, HRpostop, SAPpreop, DAPpostop, and MAS 9) on BAI score. Conclusion: Total propofol consumption was higher in patients with high anxiety levels, but it did not have a negative effect on IVF success.Öğe The effect of the prebiotic solutions in treatment of severe sepsis(Aves Yayincilik, Ibrahim Kara, 2007) Memis, Dilek; Yelken, Birguel; Sahin, Sevtap Hekimoglu; Vatan, Ilke; Yardim, TarikObjectives: In this double blind, prospective and randomized study, the effects of the enteral administration of a prebiotic preparation containing oligofructose and inulin on upper gastrointestinal colonization and systemic inflammation in intensive care patients with severe sepsis were investigated. Patients and Methods: A total of 50 patients admitted to an intensive care unit were randomized to receive either prebiotic (group 1, n=25) or placebo preparations (group 2, n=25). The prebiotic preparation consisted of prebiotic fiber inulin-oligofructose (0.8 g/100 mL, A, D3, E vitamins). Gut barrier function was assessed by culture of nasogastric aspirate on the first and eighth days. All septic complications, acute physiology and chronic health evaluation II (APACHE II) scores, ventilation days, gastrointestinal culture results, biochemical parameters, C-reactive protein (CRP) and mortality ratios were recorded. Results: There were no differences between the groups in terms of age, sex, APACHE II scores, CRP, ventilation days. There were no significant differences between the groups in terms of gastrointestinal culture, septic complications or mortality. Conclusion: The administration of prebiotic solution in intensive care patients with severe sepsis had no effect on gastrointestinal permeability, gastric colonisation, the systemic inflammatory response and morbidity.Öğe 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, IsilBACKGROUND: 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.Öğe Effects of General Anaesthesia on the Middle Ear Pressure(Aves, 2019) Deniz, Engin; Sahin, Sevtap Hekimoglu; Sut, NecdetObjective: Inhalation agents can have different effects on the middle ear pressure (MEP). We aimed to investigate the effect of sevoflurane and desflurane, the agents used in patients who do not have any car pathology and who undo go surgery under general anaesthesia, on MEP. Methods: Fifty adult patients who were scheduled to undergo inguinal hernia and lower extremity surgery were included in our study. All patients were aged between 20 and 60 years and belonged to the American Society of Anesthesiologists (ASA) I-III class. Patients were divided into two groups, according to the inhalation agent administered for the surgery: sevofluran, Group S (n=25); and desfluran, Group D (n=25). Anaesthetic agents, intraoperative end tidal carbon dioxide and airway pressures were recorded. The MEP was measured for both ears preoperatively, at the intraoperative 5th, 10th, 15th minutes, and at the postoperative 10th and 30th minutes. Results: The MEP at the intraoperative 10th minute was significantly higher in Group D compared to Group S. In Group D, the MEP increased significantly at the intraoperative 10th and 15th minutes, and postoperative 30th minute, compared to preoperative values. In Group S, the MEP increased significantly at the postoperative 10th minute, compared to preoperative values. Conclusion: We found that desflurane increases the MEP during the intraoperative and postoperative period, compared to sevoflurane.Öğe The Effects of Glasgow Coma Scales and Bispectral Index on General Anaesthesia in Neurosurgery Patients(Aves, 2021) Coker, Taygun; Sahin, Sevtap Hekimoglu; Sut, NecdetObjective: Monitorisation under anaesthesia is important for objective evaluation in intracranial surgery. We investigated general anaesthesia management performed by bispectral index (BIS) monitoring in patients who underwent surgery due to intracranial pathology with different Glasgow Coma Scales (GCS). Methods: Forty-five patients who had been planned to undergo intracranial surgery under general anaesthesia were included in the study. Patients were divided into three groups according to GCS: Group I (n = 15) = 13-15 mildly injured; Group II (n = 15) = 9-12 moderately damaged; Group III (n = 15) = 3-8 severely damaged. Heart rate (HR), mean blood pressure, and use of anaesthetic agent were recorded. Results: It was found that the consumption of the inhalation agent in Group III was lower than Groups I and II at all time intervals measured, and it was lower in Group II than Group I during the intervals at intraoperative 15th minute and up to 150th minute thereafter. The inhalation agent consumption rates according to the duration of anaesthesia were different between groups. The HR was significantly higher in Group III compared with Group II during the post-operative period. The mean arterial pressure was significantly lower in Group I than Group II pre-operatively and at 5th, 10th, 15th, 20th, and 40th minute intra-operatively, whilst it was significantly lower in Group I than Group III preoperatively and 10th minute and 15th minute, intraoperatively. Conclusion: We found that in patients whose GCS was severely damaged and underwent intracranial surgery under general anaesthesia with BIS monitoring, the consumption of inhalation anaesthetic agent decreased, but opioid consumption did not change.Öğe The effects of hyperbaric oxygen application against cholestatic oxidative stress and hepatic damage after bile duct ligation in rats(Academic Press Inc Elsevier Science, 2013) Ayvaz, Suleyman; Kanter, Mehmet; Aksu, Burhan; Sahin, Sevtap Hekimoglu; Uzun, Hafize; Erboga, Mustafa; Pul, MehmetBackground: The aim of this study was to evaluate the preventive and therapeutic potential of hyperbaric oxygen therapy (HBO) on the liver tissue against bile duct ligation (BDL)-induced oxidative damage and fibrosis in rats. Materials and methods: We divided 32 adult male Sprague Dawley rats into four groups: sham, sham plus HBO, BDL, and BDL plus HBO; each group contained eight animals. We placed the sham plus HBO and BDL plus HBO groups in an experimental hyperbaric chamber in which we administered pure oxygen at 2.5 atmospheres absolute 100% oxygen for 90 min on 14 consecutive days. Results: The application of BDL clearly increased the tissue malondialdehyde level, myeloperoxidase activity, and hydroxyproline content and decreased the antioxidant enzymes (superoxide dismutase and catalase activities) and glutathione level. Hyperbaric oxygen therapy treatment significantly decreased the elevated tissue malondialdehyde level, myeloperoxidase activity, and hydroxyproline content and increased the reduced superoxide dismutase and catalase activities and glutathione level in the tissues. The changes demonstrating the bile duct proliferation and fibrosis in expanded portal tracts include the extension of proliferated bile ducts into lobules, mononuclear cells, and neutrophil infiltration into the widened portal areas were observed in BDL group. Treatment of BDL with HBO attenuated alterations in liver histology. Alpha smooth muscle actin, cytokeratinpositive ductular proliferation, and the activity of terminal deoxynucleotidyl transferase 2'-deoxyuridine, 5'-triphosphate nick end labeling in the BDL decreased with HBO treatment. Conclusions: The data indicate that HBO attenuates BDL-induced oxidative injury, hepatocytes damage, bile duct proliferation, and fibrosis. The hepatoprotective effect of HBO is associated with antioxidative potential. (C) 2013 Elsevier Inc. All rights reserved.Öğe Fat embolism associated with anesthesia induction with propofol-lidocaine combination(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Sahin, Sevtap Hekimoglu; Memis, Dilek; Colak, AlkinFat 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.Öğe Horner's syndrome following uncomplicated internal jugular vein catheterization(Aves Yayincilik, Ibrahim Kara, 2008) Sahin, Sevtap Hekimoglu; Kaya, Gaye; Koyuncu, Onur; Pamukcu, ZaferPercutaneous 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.Öğe Is music the food of the anesthesia in children?(Bmj Publishing Group, 2022) Sahin, Sevtap Hekimoglu; Duran, Ridvan; Basaran, Umit Nusret; Sut, Necdet; Colak, Alkin; Duran, SedefBackground The noise in an operating room may have a detrimental effect on human cognitive functions, and it may cause perioperative anxiety with prolonged exposure. The aim of this study was to investigate the effects of music therapy and use of earplugs and normal noise level in the operating room under general anesthesia of pediatric patients on hemodynamic parameters and postoperative emergence delirium. Methods One hundred and five pediatric patients were involved in this study. The patients were randomly divided into three groups. Group N was exposed to the ambient operating room noise, group S received earplugs from an independent anesthesiologist, and group M used a CD player. The preoperative anxiety levels of children were evaluated with the Modified Yale Preoperative Anxiety Scale (M-YPAS). Mean arterial pressure (MAP) and heart rate were recorded at 30-minute periods until the completion of surgery, end of surgery and postoperatively. During each measurement, noise level recordings were performed using sonometer. Pediatric Anesthesia Emergency Delirium (PAED) score was evaluated after postoperative extubation. Results M-YPAS was similar between groups. The MAP at 30 and 60 min intraoperatively, at end of surgery, and at 5, 10, and 15 min postoperatively was significantly lower in group S than in group N. There were no differences in heart rate among the groups. Postoperative PAED score was not significantly different among the groups. Conclusions The music therapy was not more effective than silence and operating noise room in reducing PAED score postoperatively in pediatric patients.Öğe Modified 30-Degree Head-Up Tilt Park Bench Position in Semielective Posterior Fossa Surgery in a Patient with Pheochromocytoma(Georg Thieme Verlag Kg, 2023) Sahin, Sevtap Hekimoglu; Simsek, Osman; Akinci, Tolgay; Cakici, ZaferVon Hippel-Lindau (VHL) disease is a rare genetic disorder associated with the central nervous system and visceral organs. Pheochromocytomas occur in 10% of VHL patients, while cerebellar tumors are common tumors in VHL syndrome, with an incidence of 60%. The most common position for posterior fossa operations is the park bench or lateral decubitus position. These positions have primarily replaced the sitting position. However, the advantages of the supine position cannot be overlooked. The coexistence of pheochromocytoma and the cerebellar tumor may require modification in surgical position and anesthesia management in line with possible pathophysiological changes. We present the anesthesia management in posterior fossa surgery in patients with postponed pheochromocytoma surgery. The present case highlights the importance of a multidisciplinary team approach and anesthetic management.Öğe Modified 45-degree head-up tilt increases success rate of lumbar puncture in patients undergoing spinal anesthesia(Springer Japan Kk, 2014) Sahin, Sevtap Hekimoglu; Colak, Alkin; Arar, Cavidan; Yildirim, Ilker; Sut, Necdet; Turan, AlparslanLumbar puncture (LP) is one of the most common procedures performed in medicine. The aim of this prospective study is to determine the success rate of LP in lateral decubitus with 45-degree head-up tilt position, and compare it with traditional positions like sitting and lateral decubitus. Three hundred and thirty patients between 25 and 85 years of age who had undergone abdominal, urologic, and lower limb extremities surgeries were enrolled and 300 patients were divided into three different groups. The LP was performed with a 25-G atraumatic needle, either in the standard sitting position (group S, n = 100), lateral decubitus, knee-chest position (group L, n = 100) or lateral decubitus, knee-chest position with a 45-degree head-up tilt (group M, n = 100). The free flow of clear cerebrospinal fluid (CSF) upon first attempt was considered to be evidence of a successful LP. Total LP success rate was significantly higher in group M (85 %) than in groups S and L (70 and 65 %, respectively) (p = 0.004). When the significance between the groups was evaluated according to age, the increase in the LP success rate was not significant for a parts per thousand currency sign65 and > 65 age groups. There were no differences among the three groups in terms of bloody CSF (p = 0.229) and the number of attempts before dural puncture (p = 0.052). The lateral decubitus in knee-chest position with a 45-degree head-up tilt may be the preferred position for spinal anesthesia in young and elderly patients, due to the high success rate.Öğe Post-Operative Malignant Hyperthermia in a Child after Colon Interposition(Aves, 2015) Sahin, Sevtap Hekimoglu; Inan, Mustafa; Aksu, Burhan; Oner, Naci; Colak, Alkin; Guzel, AhmetMalignant hyperthermia (MH) is a rare and potentially life threatening fatal complication of anaesthesia. We present a 2-year-old boy with late onset MH after colon interposition to replace the oesophagus under sevoflurane anaesthesia. The patient was treated with intravenous dantrolene sodium as well as cooling and controlled ventilation. Despite treatment, the patient developed cardiopulmonary arrest at 21 hours after the operation and died. It should be kept in mind that post-operative MH may develop during these types of operations with ischaemia-reperfusion injuries.
