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Öğe Addition of meperidine to intraperitoneal bupivacaine for analgesia after laparoscopic cholecystectomy(2002) Alagöl A.; Çolak A.; Tükenmez B.; Turan F.N.; Pamukçu Z.The analgesic efficacy, haemodynamic and side effects of meperidine added via intraperitoneal (IP) or intravenous IV route to bupivacaine which administered intraperitoneally were assessed after laparoscopic cholecystectomy. In ASA I-II physical status, 35 female and 30 male were enrolled the study. Standard premedication, induction and maintnance of anaesthesia were performed to all patients. At the end of the surgical procedure, patients in Group I (n=21) received % 0.5 bupivacaine 20 mL IP and % 09 NaCl 1 mL IV; patients in Group II (n=22) received % 0.5 bupivacaine 20 mL IP and meperidine 50 mg (1 mL) IV and, Group III (n=22), % 0.5 bupivacaine 20 mL IP and meperidine 50 mg (1 mL) IV Pain scores, duration of analgesia, analgesic supplements, mean arterial pressure and heart rate were assessed at 0 and 30 min., 1, 2, 4, 12 and 24 hr postoperatively. Three groups achieved sufficient analgesia; meperidine administered via IP route provided lower pain scores than IP bupivacaine only, at 0, 2, 12 and 24 hrs (p<0.05) and than IV meperidine group at 4, 12 and 24 hrs. Duration of analgesia and analgesic consumptions of groups did not differ statistically. Side effects did not differ among groups. As a result, it is concluded that, meperidine is effective when administered intraperitoneally and it causes lower pain scores when added to IP bupivacaine.Öğe The analgesic efficacy of intraperiloneally administered ondansetron in laparoscopic cholecystectomies(2003) Alagöl A.; Karamanlio?lu B.; Turan F.N.; Pamukçu Z.A standart premedication, anaesthetic induction and maintenance was performed to 82 patients undergoing laparoscopic cholecystectomy to evaluate the analgesic efficacy of ondansetron when administered via intraperitoneal route. Patients were assigned to four groups to receive intraperitoneally 20 mL of: % 0.9 NaCl (Group I, n=20); % 0.5 bupivacaine (Group II, n=20); 8 mg ondansetron (Group III, n=20) or % 0.5 bupivacaine+8 mg ondansetron (Group IV, n=22) in a double blind manner. Pain, duration of analgesia, rescue analgesic medication (75 mg diclofenac, IM and, heart rate, systolic and diastolic arterial pressure were assessed at 0 and 30th min, 1, 2, 4, 8, 12 and 24th hours postoperatively. In Group II and IV, pain scores (Numeric Rating Scale) were lower during first 4 hours when compared with Group I and III (p<0.001); pain scores were lower in group IV when compared with Group I (p<0.05) and III (p<0.001) at 8th hour. At 12th hour, pain scores in group IV were lower than all other groups (p<0.01 for groups I and III; p<0.05 for group II). Duration of analgesia was longer in group IV when compared with other groups and, in Group II when compared with Groups I and III (p<0.01, p<0.001). Analgesic consumption was lower in the same groups (p<0.01, p<0.001). Heart rate was higher in Group I at 0, 30th min, 1 and 2nd hours and, systolic arterial pressure was higher in Group I when compared with other groups at Oth min (p<0.05, p<0.01, p<0.001; P<0.05). As a result, it is concluded that ondonsetron alone has not analgesic efficacy, although it increases the analgesic efficacy of bupivacaine when administered intraperitoneally.Öğe Comparison of intravenous sufentanil and bupivacaine administration for preventing haemodynamic responses to Mayfield Holder in craniotomies(2005) Alagöl A.; Çolak A.; Pamukçu Z.; Turan F.N.Aim: Our aim was to compere intravenous sufentanil and scalp infiltration with bupivacaine on the haemodynamic response to placement of the Mayfield head Holder used for neurosurgery. Materials and Methods: Fifty-nine ASA I/II patients aged 20-58 years undergoing craniotomy were randomized into 3 groups. Group S (n=20) received intravenous sufentanil (10 ?g) and scalp infilitration with 0.9% NaCl, Group B (n=20) received intravenous 0.9% NaCl + scalp infilitration with % 0.5 bupivacaine (10 mg); Group K (n=19) received intravenous and scalp infilitration with 0.9% NaCl. Systolic, diastolic and mean arterial pressures and heart rate were recorded before and after induction; infiltration and Mayfield frame application. Results: Sufentanil significantly decreased arterial pressures and heart rate in Group S (p<0.01; p<0.001). No significant haemodynamic differences were recorded after infiltration in Groups B and K (p>0.05). Following application of the Mayfield frame arterial pressures and heart rate increased in Group K (p<0.001) and remained high after 5 minutes (p<0.01, p<0.001). In Group B, frame application was associated with increased diastolic (p<0.05) and mean (p<0.01) arterial pressures and heart rate (p<0.05). Diastolic and mean arterial pressures remained elevated after 5 minutes (p<0.05). In Group S, pin insertion did not increase haemodynamic parameters rather the lower haemodynamic values observed following sufentanil administration persisted throughout the study period. Conclusion: Intravenous sufentanil (10 ?g) and local administration of % 0.5 bupivacaine (10 mg) blunted the haemodynamic responses to pin insertion during Mayfield frame application. Following sufentanil administration, blood pressure and heart rate was decreased throughout the period of study.Öğe Effects of Clonidine and Tramadol Premedication on Induction, Haemodynamic and Early Postoperative Analgesia in Patients Undergoing Abdominal Surgery(2004) Arar C.; Alagöl A.; Esgin S.; Turan F.N.; Pamukçu Z.Clonidine 2 ni kg-1, tramadol 1.5 mg kg-1 or saline was administered with atropine 0.5 mg intramuscularly in order to compare their effects on induction, haemodynamics and early postoperative analgesia. Sedation score was assessed preoperatively. Heart rate, peripheral oxygen saturation and non-invasive blood pressure were monitored pre, per and postoperatively. Anaesthesia induction was provided with propofol (untill response to verbal and tactile were disappeared) and atracurium 0.6 mg kg-1. At the end of the operation, analgesic consumption, nausea and vomiting were recorded in recovery room, 90 min. postoperatively. Mean arterial pressure decreased after induction (p<0.001); increased after intubation in all groups (p<0.05 for Group I; p<0.001 for Groups II and III) mean erterial pressure increased in Groups II and III after incision (p<0.001, p<0.05 respectively). Heart rate increased after premedication in all groups (p<0.001); increased after intubation in Groups II and III (p<0.001). When compared among three groups, mean arterial pressure was highest in Group III after induction (p<0.05); heart rate was lower in Group I when compared with Group III after induction (p<0.05); lower in Group I than all groups after induction and incision (p<0.05, p<0,001, respectively). Mean arterial pressure and heart rate decreased in all groups at 30th min; decreased in Group I at 30, 60 and 90 th min postoperatively (p<0.001). Pain scores were lower in Group I (at 30, 60, 90 th min) and Group II (at 60 and 90 th min) than Group III. Propofol consumption, sedation scores, nausea and vomiting were similar among three groups. As a result, it is suggested that both clonidine and tramadol can be used for premedication for abdominal surgery; clonidine was more effective for prevention the haemodynamic responses to intubation and incision and enhanced lower pain scores postoperatively.Öğe Effects of dexmedetomidine infusion on hemodynamic responses in craniotomies(2006) Alagöl A.; Kaya G.; Çolak A.; Karaçayir Y.; Pamukçu Z.; Turan F.N.Aim: The effectiveness of dexmedetomidine infusion on preventing hemodynamic response to intubation, skull pins and surgical incision in craniotomies was evaluated. Materials and Methods: Fourty ASA I-II patients undergoing craniotomy because of supratentorial tumors were randomised into: study group (n=20) received 1 ?g kg h-1 dexmedetomidine, and control group (n=20) received 0.9% NaCl infusion, 5 min. prior to induction. After intubation was performed at 10th minute, infusion rates were reduced to 50% in both groups. Control group received 1 ?g kg-1 fentanyl; dexmedetomidine group received 0.9% NaCl intravenously before skull pins. Same drugs were administered to the both groups for premedication, induction and maintenance. Results: Heart rate, systolic and diastolic arterial pressures reduced at 5th minute of infusion compared to initial values in dexmedetomidine group (p<0.001). Systolic and diastolic arterial pressures reduced after induction in both groups (p<0.001). In control group, the three haemodynamic parameters were higher after intubation compared to before intubation (p<0.001); were higher at 1 (p<0.001) and 5 minutes (p<0.05) after skull pins compared to before intubation; heart rate, systolic and diastolic (p<0.05) arterial pressures were higher after surgical incision compared to before intubation (p<0.001). In dexmedetomidine group, intubation and surgical incision did not cause significant haemodynamic response; systolic (p<0.001) and diastolic (p<0.05) arterial pressures were lower at 5 th minute than 1st minute of skull pins. Six patients in control and no patients in dexmedetomidine group needed fentanyl after surgical incision (p<0.001). Conclusion: Dexmedetomidine infusion started before induction is effective for preventing haemodynamic responses to intubation, skull pins and surgical incision in craniotomies.Öğe Effects of papaverine and ascorbic acid on reperfusion induced renal injury: An experimental ischemia and reperfusion model(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2014) Arslan K.; Hüseyin S.; Yüksel V.; Yalta T.D.; Turan F.N.; Canbaz S.; Turan E.G.E.Objective: The reperfusion injury that occurs after the treatment of acute extremity ischemia, is a clinical manifestation causes serious morbidity and mortality. Even if extremity reperfusion is totally provided, it may cause extremity loss, acute renal and respiratory failure. In this experimental study, the effect of vitamin C and papaverine on ischemia-reperfusion injury in kidneys occuring after occlusion-reperfusion of rat infrarenal abdominal aorta was investigated.Material and Methods: 32 Spraque-Dawley female rats were randomly divided into four equal groups (n=8). The same surgical procedure was applied to all rats. The microvascular klamp was put on infrarenal aorta and 60 minutes of ischemia was applied, then the klamp was removed and 120 minutes of reperfusion was supplied. The control and the ischemia-reperfusion groups were not given any drug and the other two groups were given vitamin C and papaverine. The incised renal tissues were fixed with formaldehyde then the samples were stained with Hematoxylin-Eosin. The samples were examined by light microscopy.Results: Meaningful pathological alterations were found out between ischemia and reperfusion group and control group. In vitamin C group, while dilatation of Bowman's capsule, tubular epithelial degeneration, tubular dilatation, and vascular congestion were statistically significant, interstitial inflammatory infiltration was meaningless. In papaverine group, dilatation of Bowman's capsule, degeneration of tubular epithelium, and tubular dilatation were statistically significant, vascular congestion and interstitial inflammatory infiltration were meaningless.Conclusion: We observed that the radical scavenging effect of vitamin C and vasodilatatory effect of papaverine may reduce the renal injury after the reperfusion in the acute lower extremity ischemias by preserving the microcirculation. Copyright © 2014 by Türkiye Klinikleri.Öğe Evaluating "superiority", "equivalence" and "non-inferiority" in clinical trials(King Faisal Specialist Hospital and Research Centre, 2007) Turan F.N.; Şenocak M.Clinical studies are usually performed with the aim of justifying that a new treatment approach is "superior" to the common standard approach (active control) with respect to benefits. In a general sense, this justification is carried out on the basis of the "null hypothesis significance test" with the P value based on this test used for justification. Today, new drugs differ so little from existing ones that factors such as cost and side effects affect the choice of therapy, when the bioavailability of treatment methods are found equivalent.Therefore, the aim of comparative clinical trials has extended beyond showing that a treatment is "superior" and now attempts to show that new treatments are "equal" and "non-inferior" to existing treatments. New approaches have become necessary since the classical null hypothesis approach is insufficient to justify the use of new agents, especially in cases of "equivalence" and "non-inferiority". This new approach to justification makes use of the "clinical equivalence interval", which determines the limits of the differences between specific endpoints that can be regarded as clinically "equal" to the value that was pre-specified based on studies of established therapies. It also makes use of the quantitative-based "confidence intervals" as the criteria for statistical justification. Many analyses can be done confidently when these tools are applied and the data are interpreted correctly.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 Gastroprotective effect of L-carnitine on indomethacin-induced gastric mucosal injury in rats: a preliminary study.(2006) Erkin B.; Dokmeci D.; Altaner S.; Turan F.N.BACKGROUND: Numerous studies have shown that use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with various gastric mucosal lesions, collectively referred to as NSAID gastropathy, but the detailed mechanism is still not properly understood. L-carnitine, a vitamin-like substance, is a naturally occurring enzymatic antioxidant with a potent free oxygen radical quencher and scavenger capacity; it protects the biological membranes against lipid peroxidation. It has recently been shown that L-carnitine has a gastroprotective effect on gastric mucosa. To our knowledge, the role of L-carnitine on NSAIDs-induced gastric mucosal injury is undefined. AIM: The aim of the present study was to determine the gastroprotective effect of L-carnitine on indomethacin-induced gastric mucosal lesions in the rat stomachs. MATERIAL AND METHODS: In our study, gastric mucosal injury was induced by the intragastric administration of indomethacin (30 mg/kg). L-carnitine (10, 50, 100 mg/kg) was given to rats by gavage 30 min before the indomethacin administration. The animals were killed 3 h after administration of indomethacin. The stomach of each animal was removed. Mucosal damage was evaluated with macroscopic study and histopathologically. RESULTS: The intragastric administration of indomethacin induced hyperemia and hemorrhagic erosions in the rat stomachs. L-carnitine significantly prevented gastric ulcerogenesis induced by indomethacin and decreased the ulcer index macroscopically and histopathologically. CONCLUSION: L-carnitine decreases indomethacin-induced gastric mucosal injury and this gastroprotective effect may be attributed to its well-known antioxidant effect.Öğe Inadvertent perioperative hypothermia and important risk factors during major abdominal surgeries(College of Physicians and Surgeons Pakistan, 2020) Sagiroglu G.; Ozturk G.A.; Baysal A.; Turan F.N.Objective: A relation between inadvertent perioperative hypothermia and possible important risk factors during major abdominal surgeries was investigated. Study Design: Cross-sectional descriptive study. Place and Duration of Study: Trakya University Hospital, Edirne, Turkey during 2016-2018. Methodology: Five hundred and twenty-nine patients undergoing major abdominal surgey were divided into two groups depending on postoperative body core temperature (CTM) by the use of tympanic membrane measurement. Patients with a temperature of less than 36oC indicated hypothermia group; whereas, patients with a temperature between 36 and 37.5oC indicated normothermia group. The parameters that were considered as risk factors for hypothermia include; baseline characteristics, American Society of Anesthesiologists (ASA) status, comorbidities, operative type, duration of surgery, patient and operative room temperatures, intraoperative hemodynamic parameters, transfusion of fluids and packed red blood cells (PRBCs), labaratory data, and adverse events. Correlation between these parameters and inadvertent hypothermia was sought. A p-value of less than 0.05 was considered statistically significant. Results: The risk factors that showed a correlation with hypothermia include: male gender, advanced age, high ASA scores, smoking, prolonged duration of operation, transfusion of fluids and PRBCs (p<0.05). In hypothermia group, duration of operation time was longer, need for transfusion was greater, hematocrit and hemoglobin values were lower than Normothermia Group of patients (p<0.05). Hypothermia was detected in 335 (63.3%) of patients. Conclusion: In this study, important risk factors for inadvertent hypothermia were found as; male gender, advanced age, high ASA scores, smoking, prolonged duration of operation, transfusion of fluids and/or PRBCs. © 2020 College of Physicians and Surgeons Pakistan. All rights reserved.Öğe Measurement of active abduction of metacarpophalangeal joints via electronic digital incinometric technique(2006) Gurbuz H.; Mesut R.; Turan F.N.To define the usefulness of electronic digital inclinometric (EDI) method to measure active abduction of metacarpophalangeal joints and to determine the mean scores. A modified electronic digital inclinometric method which was specifically designed to measure range of joint movements was administered to metacarpophalangeal joints of 20 male and 21 female university students. Active abduction of each metacarpophalangeal joint of both dominant and non-dominant hands were measured and recorded separately. Results were presented as mean ± standard deviation and statistical analysis of data was performed. First data obtained for Turkish people were as follows: 4.12° for thumb, 41.9° for index finger, 80.98° for median finger (approximately twice of others as it was the sum of radial and ulnar abductions), 41.57° for ring finger and 48.53° for little finger. Electronic digital inclinometer was found to be safe, practical and useful in the measurement of active movement ranges of metacarpophalangeal joints.Öğe Morphological and physiological effects of herbicide attribut (propoxycarbazone-sodium) and surfactant biopower (sodium alkylether-sulphate) on triticum aestivuml. CV. Pehlivan(2012) Yilmaz G.; Dane F.; Turan F.N.The goals of the study were to investigate morphological and physiological effects of herbicide Attribut (propoxycarbazone-sodium) and surfactant BioPower (sodium alkylether-sulphate) on Triticum aestivum L. cv. Pehlivan. For the experiments, Triticum aestivum were treated with Attribut at 4 different doses of 0.21, 0.42, 0.82 and 1.68 mM.. In order to evaluate the combined effects of BioPower and Attribut, 0.25% BioPower was added in each of applied Attribut doses. The laboratory studies showed that the EC (effective concentration) value corresponded to farmer value of (0.42 mM Attribut). Applications were done either by seed treatments or spreading. The toxic effects of each doses applied on wheat plants were monitored in terms of morphological and physiological parameters. STATISTICA AXA 7.1 statistical program which has number AXA507C775506FAN3 was used for statistical analysis. The results showed that root and shoot lengths during different growth periods of wheat and germination rates decreased, amounts of chlorophyll in leaves decreased while amount of protein in seeds increased with (0.82 mM Attribut), (0.82 mM Attribut + 0.25% BioPower) doses and more of that concentrations were found to be toxic for wheat plants. These toxic effects increased in use with BioPower. © by PSP.Öğe Serum prolidase levels and its relation with severity of acne vulgaris(Scientific Publishers of India, 2018) Günay E.; Korkmaz S.; Turan F.N.Background: The pathogenesis of acne vulgaris is multifactorial and inflammation plays a prominent role in the process. In clinical trials, independent from tissue type; it is found out that prolidase levels and activity are differing in numerous malign and chronic inflammatory processes on which collagen turnover is accelerated. This study aims to evaluate the relationship between serum prolidase levels and acne severity in acne vulgaris. Methods: Thirty patients with mild to moderate Acne Vulgaris (AV), 30 with severe AV and 28 healthy volunteers were included in the study. The GAS was used to determine disease severity in patients with AV. Serum prolidase levels were measured by ELISA method. Results: There were not statistically different between the groups in term of serum prolidase levels (p=0.819). In addition, there was no statistically significant difference between the two groups (p=0.647 for AV groups, p=0.926 for severe AV and healthy control, and p=0.539 for mild-moderate AV and healthy control). There was no statistically significant correlation between GAS and prolidase levels in patients with severe AV (r=0.207, p=0.273) and mild-moderate AV (r=0.162, p=0.392). Conclusions: In conclusion, there was no significant difference in serum prolidase levels in patients with AV. New studies with wide case series are necessary to determine the role of prolidase on the pathogenesis of acne vulgaris. © 2018, Scientific Publishers of India. All rights reserved.
