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Öğe A comparison of propofol with propofol-alfentanil using patient controlled sedation(2005) Özdemir Kol, Iclal; Aslan, Berrin D.; Gürsoy, Sinan; Kaygusuz, Kenan; Gönüllü, MustafaThe aim of this study was to compare Patient Controlled Sedation with propofol or a propofol-alfentanil combination in patients undergoing urologic endoscopic procedures under spinal anesthesia. The study was carried out on 50 male ASA I or II patients aged 35-75. Group I (n=25) received 0.3 mg kg-1 propofol, Group II (n=25) recevied 0.2 mg kg-1 propofol and 2 ?g kg-1 alfentanil using a patient controlled sedation device. Heart rate, mean arterial pressure, SpO2, respiratory rate, anxiety and sedation degrees were recorded before sedation, at the 15th and 30th minute of sedation and at the postoperative 30th minute. At the end of the operation, patient satisfaction, recovery time and presence of amnesia were assessed. Sedation scores were within desirable levels in both groups, but there was no difference in the sedation scores. While preoperative anxiety scores were high, peroperative and postoperative scores decreased significantly. There was no difference between the groups in recovery scores or patient satisfaction. None of the patients had amnesia during sedation. The adverse effects noted were 52% in group I, 24% in group II. It was concluded that there are no differences in sedation, anxiety, recovery scores and hemodynamic effects between the groups. We think that the propofol-alfentanil combination is superior since its adverse effects were fewer.Öğe Approach to HELLP syndrome in intensive care unit (seven case report)(2004) Kaygusuz, Kenan; Gürsoy, Sinan; Kunt, Nur; Kafali, HalukHELLP Syndrome is characterised by hemolysis, elevated serum levels of aspartate aminotransferase and lactate dehydrogenase and low platelet count. The pathogenesis of HELLP Syndrome remains unclear. We presented the follow up of 7 HELLP syndrome cases in the intensive care unit between 2001-2003. Patients were between 18-28 years of age and gestational ages were between 26-38 weeks. HELLP syndrome occured in the antepartum period in 3 patients and in the postpartum period in the 4 patients. Three patients with Glasgow Coma Score between 3-4 died. Six cases required mechanical ventilation therapy. CT revealed brain edema in 3 patients. ARDS was diagnosed in 3 patients and acute renal failure developed in 2 patients. When respiratory functions and laboratory values returned to normal, 4 patients were transferred to obstetrics and gynecology ward. Because severe complications may develop in HELLP syndrome, we think that the patients must be observed in ICU until the clinical and laboratory findings recover.Öğe COMPARISION OF INTRAOPERATIVE AND PREOPERATIVE HEMODYNAMIC PARAMETERS AND QT CHANGES IN ECG IN PATIENTS UNDERGOING TRANSURETHRAL RESECTION OF THE PROSTATE UNDER SPINAL ANESTHESIA Onur(Afyonkarahisar Sağlık Bilimleri Üniversitesi, 2019) Sarpdağ, Cafer; Kaygusuz, Kenan; Avcı, Onur; İsbir, Ahmet Cemil; Kol, İclal Özdemir; Gürsoy, SinanOBJECTIVE: In our study we aimed to compare intraoperative hemodynamic changes and changes in QT interval with preoperative values in patients undergoing transurethral resection of the prostate (TUR-P) under spinal anesthesia.MATERIAL AND METHODS: The study comprised of 45 patients, between the ages of 40 to 65 and ASA I-II who were planned to undergo transurethral resection of the prostate. The patients were randomly divided into 3 groups. %0.9 NaCl to group I, gelatin to group II, and to group III hydroxyethyl starch were intravenously injected via using 18 gauge intravenous catheter. Hemodynamic parameters were recorded as 5-minute intervals in preoperative period and also during the operation. QT values were recorded in 5, 15, 30, 60 minutes, before, during and after the operation.RESULTS: There was no significant hemodynamic differences between the groups whereas in Group I, QT interval, between the preoperative and postoperative period were significantly different. Also we compared preoperative values and postoperative values of post-op 5min and 10min and found significant difference and increase. In Group II, preoperative and postoperative QT intervals were significantly different and the measurements are found to be increased. In Group III the difference between preoperative and postoperative 15min and 20min values were significant and the measurements are found to be increased. In Group III, there was significant difference between the values taken in 5 min and other times and the measurements are found to be increased.CONCLUSIONS: In view of prolonging on intraoperative and postoperative QT interval on patients that have TUR-P operation; more care should be taken in patients who are planned TUR-P operation, who have coronary heart disease and have pre-operative acquired or congenital prolonged QT interval.Öğe Comparison of anesthetic effects and peroperative tolerance of remifentanil and alfentanil based Total Intravenous Anesthesia (TIVA)(2006) Kaygusuz, Kenan; Gürsoy, Sinan; Aldemir, Banu; Ba?civan, Ihsan; Kafali, Haluk; Mimaro?lu, CanerAim: The aim of this study was to compare the anesthetic offerts and peroperative tolerance: of remifentanil and alfentanil based total intravenous anesthesia (TI-VA). Materials and Methods: In this randomized, double-blinded study was applied at thirty patients of ASA physical status I and II who were scheduled for elective abdomen and urogenitale surgery lasting at least 2 h. Patients were randomly allocated to receive either remifentanil-propofol (group remifentanil) (n=15) or alfentanil-propofol (group alfentanil) (n-15). Anesthesia was induced with remifentanil 1 ?g kg-1 or alfentanil 40 ?g kg-1 with propofol 1.5 ?g kg-1 and maintained with infusion of propofol 70 ?g kg-1 dk-1 and either remifentanil 0.5 ?g kg-1 dk-1 or alfentanil 1 ?g kg-1 dk-1. In both groups, propofol infusions were constanted. Opioid dose was increased or decreased 50 % according to necessity. Hemodynamic parameters (systolic and diastolic blood pressure, and heart rate), extubation time, Aldrete recovery score, and consumption of remifentanil and alfentanil during operation were recorded. Frequency of nausea, vomiting and other side effects were recorded postoperatively. Results: Duration of operation and demographic data were similar among groups. The blood pressure and heart rate values of remifentanil group at tracheal intubation time were significantly higher than the alfentanil group (127.93±5.64 mmHg vs. 98.53±6.25 mmHg and 94.53±4.75 beat min-1 vs. 79.46±3.91 beat min-1, respectively) (p<0.05). In remifentanil group, the extubation time was shorter than the alfentanil group (8.60±0.70 min vs. 14.00±1.40 min, respectively) (p<0.05). In both groups, opioid infusions were not increased during operation. Total consumption of remifentanil und alfentanil during operation were as follows 5.9±0.76 mg, 13.3±2.1 mg respectively. Conclusions: Although alfentanil provided better hemodynamic stability than remifentanil at tracheal intubation, extubation time was longer than remifentanil. However no development of tolerance was observed during remifentanil and alfentanil infusion.Öğe Comparison Of Percutaneous and Intraabdominal Blockades Of Iliohypogastric and Ilioinguinal Nerves For Postoperative Pain Management Of Total Abdominal Hysterectomy Patients: A Randomized Controlled Clinical Trial(Sivas Cumhuriyet University, 2022) Düger, Cevdet; Avcı, Onur; Boztosun, Abdullah; İsbir, Cemil; Kol, İclal Özdemir; Kaygusuz, Kenan; Gürsoy, SinanObjective: In this study we aimed to determine whether iliohypogastric and ilioinguinal nerve blockade from intraabdominal approach for the postoperative pain management of total abdominal hysterectomy patients could be a reliable and effective alternative compared to percutaneous block of IHII nerves. Materials and Methods: This study is a randomised controlled double blind prospective clinical trial. This study was conducted in operating room, and recordings were performed in postoperative recovery unit and gynaecology clinic. Eighty seven women undergoing total abdominal hysterectomy were enrolled in this study but 82 completed the study. Patients were divided into three groups (n=29 in each), as control group (group C), percutaneous IHII block group (group PB) and intraabdominal IHII block group (group IB). Group C patients received no block procedure. The percutaneous bilateral IHII nerves block was performed after abdominal closure to group PB and intraabdominal IHII block was performed before abdominal closure to group IB. Mean arterial pressure, heart rate, pain scores, satisfaction scores, morphine consumptions and side effects were recorded at the 2nd, 6th, 12th and 24th postoperative hours. Results: Postoperative MAP, HR results of control group were found similar in all groups. VAS scores at all postoperative hours were found to be significantly lower in the block groups PB an IB than control group. There were no significant differences in pain scores between group PB and IB at any time point. Morphine consumption data were found to be significantly lower in the PB and IB groups than in the control group. Conclusions: Intraabdominal IHII blockade just before closure of the abdomen for relieving postoperative pain in total abdominal hysterectomy patients is as effective and safe method as conventional percutaneous IHII blockade without adverse effects.Öğe Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study(Turkiye Klinikleri, 2022) Göktürk, Orhan; Avci, Onur; Gündoğdu, Oğuz; İsbir, Ahmet Cemil; Özdemir Kol, İclal; Gürsoy, Sinan; Kaygusuz, KenanObjective: The aim of this study was to compare the sensitivity and specificity of Pleth Variability Index (PVI) and distensibility of inferior vena cava (dIVC) in fluid responsiveness of patients with sepsis. Material and Methods: Forty patients over 18 years of age who underwent fluid replacement for sepsis in the intensive care unit were included in the study. In our study, the patients were divided into 2 groups as those who had less than 15% increase in cardiac output (CO), and those who had more than 15% increase in CO after fluid replacement (fluid responders and non-responders). Before fluid replacement, demographic data of the patients (age, weight, cause of sepsis, body surface area, SOFA score), vital parameters (systolic arterial pressure, diastolic arterial pressure, mean arterial pressue, heart rate) and measuredd values (maximum diameter of vena cava inferior, minimum diameter of vena cava inferior, central venous pressure, PVI, CO, and stroke volume) were recorded. After applying crystalloid in a dose of 10 mL/kg for 15 minutes, the recorded parameters were repeated at 15th minute. Results: When receiver operating characteristic (ROC) analysis was performed for dIVC, the area under the curve (AUC) was found to be 0.833 (0.739-0.926). The threshold value was found to be 17.52%, sensitivity was 77.5%, and specificity was 72.5%. When ROC analysis was performed for PVI, AUC was found to be 0.889 (0.817-0.962). The threshold value was found as 12.50%, sensitivity was 72.5%, and specificity was 92.5%. Conclusion: PVI was found to be more specific but less sensitive than dIVC. dIVC is less sensitive and less specific than central venous pressure. However, dIVC and PVI can give useful results in patients who have contraindication of an invasive technique. © 2022 by Türkiye Klinikleri.Öğe Comparison of postoperative analgesia methods in lower abdominal surgery(Turkiye Klinikleri, 2006) Gürsoy, Sinan; Kaygusuz, Kenan; Demirel, Yeltekin; Duran, Bülent; Kafali, Haluk; Mimaro?lu, CanerObjective: The present study aimed to determine the advantage and disadvantage of different postoperative analgesia methods in patients undergoing cesarean section or hysterectomy under general anesthesia. Material and methods: Following ethics committee approval and patient informed consents, 120 patients were recruited from the ASA I-III groups. Patients were divided randomly into 6 groups. IM-D group received intramuscular diclofenac sodium (75 mg) every 12 hours. IM-ME group received intramuscular meperidine (1 mg kg -1) every 6 hours. IM-DME group received intramuscular meperidine (1 mg kg-1)-diclofenac sodium (75 mg) combination every 12 hours. EP-MO group received epidural morphine (bolus of 3 mg and 0.06 mg mL-1 morphine; 6 ml h-1) infusion. EP-MOB group received epidural infusion of morphine-bupivacaine combination (bolus of 2 mg morphine + 35 mg bupivacaine combination, 2 mg ml-1 bupivacaine + 0.03 mg mL-1 morphine combination; 6 ml h-1). IV-MO group received intravenous morphine via patient-controlled analgesia (loading dose of 3 mg, bolus of 1 mg and 20 minutes lockout interval). Heart rate, mean arterial pressure, SpO 2, pain and sedation levels were recorded at 2, 6, 12, 24 and 48 hours. Furthermore, additional analgesic consumption and side effects were also recorded. Results: Effective analgesia was in groups IM-DME, EP-MO, EP-MOB, and IV-MO. However, the lowest pain scores were obtained in groups EP-MO and EP-MOB. Sedation scores were higher in groups EP-MO and IV-MO. While the highest additional analgesic consumption was in groups IM-D and IM-ME, there was no additional analgesic consumption in groups EP-MO, EP-MOB and IV-MO. Side effects were not observed in any groups that required treatment. The highest incidence of side effects were in group IV-MO whereas the lowest incidence of side effects were observed in groups IM-DME and EP-MOB. Conclusion: While there was effective analgesia in groups IM-DME, EP-MO, EP-MOB, and IV-MO, IM diclofenac + meperidine combination and epidural bupivacaine + morphine combination seemed more advantageous when the side effects were considered. Copyright © 2006 by Türkiye Klinikleri.Öğe Determination of risks and benefits of intrathecal tramadol hydrochloride in rabbits(2002) Gürsoy, Sinan; Kafali, H.; Kunt, N.; Göze, F.The risks and benefits of intrathecal tramadol hydrochloride application in rabbits has been studied. In this study 35 male, Albino type New Zelland rabbits were used. The rabbits were divided into 5 groups. A, B, C and D groups were administered intrathecally single dose 1, 2, 4 and 8 mg/kg tramadol hydrochloride respectively and also single dose of saline was given intrathecally to the control group. Pain treshold, whether the seizures improved or not, respiratory depression, motor disfunction and sedation grade were evaluated at the intervals of 5, 15, 30, 60 and 120th min. Additionally neurotoxicity was searched histopathologically. It has been detected that tramadol has moderate analgesic potential which starts rapidly, lasts for a short time and depends on the dose. Motor disfunction and seizures were not observed. Light sedation and respiratory depression were observed at high doses. Neurotoxicity was found in all groups except the control group. Intrathecal tramadol hydrochloride has moderate analgesics effects which lasts for a short time and low incidence of side effects. It is assumed that it has toxic effect on the spinal cord.Öğe Early ischemic complication resulting with amputation of the thumb after radial arter cannulation (case report)(2005) Gürsoy, Sinan; Kaygusuz, Kenan; Kunt, Nur; Kafali, Haluk; Mimaro?lu, CanerThe left radial artery of a 34 year old male patient who was scheduled for surgery due to rectum cancer was cannulated after performing the Allen's test in the operating room. In the first hour following the operation, it was seen that the area between the antecubitas and the hand was hyperemic. The tenar area of the hand and the thumb was cyanotic, so the cannula was removed. Doppler showed radial artery pulsations. Antithrombotic and anticoagulant treatment was started intraoperatively. Radial artery flow was weak with doppler on the first postoperative day. Since there was no response to the treatment, the thumb finger was amputed one month later. It was concluded that the patient experienced radial trombosis resulting from the cannulation.Öğe Effect of laparoscopic bariatric surgery on cerebral oxygenation(Turkiye Klinikleri, 2019) Turan, Ezgi; Kol, İclal Özdemİr; Avci, Onur; İsbİr, Ahmet Cemil; Kaygusuz, Kenan; Gürsoy, SinanObjectives: Bariatric surgery methods are an important piece of morbid obesity treatment. In this research; we investigated the effects of laparoscopic bariatric surgery on rSO2, which is measured by using cerebral oxymeter, during reverse trendelenburg position, carbon dioxide insuflation and pneumoperitonium under general anesthesia. Material and Methods:After the patients’ and Cumhuriyet University Ethics Committee’s approval are taken; 40 voluntary, ASA I-III bariatric surgery patients at the age of 18-60 years were taken into the research. Hemodynamic parameters and rSO2 values were recorded at every 5 minutes of the operation, immediately after anesthesia induction (T1), at the starting of CO2 insuflation (T2), at 10th (T3), 20th (T4) and 30th (T5) minute of pneumoperitonium (T3), at 5th (T6) and 10th (T7) minute of positioning the patient into reverse trendelenburg, after positioning the patient into supine position at the end of the surgery (T8) and after extubation (T9). Results: When we compare the rSO2 values which were measured at different times, the difference was significant. When the measurements were compared as in double; differences between basal and T1, T2, T8 and difference between T1 and T9 were significant and differences between the other values were insignificant. In our research; there was a statistically increase in rSO2 after induction, at the start of CO2 insuflation and at 10th minute of positioning into reverse trendelenburg when compared to basal value. There was a decrease in rSO2 values that measured after extubation compared to values that measured after induction. Cerebral desaturation was not observed in any patient during the operation. Conclusion: It was seen that there was no significant difference in terms of cerebral oxygen saturation of the pneumoperitoneum and reverse trendelenburg position applied in limited number of patients undergoing bariatric surgery under general anesthesia. Surgery position was hemodynamically well-tolerated by the patients and the changes on rSO2 have parallels with hemodynamic changes. © 2019 by Türkiye Klinikleri.Öğe Evaluation of QT Interval of Patients Using Muscle Relaxants Under General Anesthesia, Randomized Clinical Trial(Sivas Cumhuriyet University, 2022) Kurt, Bekir; Gündoğdu, Oğuz; Avcı, Onur; Gürsoy, Sinan; Kol, İclal Özdemir; Kaygusuz, Kenan; İsbir, CemilObjective: The aim of the study was to investigate the effects of rocuronium, mivacurium, and atracurium on arrhythmia markers, QT interval, and QT dispersion (QTd).Method: Ninety patients scheduled for septorhinoplasty were randomly assigned to one of three groups of 30. During the induction of anesthesia, muscle relaxants of 0.6 mg/kg rocuronium in Group R, 0.2 mg/kg mivacurium in Group M, and 0.5 mg/kg atracurium in Group A were employed. Mean blood pressure (MAP), heart rate (HR), and electrocardiogram (ECG) values were measured before induction of anesthesia (T0), immediately after induction of anesthesia (T1), at 1 minute (T2), 5 minutes (T3), 10 minutes (T4) and 15 minutes (T5) after muscle relaxant administration, and QT, corrected QT (QTc), QTd and corrected QTd (QTcd) intervals were recorded. Results: When the groups were compared in terms of QTcd values, the difference between mivacurium and atracurium was significant in terms of T5 values, and atracurium (T5) QTcd was found to be shorter (p<0.05). Group M had 5 of the 6 measures with pathological QTc prolongation.Conclusions: Because the prevalence of pathological QTc is greater in mivacurium, further clinical trials should be conducted to challenge the use of mivacurium in individuals with a long QT interval.Öğe Levothyroxine intoxication: Scientific letter(Turkiye Klinikleri, 2007) Özdemir Kol, Iclal; Gürelik, Bilge; Kaygusuz, Kenan; Gürsoy, Sinan; Gönüllü, Mustafa; Mimaro?lu, CanerLevothyroxine is presently dominant agent prescribed for thyroid hormone replacement; it account for 75% of all prescriptions for thyroid hormone products. Intoxication of levothyroxine might be associated with thyrotoxicose or it might causes mild clinical symptoms as well. In this study, we presented (18-years old) a case report of levothyroxine intoxication which was treated in the intensive care unit. In the management, gastric lavage, activated charcoal prophylthiouracil, propranolol, and Prednisolon were administered. The patient was discharge without any symptoms of thyrotoxicose or any other complications. This case report presents appropriate management of levothyroxine intoxication. Copyright © 2007 by Türkiye Klinikleri.Öğe Pseudoaneurism of radial artery(2008) Kol, Iclal Özdemir; Gürsoy, Sinan; Kaygusuz, Kenan; Gürelik, Bilge; Alkin, Feridun; Gönüllü, Mustafa; Mimaroglu, CanerIntroduction: Pseudoaneurysms can be occurred due to blunt or penetrating traumas that damages arterial wall completeness. Pseudoaneurysm of radial artery is seen rarely. In this case, a pseudoaneurysm due to radial artery catheterization at intensive care unit (ICU) is presented. Case: The patient was a 56 years old man that had amyotrophic lateral sclerosis at ICU. Radial catheter was removed because of skin flushing and pain at the 190th day of hospitalization. After 24 hours of removal of the catheter a 2×3 cm palpable and pulsatile mass was determined. The diagnosis of pseudoaneurysm was made by Doppler ultrasound. Because of mass enlarging and wound formations on first and second fingers, aneurismatic mass was removed and radial artery was ligated. The ulcerations on fingers recovered completely. Conclusion: Pseudoaneurysms can be seen after the removal of catheters at the patients who are catheterized for a long time and frequently. In order to prevent this it must be paid attention to asepsia, and must be pressed for enough time. The attempting area must be observed regularly for early diagnosis, the treatment must be done before dangerous complications have been occurred.Öğe Retrospective analysis of anesthesia applications with magnetic resonance imaging(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2018) Gürbüz, Hasan; Özdemi?R Kol, İclal; Avci, Onur; Işbir, Ahmet Cemil; Kaygusuz, Kenan; Gürsoy, SinanObjective: Because it is a semi-enclosed environment, the process takes a long time, the noises from equipments and requires complete immobility the magnetic resonance imaging (MRI) requires some anesthesia during the procedure in adolescents and adults, especially with children. Material and Methods: Following the approval of the local ethics committee, anesthesia records were reviewed retrospectively of 1.008 patients whom underwent diagnostic MRI procedure and required sedation between the years 2006-2012. What type of anesthesia is applied for the patients’ according to their age and gender and what kind of adverse effects occured during the process were examined. Results: When patients complication status were analysied retrospective according to their age, gender, American Society of Anesthesiologists and mallampati, there was no significant difference (p>0.05). Following the procedure, patients' heart rate and oxygen saturation levels were significantly increased when compared with before the procedure (p<0.05). When for 23.1% of the patients, airway control ensured with mask/cannula, the other 76.9% needed laryngeal mask. Late recovery after sedation was higher while implementation of the laryngeal mask for the airway control (p<0.05). When the distribution of complications in patients were analyzed: 826 (81,9%) no complications, 97 (9,6%) nausea and vomiting, 60 (6,0%) late recovery, 17 (1,7%) desaturation, 8 (0,8%) bradycardia were identified in patients. Late recovery was higher in patients with longer duration of action in this study. When complications related to a given sedative agents were analysied, nausea and vomiting was observed lesser extent in patients who used propofol (p<0.05). Conclusion: Before the procedure, patients should be evaluated in terms of anesthesia and appropriate anesthesia methods should be selected for each patient and MRI-compatible anesthesia machine and monitors should be used to complete MRI safely with negligible side effects. Also anesthesia for MRI applications is necessary to be done by an experienced team who has good knowledge for drugs effects and side-effect profile. Copyright © 2018 by Türkiye Klinikleri.Öğe Sezaryen Gerekli Post-Covid Sağlıklı Gebelerde İntraoperatif Akciğer Mekanikleri: Randomize Kontrollü Çalışma(Sivas Cumhuriyet Üniversitesi, 2024) Balcı, Fatih; İsbir, Cemil; Gündoğdu, Oğuz; Avcı, Onur; Gürsoy, Sinan; Kol, İclal Özdemir; Kaygusuz, KenanAmaç:Bu çalışmanın amacı aktif enfeksiyon süresi boyunca akciğer görüntüleme yapılmamış ve ARDS olmadan Covid-19’dan iyileşen hastalarda akciğer mekaniklerinin etkilenip etkilenmediğini göstermektir. Yöntem:Hastalardan gebelerden oluşuyordu. Çalışma sezaryen ameliyatı sırasında yapılmıştır. Son 1 yıl içinde Covid-19 enfeksiyonu geçirip iyileşmiş gebeler ile Covid-19 enfeksiyonu geçirmemiş gebeler dahil edildi. Çalışmaya alınan 100 hasta iki gruba ayrıldı: Son 1 yıl içinde Covid-19 enfeksiyonu geçirip iyileşmiş hastalar(grup 1, n:50) ve kontrol grubu olarak hiç Covid-19 enfeksiyonu geçirmemiş hastalar(grup 2 n:50). Genel anestezi altında opere olan hastalarda MAP, HR ve SpO2 değerleri hasta takip formunda belirli zamanlarda ölçüldü ve kaydedildi. Entübasyon sonrası 1.dakikadan itibaren belirtilen zaman aralıklarında anestezi makinesi tarafından ölçülen tepe basıncı (Ppeak), plato basıncı(Pplato), dynamic compliance(Cdyn) ve positive end-expiratory pressure(PEEP) değerleri kaydedildi. Bulgular:Her iki gruptaki bireylerden belirli zamanlarda elde edilen Ppeak, Pplato, ΔP, Cdyn ve R verileri karşılaştırıldığında gruplar arası anlamlı fark bulunmamıştır. Grup 1 ve Grup 2’ye ait farklı zamanlarda elde edilen Pplato, ΔP ve R ölçümleri istatistiksel olarak anlamsız bulunmuştur. Sonuç:Covid-19 enfeksiyonu geçirmiş hasta grubu ile kontrol grubu bireylerinin akciğer mekanikleri arasında anlamlı fark yoktu. Her iki hasta grubunda SpO2, MAP, Cdyn değerlerdeki farklılıklar ; laringoskopi, endotrakeal entübasyon ve PEEP uygulama gibi genel anesteziye ait rutin uygulamalarla birlikte beklenen değişiklikler olarak düşünülmektedir.Öğe SPİNAL ANESTEZİ EŞLİĞİNDE TRANSÜRETRAL PROSTAT REZEKSİYONU UYGULANAN HASTALARIN İNTRAOPERATİF HEMODİNAMİK PARAMETRELERİNİN VE EKG’DEKİ QT DEĞİŞİKLİKLERİNİN PREOPERATİF DEĞERLER İLE KARŞILAŞTIRILMASI(2019) Avcı, Onur; Sarpdağ, Cafer; Kaygusuz, Kenan; İşbir, Ahmet Cemil; Kol, İclal Özdemir; Gürsoy, SinanAMAÇ: Çalışmamızda spinal anestezi altında transüretralprostat rezeksiyonu (TUR-P) uygulanan hastalarda intraoperatif hemodinamik değişikliklerin ve QT mesafesi de-ğişikliklerinin preoperatif değerler ile karşılaştırılmasınıamaçladık.GEREÇ VE YÖNTEM: Çalışmaya transüretral prostat rezeksiyonu uygulanacak 40-65 yaş arası ASA I-II (AmericanSociety of Anesthesiologists) toplam 45 hasta rastgeleolacak şekilde 3 gruba ayrıldı. I. gruba (n=15) %0.9 NaCl, II.gruba Jelatin, III. gruba Hidroksietil nişasta 18 gauge intraket ile açılan intravenöz (IV) damar yolundan verildi. Hemodinamik parametreler olarak ortalama arteriyel basınç(OAB), periferik oksijen saturasyonu (SpO2), kalp atım hızı(KAH) operasyon öncesi ve operasyon süresince 5 dakikaaralıklarla ve operasyon sonrası kaydedildi. QT intervalideğerleri operasyon öncesi ve operasyon süresince 5.,15., 30., 60. dakikalarda ve operasyon sonrası kaydedildi.BULGULAR: Gruplar arası ve her bir grup kendi içindedeğerlendirildiğinde ortalama arteriye basınç (OAB),periferik oksijen saturasyonu (SpO2), kalp atım hızı (KAH)açısından anlamlı bir fark bulunmazken (p>0.05), QTmesafesi grup I’de preoperatif değerler ile 5.dk ve 10.dkile postoperatif ölçümler arasındaki farklılık anlamlıolup ve bu değerlerde artış bulunmuştur (p<0.05). GrupII’de preoperatif ve postoperatif ölçülen QT değerleriarasındaki fark anlamlı olarak artmıştır (p<0.05). GrupIII’de preoperatif değerler ile, 15. dk, 20. dk, ve postoperatifdeğerler arası fark anlamlı olup (p<0.05) bu değerlerdeartış bulunmuştur. Grup III’de 5. dakika ile diğer ölçümlerarası fark anlamlı olup (p<0.05) ve bu değerlerde artışbulunmuştur.SONUÇ: Transüretral prostat rezeksiyonu operasyonu planlanan hastalarda intraoperatif ve postoperatif QT intervalinin uzadığı gözönüne alındı-ğında; özellikle koroner kalp hastalığı bulunan vepreoperatif edinsel ya da konjenital uzamış QT intervali saptanan hastalarda daha dikkatli olunmalıdırÖğe Successful treatment of intoxication case with rosiglitasone and metformin(2013) Düger, Cevdet; Isbir, Ahmet Cemil; Özdemir Kol, Iclal; Kaygusuz, Kenan; Gürsoy, Sinan; Kiliç, Isa; Mimaro?lu, CanerMetformin is a biguanide antidiabetic high doses of which may cause lactic acidosis. Rosiglitazone is a member of thiazolidinedione antidiabetics group which increases insulin sensitivity. A 35-year-old female patient was admitted to hospital with the complaints of loss of consciousness, oliguria, nausea and vomiting after a history of 48 g of metformin, 108 mg rosiglitasone uptake for suicide. Hypotension, hypoglycemia and metabolic acidosis were observed in the patient, sos he was supported by mechanical ventilation due to the Glasgow coma scale 5. The patient was discharged liome on the 45th day after continuous venovenous hemodiafdtration, supplamentary treatment and 39 days of mechanical ventilation support. There must be a suspicion for metformin intoxication in the patients with high anionic gap metabolic acidosis, and who take overdose drugs for suicide. Since metformin associated hypoglycemia, lactic acidosis and hypothermia are reversible, early diagnosis of metabolic acidosis and cardiovascular support with hemodialysis and hemofdtraiion protect blood glucose level and body temperature, which allow for possible recovery.Öğe Tavşanlarda intratekal tramadol hidrokloridin risk ve faydalarının belirlenmesi(Cumhuriyet Üniversitesi, 1999) Gürsoy, Sinan; Kafalı, HalukÖZET Oral, intramüsküler, intravenöz ve epidural uygulamalarda olumsuz etkileri düşük olan Tramadol hidroklorid, tavşanlara intratekal uygulanarak risk ve faydaları araştırıldı. Çalışma aynı yaşta, ağırlıkları 1600-1700 g arasında değişen 35 adet erkek Albino tipi Yeni Zelanda tavşanı ile yapıldı. Tavşanlar biri kontrol olmak üzere beş gruba ayrıldı. Dört gruba Tramadol hidrokloridin, değişik dozları(l,2,4,8 mg/kg) ve bir gruba da serum fizyolojik intratekal tek doz olarak uygulandı. 5, 15, 30, 60 ve 120'nci dakikalarda ağrı eşiği, konvülzyon gelişip gelişmediği, solunum depresyonu, motor zayıflık ve sedasyon dereceleri değerlendirildi. Ayrıca nörotoksisiteye neden olup olmadığı histopatolojik olarak araştırıldı. İstatistiksel değerlendirme Varyans analizi, Tukey testi, Kurskal-Wallis ve Man-Withney U testi ile yapıldı. Doza bağlı, orta derecede, hızlı başlayan kısa süren analjezik etkinlik tespit edildi. Motor zayıflık ve konvülzyon görülmedi. Yüksek dozlarda hafif sedasyon ve solunum depresyonu gelişti. Kontrol grubu dışındaki diğer gruplarda norötoksik bulgular oluştu. İntratekal Tramadol hidrokloridin, orta derecede ve kısa süreli analjeziye ve düşük yan etki profiline sahip olduğu, ancak medulla spinalis için toksik olduğu kanısına varıldı. 50Öğe The comparison effect of intrathecal hyperbaric bupivacaine, ropivacaine and levobupivacaine for cesarean section(2008) Aydin, Rukiye; Özdemir Kol, Iclal; Kaygusuz, Kenan; Gürsoy, Sinan; Mimaro?lu, CanerObjective: The aim of this study was to compare the effects of intrathecal hyperbaric bupivacaine, ropivacaine and levobupivacaine on the hemodynamic parameters, spinal blockade characteristics, Apgar scores and umbilical veneous blood gases changes in mother and newborn undergoing elective cesarean section. Methods: After the approval of the Ethical Committee and the patients, sixty patients of ASA physical status I-II, undergoing elective cesarean section under spinal anesthesia, were enrolled in this clinical study. Patients were randomized into three groups. Bupivacaine group (n = 20) receiving 8 mg hyperbaric bupivacaine and ropivacaine group (n = 20) receiving 12 mg hyperbaric ropivacaine and levobupivacaine group (n = 20) receiving 8 mg hyperbaric levobupivacaine. Hemodynamic parameters, sensorial and motor blockade characteristics, Apgar scores, umbilical venous blood gas values, postoperative VAS scores, and side effects were recorded. Results: The demographic data, sensorial blockade and duration of surgery of the study groups were comparable (p > 0.05). Also there was no significant difference among the groups with regard to the hemodynamic parameters but in all groups systolic, diastolic and mean arterial blood pressures were decreased when compared with basal values (p<0.05). When Bromage score values were compared between groups in bupivacaine group (%95) values were higher than ropivacaine (%45) and levobupivacaine groups (%75) (p<0.05). The duration of the motor blockade was longer in bupivacaine group than the levobupivacaine and ropivacaine groups (p<0.05). There were no differences among groups with regard to the newborn Apgar scores and umbilical venous blood values (p>0.05). Conclusion: Intrathecally applied equally dosage hyperbaric ropivacaine and levobupivacaine in cesarean sections, could be used successfully without changing the hemodynamic parameters of mothers and newborns. Based on these data, spinal anesthesia with administration of hyperbaric levobupivacaine and ropivacaine can be applied as an alternative to bupivacaine for similar anesthesia conditions, shorter motor blockade duration and earlier patient mobilization times.Öğe The comparison of the method for cardiac output measurement in mechanically ventilated critical care unit patients(2005) Gürsoy, Sinan; Kaygusuz, Kenan; Kunt, Nur; Kafali, Haluk; Mimaro?lu, CanerAim: Although the thermodilution technique for cardiac output monitorization is the most common used clinical method, it is very invasive and has all risks of this. Therefore the importance of the noninvasive cardiac output measurement technique is increased. In this study we aimed to compare the safety of thermodilution method and partial CO2 rebreathing fick technique which is a noninvasive method, at the cardiac output measurement of mechanically ventilated critical care unit patients. Materials and Methods: The study was scheduled to 32 critical care unit patients who were between 23-75 ages and needed mechanical ventilation. Patients ventilated on controlled mechanical ventilation mode. Cardiac output measurements were done twice simultaneously in 4 hours intervals by invasive and noninvasively. Results: There were no statistically differences in cardiac output between the methods at the two measurement (p>0.05). There were a high correlation in cardiac output between the methods at the two measurement (p<0.05). Conclusion: The noninvasive partial CO2 rebreathing fick technique may be an alternative to the thermodilution method for cardiac output determination in mechanically ventilated patients.
