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Öğe Comparison of methods used in general anesthesia without muscle relaxants and rocuronium bromide and vecuronium bromide use in cases of pediatric adeno-tonsillectomy(DRUNPP-SARAJEVO, 2012) Isbir, Ahmet Cemil; Atim, Abdulkadir; Duger, Cevdet; Deniz, Suleyman; Orhan, Emin M.; Cosar, Ahmet; Kurt, ErcanObjectives and aim: In this study a total of 60 patients in paediatric age group scheduled for adeno-tonsillectomy the induction of general anaesthesia, without muscle relaxants intubation, the intubation by applying rocuronium bromide and vecuronium bromide, as well as each of three methods were investigated in terms of the row of operation of each three methods and differences in recovery or superiority to each other. Materials and methods: 60 patients who were in ASA I-II class between the ages of 5-16 were included in the study. Patients were randomly divided into three groups. Propofol were used with 2.5-3 mg / kg doses and fentanyl were used 1.5 mu gr/kg in the induction of all patients. Group A: was stimu 5% sevoflurane and in 50/50% O-2/N2O mixture (total: 6lt / min) induction, Group B: 0.6 mg/kg rocuronium bromide I. V, 50/50% O-2/N2O mixture (total: 6lt / min) induction, Group C: 0.1 mg/kg vecuronium bromide I. V, 50/50% O-2/N2O mixture (total: 6lt / min) induction was performed; and also in all patients, prior to intubation, 10% topical lidocaine spray was applied around the oro pharyngeal and vocal cord. Sevoflurane 2% concentration and 50/50% O-2/N2O mixture (total: 6lt / min) were performed during anesthesia maintenance. After the patients were waken up, they were subjected to modified Aldrete scoring system in the recovery room, patients scored 9 and above according to the scoring system were sent to the service. Results and conclusions: As a result, Group A (the group muscle relaxant not applied to) was concluded to be a good alternative as Modified Aldrete scoring system's adequate score 9 and above have been achieved more quickly when compared to other group to which non-depolarizing muscle relaxant was applied and muscle relaxant free intubation especially in cases of paediatric adeno-ton-sillectomy, the early post-operative recovery and dispatch service, in preverntion of adverse effects and complications of muscle relaxants dependent on general anesthesia.Öğe Comparison of the Effects of Desflurane and Sevoflurane on Middle Ear Pressure: A Randomized Controlled Clinical Trial(KARGER, 2013) Duger, Cevdet; Dogan, Mansur; Isbir, Ahmet Cemil; Kol, Iclal Ozdemir; Gursoy, Sinan; Kaygusuz, Kenan; Sahin, Omer Fatih; Uysal, Ismail Onder; Mimaroglu, CanerObjective: The aim of the present study was to compare the effects of two inhalation anesthetics, desflurane and sevoflurane, on middle ear pressure. Methods: After we obtained written consent from the patients and the approval from our institutional ethical committee, we included 56 ASA I-II patients aged between 18 and 60 years in this study. They were randomly divided into two groups of 28 patients each. Desflurane 4-6% (Group D) or sevoflurane 1-2% (Group S) were used for anesthesia management in patients. Baseline tympanometry was carried out and recorded before the induction of anesthesia on both ears, and 3 more measurements were done and recorded 5, 15 and 30 min after induction. Results: In both groups, middle ear pressure values were found to be significantly elevated when compared to baseline measurements (p < 0.05). When middle ear pressure was compared between the groups, no difference was found between the values obtained at baseline and at 5 min in Group S, while especially the values obtained at 15 min revealed significantly higher middle ear pressures in Group D. Conclusion: It was observed that the increase in middle ear pressure caused by sevoflurane was significantly lower than that caused by desflurane. (C) 2013 S. Karger AG, BaselÖğe Dexmedetomidine and remifentanil as adjuncts to total intravenous anesthesia with propofol(ANAESTHESIA PAIN & INTENSIVE CARE, 2017) Subasi, Hatice; Kol, Iclal Ozdemir; Duger, Cevdet; Kaygusuz, Kenan; Isbir, Ahmet Cemil; Gursoy, Sinan; Mimaroglu, CanerAim: The aim was to compare the effects of dexmedetomidine and remifentanyl in total intraveous anesthesia (TIVA) in laparoscopic cholecystectomy operations. Methodology: Forty, 18-60 years old, elective laparoscopic cholecystectomy patients were included in the study. In Group D, TIVA was performed by 150 mu g/kg/min propofol and 0.5 mu g/kg/h dexmedetomidine infusions. In Group R patients, TIVA was performed with 150 mu g/kg/min propofol and 0.5 mu g/kg/min remifentanil infusions. Systolic blood pressure, heart rate, SpO(2), end tidal CO2 were recorded. All infusions were terminated at the end of surgery. Adequate spontaneous respiration, extubation, and response to verbal commands; and Aldrete score >= 9 times, postoperative pain scores and vital parameters in the postoperative period were recorded. Patient-controlled analgesia pump was used in all postoperative patients. Total analgesic consumption, patients' first analgesic needs were recorded. Results: Intraoperative Systolic blood pressure, diastolic blood pressure and heart rate values remained significantly lower in remifentanyl group compared to those in dexmedetomidine group (p < 0.05). First postoperative analgesia time was shorter and hemodynamic parameters were significantly higher in this group (p < 0.05). Postoperative recovery of dexmedetomidine group remained more stable in terms of VAS values (p < 0.05). Conclusions: Remifentanil provides a potent intraoperative anesthesia compared with dexmedetomidine; however, dexmedetomidine may be considered in TIVA as an option for a stable postoperative recovery.Öğe Effect of Chronic Knee Pain on Cognitive Function: Clinical Study(INFORMA HEALTHCARE, 2014) Isbir, Ahmet Cemil; Duger, Cevdet; Mimaroglu, Caner; Kol, Iclal Ozdemir; Kaygusuz, Kenan; Gursoy, SinanObjectives: Chronic knee pain is a clinical problem that causes inconvenience in social, familial, and business environments. In clinic, while etiologies of chronic knee pain are generally known, its effects on cognitive functions are not fully understood. This study aims to measure and evaluate the relationship between cognitive function and chronic knee pain. Methods: Ninety-eight patients between 18 and 70 years of age having knee pain for at least 6 months were included in the study. Two groups were divided between A1 and A2, both patients of chronic knee pain. Cognitive functions were evaluated in the A1 group before treatment and in the A2 group after taking treatment. Both groups had the same number of patients [N = 98]. The Montreal Cognitive Assessment [MOCA] was applied to the patients before and after treatment. The patients with a MOCA score 26 and over were accepted as normal in terms of cognitive functions. Results: The MOCA score of the A2 group was significantly higher than that of A1 group. Visual analog scale values in group A2 were significantly decreased compared to A1. Although orientation scores were decreased, patients in group A2 showed a statistically significant increase in cognitive functional indicators like visual functions, language, abstract thinking, and delayed recall compared with group A1. Conclusions: The chronic knee pains might lead to cognitive function disorders in the long term. This can be prevented with the effective treatment of pain so that quality of life of patients can be increased. Moreover, the use of costly diagnosis and treatment methods can be prevented.Öğe The evaluation of radiofrequency facet nerve denervation in the patients with lumbar facet syndrome: experience with 493 patients(ANAESTHESIA PAIN & INTENSIVE CARE, 2017) Mimaroglu, Caner; Mimaroglu Altinay, Beste; Duger, Cevdet; Isbir, Ahmet Cemil; Gursoy, Sinan; Kaygusuz, Kenan; Kol, Iclal OzdemirObjective: Radio frequency thermocoagulation (RFT) is a relatively new modality and has been recommended for treatment of back pain diagnosed as to be originating from spinal facet joints. We aimed to evaluate the efficacy of this novel procedure in our patients with lumbar facet syndrome in our department of algology. Methodology: In this retrospective, observational study, the medical records of 493 lumbar facet syndrome patients treated using RFT in 2008-2013, were reviewed. All data were obtained from the pain evaluation cards in the patient files and recorded. Data of age, sex, visual analog scale (VAS) scores before and after the therapy and satisfaction scores after the therapy were recorded from medical records of the patients. Visual analogue scale (VAS) pain scores, daily activities (1 = poor to 4 = very good) and satisfaction scores (1 = poor to 4 = excellent) before the procedure and at the day 1, day 2, and then at one week, 2 weeks, one month, 6 months and 12 months following the procedure, were reviewed and recorded. Results: Mean VAS score before the therapy was 8.03 +/- 1.06, one month after the therapy it was significantly reduced and 6 months after the therapy it was found as 2.18 +/- 0.76. The satisfaction scores were found significantly higher after therapy. Data of movement scores were found higher after the therapy than the scores before therapy. No complication was noted in any of the patient. Conclusion: We conclude that radio frequency thermocoagulation (RFT) can lead to significant long-term improvement in low back pain, and it can improve the physical function ability to a greater extent in patients with facet pain syndrome.Öğe The Importance of Needle Echogenity in Ultrasound Guided Axillary Brachial Plexus Block: A Randomized Controlled Clinical Study(IVYSPRING INT PUBL, 2013) Duger, Cevdet; Isbir, Ahmet Cemil; Kaygusuz, Kenan; Kol, Iclal Ozdemir; Gursoy, Sinan; Ozturk, Hayati; Mimaroglu, CanerObjective: In this study we aimed to compare the echogenic needles and the nerve stimulation addition to non-echogenic needles in ultrasound guided axillary brachial plexus block for upper extremity surgery. Methods: 90 patients were enrolled to the study. The patients were allocated into three groups randomly: Group E (n=30): ultrasound guided axillary block using echogenic needle, Group N (n=30): ultrasound guided axillary block using non-echogenic needle, Group NS (n=30): ultrasound guided axillary block using non-echogenic needle with nerve stimulator assistance. Duration of block procedure, mean arterial pressure, heart rate, pulse-oximetry, onset time of sensory and motor block, duration of sensory and motor block, time to first analgesic use, total need for analgesics, postoperative pain scores, patient and surgeon satisfaction scores were recorded. Results: Duration of block procedure values were lower in group E and NS, sensory and motor block durations, were significantly lower in group N. Sensorial and motor block onset time values were found lower in group NS but higher in group N. Patient and surgeon satisfaction scores were found lower in group N. Conclusion: We conclude that ultrasound guided axillary block may be performed successfully using both echogenic needles and nerve stimulation assisted non-echogenic needles.Öğe 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 The effect of postoperative serratus anterior plane block on postoperative analgesia in patients undergoing breast surgery(Turkish Surgical Assoc, 2020) Aslan, Gokhan; Avci, Onur; Gundogdu, Oguz; Isbir, Ahmet Cemil; Kol, Iclal Ozdemir; Kaygusuz, Kenan; Gursoy, SinanObjective: This study aimed to evaluate the effect of serratus anterior plane block (SAP) on postoperative morphine consumption. We aimed to determine the differences between both similar blocks and evaluate the effect of the methods of application of this block on patients' postoperative pain scores and morphine consumption. Material and Methods: This study is a single-center, prospective and observational study performed with 40 volunteer patients with American Society of Anesthesiologists (ASA) I-III, who were 18-70 years of age, scheduled for breast surgery. A total of 40 patients who underwent general anesthesia were divided into two groups each with 20 patients. While SAP block was applied to the study group, no block was applied to the control group. SAP block was made by injecting a total of 40 ml of 0.25% bupivacaine between 2 muscles after the test dose was injected with saline. All patients were followed up for 12 hours postoperatively with patient-controlled analgesia (PCA) pump. Morphine consumption, visual analogue score (VAS) values and side effects were recorded at the postoperative 1st, 6th and 12th hours. Results: There was no significant difference between the two groups in terms of hemodynamic parameters and demographic data. Postoperative morphine consumption and postoperative analgesic requirement were significantly lower in the SAP block group (p< 0.001). Postoperative VAS values were significantly lower in the SAP block group (p< 0.001). No complication was observed related to the block. Conclusion: It was found that the SAP block reduced morphine consumption, significantly decreased VAS values, and reduced side effects due to opioids postoperatively.Öğe The effects of interscalene block performed alone or with ultrasonography-guided peripheric nerve stimulator on block success, hemodynamic parameters and perfusion index(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2020) Kart, Caner Erman; Isbir, Ahmet Cemil; Avci, Onur; Özdemir Kol, Iclal; Kaygusuz, Kenan; Gürsoy, SinanObjective: We aimed the comparison between traditional methods and perfusion index (PI) on evaluating the block success and sufficiency of interscalene block that we applied to shoulder surgery cases by using ultrasonography (USG) and peripheric nerve stimulator or only peripheric nerve stimulator only. Material and Methods: After ethics committee and patient approvals; ASA I-III, 50 adult patients (18-70 ages) who underwent shoulder, arm surgery were allocated to this prospective research. Interscalene block was applied to all patients by using USG and peripheric nerve stimulation or peripheric nerve stimulation with bupivacaine 0.5% 1 mg/kg+prilocaine 2% 4 mg/kg+NaCl 0.9% to complete the anesthetic solution to 30 mlt. We recorded heart rate, mean arterial pressure, peripheric oxygen saturation, PI, motor block times and pin-prick test values of the patients. Results: When the PI values of the patients on different times were compared, the difference between the groups was insignificant. Loss of cold sensation time was 10.3±3.9 min in Group 1 and 11.3±4.3 min in Group 2. Pin-prick test time to be positive was 16.3±3.8 min in Group 1 and 17.6±5.1 min in Group 2. Motor block onset time was 14.2±3.7 min in Group 1 and 16.1±4.3 min in Group 2. Conclusion: Using USG enables us to benefit from local anesthetic more effectively and to encounter fewer complications. Another conclusion can be about PI parameters which significantly increase with block success in time within the groups. So, PI can be used due to being easily applicable and non-invasive technique for predicting the block success. © 2020 OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S.. All rights reserved.Öğe Total intravenous anesthesia in a case of Duchenne muscular dystrophy -single low dose rocuronium usage(2013) Isbir, Ahmet Cemil; Düger, Cevdet; Özdemir Kol, Iclal; Kaygusuz, Kenan; Gürsoy, Sinan; Mimaro?lu, CanerDuchenne Muscular Dystrophy is an X-linked progressive neuromuscular hereditary disease which effects men and is seen in 1/3.500 frequency. Although the basic problem in this disease is musclular weakness; anesthetic approach in Duchenne Muscular Dystrophy is important because the disease might cause cardiac and respiratory problems during anesthesia. Moreover, inhalation anesthetics might be the reason for malignant hyperthermia and rhabdomyolysis. This case report aims at discussing the safe anesthetic approach in a 7 year old patient who was operated by orthopedic surgeons with Duchenne Muscular Dystrophy and right supracondylar humerus fracture. In this case ventilator was totally cleaned from anesthetic agents to avoid from malignant hyperthermia and rhabdomyolysis. 50% oxygen-air mixture and low dose propofol with remifentanil were used in total intravenous anesthesia. Because of the non-depolarizing muscle relaxant sensitivity, low-dose rocuronium and sugammadex were used as its reverse agent. No complications were encountered during preoperative and perioperative period. After the case was observed in intensive care unit, he was transferred to the orthopedics clinic. It has been concluded that use of propofol and remifentanil together with total intravenous anesthesia, and low-dose rocuronium bromide will be a safer anesthesia application.Öğe An unusual condition during internal jugular vein catheterisation: vertebral artery catheterisation(CLINICS CARDIVE PUBL PTY LTD, 2016) Korkmaz, Ozge; Goksel, Sabahattin; Soylemez, Burcak; Durmus, Kasim; Isbir, Ahmet Cemil; Berkan, OcalVertebral artery cannulation is an unusual complication during internal jugular vein cannulation. We report a case of vertebral artery cannulation, which occurred during an attempt to cannulate the right internal jugular vein, and we discuss the management of such a rare complication.
