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Öğe Anesthetic and analgesic effects in patients undergoing a lumbar laminectomy of spinal, epidural or a combined spinal-epidural block with the addition of morphine(ELSEVIER SCI LTD, 2012) Duger, Cevdet; Gursoy, Sinan; Karadag, Ozen; Kol, Iclal Ozdemir; Kaygusuz, Kenan; Ozal, Hasan; Mimaroglu, CanerThis study was designed to evaluate the anesthetic, analgesic and side effects of spinal, epidural and combined spinal-epidural anesthesia with the addition of morphine for lumbar laminectomy. A total of 66 patients undergoing lumbar laminectomy were included in the present study of whom 64 completed the study. Patients were randomly divided into three groups: (i) spinal anesthesia - the SA group; (ii) epidural anesthesia - the EA group; and (iii) combined spinal-epidural anesthesia - the CA group. Demographical data, surgical times and peak sensory levels of groups were similar. Heart rate, mean arterial pressure, and peripheral oxygen saturation did not differ between the three groups. No differences were observed intraoperatively in Ramsey sedation scale (RSS) scores between the groups, but postoperatively, although RSS scores were similar for the EA and CA groups, they were significantly lower for the SA group. The postoperative visual analogue scale pain scores were higher in the SA group compared to the EA and the CA groups except for the second postoperative hour. Time-to-use of the first patient controlled analgesia was similar for all groups. The total consumption of morphine over the 24-hour study period was significantly higher in the SA group compared to the EA and the CA groups. Postoperative nausea and vomiting frequencies were higher in SA group, but pruritus frequency was lower than the EA and the CA groups. In conclusion, although spinal, epidural, and combined spinal-epidural anesthesia are adequate and effective for lumbar laminectomies, epidural and combined spinal-epidural anesthesia techniques are more effective than spinal anesthesia for postoperative analgesia and sedation with lesser side effects. (C) 2011 Elsevier Ltd. All rights reserved.Öğe Comparison of In Vitro Effects of Opioid Analgesics on Spontaneous Proximal and Distal Colon Contractions in Healthy Rats and Rats with Peritonitis(AVES, 2018) Ersan, Idris; Gursoy, Sinan; Avci, Onur; Altun, Ahmet; Bagcivan, Ihsan; Duger, Cevdet; Kol, Iclal Ozdemir; Kaygusuz, Kenan; Mimaroglu, Mehmet CanerObjective: The goal of this study was to investigate and compare the effects of opioids on proximal and distal colon contractions in normal rats and rats with peritonitis, with and without the presence of naloxone in the environment. Methods: The study was approved by Cumhuriyet University Ethics committee. In this study, 16 Wistar Albino male rats were used. Rats were divided into two groups. Peritonitis was induced using a cecum ligation and perforation method, 24 h before the tissues of rats in the peritonitis group were collected, and sham surgery was performed 24 h before the tissues of rats in the control group were collected. Twenty-four hours after the surgery, rats' organs were harvested and hung in organ baths. Concentration-dependent inhibitory effects of morphine and meperidine on spontaneous intestinal movements were observed. Any differences between the groups were tested using the Kruskal-Wallis test, and any differences between the groups were tested using the Tukey test. Results: No significant difference was observed between the proximal and distal colon smooth muscle contraction responses in both groups after 80 mM Potassium Chloride (KCl) injection (p>0.005). In the peritonitis group, amplitudes and frequencies of spontaneous contractions in proximal and distal colon significantly increased (p<0.05). Drugs decreased the amplitude and frequency responses in the control group (p<0.05). In the peritonitis group, whereas morphine decreased the amplitude and frequency responses in comparison with the control group (p<0.05), meperidine did not cause any significant changes (p>0.05). In both groups, adding naloxone to the organ baths before adding opioids completely blocked the morphine's inhibitory effect on the amplitude and frequency (p<0.05), but it could not completely block the inhibition caused by meperidine. Conclusion: Morphine and meperidine exhibit an inhibitory effect on the intestinal motility in both groups. This effect can be blocked by naloxone completely in morphine, and partially in meperidine.Öğe Comparison of inflammatory level and symptom level in cases having chronic rhinosinusitis(DERMAN MEDICAL PUBL, 2018) Dogan, Mansur; Tuncer, Ersin; Kol, Iclal Ozdemir; Uysal, Ismail Onder; Yuce, Salim; Muderris, SuphiAim: The aim of this study was to Investigate whether the endoscopic findings, corona! computed tomography data and the level of histopathological changes observed in tissue samples had any effects on the quality of life in chronic rhinosinusitis cases. Material and Method: In this prospective study, 34 patients diagnosed with chronic rhinosinusitis (Group 1) and 34 volunteer individuals having no chronic rhinosinusitis (Group 2) were included. Detailed anamnesis, endoscopic examination findings, quality of life in patients with chronic rhinosinusitis questionnaire scores and coronal paranasal computed tomography scores were recorded in the files of all the cases. Endoscopic evaluation findings were evaluated using the Lund-Kennedy scoring system, all the cases were given a chronic rhinosinusitis evaluation questionnaire, coronal paranasal computed tomography findings were scored using the Lund-MacKay system. Results: The average quality-of-life score, the average radiological score, the average endoscopic examination score, the histopathological evaluation of the surgical specimens, the average inflammatory score, the average fibrosis scores and the average osteoblastic-osteoclastic score was statistically different between two groups. When a correlation analysis was performed, the quality-of-life scores were found to have a negative correlation with the radiological scores, endoscopic scores. fibrosis scores and osteoblastic-osteoclastic activity scores in Group 1. And also radiological scores were positively correlated both with the endoscopic scores and the osteoblastic-osteoclastic activity scores and a positive correlation was found between the endoscopic scoring and the mucosal inflammation in Group 1. Discussion: The results of our study showed that the histopathological changes affected the quality of life negatively.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 Controlled Hypotension With Desflurane Combined With Esmolol or Dexmedetomidine During Tympanoplasty in Adults: A Double-Blind, Randomized, Controlled Trial(ELSEVIER SCIENCE INC, 2009) Kol, Iclal Ozdemir; Kaygusuz, Kenan; Yildirim, Altan; Dogan, Mansur; Gursoy, Sinan; Yucel, Evren; Mimaroglu, CanerBACKGROUND: Controlled hypotension is a technique that is used to limit intraoperative blood loss to provide the best possible Surgical field during surgery. OBJECTIVE: The aim of this double-blind, randomized, controlled study was to compare the effects of desflurane combined with esmotol or dexmedetomidine on the amount of blood in the surgical field, recovery time, and tolerability in adult patients undergoing tympanoplasty. METHODS: Turkish patients aged IS to 60 years, classified as American Society of Anesthesiologists physical status I or II, who were scheduled for tympanoplasty were randomly divided into 2 groups: the esmolol group or the dexmedetomidine group. After the anesthesia induction in the esmolol group, a loading dose of esmolol was infused intravenously over 1 minute at 1 mg/kg, followed by a maintenance rate of 0.4 to 0.8 mg/kg/h. In the dexmedetomidine group, a loading dose of dexmedetomidine was infused intravenously over 10 minutes at a rate of 1 mu g/kg, followed by a maintenance rate of 0.4 to 0.8 mu g/kg/h. The infusion rates were then titrated to maintain mean arterial pressure (MAP) of 65 to 7 5 mm Hg. General anesthesia was maintained with desflurane 4% to 6%. Heart rate (HR) and MAP were recorded during anesthesia. The following 6-point scale was used to assess the amount of bleeding in the operative field: 0 = no bleeding, a virtually bloodless field; 1 = bleeding that was so mild that it was not a surgical nuisance; 2 = moderate bleeding that was a nuisance but did not interfere with accurate dissection; 3 = moderate bleeding that moderately compromised surgical dissection; 4 = bleeding that was heavy but controllable and that significantly interfered with surgical dissection; and 5 = massive bleeding that was uncontrollable and made dissection impossible. Scores ! 2 were considered to be optimal surgical conditions. The sedation score was determined at 15, 30, and 60 minutes after tracheal extubation using the following scale: 1. = anxious, agitated, or restless; 2 cooperative, oriented, and tranquil; 3 = responsive to commands; 4 = asleep, but with brisk response to light, glabellar tap, or loud auditory stimulus; 5 = asleep, sluggish response to glabellar tap or auditory stimulus; and 6 = asleep, no response. Time to extubation and to total recovery from anesthesia (Aldrete score >= 9 on a scale of 0-10), adverse effects (eg, intraoperative hypotension [blood pressure <65 mm Hg], bradycardia [HR <50 beats/min]), intraoperative fentanyl consumption, and postoperative nausea and vomiting were recorded. Arterial blood gas analysis and kidney and liver function tests were conducted. All patients were evaluated by the same attending surgeon and anesthesiologist, both of whom were blinded to the administered study drugs. RESULTS: Fifty-two consecutive white patients undergoing tympanoplasty were identified. Two patients had to be excluded because of hypertension and 2 refused to participate. Forty-eight patients were equally randomized to either the esmolol group (n = 24 [16 women, 8 men]; mean [SD] age, 38.4 [10.5] years) or the dexmedetomidine group (n = 24 [17 women, 7 men]; mean age, 35.5 [14.7] years). Sedation scores were not collected for I patient in the esmolol group; therefore, analysis was conducted for 23 patients. The median (range) of the scores for the amount of blood in the surgical field in the esmolol and dexmedetomidine groups was 1 (0-3) and 1 (0-2), respectively (P = NS). Mean intracoperative fentanyl consumption in the esmolol group was significantly higher than in the dexmedetomidine group (50.0 [3-0] vs 25.0 [2-5] mu g/min; P = 0.002). In the esmolol group, the mean times to extubation and to recovery from anesthesia were significantly shorter than those of the dexmedetomidine group (7.0 [1.4] vs 9.1 [1.9] minutes, respectively; 5.9 [2.1] vs 7.9 [2.3] minutes; both, P = 0.001). The mean sedation scores were significantly lower in the esmolol group (n = 23, because of intent-to-treat analysis) compared with the dexmedetomidine group at 15 minutes (2.5 [0.6] vs 3.6 [0.5]; P = 0.001) and 30 minutes (2.6 [0.6] vs 3.3 [0.6]; P = 0.001) postoperatively. No significant differences were found between the study groups in regard to blood urea nitrogen or creatinine concentration, aspartate aminotransferase or alanine aminotransferase activities, pH, partial pressure of carbon dioxide, or bicarbonate, before or after the operation. CONCLUSIONS: Both esmolol and dexmedetomidine, combined with desflurane, provided an effective and well-tolerated method of achieving controlled hypotension to limit the amount of blood in the surgical field in these adult patients undergoing tympanoplasty. Esmolol was associated with significantly shorter extubation and recovery times and significantly less postoperative sedation compared with dexmedetomidine. (Curr Ther Res Clin Exp. 2009;70:197-208) (C) 2009 Excerpta Medica Inc.Öğe 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 Effect of high-energy extracorporeal shock waves on the immature epiphysis in a rabbit model(SPRINGER, 2008) Ozturk, Hayati; Bulut, Okay; Oztemur, Zekeriya; Kaloglu, Celal; Kol, Iclal OzdemirIntroduction We investigated the effect of high-energy extracorporeal shock wave (ESW) on immature tibial epiphysis in a rabbit model. Materials and methods Twenty New Zealand white immature rabbit were used in this study. Animals were divided into two groups and they received 14 kW, 0.6 mJ/mm(2), 1,500 or 3,000 shots for three times with an interval of 7 days. After 6 weeks all rabbits were killed. The all tibia epiphysis were assessed by histology. The epiphyseal plaque thickness of right tibiae of the 3,000-shot ESW group was significantly higher than those of the 1,500-shot ESW group and the left tibia epiphyses of the 1,500- and 3,000-shot ESW groups as controls (P < 0.05). Results The epiphyseal plaque thickness of right tibiae of the 1,500-shot ESW group was significantly higher than that of the left tibia epiphyses of the 1,500- and 3,000-shot ESW groups as controls (P < 0.05). Discussion We demonstrated that high-energy ESW stimulated the growth of immature rabbit epiphysis. The long-term effect of shock wave on the immature rabbit epiphysis deserves further study.Öğe Effects of Adding Dexmedetomidine to Levobupivacaine in Axillary Brachial Plexus Block(ELSEVIER SCIENCE INC, 2012) Kaygusuz, Kenan; Kol, Iclal Ozdemir; Duger, Cevdet; Gursoy, Sinan; Ozturk, Hayati; Kayacan, Ulku; Aydin, Rukiye; Mimaroglu, CanerBACKGROUND: Although several studies have described effects of dexmedetomidine on peripheral nerve blocks, to date there is limited knowledge available on the impact of dexmedetomidine adjunct to levobupivacaine in axillary brachial plexus block. OBJECTIVE: In this study, we aimed to investigate the effects of adding dexmedetomidine to levobupivacaine for an axillary brachial plexus block. METHODS: A total of 64 patients of American Society of Anesthesiologists physical status I/II scheduled to undergo forearm and hand surgery, in which an axillary block was used, were enrolled. The patients were randomly divided into 2 groups: in group L patients (n = 32), an axillary block was performed with 39 mL levobupivacaine 5% plus 1 mL of isotonic sodium chloride. In group D patients (n = 32), an axillary block was performed with 39 mL levobupivacaine 5% and 1 mL dexmedetomidine 1 mu g/kg(-1) plus isotonic sodium chloride. Demographic data, mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (Spo(2)), sensory and motor block onset times and block durations, time to first analgesic use, total analgesic need, intraoperative verbal analog scale, postoperative visual analog scale (VAS) data, and side effects were recorded for each patient. RESULTS: There were no significant differences in patient and surgery characteristics between the 2 groups. Sensory block onset time was shorter in group D (P < 0.05). Sensory and motor block duration and time to first analgesic use were significantly longer in group D (P < 0.05), and the total need for analgesics was lower in group D (P < 0.05). Intraoperative 5- and 10-minute verbal analog scale values and postoperative VAS value at 12 hours were significantly lower in group D (P < 0.05). Intraoperative MAP and HR values, except at 5 minutes and postoperatively at 10 and 30 minutes and 1 and 2 hours, were significantly lower in group D (P < 0.01). Bradycardia, hypotension, hypoxemia, nausea, vomiting, and any other side effects were not seen in any patients. CONCLUSIONS: It was concluded in our study that adding dexmedetomidine to axillary brachial plexus block shortens sensory block onset time, increases the sensory and motor block duration and time to first analgesic use, and decreases total analgesic use with no side effects. ClinicalTrials.gov identifier ISRCTN67622282. (Curr Ther Res Clin Exp. 2012;73:103-111) (C) 2012 Elsevier HS Journals, Inc. All rights reserved.Öğe The effects of different doses of remifentanil on intraocular pressure after tracheal intubation: A randomized, double-blind and prospective study(AMER SOC CONTEMPORARY MEDICINE SURGERY & OPHTHALMOLOGY, 2007) Kaygusuz, Kenan; Toker, M. Ilker; Kol, Iclal Ozdemir; Erdogan, Haydar; Gursoy, Sinan; Mimaroglu, CanerWe investigated the effects of alfentanil and different doses of remifentanil on intraocular pressure (IOP) and hemodynamic responses during laryngoscopy and endotracheal intubation in 60 patients. IOP values decreased significantly from 30 seconds before the intubation to 5 minutes after intubation measurements compared to baseline values in all the groups. However, a significant increase in 1OP was recorded in the 0.5-mu g remifentanil group after tracheal intubation.Öğe Effects of facet joint nerve block addition to radiofrequency in the treatment of low back pain(DRUNPP-SARAJEVO, 2012) Duger, Cevdet; Kol, Iclal Ozdemir; Kaygusuz, Kenan; Gursoy, Sinan; Mimaroglu, CanerObjective: We aimed to compare the effects of radiofrequency, local anesthetic and steroid injection and combination of them for facet syndrome that is a reason of low back pain. Summary of Background Data: Basically, radiofrequency thermocoagulation is a procedure that causes tissue damage like nerves by exposing the tissue to heated electrode tip. Nerve blocking has been used as an effective pain therapy method. So we tried to compare and combine these two methods in the treatment of lumbar facet syndrome. Methods: Patients were randomly divided into 3 groups (n=40) each consisted of 40 individuals. Local anesthesia was applied after determining the injection area by c-arm scope device. Radiofrequency was applied in Group R, a mixture of 20 mg metilprednisolone and 5 mg bupivacain was administered in Group B and combination of all these was applied in Group RB. VAS, activity and satisfaction scores were recorded before and after the procedure. Results: In Group R and Group RB, VAS and activity scores were similar except day 1, day 2 and week 1 and better than group B. Satisfaction scores of Group B were lower when compared to Group R and RB. However, satisfaction scores of Group RB were higher than those of Group R in day 1, day 2 and week 1 but there was no difference at later time points. Conclusion: In conclusion, we suggest that successful results can be obtained with radiofrequency thermocoagulation plus facet nerve block combination therapy in patients having lumbar facet syndrome.Öğe Effects of High-Frequency Bio-Oxidative Ozone Therapy in Temporomandibular Disorder-Related Pain(KARGER, 2014) Dogan, Mansur; Dogan, Derya Ozdemir; Duger, Cevdet; Kol, Iclal Ozdemir; Akpinar, Aysun; Mutaf, Burcu; Akar, TurkerObjective: It was the aim of this study to compare the efficacy of ozone therapy and drug treatment in patients with painful temporomandibular joint (TMJ) disorder (TMD). Subjects and Methods: A total of 63 patients with TMD were enrolled; 33 were treated with bio-oxidative therapy and 30 with a ketoprofen tablet thiocolchicoside capsule 2 x 1 for 7 days. Maximum voluntary interincisal mouth opening (MMO) was measured in millimeters using a scale and recorded during the pre- and posttreatment periods. The patients evaluated their subjective pain using a visual analogue scale (VAS). Data were analyzed using the Mann-Whitney U test, the Kolmogorov-Smirnov test, and the independent t test. Results: The mean MMO of the group that received ozone therapy during the pretreatment period was 46.51 +/- 8.2 mm, and it immediately increased to 48.78 +/- 7.5 mm after 1 week of ozone therapy, which was statistically significant (p = 0.04). For those who received medication, the mean MMO during the pretreatment period was 46.30 mm, and at the end of 1 week it was 46.9 mm. In the ozone group, 29% of patients showed a gradual decrease in their VAS pain scores compared to pretreatment values (6.3 +/- 2.1 to 3.0 +/- 2.2). In the medication group, 24% of patients showed a significant decrease in VAS pain scores during the follow-up period (6.9 +/- 1.4 to 5.0 +/- 1.5). Conclusion: This study showed that bio-oxidative therapy was a more effective treatment than medication therapy for relieving TMJ pain. (C) 2014 S. Karger AG, BaselÖğe The Effects of Intravenous Ephedrine During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial(KOREAN ACAD MEDICAL SCIENCES, 2009) Kol, Iclal Ozdemir; Kaygusuz, Kenan; Gursoy, Sinan; Cetin, Ali; Kahramanoglu, Zeki; Ozkan, Fikret; Mimaroglu, CanerWe designed a randomized, double-blinded study to determine the efficacy and safety of 0.5 mg/kg intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Patients were randomly allocated into two groups: ephedrine group (n=21) and control group (n=21). Intravenous preload of 15 mL/kg lactated Ringer's solution was given. Shortly after the spinal injection, ephedrine 0.5 mg/kg or saline was injected intravenous for 60 sec. The mean of highest and lowest heart rate in the ephedrine group was higher than those of control group (P<0.05). There were significant lower incidences of hypotension and nausea and vomiting in the ephedrine group compared with the control group (8 [38.1%] vs. 18 [85.7%]); (4 [19%] vs. 12 [57.1%], respectively) (P<0.05). The first rescue ephedrine time in the ephedrine group was significantly longer (14.9 +/- 7.1 min vs. 7.9 +/- 5.4 min) than that of the control group (P<0.05). Neonatal outcome were similar between the study groups. These findings suggest, the prophylactic bolus dose of 0.5 mg/kg intravenous ephedrine given at the time of intrathecal block after a crystalloid fluid preload, plus rescue boluses reduce the incidence of hypotension.Öğe Epidemiology and risk factors of intensive care unit-acquired infections: a prospective multicentre cohort study in a middle-income country(SINGAPORE MEDICAL ASSOC, 2012) Meric, Meliha; Baykara, Nur; Aksoy, Suleyman; Kol, Iclal Ozdemir; Yilmaz, Gurdal; Beyazit, Nurhayat; Mete, Birgul; Vahaboglu, HalukIntroduction This study aimed to determine the incidence and risk factors of infections among patients admitted to intensive care units (ICUs) in tertiary care hospitals in Turkey. Methods Adult patients who were admitted to the ICUs of five tertiary care hospitals for over 48 hours between June and December 2007 were monitored daily. Potential risk factors such as age, gender, comorbidities, diagnosis at admission, severity of disease (Acute Physiology and Chronic Health Evaluation II scores), exposure to antibiotics, history of invasive procedures and significant medical interventions were evaluated. A multivariate analysis of these risk factors was carried out using Cox regression. Results A total of 313 patients with a median ICU stay of 12 days were selected for the study. 236 infectious episodes (33.8/1,000 ICU-days) were diagnosed among 134 patients (42.8/100 patients) in this group. Multivariate analysis revealed that exposure to a cephalosporin antibiotic (hazard ratio [95% confidence interval] 1.55 [1.10-2.19]) was an independent risk factor, whereas having a tracheostomy cannula (0.53 [0.36-0.81]) or nasogastric tube (0.48 [0.33-0.70]) was protective. Patients admitted to the ICUs from surgical wards were significantly more exposed to cephalosporins. Conclusion ICU-associated infections, which are quite high in Turkey, are largely due to inadequate infrastructure and facilities and understaffing. Abuse of antibiotics, particularly in patients who have undergone surgery, and prolonged ICU stays are significant risk factors for such infections.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 Evaluation of Reasons for Not Giving Donor Consent by Families of Patients With Brain Death: A Retrospective, Mixed-Method Study(Baskent Univ, 2024) Gulsoy, Zuhal; Kol, Iclal Ozdemir; Yildirim, GulayObjectives: The number of patients with organ failure is increasing day by day; today, the numbers of organs and tissues for transplant remain inadequate. This study, which was carried out in a hospital of Sivas Cumhuriyet University in Turkey, aimed to determine reasons for not giving consent for organ donation after brain death and to clarify the familial causes listed among these reasons. Materials and Methods: This study was a retrospective, mixed -method study. Records of patients diagnosed with brain death and patient relatives who stated that they did not donate organs and who agreed to participate were included in the study. Results: Of 48 patients diagnosed with brain death, 39 (81.3%) did not donate organs. Reasons for not donating could be grouped under 5 themes: distrust (communication defects, frustration, anger, not meeting expectations), thoughts that the procedure would not provide benefits, fear (not accepting death, not understanding brain death, and experiencing loss), unwillingness to impair body integrity, and phobia of social reactions. Conclusions: We found that some patient relatives who were not against and even supported organ donation decided not to donate organs at the last minute. Reasons for not giving donation consent included distrust, anger, and frustration resulting from communication problems with health professionals, making the candidate donor feel valueless, previous bad experiences and prejudgments about the institution, and not providing the appropriate physical conditions related to the comfort of the patient relative during the process. It is important to keep in mind that the organ donation process begins with the patient's admission to the hospital; if managed correctly, the process can affect the decision of relatives in a positive way. Identifying and preventing potential obstacles that could affect decisions may increase donation rates. Health professionals with special training on this subject are needed for these situations.Öğe Ilioinguinal-Iliohypogastric Nerve Block with Intravenous Dexketoprofen Improves Postoperative Analgesia in Abdominal Hysterectomies(ELSEVIER SCIENCE INC, 2013) Yucel, Evren; Kol, Iclal Ozdemir; Duger, Cevdet; Kaygusuz, Kenan; Gursoy, Sinan; Mirnaroglu, CanerBackground and objective: In this study, our aim was to evaluate the effects of intravenous dexketoprofen trometamol with ilioinguinal and iliohypogastric nerve block on analgesic quality and morphine consumption after total abdominal hysterectomy operations. Methods: We conducted this randomized controlled clinical study on 61 patients. The study was conducted in the operation room, post-anesthesia care unit, and inpatient clinic. We randomly grouped the 61 patients into control group (group C), block group (group B) and dexketoprofen-block group (group DB). Before the skin incision performed after anesthesia induction, we performed ilioinguinal iliohypogastric block (group C given saline and group P and DB given levobupivacaine). In contrast to group C and B, group DB was given dexketoprofen. We administered morphine analgesia to all patients by patient-controlled analgesia (PCA) during the postoperative 24 hours. We recorded Visual Analogue Scale (VAS), satisfaction scores, morphine consumption and side effects during postoperative 24 hours. Results: We found the DB group's VAS scores to be lower than the control group and block group's (p < 0.05) values at postoperative 1st, 2nd, 6th and 12th hours. VAS scores of group C were higher than of group B at postoperative first 2 hours. Time to first,PCA demand was longer, morphine consumption values were lower and satisfaction scores were higher in group DB than in the other two groups (p < 0.05). Conclusions: Ilioinguinal-iliohypogastric nerve block with IV dexketoprofen increases patient satisfaction by decreasing opioid consumption, increasing patient satisfaction, which suggests that dexketoprofen trometamol is an effective non-steroidal anti-inflammatory analgesic in postoperative analgesia. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.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 Ineffective Doses of Dexmedetomidine Potentiates the Antinociception Induced by Morphine and Fentanyl in Acute Pain Model(KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY, 2013) Unal, Mumin; Gursoy, Sinan; Altun, Ahmet; Duger, Cevdet; Kol, Iclal Ozdemir; Kaygusuz, Kenan; Bagcivan, Ihsan; Mimaroglu, CanerThe aim of this study was to evaluate the synergistic potentiation effect of ineffective doses of dexmedetomidine on antinociception induced by morphine and fentanyl in acute pain model in rats. Seventy albino Wistar rats were separated into 7 groups. Data for the control and sham groups were recorded. The ineffective dose of dexmedetomidine was investigated and found to be 3 mu g/kg. Each group was administered the following medications: 3 mg/kg morphine (intraperitoneal) to Group 3, 5 mu g/kg fentanyl (intraperitoneal) to Group 4, dexmedetomidine 3 mu g/kg (subcutaneously) to Group 5, dexmedetomidine 3 mu g/kg (subcutaneous)+3 mg/kg morphine (intraperitoneal) to Group 6 and finally 3 mu g/kg dexmedetomidine (subcutaneous)+5 mu g/kg fentanyl (intraperitoneal) to Group 7. Just before the application and 15, 30, 60, 90 and 120 min after the administration of medication, two measurements of tail flick (TF) and hot plate (HP) tests were performed. The averages of the measurements were recorded. TF and HP latencies were the main outcomes. The analgesic effect of the combinations with dexmedetomidine+morphine (Group 6) and dexmedetomidine+fentanyl (Group 7), compared to the analgesic effect of morphine alone and fentanyl alone was significantly higher at 15, 30, 60 and 90 minutes after administration. In this study, dexmedetomidine in ineffective doses, when combined with morphine and fentanyl, potentiates the effects of both morphine and fentanyl.Öğe Investigation of the Cardiac Effects of Pancuronium, Rocuronium, Vecuronium, and Mivacurium on the Isolated Rat Atrium(ELSEVIER SCIENCE INC, 2011) Gursoy, Sinan; Bagcivan, Ihsan; Durmus, Nedim; Kaygusuz, Kenan; Kol, Iclal Ozdemir; Duger, Cevdet; Yildirim, Sahin; Mimaroglu, CanerBACKGROUND: Pancuronium, vecuronium, rocuronium, and mivacurium are nondepolarizing neuromuscular blocking agents that affect the cardiovascular system with different potencies. Their cardiovascular effects are clinically significant in the anesthetic management of patients, particularly those undergoing cardiac surgery. OBJECTIVE: We aimed to compare the cardiac effects of these compounds, such as heart rate and developed force, in one species under identical experimental conditions in isolated rat atria. METHODS: The left or right atria of rats were removed and suspended in organ baths. Pancuronium, vecuronium, rocuronium, or mivacurium were added cumulatively (10(-9)-10(-5) M) in the presence and absence of the nonselective beta-blocker propranolol (10(-8) M) and the noradrenaline reuptake inhibitor desipramine (10(-7) M), and heart rate changes were recorded in spontaneously beating right atria. Left atrial preparations were stimulated by electrical field stimulation using a bipolar platinum electrode, and the effects of cumulative concentrations of these nondepolarizing neuromuscular blocking agents on the developed force in the presence and absence of propranolol (10(-8) M) and desipramine (10(-7) M) were recorded. RESULTS: Pancuronium increased heart rate in a dose-dependent manner compared with the control group (P < 0.027). Vecuronium, rocuronium, and mivacurium also increased heart rate in a dose-dependent manner, but the changes were not statistically significant. Although propranolol decreased the pancuronium heart rate effect (P < 0.05), it did not change the heart rate effects with vecuronium, rocuronium, or mivacurium. Desipramine did not change the heart rate effects of vecuronium, rocuronium, mivacurium, or pancuronium. All 4 drugs increased developed force in a dose-dependent manner; the increases were significant at 10(-5) M concentration for pancuronium and at 10(-6) and 10(-5) M concentrations for vecuronium, rocuronium, and mivacurium (P < 0.038). These increases in developed force were abolished with the addition of propranolol. Desipramine did not change the developed force effects of any of the 4 drugs. CONCLUSIONS: The heart rate effect of pancuronium and developed force effects of pancuronium, vecuronium, rocuronium, and mivacurium may occur via direct stimulation of p receptors. Although our investigation was an in vitro study, the effects found may be important especially under pathologic conditions, such as hypertension, in which patients usually use beta-blocking agents, which cause beta receptor upregulation. (Curr Ther Res Clin Exp. 2011;72:195-203) (C) 2011 Elsevier HS Journals, Inc. All rights reserved.
