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Research Interests: Adolescent, Medicine, Humans, Child, Paediatric Anaesthesia, and 15 moreFemale, Male, Anesthesia, Heart rate, Infant, Pediatric, Cardiac Arrhythmias, Nitrous Oxide, Pediatric Anaesthesia, Inguinal Hernia, Pediatric Anesthesia, Isoflurane, Child preschool, Paediatrics and reproductive medicine, and Hernia inguinal
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The incidence of a difficult laryngoscopy/intubation, which could lead to failed intubation is in the range of 1.5%-13%. Failed intubation may lead to hypoxia, brain damage or death. Preoperative evaluation of the airway can be... more
The incidence of a difficult laryngoscopy/intubation, which could lead to failed intubation is in the range of 1.5%-13%. Failed intubation may lead to hypoxia, brain damage or death. Preoperative evaluation of the airway can be accomplished by non-invasive bedside clinical tests during physical examination. We studied interobserver variability for non-invasive prediction of difficult intubation in different anesthesiology residency years. Three hundred eighty four adult patients undergoing elective surgery with general anesthesia and endotracheal intubation were enrolled this study. The investigators were divided in to two groups: three of them were in 4th (Group 1) and the other three were in 1st (Group 2) year of their anesthesiology residency. The variables evaluated were age, weight, height, submental-cervical angle, measurements of mandibular space, deviation of trachea, jaw-hyomental distance, swelling or scar tissue at neck, limited mouth opening, small mouth cavity, macroglo...
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Immunosuppression is directly related to the degree of trauma. The aim of this study is to compare the effects of low and high intra-abdominal pressure on immune response in moderate surgical trauma. Twenty-two patients, scheduled for... more
Immunosuppression is directly related to the degree of trauma. The aim of this study is to compare the effects of low and high intra-abdominal pressure on immune response in moderate surgical trauma. Twenty-two patients, scheduled for laparoscopic cholecystectomy, were randomly allocated to one of 2 groups according to intra-abdominal pressure: low and high intra-abdominal pressure. This study was conducted in the Hacettepe University Faculty of Medicine, Operation Room, Ankara, Turkey. Serum interleukin (IL)-2 and IL-6 levels were measured. Serum IL-2 showed a significant decrease before the incision in high intra-abdominal pressure group. The increase in serum IL-6 at the end of surgery and postoperatively was lower in low intra-abdominal pressure group. These results, can be interpreted as the immune system, are less depressed when there is lower intra-abdominal pressure. This may have clinical implications in immunocompromised patients.
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Entrapment of a pulmonary artery catheter in the pulmonary artery is a rare and severe complication that may lead to fatal complications such as pulmonary artery injury. We describe entrapment of a Swan-Ganz catheter within the right... more
Entrapment of a pulmonary artery catheter in the pulmonary artery is a rare and severe complication that may lead to fatal complications such as pulmonary artery injury. We describe entrapment of a Swan-Ganz catheter within the right pulmonary artery ligature in a patient undergoing right pneumonectomy. This situation resulted with removal of catheter safely without any complication. We concluded that with early recognition of the complication during thoracotomy, is golden standard in preventing pulmonary artery catheter entrapment and surgeons should be aware of the risk of accidentally transfixing pulmonary artery catheter in every type of operation that takes place in thorax.
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Episodes of wheezing are very common in infancy. In pediatrics, indications for flexible bronchoscopy include prolonged wheezing, where airway abnormalities such as malacia disorders, tracheobronchial abnormalities, and vascular ring may... more
Episodes of wheezing are very common in infancy. In pediatrics, indications for flexible bronchoscopy include prolonged wheezing, where airway abnormalities such as malacia disorders, tracheobronchial abnormalities, and vascular ring may be found. The study was performed to determine the diagnostic use of flexible bronchoscopy in wheezy patients who were previously administered bronchodilators and steroids for asthma and whose symptoms recurred or were not improved at all. Infants with wheezing were identified and collected over a 3-year period at the pediatric pulmonology unit. Flexible bronchoscopy was performed for diagnostic purposes in 34 (24 boys and 10 girls) patients with wheezing who were previously treated for asthma. The mean age for the onset of the symptoms was 2.5 months (0-12 months), and the mean age of bronchoscopic assessment was 9 months (45 days-48 months). A definitive diagnosis was made by bronchoscopy in 29 (85%) patients. Functional abnormalities in 15 patien...
Research Interests: Immunology, Humans, Female, Male, Infant, and 4 moreTrachea, Bronchoscopy, Respiratory Sounds, and Child preschool
Research Interests: Surgery, Treatment, Adolescent, Medicine, Safety, and 15 moreComplication, Humans, Child, Toxicity, Anesthesia, Fluorides, Liver Transplantation, Middle Aged, Digestive System, Adult, Urinary System, Biotransformation, Metabolic pathway, Platelet Aggregation Inhibitors, and Medical and Health Sciences
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Anesthetic management of a 3-month-old boy with Beckwith-Wiedemann syndrome for bronchoscopy is reported. Management may be complicated by a difficult airway, congenital heart disease, and hypoglycemia. We did not have difficulty in... more
Anesthetic management of a 3-month-old boy with Beckwith-Wiedemann syndrome for bronchoscopy is reported. Management may be complicated by a difficult airway, congenital heart disease, and hypoglycemia. We did not have difficulty in airway management either with tracheal intubation or rigid bronchoscopy, but we could not extubate the baby because of tracheomalacia.
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Catheter cryoablation of supraventricular tachycardias involving the perinodal regions is considered to be a safer alternative compared to radiofrequency ablation. Limited information is available for efficacy, midterm outcomes, and... more
Catheter cryoablation of supraventricular tachycardias involving the perinodal regions is considered to be a safer alternative compared to radiofrequency ablation. Limited information is available for efficacy, midterm outcomes, and complications regarding the ablation of parahissian accessory pathways (APs) in pediatric patients. A retrospective review of all pediatric patients who underwent cryoablation for treatment of a parahissian AP was performed. Twenty-five patients (median age 13 years and weight 45.6 kg) underwent cryoablation of a parahissian AP. Median number of cryolesions applied was four (range: 3-6). Initial procedural success was achieved in 23 patients (23/25, 92%). Transient third-degree atrioventricular (AV) block was noted in two patients. There was no permanent AV block. Transient right bundle branch block (RBBB) was observed in one patient and permanent RBBB occurred in two patients. Of the patients successfully ablated with cryo, there was only one recurrence (1/23, 4.3%) over a follow-up of 17.5 months (range 6-34 months). Cryoablation of parahissian APs is both safe and effective with a low risk of recurrence in pediatric patients.
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To investigate the effects of oral carbohydrate solution consumed until 2 h before the surgery in the patients that would undergo open radical retropubic prostatectomy on postoperative metabolic stress, patient anxiety, and comfort. A... more
To investigate the effects of oral carbohydrate solution consumed until 2 h before the surgery in the patients that would undergo open radical retropubic prostatectomy on postoperative metabolic stress, patient anxiety, and comfort. A total of 50 adult patients, who were in ASA I-II group and would undergo open radical retropubic prostatectomy, were included in the study. While Group 1 = CH (n = 25) received oral glucose solution, Group 2 = FAM (n = 25) was famished starting from 24:00 h. Blood glucose, insulin, and procalcitonin levels of the patients were recorded, and the patients completed state-trait anxiety inventory (STAI) test, which reflects the anxiety level of the patients, both before surgery and on the postoperative 24th hour. In order to evaluate patient comfort, senses of hunger, thirst, nausea, and cold were assessed in the morning prior to the surgery. No difference was observed between the two groups in terms of demographic data and insulin resistance levels (p > 0.05). Comparing with the preoperative levels, insulin resistance showed statistically significant elevation in both groups (p < 0.05). Procalcitonin levels were similarly increased in both groups in the postoperative period (p < 0.05). Preoperative and postoperative STAI state scores were similar in both groups (p > 0.05). With regard to preoperative patient comfort, sense of hunger was present in lesser number of subjects and at lower level in Group 1 (p < 0.05). Preoperative consumption of high carbohydrate drink (Pre-op) decreases insulin resistance and enhances patient comfort leading to lesser sense of hunger and thirst in the preoperative period in open radical retropubic prostatectomies.
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ABSTRACT Objective: The aim of the study was to compare the effects of prilocaine, bupivacaine and ropivacaine for postoperative pain management in children. Method: Sixty ASA I-II children between 1 and 7 years of age and scheduled for... more
ABSTRACT Objective: The aim of the study was to compare the effects of prilocaine, bupivacaine and ropivacaine for postoperative pain management in children. Method: Sixty ASA I-II children between 1 and 7 years of age and scheduled for urologic surgery with general anaesthesia were recruited. The patients were randomly allocated into three groups. Group I received caudal prilocaine 1% 0.5 mL kg -1 after the operation, Group II received 0.25% 1 mL kg -1 bupivacaine and Group III received 0.25% 1 mL kg -1 after induction of anesthesia. During anaesthesia, hemodynamic parameters and fentanyl requirements were recorded. Haemodynamic parameters, sedation and pain scores were recorded at 15 and 30 minutes, 1, 2, 4 and 6 hours following recovery from anaesthesia. Pain was evaluated by CHEOPS and sedation with a five point sedation test. Results: Demographic data were similar in all groups. No statistically significant differences between the groups were observed in intraoperative haemodynamic parameters. The first analgesic requirement time was 247.5±159.0 minutes in Group I, 315.0±117.8 minutes in Group II and 340.2±93.9 minutes in Group III. The intraoperative fentanyl requirement was higher in Group I than in the other two groups (p<0.05). Sedation scores and CHEOPS were similiar in all groups. No motor block was seen in either group on awakening. There were no differences in the insidence of emesis, vomiting and urinary retention among the groups. Conclusion: All three anesthetic agents may be used effectively in caudal anesthesia in children but time to first analgesic requirement was found to be shorter for prilocaine.
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... How to Cite. Karakas, O., Canbay, O., Celebi, N., Sahin, A., Karagoz, A., Iskit, A. and Aypar, U. (2006), 317 THE EFFECTS OF LORNOXICAM AND KETAMINE ON INFLAMMATION AND MECHANICAL HYPERALGESIA MODELS IN RATS. European Journal of Pain,... more
... How to Cite. Karakas, O., Canbay, O., Celebi, N., Sahin, A., Karagoz, A., Iskit, A. and Aypar, U. (2006), 317 THE EFFECTS OF LORNOXICAM AND KETAMINE ON INFLAMMATION AND MECHANICAL HYPERALGESIA MODELS IN RATS. European Journal of Pain, 10: S85. ...
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There have been many studies to find the optimum anaesthetics to provide excellent conditions for laryngeal mask insertion. We compared the effects of dexmedetomidine administered before propofol, on laryngeal mask insertion with fentanyl... more
There have been many studies to find the optimum anaesthetics to provide excellent conditions for laryngeal mask insertion. We compared the effects of dexmedetomidine administered before propofol, on laryngeal mask insertion with fentanyl combined with propofol. In all, 52 patients, ASA I-II, scheduled to have minor urological procedures were randomized into two groups. Group F received 1 microg kg(-1) fentanyl (in 10 mL normal saline) and Group D received 1 microg kg(-1) dexmedetomidine (in 10 mL normal saline). We used 1.5 mg kg(-1) propofol for induction and 50% N2O and 1.5% sevoflurane in oxygen for maintenance. We observed jaw mobility (1: fully relaxed; 2: mild resistance; 3: tight but opens; 4: closed), coughing or movement (1: none; 2: one or two coughs; 3: three or more coughs; 4: bucking/movement) and other events such as spontaneous ventilation, breath holding, expiratory stridor and lacrimation. In each category, scores <2 were acceptable for laryngeal mask insertion. More patients developed apnoea and their apnoea times were longer in Group F than Group D (P < 0.001). Respiratory rates increased in Group D (P < 0.001). Adverse events during laryngeal mask insertion were similar. The reductions in systolic and mean blood pressures were greater in Group F (systolic: P < 0.05, mean: P < 0.01). Emergence times were shorter in Group F than in Group D (P < 0.001). Dexmedetomidine, when used before propofol induction provides successful laryngeal mask insertion comparable to fentanyl, while preserving respiratory functions more than fentanyl.
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The aim of this study was to assess time dependent cumulative effects of three different inhalation anaesthetics on QTc interval during the maintenance of anaesthesia. Seventy-five ASA I-II male patients undergoing inguinal herniorrhaphy... more
The aim of this study was to assess time dependent cumulative effects of three different inhalation anaesthetics on QTc interval during the maintenance of anaesthesia. Seventy-five ASA I-II male patients undergoing inguinal herniorrhaphy were randomly allocated into three groups. No premedication was given. Anaesthesia was induced with thiopental and tracheal intubation was facilitated by vecuronium in all groups. Anaesthesia was maintained with 0.8% halothane (Group I) (n = 25), 1% isoflurane (Group II) (n = 25), or 2% sevoflurane (Group III) (n = 25) and 66% nitrous oxide in oxygen. Three lead electrocardiogram recordings were taken before induction, 2, 5, 10, 15, 30 and 45 min after induction and after extubation. Heart rate, systolic, diastolic, mean arterial pressure and SpO2 were recorded at the same time. Heart rate and corrected QT interval were evaluated by using Bazett's formula. Multivariate analysis of variance for repeated measures was used to determine intergroup and intragroup differences. There was no statistically significant difference in the baseline QTc values of the groups. There was no difference between QTc values with halothane and sevoflurane. There was a difference between QTc values with isoflurane and those with the other two inhalation anaesthetics (P < 0.05). Although QTc values in the isoflurane group were higher at all times, the critical value of 440 ms was not exceeded. We conclude that halothane 0.8%, isoflurane 1% and sevoflurane 2% do not prolong QTc interval.
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To compare the perioperative effects of melatonin and midazolam given in premedication, on sedation, orientation, anxiety scores and psychomotor performance. Exogenous administration of melatonin not only facilitates the onset of sleep... more
To compare the perioperative effects of melatonin and midazolam given in premedication, on sedation, orientation, anxiety scores and psychomotor performance. Exogenous administration of melatonin not only facilitates the onset of sleep but also improves its quality. A prospective, randomized, double-blind, placebo-controlled study was performed in 66 patients undergoing laparoscopic cholecystectomy. Patients were given melatonin 5 mg, midazolam 15 mg or placebo, 90 min before anaesthesia, sublingually. Sedation, orientation and anxiety were quantified before; 10, 30, 60 and 90 min after premedication; and 15, 30, 60 and 90 min after admission to the recovery room. Neurocognitive performance was evaluated at these times, using the Trail Making A and B and Word Fluency tests. The differences between the groups were analysed by ANOVA. Two-way comparisons were performed by Scheffé analysis. Sedation and amnesia were analysed by the chi2 test. Patients who received premedication with either melatonin or midazolam had a significant increase in sedation and decrease in anxiety before operation compared with controls. After operation, there was no difference in sedation scores of all groups. Whereas, 30, 60 and 90 min after premedication the melatonin and midazolam groups exhibited a significantly poorer performance in Trail Making A and B tests compared with placebo, there were no significant differences among the groups in terms of neuropsychological performance after the operation. Amnesia was notable only in the midazolam group for one preoperative event. Melatonin premedication was associated with preoperative anxiolysis and sedation without postoperative impairment of psychomotor performance.
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... E. Barrera, S. Fernández-Galinski, E. Arbonés F. Escolano, MM Puig Anaesthesiology Service Hospital Universitario del Mar UAB, Barcelona, Spain References ... 5. Myles PS, Leslie K, McNeil J, Forbes A, Chan MTV, for the B-Aware trial... more
... E. Barrera, S. Fernández-Galinski, E. Arbonés F. Escolano, MM Puig Anaesthesiology Service Hospital Universitario del Mar UAB, Barcelona, Spain References ... 5. Myles PS, Leslie K, McNeil J, Forbes A, Chan MTV, for the B-Aware trial group. ...
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To compare the effects of crystalloid and colloid solutions, tranexamic acid and epsilon-aminocaproic acid on the need for allogenic blood transfusion and on coagulation and fibrinolysis parameters. We conducted the study in the... more
To compare the effects of crystalloid and colloid solutions, tranexamic acid and epsilon-aminocaproic acid on the need for allogenic blood transfusion and on coagulation and fibrinolysis parameters. We conducted the study in the Anesthesiology and Reanimation Department of Hacettepe University Medical Faculty, Ankara, Turkey between March 2004 and April 2005. The study included 105 patients, classified by the American Society of Anesthesiology as physical status groups I-II, undergoing gynecologic cancer treatment. We divided them into 5 groups: group I (crystalloid) received crystalloid solutions, group II (colloid) received colloid solutions, group III (tranexamic acid) received 10 mg x kg(-1) tranexamic acid, and group 5 (epsilon-aminocaproic acid) received 100 mg x kg(-1) epsilon-aminocaproic acid. All patients bleeding amount was measured and recorded perioperatively, and at the 12th and 24th hours postoperatively. We then evaluated the patients' hemoglobin, hematocrit, activated thromboplastin time, international normalized ration, fibrinogen, and thrombocyte count and symptoms of pulmonary embolism. In comparing the amount of bleeding, the bleeding in the tranexamic acid group was 30.8% less than the crystalloid group (p<0.05), 33.3% less than the colloid group (p<0.05), and 23.9% less than the epsilon-aminocaproic acid group (p<0.05). When the negative effects of blood transfusions were considered, tranexamic acid administration can be recommended for decreasing the need for blood transfusion in gynecologic cancer surgery.