Browsing by Author "Çavuş Z."

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    Assessment of neuromuscular and haemodynamic effects of cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia in elderly patients
    (2004) Keleş G.T.; Yentür A.; Çavuş Z.; Sakarya M.
    Background and objective: Neuromuscular block times, quality of muscle relaxation for tracheal tube insertion, and the haemodynamic effects after cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia were compared in elderly patients. Methods: The study was performed in 40 patients over 65 yr of age. Anaesthesia was induced with thiopental, and maintained with sevoflurane in N2O/O2 and remifentanil. Cisatracurium 0.15 mg kg-1 or vecuronium 0.1 mg kg-1 were administered after induction. Intubation was attempted when neuromuscular block was 95%. Onset time, clinical duration of action, recovery index, spontaneous recovery time and tracheal intubation conditions were assessed. Haemodynamic parameters were also monitored. Results: The average ages of the patients were 72.5 ± 5.1 and 73.6 ± 6.3 in the cisatracurium and vecuronium groups, respectively. Onset time was significantly shorter after vecuronium, 158 ± 34s vs. 200 ± 50s, respectively. Recovery index was significantly shorter after cisatracurium, 19.5 ± 7.5s vs. 33.7 ± 18.6s (P < 0.05). Clinical duration and spontaneous recovery time were similar in both groups as well as haemodynamic variables. Conclusions: In elderly patients, vecuronium has a faster onset time while cisatracurium has a shorter recovery index under sevoflurane-remifentanil anaesthesia.
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    The comparison of efficiency of bupivacaine-fentanyl with ropivacaine-fentanyl in patient controlled epidural analgesia for labour; [Hasta kontrollü epidural doǧum analjezisi için bupivakain fentanil ile ropivakain fentanilin etkinliǧinin karşilaştirilmasi]
    (2004) Topçu I.; Yentür E.A.; Tekin S.; Çavuş Z.; Ekici N.Z.; Sakarya M.
    In this prospective, randomized, double-blinded study we aimed to evaluate the efficiency of 1μg mL-1 fentanyl with 0.125% bupivacaine and 1μg mL-1 fentanyl with 0.125% ropivacaine by patient controlled epidural analgesia (PCEA) for labour. The study was performed in 2 groups; each consisted of 20 pregnants which had healthy, single fetus in 36-41 gestational weeks with normal fetal pulse pattern in vertex position, 3-6 cm of cervical dilatation and at active phase of labour. Solution of 1μg mL-1 fentanyl with 0.125% ropivacaine was applied to Group I and 1μg mL-1 fentanyl with 0.125% bupivacaine to Group II. PCEA was programmed as 5 ml bolus dose, 10 minutes lock-out (without basal infusion, and 1-4 h limit) and 10 mL loading dose. Patients' pain was evaluated by VAS (visual analog scale) (0-100mm), sensory block by PinPrick test (0-3) and motor block by modified Bromage scale. Maternal mean arterial pressure (MAP), heart rate (HR) and fetal HR were recorded during the labour. Umblical artery blood pH, APGAR of fetus and patient satisfaction after delivery (1-5) were assessed. Mode of delivery (normal, operative and cesarean), side-effects, duration of labour and analgesics consumption for the first and second stages of labour were recorded by calculating the values via PCEA. No differences were obtained in the evaluation of MAP, HR, fetal HR, VAS, sensory block, amount of analgesics solution, mode of delivery, duration of labour, side effects and patient satisfaction between the groups. However, lesser motor block was observed in ropivacaine/fentanyl group rather than bupivacaine/fentanyl group (p<0.05). Consequently, both 1μg mL-1 fentanyl with 0.125% ropivacaine and 1μg mL-1 fentanyl with 0.125% bupivacaine by patient controlled epidural analgesia (PCEA) for labour, provided sufficient and trustworthy analgesia. Similar effects were obtained on hemodynamics but because of lesser motor block effect, we propose that ropivacaine more superior for labour analgesia.
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    Comparison of effects of dexmedetomidine and magnesium in traumatic brain injury; [Travmatik beyin hasarinda serebral korumada deksmedetomidin ve magnezyumun etkilerinin karşilaştirilmasi]
    (2006) Çavuş Z.; Topçu I.; Vatansever S.; Var A.; Sakarya M.
    Aim: Prevention of secondary serebral injury plays a major role in intensive care of head injury patients. In this study, the effects of dexmedetomidine and magnesium to prevent brain injury in head trauma are compared. Materials and Methods: Diffuse head injury was induced in 30 adult Wistar albino male rats by Marmarou method after anesthetized by intraperitoneal injection of 30 mg kg-1 sodium thiopental. Rats were divided randomly into 3 groups, each consisting of 10 rats: 2 mL saline to Group 1, 2 mL 100 μg kg-1 dexmedetomidine to Group II and 2 mL 750 μmol kg-1 magnesium sulphate to Group III were administered by intraperitoneal route. Rats were sacrificed by cervical dislocation 120 minutes after the drug administration and brain tissues were obtained without damaging the brains. Brain tissue samples were divided into two by interhemispheric incision for biochemical and histological analysis. Brain tissues were fixed in 10% formalin solution and embedded in paraffin and examined by hematoxylin-eosin staining for morphological alterations. Sections were stained via TUNEL method in order to detect apoptosis. The tissue concentration of malonyldialdehyde (MDA), Superoxide dismutase (SOD) and glutathione peroxidasc (GSH-Px) in brain tissue was also measured. Results: Hematoxylin-eosin-stained brain sections arc compared; dexmedetomidine is more effective than magnesium in reducing brain cell injury caused by head trauma. Evaluation of apoptosis by the TUNEL method revealed that magnesium is more effective than dexmedetomidine in preventing cell death. Malonyldialdehyde (MDA) levels of Group I was found significantly lower than Group II and III (p<0.05). Also the decrease in the level of superoxide dismutase (SOD) in Group I was found significantly higher than Group II and III. There was no difference in glutathione peroxidasc (GSH-Px) levels between the groups. Conclusion: Dexmedetomidine reduces secondary cerebral injury significantly: however, magnesium prevents apoptosis more effective than dexmedetomidine in experimental models of diffuse traumatic brain injury. The effects of magnesium and dexmedetomidine in brain cell protection may occur through different mechanisms but not by enzymes because the biochemical results arc in contradiction with the histopathological analysis.