Browsing by Author "Öztürk T."
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Item The effect of levosimendan on weaning from cardiopulmonary bypass and early hemodynamic parameters in patients with compromised left ventricular function; [Kötü sol ventrikül fonksiyonlu hastalarda levosimendanin kardiyopulmoner baypastan ayrilma ve erken dönem hemodinamik parametreler Üzerine etkileri](2006) Öztürk T.; Şirin H.; Toprak V.; Ertan Y.; Cerrahoǧlu M.In this study we determined the effects of levosimendan on hemodynamic parameters during weaning from cardiopulmonary bypass (CPB) and in the early postoperative period in patients with compromised left ventricular-function. Charts of 18 patients with an ejection fraction of ≤30 % who underwent elective coronary artery bypass (CABG) surgery were reviewed. Eight (Group L) had received a loading dose of levosimendan (6 μg kg-1) within 10 minutes after removal of the cross clamp, followed by an infusion (0.1 mcg kg-1 min-1). Control patients (n=10, Group C) received dopamine, dobutamine or adrenaline. Hemodynamic parameters during the early postoperative period were compared. Cardiac index (CI) was significantly higher than baseline in both groups at one and six hours after removal of the cross clamp (p<0.05). CI was significantly greater, and SVRI and PVRI were significantly lower, in Group L at both one and six hours (p<0.001). In conclusion, the use of levosimendan was associated with more favourable hemodynamic effects in patients with compromised left ventricular function during weaning from CPB and in the early postoperative period after CABG surgery.Item The effects of esmolol on anesthetic and analgesic requirement; [Esmololün anestezik ve analjezik gereksinimi üzerine etkisi](2007) Topçu I.; Öztürk T.; Taşyüz T.; Işik R.; Çetin I.; Sakarya M.Aim: There are many adjuvant agents which decrease the need of anesthetic and analgesic drugs during general anesthesia management. The comparison of the effects of esmolol, a β1 receptor antagonist with a ultra-short-acting, is aimed upon the consumption of analgesic, anesthetic and neuromuscular blocker drugs in this randomized, double-blinded study. Materials and Methods: 18-70 year old, ASA I-II, 60 patients scheduled for elective abdominal operations under general anesthesia were equally divided into 2 groups. In Group E; 1 mg kg-1 esmolol infusion was started slowly prior to induction and 250 μg kg-1 min-1 esmolol infusion lasted during the operation, in Group C (control group) isotonic solution was administered in the same volume. Propofol (due to BIS values) and remifentanil (due to heart beat rate and blood pressure) were administered by TIVA in anesthesia maintenance to the patients. Rocuronium was used as a neuromuscular blocker drug. All hemodynamics values of the cases, the amounts of the anesthetic consumption, analgesic and neuromuscular blocker drugs before and after induction were recorded. Results: There was no difference for age, gender, type and period of operation and induction doses between the groups (p>0.05). The need of analgesic and anesthetic drug was decreased but the consumption of neuromuseular blocker drug not affected in Group E than Group K (p<0.05). Mean arterial blood pressure and heart beat rate variables were more stabile in the perioperative period in Group E. The hemodynamic response to intubation and extubation were reduced by esmolol infusion. Conclusion: The results suggest that the perioperative esmolol administration may reduce intraoperative requirement of the anesthetics and the analgesic to prevent acute autonomic responses during anesthesia and surgery.Item Hepatobiliary insufficiency-candidate of transplantation newborns and anesthesia (two cases); [Hepatobilier yetmezlikli-transplantasyon adayi neonatal olgular ve anestezi](2008) Öztürk T.; Bulut S.; Toprak V.; Tezcan Keleş G.Biliary atresia (BA) is the most common and important neonatal hepatobiliary disorder and is seen in 1 in 8.000 to 1 in 18.000. Consequently, 70-80 % of BA patients will eventually require liver transplantation, approximately half in the first 2 y of life. Early diagnosis and therapy is essential especially for the survival of patients with biliary atresia.Item Comparison of TD-fentanyl with sustained-release morphine in the pain treatment of patients with lung cancer; [Akciǧer kanserli hastalarin aǧrilarinin tedavisinde transdermal fentanil ve yavaş salinimli morfinin karşilaş tirilmasi](2008) Öztürk T.; Karadibak K.; Çatal D.; Çakan A.; Tugsavul F.; Çirak K.Comparison of TD-fentanyl with sustained-release morphine in the pain treatment of patients with lung cancer AIM: The aim of this randomized and controlled trial was to evaluate the analgesic efficacy of trans-dermal fentanyl (TDF) and sustained-release oral morphine (SRM) primarily and their side effects secondarily, in patients with chronic lung cancer-related pain. MATERIAL-METHODS: According to three step analgesic guidelines recommended by the World Health Organization, 50 chronic lung cancer patients requiring third line therapy were enrolled and received either TDF patch (Grup F, n=25) or SRM per orally (Grup M, n=25) for 15 days. Patients were assessed in view to numeric rating scale of their pain, as well as the drugs' side effects like constipation, nausea-vomiting, urinary retention and urticaria, hypoventilation. RESULTS: Pain scores were similar for both groups at the beginning (p>0.05). While significantly lower pain scores were achieved on the 7th and 15th days compared to those of initial values in Group F and Group M patients (p<0.001); these decreases did not reach statistical significance between the groups (p>0.05). Compared to Group M, constipation was significantly lower in Group F (14 patients and 64% vs. 6 patients and 27%, respectively) (p=0.03). However, the frequencies of nausea-vomiting, urinary retention and urticaria were different between the groups (p>0.5). None of the patients developed hypoventilation. CONCLUSION: Both TDF and SRM are safe and effective analgesics for the management of chronic cancer pain. However, TDF is associated with significantly less constipation rate than that of with SRM.Item The effect of levosimendan in patients undergoing to coronary bypass operation with low ejection fraction; [Koroner baypas geçi̇ren düşük ejeksi̇yon fraksi̇yonlu hastalarda levosi̇mendanin etki̇leṙi](2009) Kurdal A.T.; Öztürk T.; Badak O.T.; Eserdaǧ M.; Işkesin I.; Cerrahoǧlu M.; Şirin B.H.In this study we determined the effects of levosimendan on hemodynamic parameters during weaning from cardiopulmonary bypass and in the early postoperative period in patients with low ejection fraction. Charts of 39 patients with an ejection fraction of ≤30% who underwent elective coronary artery bypass surgery were reviewed. Nineteen (Group L) had received a loading dose of levosimendan (6 μg·kg-1) within 10 minutes after removal of the cross clamp, followed by an infusion (0.1 mcg·kg-1·min-1). Control patients (n=20, Group C) did not receive levosimendan. Hemodynamic parameters during the early postoperative period were compared. Cardiac index was significantly higher than baseline in both groups at one and six hours after removal of the cross clamp (p<0.05). Cardiac index was significantly greater, and systemic vascular resistance index and Pulmonar vascular resistance index were significantly lower, in Group L at both one and six hours (p<0.001). In conclusion, the use of levosimendan was associated with more favourable hemodynamic effects in patients with low ejection fraction during weaning from cardiopulmonary bypass and in the early postoperative period after Coronary Artery Bypass Grefting surgery.Item Anesthetic management in a case severe thoracolumbar kyphoscoliosis and difficult airway; [Ciddi torakolomber kifoskolyozu ve zor hava yolu olan olguda anestezi yönetimi](2009) Topçu I.; Öztürk T.; Bulut S.; Tezcan Keleş G.Anesthetic management in a case severe thoracolumbar kyphoscoliosis and difficult airway Spinal deformities may cause difficulties with both tracheal intubation and regional anesthesia. This report describes the anesthetic management that was performed in 48 years old patient with extremely severe thoracolumbar kyphoscoliosis and mallampati class IV. After examining the risk factors, spinal block by injecting single dose 12, 5 mg bupivacaine solution to the intratechal space was chosen to provide anaesthesia. Motor and sensory blockade at the level of Thl2 was achieved. Spinal anesthesia can be successfull even in cases of severe thoracolumbar kyphoscoliosis and difficult airway manage-ment.Item Evaluation of hemostatic changes using thromboelastography after crystalloid or colloid fluid administration during major orthopedic surgery(Associacao Brasileira de Divulgacao Cientifica, 2012) Topçu I.; Çivi M.; Öztürk T.; Keleş G.T.; Çoban S.; Yentür E.A.; Okçu G.The effects of Ringer lactate, 6% hydroxyethyl starch (130/0.4) or 4% succinylated gelatin solutions on perioperative coagulability were measured by thromboelastography (TEG). Seventy-five patients (ASA I-III) who were to undergo major orthopedic procedures performed under epidural anesthesia were included in the study. Patients were randomly divided into three groups of 25 each for the administration of maintenance fluids: group RL (Ringer lactate), group HES (6% hydroxyethyl starch 130/0.4), and group JEL (4% gelofusine solution). Blood samples were obtained during the perioperative period before epidural anesthesia (t1, baseline), at the end of the surgery (t2), and 24 h after the operation (t3). TEG data, reaction time (R), coagulation time (K), angle value (α), and maximum amplitude (MA) were recorded. TEG parameters changed from normal values in all patients. In group RL, R and K times decreased compared to perioperative values while the α angle and MA increased (P < 0.05). In group HES, R and K times increased, however, the α angle and MA decreased (P < 0.05). In group JEL, R time increased (P < 0.05), but K time, α angle and MA did not change significantly. In the present study, RL, 6% HES (130/0.4) and 4% JEL solutions caused changes in the coagulation system of all patients as measured by TEG, but these changes remained within normal limits.Item Epidural anesthesia for caesarian section in a pregnant with porphyria; [Porfi̇ri̇li̇ bi̇r gebede sezaryen operasyonunda epi̇dural anestezi̇](2013) Topçu I.; Uysal C.; Öztürk T.Porphyria which is characterized by enzyme deficiency in heme biosynthesis pathway is life-threatening and genetically inherited disease. Anesthesia of a patient with porphyria requires knowledge about non-porphyrogenic agents and safe methods. Each of anesthetics, surgery and pregnancy has the risk of triggering acute porphyria crisis. In this case report; the epidural anesthesia management with bupivacaine and fentanyl in two pregnant women with porphyria who had undergone cesarean operation without any problems is valuated.Item The effect of beta-blocking agents on morbidity und mortality following coronary artery bypass surgery; [Kronik beta bloker kullaniminin koroner baypas cerrahisi sonrasi morbidite ve mortalite üzerine etkileri](2013) Öztürk T.; Koçan A.A.; Yildirim F.; Alp D.; Kurdal T.Objective: Aim of this study was to investigate the effect of beta-blocking agents on both short and long-term morbidity and mortality in patients undergoing coronary artery bypass surgery. Material and Methods: Between January 2010 and March 2012, the patients undergoing coronary artery bypass surgery in our cardiovascular surgery clinic were divided into two groups; Group B included the patients who had (Group B) or had not (Group C) been using beta-blocking agents preoperatively, Demographic and clinical characteristics, intraoperative and postoperative clinical parameters as well as short (30-days) and long-term (1 year) rates of morbidity and mortality were retrospectively evaluated. Results: Number of patients with atrial fibrillation was significantly lower in Group B (n=17, 20% vs. n=28, 35%; p<0.01). Frequency of agitation-delirium in Group B was also significantly less than Group C (n=2, 3% vs. n=8, 10%; p=0.05). Thirty-day morbidity was also higher in Group C than Group B (n=28, 35% vs. n=17, 20%; p<0.04), however this difference disappeared after 1 year (n=30 38% vs. n=24, 28%; p=0.2). Neither 30-day nor 1 year-mortality rates were statistically significant between Groups B and C (p=0.4 and p=0.2, respectively). Conclusion: Compared to the control group, the frequencies of both atrial fibrillation and agitation-delirium were significantly lower in Group B in this cohort of patients. The long term use of beta-blocking agents prior to coronary artery bypass surgery appears to markedly reduce 30-day morbidity, despite this effect was not reflected on short and long-term mortality rates.Item Fentanyl reaction in a parkinsonian patient receiving monoamine oxidase inhibitor while undergoing cardiac surgery; [Kardiyak cerrahi geçiren ve monoamin oksidaz inhibitörü kullanan parkinson hastasinda fentanil reaksiyonu](Turkish Anaesthesiology and Intensive Care Society, 2014) Öztürk T.; Çikrikci C.; Yildirim F.; Kurdal A.T.; Çivi M.Use of fentanyl is a controversial issue because of possible adverse drug interactions in patients using monoamine oxidase inhibitors during cardiac surgery. In this case report we described a drug interaction with fentanyl in a parkinsonian patient who was 57 years old, 45 kg weigh and required mitral valve replacement surgery while he was taking a selective monoamine oxidase inhibitor type B (Rasajilin) with selective serotonin reuptake inhibitor (paroxetin). Despite anesthesia and surgery were maintained normally, supraventricular tachycardia, hypertension, sweating, flushing and hypertermia were observed during warming of the heart and the weaning period of cardiopulmonary bypass. Tachycardias were treated by cardioversion and beta-blocker therapy. Patient's body temparature was controlled at 37°C by using pump perfusion. Fentanyl infusion was discontinued. After hemodynamic stability was achieved, cardiopulmonary bypass was terminated. Total fentanyl consumption was 2.8 mg. Parkinson's therapy was resumed at the first day postoperatively. Patient was discharged at the 7th day.Item Coagulation effects of hydroxyethylstarch versus modified fluid gelatin when used as normovolemic hemodilution solutions during cardiac surgery(Turkish Anaesthesiology and Intensive Care Society, 2014) Öztürk T.; Topçu I.; Tuncer B.; Açikgöz B.; Yildirim F.; Işkesen I.Objective: The aim of this study to examine the effects of hydroxyethyl starch and gelatin solutions used for acute normovolemic hemodilution on coagulation during coronary artery bypass surgery. Material and Method: Seventy-two patients undergoing elective coronary artery bypass graft surgery randomly received no hemodilution (control), or 6% HES 200/0.5 (n=24) or 4% gelatin solution (n=24) for acute normovolemic hemodilution before cardiopulmonary bypass. Thromboelastography parameters were measured before (T0) and after (T1) acute nor-movolemic hemodilution, and one (T2) and four (T3) hours after separation from CPB. Results: The R (reaction) time in HES was significantly longer than in controls at T(2) (p=0.03). The K (coagulation) values in group HES and GEL were significantly longer than in controls at T(2) and T(3) (p=0.02 and 0.03, respectively). Rapidity of clot formation (alpha angle) was significantly smaller in HES and GEL compared to controls (p=0.01 and p=0.02, respectively). Maximum amplitudes in HES and GEL were not significantly different than controls at T(2) (p=0.3 and 0.9, respectively). At T2, three patients in GEL (but none in HES) showed clotlysis at 30 min (p=0.1). GEL and HES received fewer units of erythrocyts compared to controls(p<0.001); however, use of fresh frozen plasma was not significantly different than in controls. Mediastinal blood loss was greater in group HES than in controls (p<0.05). Conclusion: Performing acute normovolemic hemodilution with HES and GEL solutions caused significant change in coagulation state by thromboelastography, reduced the need for errytrocyt. Regarding the increase in mediastinal chest drainage, we concluded that HES may not be safety in patients undergoing coronary surgery.Item Anaesthetic management of the patient undergoing cardiopulmonary bypass graft surgery after pneumonectomy(Turkish Anaesthesiology and Intensive Care Society, 2014) Öztürk T.; Bambal H.; Işkesen I.; Şirin H.The aim of this case report is to discuss the recommendations for preoperative evaluation, the technical difficulties experienced in the perioperative period and the ventilation methods used to minimize pulmonary injury in a post-pneumonectomy patient undergoing coronary artery bypass grafting surgery.Item Effects of high-dose rocuronium on the QTc interval during anaesthesia induction in patients undergoing coronary artery bypass graft surgery; [Koroner arter cerrahisi geçirecek olgularda anestezi İndüksiyonu sırasında yüksek doz roküronyumun QTc İntervali üzerine etkileri](AVES Ibrahim Kara, 2014) Ağdanlı D.; Öztürk T.; Ütük O.; Keleş G.T.Objective: Existing myocardial damage in coronary artery disease patients causes prolonged QT syndrome. The primary objective of this trial is to explore the effects of different doses of muscle relaxant agent rocuronium (0.6 mg.kg−1 and 1.2 mg.kg −1) on QTc following anesthetic induction. Seconder objective is to determine the incidence and kinds of arrythmias.; Methods: In this prospective and randomized trial, patients undergo elective coronary arteria revascularisation surgery were included in one of two groups. Both groups took same anesthetic induction agents; midazolam and fentanyl. Rocuronium was administered in Group 1(n=20) with dose of 0.6 mg. kg−1 and in Group 2 (n=20) with dose of 1.2 mg.kg−1 for muscle relaxation.; Heart rate, avarage arteria pressure and QTc were recorded before induction(T0), after induction(T1), after muscle relaxant(T2), 2 minutes(T3) and 5 minutes after entubation(T4).; Results: QTc was significantly long just in 2 minutes after entubation (in Group 1 and Group 2 respectively, 447.9±28.3, 466.1±37.8ms), than those at the beginning (respectively, 426.9±25.7, 432.0±35.5ms)(p<.0.01). In intergroup comparison, avarage QTc values were similar in all trial periods (p>0.05). The prevalance of arrythmias in between Group 1 (35%, n=7), and Group 2 (15%, n=3) were similar (p=0.06). Arrythmias were recorded 2 minutes after entubation in both groups (n=10, 25%).; Conclusion: In patients undergoing coronary arteria revascularisation surgery, rocuronium doses of 0.6 mg kg −1 and 1.2 mg kg −1 had have prolonged the QTc interval after entubation. Cardiac arrthymias related to long QTc arising after entubation should be taken into consideration. © 2014 by Turkish Anaesthesiology and Intensive Care Society.Item Effects of conventional vs high-dose rocuronium on the QTc interval during anesthesia induction and intubation in patients undergoing coronary artery surgery: A randomized, double-blind, parallel trial(Associacao Brasileira de Divulgacao Cientifica, 2015) Öztürk T.; Ağdanlı D.; Bayturan Ö.; Çıkrıkcı C.; Keleş G.T.Myocardial ischemia, as well as the induction agents used in anesthesia, may cause corrected QT interval (QTc) prolongation. The objective of this randomized, double-blind trial was to determine the effects of high- vs conventional-dose bolus rocuronium on QTc duration and the incidence of dysrhythmias following anesthesia induction and intubation. Fifty patients about to undergo coronary artery surgery were randomly allocated to receive conventional-dose (0.6 mg/kg, group C, n=25) or high-dose (1.2 mg/kg, group H, n=25) rocuronium after induction with etomidate and fentanyl. QTc, heart rate, and mean arterial pressure were recorded before induction (T0), after induction (T1), after rocuronium (just before laryngoscopy; T2), 2 min after intubation (T3), and 5 min after intubation (T4). The occurrence of dysrhythmias was recorded. In both groups, QTc was significantly longer at T3 than at baseline [475 vs 429 ms in group C (P=0.001), and 459 vs 434 ms in group H (P=0.005)]. The incidence of dysrhythmias in group C (28%) and in group H (24%) was similar. The QTc after high-dose rocuronium was not significantly longer than after conventional-dose rocuronium in patients about to undergo coronary artery surgery who were induced with etomidate and fentanyl. In both groups, compared with baseline, QTc was most prolonged at 2 min after intubation, suggesting that QTc prolongation may be due to the nociceptive stimulus of intubation. © 2015, Associacao Brasileira de Divulgacao Cientifica. All rights reserved.Item Effects of non-dependent lung oxygen insuffation on oxygenation and respiratory mechanics during one-lung ventilation in patients with stage II COPD(Turkish Anaesthesiology and Intensive Care Society, 2015) Öztürk T.; Aydin D.; Yaldiz S.; Yuncu G.; Atay A.; Savaci S.Introduction: The aim of this study was to investigate the changes on oxygenation, shunt ratio and respiratory mechanics of 6 L/min oxygen insuffation to the non-dependent lung, while extrinsic PEEP (PEEPe, equivalent to the patient's PEEPi) was being applied to the dependent lung in patients undergoing lung surgery. Material and Methods: Patients with stage II COPD undergoing elective lung surgery (n=22) were intubated with a doublelumen endobronchial tube and performed a PA catheterization. One lung ventilation settings were: tidal volume 6 ml/kg, 12 breaths/min, and I: E ratio 1: 2. Procedure was performed in four sequential periods (each period continued for 15 minutes): After frst stabilization period (PEEP0-1), PEEPe (at the level of intrinsic PEEP, PEEPi) was applied in the dependent lung while the non-dependent lung was exposed to air. After second stabilization period (PEEP0-2), the non-dependent lung received 6 L/min oxygen (O2) through a catheter placed into the tube while PEEPe (at the level of PEEPi) was applied in the dependent lung (PEEPe+O2). At the end of each 15 minute period, haemodynamic data, lung compliance (C), airway resistance (R), and PEEPi were recorded and blood gas samples were obtained. Results: PaO2 was signifcantly higher during the PEEPe+O2 period (p<0.001), while Qs/Qt was signifcantly lower in the PEEPe+O2 period when compared with the PEEPe period (p<0.0001). Compliance increased signifcantly during PEEPe compared to PEEP0-1 (p<0.05). Discussion and Conclusion: The insuffation of oxygen to the non-dependent lung with application of PEEPe-equivalent to the patient's PEEPi - to the dependent lung increased oxygenation and decreased Qs/Qt in patients with moderate COPD. We recommend this simple and useful method which does not need extra equipment.Item Immune and inflammatory role of hydroxyethyl starch 130/0.4 and fluid gelatin in patients undergoing coronary surgery(Academic Press, 2015) Öztürk T.; Onur E.; Cerrahoğlu M.; Çalgan M.; Nizamoglu F.; Çivi M.Objectives: Compare the effects on inflammatory (TNF-α, IL-6, IL-8 and IL-10) and immunologic (CD3+, CD4+, CD8+, CD11b+, CD16+/56+ T cells and total lymphocyte concentration) variables of hydroxyethyl starch 130/0.4, 4% modified fluid gelatin, or crystalloid when used as volume replacement fluids for acute normovolemic hemodilution (a blood conservation technique) in coronary artery bypass graft patients. Methods: Thirty patients undergoing coronary artery bypass graft surgery were randomized to receive Isolyte S® (Group ISO), 6% hydroxyethyl starch 130/0.4 (Group HES) or 4% modified gelatin solution (Group GEL) for acute normovolemic hemodilution. Blood samples were taken immediately after induction of anaesthesia (T0), and 2h (T1), 12h (T2), 24h (T3), and 48h (T4) after separation from cardiopulmonary bypass. TNF-α, IL-6, IL-8 and IL-10 levels were determined with commercially available ELISA kits. CD3+ (mature T cells), CD4+ (T helper cells), CD8+ (suppressor cytotoxic T cells), CD16+/56+ (natural killer lymphocytes), and CD11b+ (Mac-1, adhesion receptor) levels were measured using flow-cytometry reagents. The CD4+:CD8+ ratio was calculated. Results: Between-group comparisons showed significantly higher levels of TNF-α at T1 (2h after weaning from cardiopulmonary bypass) in Group HES compared to Group ISO (p=0.003). IL-8 was significantly lower in Group HES than Group GEL at T1 (p=0.0005). IL-10 was significantly higher in Group HES than in Group GEL at T1 (p=0.0001). The CD4+:CD8+ ratio in Group ISO was significantly lower than that in Group HES at T2 (p=0.003). CD11b+ levels in Group HES were also higher than those in Group GEL and group ISO at T2, but not significantly. CD16/56+ levels in Group HES were higher than those in Group GEL at T2 (p<0.003). No excessive hemorrhage occurred in any patient. Mediastinal drainage during the first 24h after surgery in Group HES (347±207mL) was not significantly different from that of Group GEL (272±177mL) or Group ISO (247±109) (p>0.05). Conclusion: Hydroxyethyl starch 130/0.4 reduced pro-inflammatory responses and increased anti-inflammatory responses to a greater degree than gelatin solution and isolyte S®. The use of hydroxyethyl starch, compared to gelatin solution and isolyte S®, resulted in less decrease in the CD4+:CD8+ ratio, suggesting less immunosuppression. © 2014 Elsevier Ltd.Item Comparison of thoracic epidural and paravertebral analgesia for postoperative pain control after thoracotomy; [Torakotomi sonrasi postoperatif aǧri kontrolünde torakal epidural ve paravertebral bloǧun karşilaştirilmasi](Turkish Society of Algology, 2016) Öztürk T.; Topcu I.; Yaldiz S.; Özbakkaloǧlu A.; Aşik K.; Yentür A.Objectives: In the present randomized, controlled, and blinded study, the effects of thoracic paravertebral analgesia were compared to those of epidural analgesia on postoperative pain, hemodynamics, and respiration rate following thoracotomy. Methods: Patients scheduled for elective open-lung surgery were included. One hour prior to surgery, thoracic epidural catheters were used in 18 patients (ED group), and ultrasound-guided paravertebral catheters were used in 17 patients (PV group). Standard general anesthesia was administered to all. Following anesthesia, postoperative analgesia of levobupivacaine 0.1% and morphine 0.1 mg mL-1 was administered via catheter. Patient-controlled analgesia (PCA) regime with tramadol was initiated, and amounts of local anesthetics and tramadol demanded and delivered within the first 24 hours were recorded. Visual analog scale (VAS) pain score, sedation score, side effects, and vital signs (blood pressure, heart rate, and respiratory rate) were assessed by an observer blinded to patient data at 1, 2, 3, 4, 6, 12, and 24 hours. Results: Differences in PCA bolus demands and deliveries were not statistically significant between the PV group (26.8±1.3 and 33.1±4.5) and the ED group (25.1±3.5 and 32.5±4.3). Neither were differences in VAS scores statistically significant (p=0.3). Rates of sedation among the PV group were lower than those of the ED group at 1 hour (p=0.001). Five patients in the ED (%28) group experienced hypotension (p=0.02). Conclusion: Paravertebral block with levobupivacaine 0.1% and morphine 0.1 mg mL-1 may be an alternative form of pain relief following thoracotomy. © 2016 Türk Algoloji Derneǧi.Item Acute and Chronic Pretreatment With Atenolol Attenuates Intestinal Ischemia and Reperfusion Injury in Hypercholesterolemic Rats(W.B. Saunders, 2016) Öztürk T.; Vural K.; Tuğlu İ.; Var A.; Kurdal T.; Aydemir I.Objective To evaluate the protective effects of preinjury atenolol (acute v chronic) on apoptosis, contractility, oxidative stress, and inflammatory markers in hypercholesterolemic rats undergoing intestinal ischemia-reperfusion (I/R) injury. Design Prospective, experimental animal study. Setting University laboratory. Participants Male Wistar rats (n = 32). Interventions Rats were divided into the following 4 groups: 1 group was fed a normal diet (ND) (group ND+NoAT [no atenolol]), and the other 3 groups were fed a high-cholesterol diet (HCD)—group HCD+NoAT, group HCD+ChAT (chronic atenolol, 3 mg/kg/day for 8 weeks), and group HCD+AcAT (acute atenolol, 1.5 mg/kg, given 5 minutes before intestinal clamping). All rats underwent I/R injury. The superior mesenteric artery was clamped for 60 minutes, then opened for 120 minutes (reperfusion). Apoptotic cells and stimulated contractions of ileal segments were examined. Tissue markers of intestinal I/R injury were examined. Intestinal malondialdehyde, superoxide dismutase, and nitrate/nitrite levels were measured. Measurements and Main Results The chronic atenolol group had fewer apoptotic cells and higher superoxide dismutase activity compared with the other groups. Intestinal contraction was higher in both atenolol pretreatment groups compared with the NoAT groups. Chronic and acute atenolol resulted in lower ileal levels of malondialdehyde and immunolabeling-positive cells (intestinal inducible nitric oxide synthase, endothelial nitric oxide synthase, interleukin-1, and interleukin-8) after I/R injury compared with the no atenolol groups. Conclusions Both chronic and acute pre-I/R injury treatment with atenolol attenuated I/R injury in this hypercholesterolemic rat model. These findings should encourage future studies of atenolol in hypercholesterolemic patients undergoing procedures with a high risk of intestinal ischemia. © 2016 Elsevier Inc.Item The efficacy of femoral block and unilateral spinal anaesthesia on analgesia, haemodynamics and mobilization in patients undergoing endovenous ablation in the lower extremity; [Alt ekstremitede endovenöz ablasyon uygulanan olgularda femoral sinir bloğu ve tek taraflı spinal bloğun analjezi, hemodinami ve mobilizasyon üzerine etkileri](AVES Ibrahim Kara, 2016) Öztürk T.; Çevikkalp E.; Nizamoglu F.; Özbakkaloğlu A.; Topcu İ.Objective: This study aimed to investigate the efficacy of femoral block and unilateral spinal anaesthesia on analgesia, haemodynamics and mobilization during endovenous ablation in patients with lower extremity venous insufficiency. Methods: Forty patients of ASA physical status I and II, with ages ranging between 30 and 45 years, and who were scheduled for endovenous laser ablation for varicose veins were prospectively enrolled in this study. Patients were randomized into a unilateral spinal anaesthesia group (group HS, n=20) or a femoral block group (group F, n=20). Group HS received 7.5–10 mg of heavy bupivacaine for unilateral spinal anaesthesia, while group F received 100 mg prilocaine for femoral block with ultrasound guidance. The level of motor blockage (Bromage score), visual pain score, mean heart rate and mean arterial pressures were recorded at postoperative 0, 1, 2, 3d and 6 h, respectively. Results: Perioperative visual pain score values in both groups were <4. None of the groups required an additional analgesic agent. Bromage scores were significantly lower in group F than in group HS during the postoperative period (p<0.01). Motor function returned to normal in all patients at 3 h in group F and at 6 h in group HS. Postoperative mean heart rate and arterial pressure did not differ between the groups (p>0.05). Conclusion: In patients with lower extremity venous insufficiency who were undergoing endovenous laser ablation, an ultrasound-guided femoral block provided similar analgesia with that of unilateral spinal anaesthesia. In group F, the duration of anaesthesia and mobilization time was shorter. © 2016 by Turkish Anaesthesiology and Intensive Care Society.Item Comparison of patient satisfaction between general and spinal anaesthesia in emergency caesarean deliveries; [Acil sezaryen operasyonlarında genel ve spinal anestezinin hasta memnuniyeti yönünden karşılaştırılması](AVES Ibrahim Kara, 2017) Açıkel A.; Öztürk T.; Göker A.; Hayran G.G.; Keleş G.T.Objective: Obstetric anaesthesia aims to deliver a healthy baby as well as render a comfortable operation for the mother. This study compared general and spinal anaesthesia in terms of the quality of recovery and patient satisfaction in women undergoing emergency caesarean deliveries. Methods: In total, 100 patients were enrolled in this prospective, single-blind, cross-sectional clinical study. Patients were divided into spinal (n=50) and general (n=50) anaesthesia groups. The recovery score, pain and satisfaction were evaluated by Quality of Recovery Score (QoR-40), Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS) at 24 hours postoperatively. Results: The total QoR-40 scores were significantly higher and the total operation time was longer in the spinal anaesthesia group (median score: 194.5 vs. 179.0, p<0.001 and mean±SD: 69.0±13.3 vs. 62.7±13.4 minutes, p=0.02, respectively). There was no significant difference in VAS and NRS scores between the groups. Conclusion: Both spinal anaesthesia and general anaesthesia have advantages and disadvantages in terms of emergency caesarean deliveries. Spinal anaesthesia speeds up the recovery time and enables the mother to return to normal life earlier, while general anaesthesia has a short initiation time and does not affect patient satisfaction. © 2017 by Turkish Anaesthesiology and Intensive Care Society.