Browsing by Author "Acikel, A"

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    Effects of low-dose propofol vs ketamine on emergence cough in children undergoing flexible bronchoscopy with sevoflurane-remifentanil anesthesia: a randomized, double-blind, placebo-controlled trial
    Ozturk, T; Acikel, A; Yilmaz, O; Topçu, I; Çevikkalp, E; Yuksel, H
    Study Objective: To determine the effects of low-dose ketamine and propofol on cough during emergence and the recovery period when administered at emergence in children undergoing fiberoptic bronchoscopy for bronchoalveolar lavage (FOBL) with sevoflurane-remifentanil anesthesia. Design: Randomized, double-blind, placebo-controlled trial. Setting: Operating room, postoperative recovery area. Patients: Sixty-eight children aged 1 to 8 years old undergoing elective diagnostic FOBL. Interventions: After discontinuation of anesthetics at the end of FOBL, patients were randomly divided into 3 groups: in group K, children were administered 0.5 mg/kg of ketamine; in group P, 0.5 mg/kg of propofol; and in group C, 0.1 mL/kg of normal saline. Measurements: Anesthesia time, procedure time, emergence time, and recovery time were recorded. Coughing and delirium scores were recorded as the patient fully emerged from anesthesia (time 0) and 5, 10, 15, and 20 minutes later. Main Results: The percentage of children with moderate or severe cough during emergence was similar in all groups. Mean delirium scores at emergence (TO) were significantly lower in group K than those in group P and in group C (P = .0001 and P = .02). Mean delirium score at 5 minutes in group K (6 [5-10]) was significantly lower than that of group C (P = .02) and similar to that of group P. The recovery time of group K was significantly longer than that of group C and group P (P = .01 and P = .03, respectively). Conclusions: Ketamine or propofol given at the end of sevoflurane-remifentanil general anesthesia in children undergoing FOBL did not decrease cough more than normal saline during the emergence period. Ketamine and propofol, compared to normal saline, had a beneficial effect on decreasing the incidence of emergence delirium. Ketamine lengthened recovery time. (C) 2016 Elsevier Inc. All rights reserved.
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    The effect of regional and general anaesthesia on cerebral oxygenation in shoulder arthroscopy
    Acikel, A; Topcu, I; Ozturk, T; Keles, GT; Ozalp, T
    Aim: Shoulder arthroscopy in the beach-chair position can negatively affect cerebral perfusion and oxygenation, and thus, neurocognitive function. In this study, we aimed to compare the effects of general and regional anaesthesia (GA and RA, respectively) on cerebral oxygenation in patients undergoing shoulder arthroscopy in the beach-chair position. Material and Methods: This prospective, randomized study included 60 patients who underwent shoulder arthroscopy in the beach-chair position. Patients were divided into two groups: (1) GA (n = 30), and (2) RA using an interscalene brachial plexus block (ISB; n = 30). All patients were laid supine prior to GA or ISB (T0), and after induction of GA or ISB (T1). Next, patients were placed in the beach-chair position. The right and left cerebral oxygen saturation (NIRS-R, NIRS-L, respectively), peripheral oxygen saturation (SpO2), heart rate (HR), and mean arterial pressure (MAP) values were recorded at T0 and T1, as well as 5 (T2), 10 (T3), 20 (T4), and 30 minutes (T5) after patients were placed in the beach-chair position. Results: Patient's clinical characteristics, initial laboratory findings, and perioperative data were similar in both groups. Compared to T0, MAP was significantly lower at T1, T2, T3, and T4 in the GA group. Tukey's HSD test indicated p<0.05, p<0.0001, p<0.0001, and p<0.001, respectively. Although NIRS-R and NIRS-L values fluctuated substantially, there were no differences between groups at any of the pre-defined time points. Discussion: ISB in the beach-chair position may better preserve cerebral oxygenation compared to GA.
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    FIRST LINE TREATMENT FOR FOREIGN BODY ASPIRATION IN CHILDREN: FLEXIBLE BRONCHOSCOPY
    Yuksel, H; Yilmaz, O; Acikel, A; Basbay, Y; Yasar, A; Topcu, I