Browsing by Author "Alincak H."

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    Changes in the intraocular pressure during anaesthesia with sevofluran and propofol; [Propofol ve sevofluran anestezilerinde gozici basinci degisikliklerinin karsilastirilmasi]
    (1997) Ozturk F.; Tekin I.; Kurt E.; Luleci N.; Inan U.; Alincak H.; Tutan A.
    Variations in intraocular pressure during anaesthesia were studied prospectively in two groups of 20 patients selected randomly. The first group received sevoflurane and the second group received IV propofol. Intraocular pressure, heart rate, arterial pressure and oxygen saturation were measured before and after induction of anaesthesia and following vecuronium. Compared with baseline values, the decrease in intraocular pressure were similar (p>0.05) and statistically significant (p<0.05) in two groups. Haemodynamic control were better in sevoflurane group. In ophthalmic operations when intraocular pressure control were required, both anaestetic agents seem to be proper.
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    A comparison of two sedation methods for elective cataract surgery; [Katarakt cerrahisinde lokal anestezi oncesinde iki farkli sedasyon yonteminin karsilastirilmasi]
    (1998) Tekin I.; Ozturk F.; Erincler T.; Luleci N.; Alincak H.; Kurt E.; Inan U.
    The aim of this study was; to compare two different ways of sedation for elective cataract surgery. 30 patients (in ASA I-II-III classes and 18-65 years old), undergoing to elective cataract surgery were divided in two groups, each of them consisted from 15 patients. In group I sedation was performed with 1 mg/kg propofol IV and in the second group with a combination of 0.07 mg/kg droperidol and 1 μg/kg fentanil IV. Intraocular pressure (IOP) was measured; heart rate (HR), mean arterial blood pressure (MAP), SpO2, respiratory rate (RR) and sedation scores (SS) were noted before (T1), 5 minutes after sedation (T2), and at the end of the operation (T3). Just after the operation side effects, amnesia and general agreement of the patients were asked. Between two groups the IOP and MAP values were not significantly different before sedation (p>0.05). A significant fall of both values were noted after sedation in both groups. At the end of the operation the values were higher in the second group (p<0.05). The sedation scores were not different between two groups before the application of sedative drugs. After this application significantly deeper sedation was noted in the first group (p<0.05). In the second group the sedation scores were not significantly different before, after the application and at the end of the operation (p>0.05). In the first group, the sedation scores were higher at the end of the operation if compared with values that noted after the application of propofol. The agreement of the patients to this method were better in the first group. As a result, it can be said that; sedation with the combination of droperidol and fentanyl for elective cataract surgery in also possible, but low doses of propofol are better for this purpose.
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    The effects of magnesium sulphate on postoperative analgesia; [Magnezyum sulfatin postoperatif analjeziye etkileri]
    (2000) Tekin I.; Erbuyun K.; Oruc S.; Toprak V.; Alincak H.
    It has been suggested that magnesium with its calcium channel blocking and NMDA antagonist properties could play a role in prevention and treatment of pain. We assessed the effect of perioperative IV magnesium sulfate on the early period of postoperative analgesia. ASA I or II class, at least graduated from secondary school, 30 patients, undergoing elective abdominal hysterectomy with TIVA (total intravenous anaesthesia), received standard premedication. We added saline (group I, n:15) or 15 % MgS04 (group II, n:15), 15 mL IV bolus after induction agents and 3 mL/h IV infusion at the end of the postoperative 6th hour. PCA (patient controlled analgesia) with fentanyl was used for postoperative analgeesia. Peroperative hemodynamic data, total propofol, fentanyl and vecuronium doses are noted. VAS (visuel analog scale) was used to assess postoperative pain and sedation scale for sedation assessment in postoperative 30. minutes and 2-4-6. hours. Determination of serum magnesium-concentration were obtained before the start Of the intravenous study drug treatment and after the end of the infusion. There were no differences in demographic data, ASA classification, duration of surgery, intraoperatif total propofol, fentanyl and vecuronium doses between two groups. Postoperative demand, delivery and total fentanyl levels were higher in group I (p<0.05). VAS and SS were similar in two groups. At the end of the infusion serum magnesium concentrations were higher than preoperative values in group II (p<0.05). In this study we found that magnesium-reduces postoperative analgesic requirements without adverse effects. In conclusion, magnesium is a good adjuan analgesic agent and will gain a popularity in the early future with new studies.
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    Changes of plasma magnesium concentrations in peroperative magnesium administration for analgesia; [Peroperatif analjezi amaçli magnezyum uygulamasinda plazma magnezyum düzeyi degişiklikleri]
    (2001) Tekin I.; Alincak H.; Ok G.; Erbüyün K.
    We evaluated the effect of peroperative magnesium replacement on analgesic consumption and changes of plasma magnesium (Mg) concentrations peroperatively. We administered % 0.9 NaCl (Group K, n=20) and MgSO4 (Group M, n=20) bolus and infusion peroperative and untill the end of the postoperative 6th hour in patients undergoing total hysterectomy. Fentanyl 3 μg/kg, propofol 2 mg/kg and vecuronium 0.1 mg/kg had been given in anesthesia induction and continued with % 60 N2O+O2 and 1 % sevoflurane after tracheal intubation into the both groups. Fentanyl 2 μg/kg had been added when heart rate (HR) and mean arterial pressure (MAP) were 15-20 % greater than basal values in all patients. Plasma Mg concentration, MAP and HR were recorded preoperatively, after induction and incision, on postoperative 30. min., 3-6th hours. In addition VAS and sedation scores were recorded postoperatively. Patient controlled analgesia with fentanyl was used for postoperative analgesia. Total fentanyl dose, demand and delivery were recorded. Intraoperative fentanyl consumption was decreased by 40 % in Group M. Postoperative fentanyl consumption was not different between two groups. VAS scores decreased on the 3th and 6th hours in comparison to 30th min postoperatively in Group M. Blood magnesium concentrations were decreased after preoperative period in Group K, and all recordings were higher than preoperative values in Group M. In conclusion, we believed that blood magnesium concentration decreases peroperatively in total hysterectomies, and that the doses we choose were safe despite increased plasma Mg concentration.
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    Perioperative use of corticosteroid and bupivacaine combination in lumbar disc surgery: A randomized controlled trial
    (2002) Mirzai H.; Tekin I.; Alincak H.
    Study Design. A prospective and controlled study of perioperative use of combined local anesthetic and corticosteroid in lumbar disc surgery. Summary of Background Data. The anti-inflammatory mechanism of corticosteroids is considered to be caused by the inhibition of phospholipase A2, which plays an important role in the pain mechanism of lumbar disc problems. Although some authors have demonstrated that the use of intramuscular bupivacaine during lumbar discectomy resulted in a marked reduction of postoperative back pain, others have reported that the key intervention was probably the administration of epidural corticosteroid. The coadministration of these two drugs in lumbar disc surgery for the relief of postoperative back pain has yet not been studied adequately. Objectives. Assessment of the combined use of perioperative corticosteroids and bupivacaine for the relief of postoperative pain after lumbar disc surgery. Methods. Forty-four selected patients had acute-onset single-level unilateral herniated nucleus pulposus that were refractory to conservative management. All patients underwent lumbar disc surgery under standard general anesthesia. Before surgical incision, the skin and subcutaneous tissues were infiltrated with 10 mL of 1% lidocaine with 1:200,000 adrenaline to produce local vasoconstriction. During wound closure, 20 mL 0.9% saline in Group 1 (n = 22) and 20 mL 0.25% bupivacaine in Group 2 (n = 22) were injected into the paravertebral muscles and subcutaneus tissues. In addition, a piece of autologous fat taken from the wound was first soaked in 40 mg of methylprednisolone for 10 minutes, then placed over the exposed nerve root, and the remaining steroid was flushed into the wound in Group 2. The wound was closed after drug administration in both groups. In the postoperative period, all patients received 100 mg of meperidine intramuscularly when needed and were allowed to receive a second dose at least 4 hours later than the first dose for postoperative analgesia. Postoperative back pain intensity, heart rate, and mean arterial pressure were assessed 1, 3, 6, and 12 hours after the conclusion of surgery. Results. Visual analog scale pain scores for the postoperative recordings were lower in Group 2 than in Group 1, but these findings were not statistically significant. Patients in Group 1 received 77.3 ± 48.8 mg meperidine, and those in Group 2 received 31.8 ± 45.5 mg meperidine, for pain medication in the first 12 hours (P < 0.05). Heart rate and mean arterial pressure were not significantly different between the two groups in all recording periods. Conclusion. It is concluded that the perioperative use of bupivacaine and corticosteroids during lumbar discectomy maintains effective postoperative analgesia and decreases opioid usage without complications.