Browsing by Author "Erbuyun K."

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    Anaesthetic quality in children during inhalational induction and anaesthesia with sevoflurane or halothane; [COCUKLARDA SEVOFLURAN ILE HALOTANIN ANESTEZI KALITESI YONUNDEN KARSILASTIRILMASI]
    (1997) Erincler T.; Luleci N.; Gul R.; Erbuyun K.; Tutan A.
    Due to its low blood gas partition coefficient (0.69) and its neutral odor, sevoflurane (S) is suitable for inhalational induction of anaesthesia. At the moment halothane (H) is preferentially used for this purpose due to its non-irritating odor and the smoothness of anaesthetic action. However, experience is limited with the use of S in children. Therefore, we compared S and H in an open, randomized trial. 40 children (age 1-10, mean, 5.3 years, ASA class I and II) had anaesthesia induced without premedication (fresh gas flow 6 L/min, N2O/O2=65/35). Concentration of volatile anaesthetics was increased ever 3-5 breats (S: % 0.8....3.2 vol, H: % 0.4....1.6 vol). The ciliary reflex was tested until it disappeared. Airway reflexes and excitation were quantified using a score. Upon venipuncture, relaxation and intubation, anaesthesia was maintained with S (Fi: % 1.8 vol) or H (Fi: % 0.9 vol) in N2O/O2 (3 L/min) E(T)CO2 35-38 mmHg). Alfentanyl was supplemented in repeated doses of 10 μg/kg, ECG, NIBP, SpO2, Fi and Fet of CO2 and volatile anaesthetics were continuously recorded. At the end of surgery anaesthetics were terminated abruptly and fresh gas flow was increased to 6 L/min O2. Time to the first purposeful movement was registered. Time to possible discharge from the PACU was quantified using a modified Aldrete score. Data were analysed with 'Student's t' test or non-parametric tests as appropriate. Groups did not differ with respect to age, weight, sex, or type of surgery. It's concluded that sevoflurane is an alternative to halothane in pediatric inhalational anaesthesia, with a comparable, low incidence of airway irritation and smoothness of induction. Because of the significantly faster induction and recovery it seems superior to halothane.
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    The addition of metoclopramide to the PCA with tramadol; [Tramadol ile yapilan PCA'ya metoklopramid eklenmesi]
    (1998) Luleci N.; Erincler T.; Tekin I.; Gumus B.; Erbuyun K.; Tutan A.
    Nausea and vomiting is a major problem during opioid administrations. In PCA (Patient Controlled Analgesia), sufficient analgesia can be obtained with smaller doses of opioids but nause and vomiting may still a great problem. Addition of antiemetics to opioids in PCA applications is not studied adequately. In this study we added metoclopramide to tramadol hydrochloride (TH) TH for PCA and evaluated its effects on the nausea and vomiting. 36 patients in ASA I-III, were allocated randomly into two groups (each had 18 patients) to receive patient-controlled analgesia with either TH and metoclopramide combination or with TH alone. Bolus doses of TH 20 mg (limited to 200 mg in four hours) alone used in the first and combined with metoclopramide 5 mg in the second group were used with a lockout time of 15 min. During the first 24 h. after surgery the VAS scores and side effects were recorded. The patients in metoclopramide group have significantly lower PAC scores (p<0.05). As a result nausea and vomiting can be reduced by addition of metoclopramide to TH in PCA. The same method maybe used also with of other opioids.
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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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    Hearing loss does not occur in young patients undergoing spinal anesthesia
    (2004) Ok G.; Tok D.; Erbuyun K.; Aslan A.; Tekin I.
    Although uncommon, hearing loss after spinal anesthesia has been described. Vestibulocochlear dysfunction after spinal anesthesia in which 22-gauge and 25-gauge Quincke needles were used was investigated to determine if needle size affected hearing. Patients with American Society of Anesthesiologists physical status I and II, aged 20 to 40 years, who were undergoing lower extremity surgery under spinal anesthesia were randomized into 2 groups. After intravenous hydration, 3 mL of 0.5% bupivacaine was administered for spinal anesthesia, which was performed with a 22-gauge Quincke needle in group I (n = 30) patients and a 25-gauge Quincke needle in group II (n = 30) patients. Before surgery and 2 days after surgery, pure-tone audiometry and tympanometry were performed. Preoperative and postoperative hearing data were obtained in the right and left ears for every frequency. Headache, nausea, and vomiting and cranial nerve III, IV, V, VI, VII, and VIII function were assessed on postoperative day 2. Demographic data were not different between the groups. No hypoacousis was noted at any frequency during the entire testing period in either group. Two patients from group I experienced postdural puncture headache on postoperative day 3, and neither had hearing loss. No patient had cranial nerve dysfunction. We were unable to induce hearing loss in young patients undergoing spinal anesthesia by injecting the anesthetic with a 22-gauge or a 25-gauge Quincke needle.
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    A comparison of conventional and pulsed radiofrequency denervation in the treatment of chronic facet joint pain
    (2007) Tekin I.; Mirzai H.; Ok G.; Erbuyun K.; Vatansever D.
    OBJECTIVES: The goal of this study was to compare the effects of conventional radiofrequency (CRF) and pulsed RF (PRF) denervation to medial branches of dorsal rami in the treatment of facet joint pain. METHODS: The patients greater than 17-year old, with continuous low back pain with or without radiating pain with focal tenderness over the facet joints, pain on hyperextension, absence of neurologic defect, unresponsiveness to conservative treatment, no radicular syndrome, and no indication for low back surgery were included in the study. Local anesthetic was applied in the control group (n=20), whereas 80°C CRF were applied in the CRF (n=20) and 2 Hz PRF were applied in the PRF group (n=20). Pain relief was evaluated by visual analog scale (VAS) and Oswestry Disability Index (ODI) at preprocedure, at procedure, at 6 months and 1 year after the procedure. Reduction in analgesic usage, patients' satisfaction, and complications were assessed. RESULTS: Mean preprocedural VAS and ODI scores were higher than postprocedural scores in all groups. Both VAS and ODI scores of PRF and CRF groups were lower than the score of the control group at the postprocedural evaluation. Although decrease the pain score was maintained in the CRF group at 6 months and 1-year period, this decrease discontinued in the PRF group at the follow-up periods. The number of patients not using analgesics and patient satisfaction were highest in CRF group. DISCUSSION: PRF and CRF are effective and safe alternatives in the treatment of facet joint pain but PRF is not as long lasting as CRF. © 2007 Lippincott Williams & Wilkins, Inc.
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    An alternative method of prosthetic mitral valve implantation in the presence of extensive calcification
    (2007) Sirin B.H.; Iskesen I.; Erbuyun K.
    Annular calcifications carry some technical difficulties for success in conventional valve surgery. In this paper we present an easy alternative mitral valve replacement method applied for a patient with a heavily calcified mitral annulus. Excision of both leaflets and partial resection of the annular calcification with an ultrasonic dissector allowed the intra-atrial insertion of a 33-mm Omnicarbon monoleaflet prosthetic valve through a smaller opening of the left posterior atrium. The technical difficulties in inserting a prosthetic valve in a patient with a heavily calcified mitral annulus are discussed.
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    A comparison of the neuroablative effects of conventional and pulsed radiofrequency techniques
    (Lippincott Williams and Wilkins, 2008) Vatansever D.; Tekin I.; Tuglu I.; Erbuyun K.; Ok G.
    Objectives: To compare the neuroablative effects of pulsed radiofrequency (PRF) and conventional radiofrequency (CRF) techniques on the sciatic nerve, a peripheral nerve that includes motor, sensory, and autonomous fibers. Methods: The study consisted of 5 groups of 6 adult male Wistar rats. In the control group, no procedure was performed. In the sham group, electrode placement was the same as the other groups, but radiofrequency energy was not given to the rats. In the CRF40 group, 40°C CRF was applied to the rats for 90 seconds. In the CRF80 group, 80°C CRF was applied for 90 seconds. In the PRF group, the rats received 45 V PRF, which did not exceed 42°C for 240 seconds. Two days later, sciatic nerve samples were taken. All specimens were evaluated both with light and electron microscopy. Sciatic nerve morphology was analyzed to compare the effects of CRF and PRF. Kruskal-Wallis and Mann-Whitney U tests were used for comparing the means. Results: Minimal damage was observed in the control group, but damage increased in the sham group and became increasingly more distinct in the PRF, CRF40, and CRF80 groups. Discussion: Nerve tissues can be affected during any type of procedure, even during surgical applications. Our results suggest that PRF is less destructive than CRF for the peripheral nerves. However, this idea should also be investigated at the molecular level, and safety analysis should be performed for routine clinical practice. © 2008 by Lippincott Williams & Wilkins.
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    The effect of remifentanil on the emergence characteristics of children undergoing FBO for bronchoalveolar lavage with sevoflurane anaesthesia
    (2009) Ozturk T.; Erbuyun K.; Keles G.T.; Ozer M.; Yuksel H.; Tok D.
    Background and objective The aim of this study was to compare the effects of sevoflurane vs. sevoflurane and remifentanil on cough and agitation during emergence and recovery after fiberoptic bronchoscopy. Methods Children between 2 and 6 years of age undergoing fiberoptic bronchoscopy were enrolled. All patients were premedicated with oral midazolam. Patients were randomly assigned to either group S (sevoflurane alone, n = 25) or group SR (sevoflurane with remifetanil, n = 25). Anaesthesia was induced and maintained with sevoflurane in all patients. Group SR received remifentanil at a bolus dose of 1 μg/kg over 2 min followed by a maintenance infusion of 0.15 μg/kg/min. In addition to routine anaesthesia documentation, agitation scores and cough scores were recorded every 5 min during emergence and recovery. Results Duration of the procedure, anaesthesia and emergence phases was similar in both groups (P>0.05). Time until recovery was significantly shorter in group SR than in group S (7.0 ± 5.5 min and 13.0 ± 3.5 min, respectively; P = 0.001). Cough scores were not significantly different between the two groups during emergence and recovery (Kruskal-Wallis ANOVA test, P0.05). However, the mean agitation score at 5 min in group SR was significantly higher than that in group S (Kruskal-Wallis ANOVA test, P<0.01). One case of hypoxaemia from thoracic rigidity occurred in a patient in group SR. Conclusion The addition of remifentanil significantly shortened recovery time in children undergoing fiberoptic bronchoscopy under sevoflurane anaesthesia. In the recovery period, remifentanil did not decrease cough, and increased agitation. © 2009 European Society of Anaesthesiology.