Browsing by Author "Mirzai I.T."

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    Repeated epidural injections of ketamine with preservative benzethonium chloride produce evidence for neurotoxicity in rabbits
    (2003) Yentur E.A.; Mirzai I.T.; Mirzai H.; Ates U.; Baka M.; Yurtseven M.
    Background and objectives: In this study, we investigated whether repeated doses of 1% ketamine with preservative benzethonium chloride, administered into the epidural space of the rabbit, caused direct neurotoxicity. Methods: Twelve rabbits were randomly assigned to two groups (ketamine and control). After the animals were anesthetized, lumbar epidural catheters were placed for repeated epidural drug delivery. The ketamine group received 1% ketamine with preservative benzethonium chloride (0.5 ml) and the control group received isotonic saline (0.5 ml) once a day for 14 consecutive days. The day after the last injection, the animals were reanaesthetized, the left and right ventricles were cannulated and perfused with 2% glutaraldehyde, 1% formaldehyde mixture, in 0.1 mol/l phosphate buffer. Then, laminectomy was performed. A five centimetre segment of the spinal cord was removed and examined by light and electron microscopy to observe possible histological changes. Microscopic examinations were performed by coding each animal by a neuro-histologist who was blinded as to the source of each specimen. Results: Ketamine-treated rabbits showed significant histological changes at light and electron microscopy findings compared with the control group (p < 0.05). Conclusions: These changes suggested a neurotoxic effect of ketamine with preservative benzethonium chloride following chronic epidural administration.
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    Comparison of intranasal ketamine and midazolam premedication in pediatric patients; [Pediyatrik olgularda i̇ntranazal ketamin ile midazolam premedikasyonunun karşilaştirilmasi]
    (2004) Ok G.; Mirzai I.T.; Leblebici H.; Erbüyün K.
    In our study, effectiveness and safety of intranasal ketamine and midazolam premedication were compared in pediatric patients. After the approval of ethics' committee, 40 ASA I patients, aged between 2-7 years were divided into two groups. 30 min before operation, in group K (ketamine group), ketamine, 5 mg kg-1 and in group M (midazolam group), midazolam, 0.25 mg kg -1 were administered intranasally. Peripheral O2 saturation (SpO2), systolic arterial blood pressure (SAB), diastolic arterial blood pressure (DAB), heart rate (HR) and respiration rate were recorded at 0, 10, 20, and 30th minutes. Sedation levels of patients were evaluated according to the Ramsey Sedation Scale. Separation from the family were evaluated according to a three level scale; (0: Agitate 1: Calm, 2: Sleeping), iv cannulation condition were evaluated according to a three level scale (1: Agitate 2: Pulling his hand away 3: No reaction). Postoperative Aldrete recovery scores and adverse effects were recorded. Demographic data, SpO2 and respiratory rate were similar in both groups. In both groups, there was a significant decrease in SAB, DAB and HR values according to the baseline values (p<0.05). However, the decrease in SAB in midazolam group was more significant than the ketamine group (p<0.05). The sedation scores after 20th min were found to be higher in midazolam group when compared with ketamine group (p=0.02). Midazolam group had higher scores for iv cannulation which was not statistically significant. The scores for separation from the family were similar in two groups. Aldrete scores were higher in group K than group M which is not statistically significant. In group K, diplopia and nystagmus were detected in 4 patients. We concluded that more profound sedation with midazolam and quicker recovery with ketamine in our results may be determining factors in selection of agents for premedication.
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    Efficacy of ropivacaine and ropivacaine+neostigmine combination for elective cesarean section; [Sezaryen operasyonlarinda i̇ntratekal ropivakain ve ropivakain + neostigminin anestezik etkilerinin karşilaştirilmasi]
    (2007) Özaslan S.; Ok G.; Erbüyün K.; Mirzai I.T.
    The objective of this study is to compare the efficacy of intrathecal ropivacaine and the combination of ropivacaine with neostigmine for elective cesarean sectio. Forty ASA grade I-II parturients were scheduled for elective cesarean delivery under spinal anesthesia. The patients were randomly assigned into two groups. Grup 1 received 15 mg of 0.75 % hyperbaric ropivacaine. Group 2 received 15 mg of % 0.75 hyperbaric ropivacaine combined with 25 μgr neostigmine. Hyperbaric solutions were made with 2 ml of 0.75 % ropivacaine and 0.5 ml of 20 % dextrose. After injection of the spinal medication patients were turned head up 20-30° supine. Baseline mean arterial blood pressure, heart rate, pulse oximetry were recorded and every 5 min during the surgery the same parameters also sensory block level, motor block degree were recorded. Sensory block, motor block and VAS scores were recorded postoperatively at first, second and forth hour. Time until first analgesic requirement and total analgesic consumption in the first 24 hours were recorded. Homodynamic changes, sensory block level, motor block degree, VAS scores, time until first analgesic requirement, postoperative total analgesic consumption were similar among two groups. No statistically noteworthy difference was determined. In conclusion, the time until first analgesic requirement is increased by 25 μgr neostigmine without any adverse effect although there wasn't any significant difference.