MCBÜ Açıkerişim Sistemi :: Browsing by Author "Tekin I."

Browsing by Author "Tekin I."

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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.
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.
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.
The effects of propofol and thiopentone on natural cytotoxic cell activity; [Tiyopenton ve propofol'un naturel killer hucre aktivitesine etkileri]
(1998) Luleci N.; Erincler T.; Tekin I.; Sengil A.Z.; Tutan A.
The effects of thiopentone and propofol on Natural Killer cell activity were studied by the use of candidial colony inhibition method in venous blood samples from healthy volunteers. Following three hours of incubation mean CFU (colony forming unit) was 72.1 in control group while it was 66.3 and 64.1 CFU in samples containing 15 and 150 μL/mL of thiopentone respectively; and 67 and 63.8 in samples containing 5 and 50 μL/mL of propofol respectively. With small doses of propofol and thiopentone colony inhibition was 7% and 8% respectively while high doses leaded higher inhibitions of 11.5% and 11% respectively. It was concluded that a significant increase in anticandidal activity of natural cytotoxic cells is observed with high concentrations of thiopentone and propofol (p<0.01). However, the increase of this activity is not significant in anaesthetic concentrations used in clinical practice.
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.
The effect of adding clonidine to prilocaine in brachial plexus blockade; [Prilokaine klonidin eklenmesinin brakiyal pleksus bloǧuna katkisi]
(2001) Tekin I.; Topçu I.
The aim of this study was to determine the analgesic and systemyc effects of a low dose clonidine added to prilocaine in brachial plexus blockade. We studied 40 ASA I-II class patients in two equal groups who were scheduled for elective upper arm surgery. Brachial plexus block was performed with 30 mL of 1.5 % prilocaine in Group 1 and 75 μg clonidine was added to same solution in Group II. We monitored heart rate (HR), systolic and diastolic arterial blood pressure (SBP, DBP) and peripheral O2 saturation (SpO2) throughout the study. We recorded HR, SBP, DBP and sedation scores at 0, 10, 20, 30, 60, 120. minutes. Onset of action and duration of sensory and motor blockade, adverse effects and complications were recorded. Onset of motor and sensory block in radial, median and ulnar nerve were not different between the groups. Duration of motor and sensory block in radial and median nerve were more extended in Group II but there were no difference in ulnar nerve. This study suggests that, adding 1 μg/kg clonidine to prilocaine in brachial plexus blockade increases the duration of the block.
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.
Postoperative analgesic effects of intraarticular morphine and neostigmine after arthroscopy
(2002) Tekin I.; Ongun B.; Kafesçiler K.
Postoperative analgesic effect of intraarticular morphine and neostigmine after arthroscopy were compared. We studied 60 patients, undergoing elective knee arthroscopy. A standardized general anesthetic was administered. Patients were allocated to 3 groups at the end of the surgery. Group K (control, n=20) recieved 20 mL 0.9% saline, group M (morphine, n=20) recieved 1 mg morphine in 20 mL 0.9% saline and Group N (neostigmine. n=20) recieved 0.5 mg neostigmine in 20 mL 0.9% saline intraarticularly, 10 minutes before the limb tourniquet was deflated. Postoperative pain scores were recorded at the end of the surgery, at 30. min, 1., 2., 4., 6. and 12. hours postoperatively by VAS. Heart rate, mean arterial pressure, breathing rate and adverse effects were also recorded at the same times. Additional analgesic requirements, total analgesic consumption and first analgesic administration time were settled. There were no significant differences in hemodynamic parameters and additional analgesic requirements between the Group M and Group N. VAS scores on flexion and extention were significantly lower in group M and N compared with group K at postop 30. min. At subsequent measurements, VAS scores on extention were lower in group M and N according to group K. Additional analgesic administration was very high in group K, compared with the othe groups. First analgesic administration time was not different between Group M and N. Patients didn't complain from any adverse effects. Finally, we conclude that İntraarticular low-dose (1 mg) morphine and 0.5 mg neostigmine produce significant analgesic effect compared with placebo but they are not superior each other.
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.
Anaesthetic management in McKusick-Kaufman syndrome
(2003) Tekin I.; Ok G.; Genc A.; Tok D.
The cardinal features of McKusick-Kaufman syndrome (MKS) are polydactyly and hydrometrocolpos. Sometimes, this abdominopelvic mass may restrict pulmonary function and decrease the oxygenation of the newborn. We present a case of MKS and review the clinical features and appropriate anaesthetic management. A 45-day-old girl, weighing 4450 g, born at term, presented to our Paediatric Surgery Department with abdominal distention, diarrhoea and vomiting, which started on the 15th day of life. On physical examination, peripheral cyanosis, tachycardia and tachypnoea were found. A prominent mass was palpated in the lower abdomen. There was vaginal atresia and a sixth digit was found on her left foot. There was a large cystic mass extending from the pelvis to the level of L1 displacing the diaphragm, and bilateral hydroureteronephrosis were seen on plain abdominal X-ray, ultrasonography and computerized tomography. In the preanaesthetic assessment, the patient was evaluated for multiple congenital anomalies. Our management of anaesthesia, for a neonate with severe hydrometrocolpos compressing the diaphragm, consisted of gastric decompression and preoxygenation before tracheal intubation, routine and airway pressure monitoring, periodic analyses of blood gases and maintenance of anaesthesia with a low concentration of volatile agent, together with an opioid.
Effects of Different Disinfectants on Decontamination of Laryngoscopes; [Laringoskoplarin Dezenfeksiyonunda Kullanilan Dezenfektanlarin Etkinliǧinin Karşilaştirilmasi]
(2003) Tekin I.; Arican I.; Akçali S.; Şanlidaǧ T.; Özbakkaloǧlu B.
Guidelines for controlling possible contamination of laryngoscopes should be formulated with the benefit of relevant experimental data. In this study, the effects of five different disinfectants commonly used for the disinfection of laryngoscopes are evaluated. We formed 14 groups consisting of 10 blades in each. The first 7 groups were contaminated with hospital related meticillin resistant Staphylococcus aureus (MRSA), and the other 7 groups with hospital related multiple resistant Pseudomonas aeruginosa (PA). For the first group of blades, no disinfection procedure was carried out and, were assumed as a control group. Blades in other groups were rested for 10 minutes in containers containing 70 % alcohol, 1/100 dilution of cetrimide, 1/100 dilution of chlorhexidine, 1/10 dilution of chlorhexidine, 1/10 dilution of povidone iodine, and 1/100 dilution of ammonium chloride in groups II,III,IV,V,VI, and VII respectively. Disinfectant used in a group was considered as effective when growth was seen in 5 or less than 5 plates representing that group. All disinfectants tested were found effective on decontamination of laryngoscopes. 5 different moderate level disinfectants which are commonly used for the disinfection of laryngoscopes have been found effective even on resistant hospital microorganisms like MRSA and P. aeruginosa. Finding effective, cheap and time saving methods by choosing a specific disinfectant, concentration and contact time is not difficult as long as clinicians are aware of the principles of the laringoscopes disinfection procedures.
Urethral meatal dilatation using topical EMLA cream for anaesthesia [3]
(Blackwell Publishing Ltd., 2003) Genç A.; Tekin I.; Taneli F.; Arslan O.A.; Taneli C.; Mir E.
[No abstract available]
Effects of different disinfectants on decontamination of laryngoscopes
(2003) Tekin I.; Arican I.; Akcali S.; Sanlidag T.; Ozbakkaloglu B.
Guidelines for controlling possible contamination of laryngoscopes should be formulated with the benefit of relevant experimental data. In this study, the effects of five different disinfectants commonly used for the disinfection of laryngoscopes are evaluated. We formed 14 groups, with 10 blades in each. The first 7 groups were contaminated with hospital related meticillin resistant Staphylococcus aureus (MRSA), and the remaining 7 groups with hospital related multiple resistant Pseudomonas aeruginosa (PA). For the first group of blades, no disinfection procedure was carried out and, were assumed as a control group. Blades in remaining groups were rested for 10 minutes in containers containing 70% alcohol (II), 1/100 dilution of cetrimide (III), 1/100 dilution of chlorhexidine (IV), 1/10 dilution of chlorhexidine (V), 1/10 dilution of povidone iodine (VI), and 1/100 dilution of ammonium chloride (VII). Disinfectant used in a group was considered effective when growth was seen in 5 or less than 5 plates representing that group. All disenfectants tested were found effective on decontamination of laryngoscopes. Five different moderate level disinfectants, which are commonly used for the disinfection of laryngoscopes, have been found effective even on resistant hospital microorganisms like MRSA and P. aeruginosa. They may be the choices of the disinfectants, especially 1/10 dilution of chlorhexidine gluconate and 1/100 dilution of ammonium chloride.
Effect of Propofol and Clonidine on Cerebral Blood Flow Velocity and Carbon Dioxide Reactivity in the Middle Cerebral Artery
(2004) Mirzai H.; Tekin I.; Tarhan S.; Ok G.; Goktan C.
This study was designed to evaluate the effects of propofol alone and propofol-clonidine combination on human middle cerebral artery blood flow velocity (Vmca) and cerebrovascular carbon dioxide (CO2) response by using transcranial Doppler ultrasonography. Mean Vmca in response to changes in arterial partial pressure of CO2 (PaCO2) was determined under the following conditions: awake (group 1), propofol anesthesia (group 2), and combined propofol-clonidine anesthesia (group 3). Normocapnic, hypercapnic, and hypocapnic values of heart rate, mean arterial pressure, partial end-tidal CO2 pressure, PaCO2, and Vmca were obtained. The mean Vmca in groups 2 and 3 was significantly lower than that in group 1 at each level of PaCO2. The calculated Vmca at each level of PaCO 2 was not different between groups 2 and 3. There was a correlation between PaCO2 and Vmca in all groups, but in the anesthetized groups the effect of PaCO2 on Vmca was attenuated. The present data demonstrated that clonidine-propofol does not change CO2 reactivity compared with propofol alone, but both anesthetics attenuate cerebral blood flow compared with awake controls.
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.
Epidemiologic and clinical features of cases applying to Celal Bayar University emergency unit with head trauma; [Celal Bayar Üniversitesi Tip Fakültesi acil birimine başvuran kafa travmali olgularin epidemiyolojik ve klinik özellikleri]
(Turkish Association of Trauma and Emergency Surgery, 2005) Mirzai H.; Yaǧli N.; Tekin I.
BACKGROUND: Head trauma (HT) patients constitute a major part of referrals to emergency unit (EU). We aimed to evaluate cases with HT who applied to our emergency unit retrospectively. METHODS: A hundred and seventy seven HT cases who applied to EU between January 1, 2001-June 30, 2003 were analyzed. Age, gender of the patients, time of intervention, type of trauma, level of consciousness, severity of trauma, concomitant systemic trauma, neuroradiological evaluation, intervention in EU, operation requirement and outcomes were recorded. RESULTS: Patients (men, 73.44% and women 26.55 %) referred because of traffic accidents (32 ± 19 yrs;59.88 %) and other etiologies (21 ± 17 yrs;40.11 %). According to Glasgow coma scale (GCS) 79.1% had minimal or mild (GCS:13-15), 3.95% had moderate (GCS:9-12), and 16.95% had severe HT (GCS:3-8). On craniography fracture was present in 25.99%, on cranial CT lesions were present in 25.99%. Some (18.64%) were discharged after first examination, and 14.12% after short observation. Some (24.29%) were admitted to neurosurgery, 4.52% to intensive care units; 4.52% died in EU; 9.04% underwent neurosurgical operations. CONCLUSION: While traffic accidents constitute the primary cause of adulthood HT, falls lead during childhood. HT is usually of minimal or mild severity. Collaboration of patient transport, first aid and EU are important factors affecting prognosis of HT.
Carpal tunnel release under intravenous regional anaesthesia with ropivacaine or lidocaine
(2005) Tekin I.; Mirzai H.; Ok G.
Carpal tunnel syndrome (CTS) surgery is usually performed utilizing regional anaesthesia techniques such as local infiltration, brachial plexus block and intravenous regional anaesthesia (IVRA). The present investigation aimed to compare the clinical effects of IVRA with lidocaine or ropivacaine. Forty patients undergoing carpal tunnel release were divided into two groups (20 each) and 0.1% ropivacaine or 0.25% lidocaine were administred for IVRA. All patients underwent a standard surgical procedure. The patients were asked about their satisfaction regarding analgesia. After tourniquet deflation, patients were evaluated for any signs of side effects. Verbal numerical pain scores of patients were recorded periodically in the postoperative period. Onset of and recovery from sensory anaesthesia and quantification of analgesic consumption were assessed. According to our results, 0.25% lidocaine and 0.1% ropivacaine provided satisfactory anaesthetic quality with a low toxicity profile. The recovery time from sensory block was longer and analgesic consumption was less with ropivacaine than with lidocaine. © 2005 VSP.
The results of nucleoplasty in patients with lumbar herniated disc: a prospective clinical study of 52 consecutive patients
(2007) Mirzai H.; Tekin I.; Yaman O.; Bursali A.
Background context: Nucleoplasty is a minimally invasive, percutaneous procedure that uses radiofrequency energy to ablate nuclear material and create small channels within the disc. Purpose: To evaluate the efficacy of nucleoplasty technique in patients with leg pain caused by radicular encroachment. Study design/setting: A prospective clinical study of subjects with lumbar disc herniation, and radicular pain resistant to previous medical treatment and physiotherapy for a period of at least 3 months. Patient sample: Fifty-two consecutive patients with leg pain and magnetic resonance imaging evidence of small and medium-sized herniated discs correlating with the patient's symptoms (contained disc herniation<6 mm, with a disc height≥50% in comparison to normal adjacent discs) were included. Outcome measures: Visual analogue scale (VAS) was administered and Oswestry disability questionnaires were filled out at preprocedure and postprocedure 2 weeks, 6 months, and 1 year. Reduction of analgesic treatment and the patients' satisfaction were also recorded. Methods: All procedures were performed under local anesthesia and fluoroscopic guidance on an outpatient basis. Patients underwent discography to evaluate annular integrity just before nucleoplasty. Channels were created in the nucleus by advancing the radiofrequency probe (ablating) and withdrawing it (coagulation). In all patients six channels were created. Results: Thirty-four patients had one and 18 had two discs treated; a total of 70 procedures were performed. Mean age of patients was 44.8±8.6 years. The mean follow-up period was 12.1±1.6 months. Mean VAS reduced from preprocedure 7.5 to 3.1 at postprocedure 6 months and to 2.1 at the latest follow-up. Mean Oswestry index decreased from 42.2 to 24.8 at 6 months and to 20.5 at the latest examination. Analgesic consumption was stopped or reduced in 42 patients (85%) at 6 months and in 46 patients (94%) 1 year after the procedure. Overall patient satisfaction was 81% at 2 weeks, 85% at 6 months, and 88% at the latest follow-up. There were no complications related to the procedures. Conclusions: Our results encourage us to use nucleoplasty in carefully selected patients with leg pain caused by radicular encroachment. We recommend applying this minimally invasive technique only in those patients with small (<6 mm) contained disc herniations, with a disc height of≥50% and with annular integrity. © 2007 Elsevier Inc. All rights reserved.
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.
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.

Browsing by Author "Tekin I."

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