Browsing by Author "Tekin S."

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    The comparison of efficiency of bupivacaine-fentanyl with ropivacaine-fentanyl in patient controlled epidural analgesia for labour; [Hasta kontrollü epidural doǧum analjezisi için bupivakain fentanil ile ropivakain fentanilin etkinliǧinin karşilaştirilmasi]
    (2004) Topçu I.; Yentür E.A.; Tekin S.; Çavuş Z.; Ekici N.Z.; Sakarya M.
    In this prospective, randomized, double-blinded study we aimed to evaluate the efficiency of 1μg mL-1 fentanyl with 0.125% bupivacaine and 1μg mL-1 fentanyl with 0.125% ropivacaine by patient controlled epidural analgesia (PCEA) for labour. The study was performed in 2 groups; each consisted of 20 pregnants which had healthy, single fetus in 36-41 gestational weeks with normal fetal pulse pattern in vertex position, 3-6 cm of cervical dilatation and at active phase of labour. Solution of 1μg mL-1 fentanyl with 0.125% ropivacaine was applied to Group I and 1μg mL-1 fentanyl with 0.125% bupivacaine to Group II. PCEA was programmed as 5 ml bolus dose, 10 minutes lock-out (without basal infusion, and 1-4 h limit) and 10 mL loading dose. Patients' pain was evaluated by VAS (visual analog scale) (0-100mm), sensory block by PinPrick test (0-3) and motor block by modified Bromage scale. Maternal mean arterial pressure (MAP), heart rate (HR) and fetal HR were recorded during the labour. Umblical artery blood pH, APGAR of fetus and patient satisfaction after delivery (1-5) were assessed. Mode of delivery (normal, operative and cesarean), side-effects, duration of labour and analgesics consumption for the first and second stages of labour were recorded by calculating the values via PCEA. No differences were obtained in the evaluation of MAP, HR, fetal HR, VAS, sensory block, amount of analgesics solution, mode of delivery, duration of labour, side effects and patient satisfaction between the groups. However, lesser motor block was observed in ropivacaine/fentanyl group rather than bupivacaine/fentanyl group (p<0.05). Consequently, both 1μg mL-1 fentanyl with 0.125% ropivacaine and 1μg mL-1 fentanyl with 0.125% bupivacaine by patient controlled epidural analgesia (PCEA) for labour, provided sufficient and trustworthy analgesia. Similar effects were obtained on hemodynamics but because of lesser motor block effect, we propose that ropivacaine more superior for labour analgesia.
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    Effectiveness of clonidine and fentanyl addition to bupivacaine in postoperative patient controlled epidural analgesia; [Wirksamkeit von clonidin und fentanyl als zusatz bei der postoperativen patientenkontrollierten epiduralanalgesie mit bupivacain]
    (2005) Topcu I.; Luleci N.; Tekin S.; Kefi A.; Erincler T.
    Background and Objectives: The aim of this prospective randomized double-blinded study was to compare the analgesic and side-effects of bupivacaine in combination with clonidine or fentanyl during patient-controlled-epidural analgesia (PCEA) in the postoperative period after abdominal hysterectomy. Methods: 75 patients from 18 to 65 years of age with ASA status I - II were investigated. After preoperative epidural catheterization, the patients were operated in general anesthesia. After surgery, the patients were randomly allocated to 3 PCEA-groups: Group B 0.125% bupivacaine, Group F 0.125% bupivacaine plus 1 μg × ml-1 fentanyl, Group C 0.125% bupivacaine plus 0.75 μg × ml-1 clonidine (10 ml loading dose, 5 ml repetitive bolus dose, 10 min lockout time, 30 ml limit within 4h). During the following 24 hours, hemodynamic parameters, pain score using visual analog scale (VAS), total analgesic consumption, additional analgesic requirements, sedation, satisfaction, nausea scores and probable side-effects were evaluated. Results: Total analgesic consumption was not different between Group F and Group C, but lower than in Group B (p < 0.05). Additional analgesic use was not different between the groups. Group F and Group C had lower VAS-scores in 24 hours than Group B (p < 0.05). Hemodynamic and sedation scores of patients were not different. In Group C, incidence of nausea was lower and satisfaction of patients was higher (p < 0.05). Conclusions: Addition of clonidine or fentanyl to local anesthetics for PCEA can reduce the analgetic demand. Epidural clonidine can reduce postoperative nausea and is connected with higher patients' satisfaction. © Georg Thieme Verlag KG Stuttgart.
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    Comparison of preoperative tests for predicting difficult endotracheal intubation; [Zor endotrakeal entübasyonun tahmininde preoperatif testlerin etkinliǧinin karşilaştirilmasi]
    (2006) Sabanci Ü.; Topçu I.; Tekin S.; Ekici N.Z.; Lüleci N.
    Aim: Many different teats were proposed preoperatively to predict difficult endotracheal intubations. In this prospective study, we aimed to assess the effectiveness of the tests for predicting difficult intubation. Materials and Methods: 603 adult patients (238 male, 365 female) submitted for elective surgery under general anesthesia were included in this study. Age, height, weight, interincisor gap, neck circumference, sternomental and thyromental distance were recorded during prcoperative evaluation. Wilson risk score, modified Mallampati classification, head-neck movement, mandibular protrusion, history of difficult laryngoscopy or intubation and anatomic anomalies were also noted. Cormack and Lehane classification was used for visualization of the larynx. The number and duration of attempts at each tracheal intubation were recorded. Results: Tracheal intubations were difficult to perform in 25 (4.1%) patients. There was not any significant correlation between the difficult intubation and weight, thyromental and sternomental distances, mandibular protrusion and limited neck extension of the patients (p>0.05). Difficult intubations had significant association with increased age, male sex, two and more Wilson's risk score, mean interincisor gap and neck circumference, increased Mallampati score, Cormack-Lehane Grade 3 or 4 and decreased mouth opening (p<0.05). <2 cm interincisor gap had high (99 %) specificity. Also sensitivity of Cormack-Lehane Grade 3 or 4 was found higher (71%) than other parameters. Concluions: Cormack and Lehane classification is the most valuable test for predicting difficult intubation. Therefore laringoscopic view must be evaluated well and suitable position for the patient must be obtained. The highest specificity (99.8%) and positive predictive value (50%) belongs to <2 cm interincisor gap in our patients as a preoperative test. Not all but some of the preoperative tents have significant predictive value for difficult intubation.
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    Comparison of analgesic activity of the addition to neostigmine and fentanyl to bupivacaine in postoperative epidural analgesia
    (2006) Tekin S.; Topcu I.; Ekici N.Z.; Caglar H.; Erincler T.
    Objectives: To compare the analgesic and side effects of bupivacaine in combinations with neostigmine and fentanyl using patient-controlled-epidural analgesia (PCEA) methods in the postoperative period after abdominal hysterectomy. Methods: Seventy-five adult American Society of Anesthesiologists physical status I-II patients, aged 18-65 years were included in the study. The study took place in Celal Bayar University Hospital, Turkey between 2003-2004 years. After preoperative epidural catheterization, the patients were operated under general anesthesia. After surgery, the patients were randomly allocated in a double-blinded manner to receive PCEA and divided into 3 groups: Group B: 0.125% bupivacaine, Group N: 0.125% bupivacaine plus neostigmine 4 μg kg-1 and Group F: 0.125% bupivacaine plus 1 μg kg-1 fentanyl solutions (10 mL loading dose, 5 mL bolus dose, 10 min lockout time, 30 mL in 4 hour limit). During the following 24 hours, hemodynamic parameters, pain score using visual analog scale, total analgesic consumption, additional analgesic requirements, sedation, satisfaction, nausea scores and probable side-effects were evaluated. Results: Total analgesic consumption was 143.7 ± 7.2 mL in Group B, 123.4 ± 6.2 mL in Group N and 106 ± 8.3 mL in Groups F. The mean value in Group F was significantly lower than Group N and Group B (p<0.05), and was lower in Group N than Group B. Visual analog scale scores were lower in Group F than other groups (p<0.05). There were no differences in side effects between all groups. Conclusions: Fentanyl and neostigmine by the PCEA method can be used safely for postoperative analgesia after gynecologic surgery. They increase analgesia quality and satisfaction without an increase in side effects.
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    Validity and reliability of the Turkish version of the Innsbruck RBD-9 diagnostic inventory (IRBD-9-TR)
    (2025) Aslan-Kara K.; Ak A.K.; Sarıtaş A.Ş.; Yılmaz H.; Metin K.M.; Çokal B.G.; Ağan K.; Aksu M.; Akyıldız U.O.; Demir A.B.; Çevik B.; Ertürk A.Y.; Karadeniz D.; Öztura İ.; Sünter G.; Tekin S.; Tezer İ.; Berktaş D.T.; Totik N.; Şenel G.B.
    BACKGROUND:  Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is characterized by loss of the normal atonia of REM sleep accompanied by repetitive motor and behavior phenomena of dream content. OBJECTIVE:  To evaluate the reliability and validity of the Turkish version of the original form of the Innsbruck Rapid Eye Movement Sleep Behavior Disorder Diagnostic Inventory (IRBD-9) scale (IRBD-9-TR) and ensure that this screening test can be easily used in the Turkish language. METHODS:  The present is a multicenter and prospective study involving 184 patients: 51 with iRBD and 133 healthy controls. The iRBD patients were not diagnosed before submitted to video polysomnography (vPSG) and filling out the IRBD-9-TR. RESULTS:  The optimal cut-off value for the IRBD-9-TR symptom score was of 0.28, with a sensitivity of 0.941 and a specificity of 0.947, and 94.4% of the patients were correctly diagnosed. The rotated factor loadings for the diagnostic accuracy of each individual question showed that the short version of the IRBD-9-TR (questions 1, 2, 3, 6, and 8) presented higher specificity and excellent discrimination of iRBD patients from healthy controls. The Cronbach's α coefficient for the symptom section of the IRBD-9-TR was of 0.857, and the Kappa coefficient, of 0.885. CONCLUSION:  The short version of the IRBD-9-TR presents good validity and reliability to be used as a screening test to assess iRBD patients. It is convenient and potentially useful in both outpatient clinical and epidemiologic research settings. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/).