Browsing by Author "Yentür E.A."

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    Nervus intermedius neuralgia: An uncommon pain syndrome with an uncommon etiology [2]
    (2000) Yentür E.A.; Yegül I.
    [No abstract available]
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    Comparing the effects of two different doses of remifentanil infusion during induction; [Anestezi indüksiyonu sirasinda iki farkli dozda reṁifentanil infüzyonunun karşilaştirilmasi]
    (2002) Tezcan Keleş G.; Yentür E.A.; Sakarya M.; Toprak V.; Ok G.; Taşyüz T.
    In this study we compared the effects of two different doses of remifentanil infusion on haemodynamic variables and complications during the anesthesia induction. 50 patients, undergoing tympanoplasty operation were enrolled in this study. They were randomly divided into two groups. Before the anesthesia induction, bolus dose of 1 μg kg-1 remifentanil was administered to all patients. Immediately after, an infusion of remifentanil either 0.5 μg kg-1 min-1 min-1 (Grup I: n=25) or μg kg-1 min-1 (Grup II:n=25) was commanced. After three minutes 2 mg kg-1 propofol and 0.1 mg kg-1 vecuronium was administered before tracheal intubation. Anesthesia was maintained with 66 % N2O in O2 and 1.2 % (end tidal) sevoflurane and remifentanil infusion. Hemodynamic values (systolic, diastolic and mean arterial blood pressures and heart rate) and all adverse effects were recorded at 1 and 3 min after the initiation of infusion, before and after intubation, before and surgical incision. For the statistical analysis student's t-test and Mann Whitney -U tests were used. Results were considered significant when p<0.05. With regard to hemodynamic variables systolic, diastolic and mean arterial blood pressures were significantly lower in Group I and Group II three and one minutes after the initiation of remifentanil infusion respectively (p<0.05). Heart rates were significantly lower after the preintubation measurements in group I and after the third minute measurements at group II (p<0.05). There were no hemodynamic response to intubation and skin incision in both groups. At the induction, bradycardia was more prominent in Grup II than Grup I (p<0.05). We concluded that, higher doses of remifentanil did not effect the haemodynamics but lead an increase in adverse effects.
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    The role of trigger point therapy in knee osteoarthritis
    (2003) Yentür E.A.; Okçu G.; Yegül I.
    Background and objectives: The purpose of this study was to investigate whether injection of trigger points with lidocaine combined with intra-articular hyaluronic acid injection would be more effective in pain reduction and assisting daily activities of patients with knee osteoarthritis then hyaluronic acid injection alone. Methods: Thirty-four, female, osteoarthritis patients were randomly assigned into two groups (hyaluronic acid group, n = 17; trigger point group, n = 17). Patients in the trigger point group received intraarticular 2 ml Na-hyaluronate injections and trigger point injections, three times with one-week intervals. The hyaluronic acid group received only hyaluronic acid injections. Before the treatment and 7 days after the third injection, the same physician who was blind to the treatment, assessed the intensity of pain at rest or during normal daily activities, activity restrictions, and joint range of motion. Results: A significant improvement of pain and reduction of activity restrictions was observed in the trigger point group (p < 0.001) while in the hyaluronic acid group, there were significant improvements only in squatting and walking (p = 0.03). A significant improvement in range of movement was observed only in the trigger point group.
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    Basic life support skills of doctors in a hospital resuscitation team
    (2004) Tok D.; Tezcan Keleş G.; Taşyüz T.; Yentür E.A.; Toprak V.
    The aim of the present study was to evaluate the basic life support skills of doctors in a hospital resuscitation team and to identify potential factors affecting those skills. Twelve anesthesiology residents were induced in this study. Each doctor was asked to perform mouth-to-mouth ventilation for 10 minutes and then chest compression for another 10 minutes on a Laerdal Skillmeter Resusci-Anne manikin during the day (10 am) and at night (10 pm). The rates of correct ventilation, correct chest compression, ventilation errors (i.e., excessive inflation, stomach insufflation, insufficient ventilation), and compression errors (i.e., insufficient chest compression/decompression, excessive chest compression, incorrect hand placement) were determined for each 2-min interval up to 10 min. In addition, effects of sex, seniority, CPR duration, and time of day (day vs night) on those skills were assessed. The mean rates of correct ventilation were 53.3±23.9% (day) and 60.4±16% (night); the mean rates of correct chest compression, 76.9±15% (day) and 76.5±14.7% (night). During the first 2-minutes period of testing at night, men doctors more frequently achieved correct ventilation than did women doctors (p<0.05). Overall, the practical CPR skills of the study participants were not influenced by sex, seniority, CPR duration, or time of day; however, the participants' skills were poor. This suggests that all medical staff, especially members of in-hospital resuscitation teams, should undergo regular, periodic CPR training. © 2004 Tohoku University Medical Press.
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    Subanalgesic Dose of Ketamine Added to Tramadol Does Not Reduce Analgesic Demand; [Tramadole, Subanaljezik Dozda Ketamin İlavesi Analjezik Gereksinimini Azaltmiyor]
    (2004) Yentür E.A.; Topçu I.; Keleş G.T.; Taşyüz T.; Sakarya M.
    Tramadol is an analgesic with agonistic properties on opioid receptors. In this study we investigated the effect of systemic coadministration of subanalgesic dose of ketamine with tramadol on postoperative tramadol consumption. By this way we intended to find a clue whether tramadol also have opioid induced algesic effect like morphine via NMDA receptors. Thirty patients undergoing abdominal surgery with general anesthesia were enrolled in this prospective, placebo controlled, double blind study. Anesthesia was induced with propofol 2-2.5 mg kg-1 and was maintained with sevoflurane in N2O/O2 mixture. Muscle relaxation was provided by vecuronium. Analgesia was maintained by iv remifentanyl infusion. Infusion of remifentanyl was stopped 15 min before the end of operation, and 10 min later patients were randomly administered either 75 mg kg-1 ketamine (5 mL) and 1 mg kg-1 tramadol (ketamin group) or normal saline (5 ml) and 1 mg kg-1 tramadol bolus (placebo group). Intravenous PCA with tramadol was started on the arrival at postoperative recovery room, and continued for 24 hours in all patients. Pain and sedation scores were evaluated in the recovery room every 15 min until the time of discharge to the ward. Aldrete Post Anesthesia Recovery Scores (≥9) were used as discharge criteria. Total tramadol consumptions at the 6th and 24th hours were recorded. There was no significant difference between the groups with respect to Visual Analog Scale (6.1±1.1 vs 6.6±1.1) and total tramadol consumption (51.5±26.4 vs 53.7±18.3 mg) at the end of recovery period (p>0.05). Also the total tramadol consumptions at 6th and 24th hours (188.9±82.9 vs 215.3±104.7 and 365.0±118.6 vs 403.8±243.8 respectively) were not different between groups (p>0.05). Subanalgesic dose of ketamine did not augment tramadol induced analgesia so these findings may suggest that tramadol does not have NMDA receptor activating property like morphine.
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    Subanalgesic doses of ketamine and morphine but not morphine alone, prolong the sensory block time of hyperbaric bupivacaine in unilateral spinal anaesthesia
    (2004) Yentür E.A.; Tok D.; Keleş G.T.; Toprak V.; Aslan F.
    Aim: In this study, we aimed to compare the sensory and motor effects of a subanalgesic dose of morphine and morphine + ketamine added to 5% hyperbaric bupivacaine (HB) in unilateral spinal anaesthesia. Methods: 45 patients were randomly assigned to one of three groups. The first group received 1.5 ml 0.5% HB + 0.2 ml saline; the second group received 1.5 ml 0.5% HB + 0.1 ml morphine (0.1 mg) + 0.1 ml saline; the third group received 1.5 ml 0.5% HB + 0.1 ml ketamine (0.5 mg) + 0.1 ml morphine (0.1 mg). Maximum block levels, time to reach that level, time to reach T10 level and block levels after 120 min were recorded. Results: Maximum sensory and motor block levels, time to reach these levels and time to reach T10 level were similar in all three groups, but there was less regression of sensory block level in the third group than in the other two groups. Conclusion: Subanalgesic doses of morphine and ketamine added to 0.5% HB extended the sensory block period but not the motor block in unilateral spinal anaesthesia.
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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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    Radiation safety in invasive pain medicine; [Girişimsel aǧri tedavisinde radyasyon güvenliǧi]
    (2006) Yentür E.A.; Bayindir P.; Pabuşcu Y.
    Invasive procedures have been an inseparable part of contemporary pain medicine. As a result, flouroscope has been an indispensable equipment in our daily practice but this development brings some questions into mind like how much knowledge do we have about the operation of flouroscope, ionizing radiation and radiation safety? We aimed to give basic information about radiation physics, ionizing radiation. Besides, important points about radiation safety will be specially emphasized.
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    Evaluation of hemostatic changes using thromboelastography after crystalloid or colloid fluid administration during major orthopedic surgery
    (Associacao Brasileira de Divulgacao Cientifica, 2012) Topçu I.; Çivi M.; Öztürk T.; Keleş G.T.; Çoban S.; Yentür E.A.; Okçu G.
    The effects of Ringer lactate, 6% hydroxyethyl starch (130/0.4) or 4% succinylated gelatin solutions on perioperative coagulability were measured by thromboelastography (TEG). Seventy-five patients (ASA I-III) who were to undergo major orthopedic procedures performed under epidural anesthesia were included in the study. Patients were randomly divided into three groups of 25 each for the administration of maintenance fluids: group RL (Ringer lactate), group HES (6% hydroxyethyl starch 130/0.4), and group JEL (4% gelofusine solution). Blood samples were obtained during the perioperative period before epidural anesthesia (t1, baseline), at the end of the surgery (t2), and 24 h after the operation (t3). TEG data, reaction time (R), coagulation time (K), angle value (α), and maximum amplitude (MA) were recorded. TEG parameters changed from normal values in all patients. In group RL, R and K times decreased compared to perioperative values while the α angle and MA increased (P < 0.05). In group HES, R and K times increased, however, the α angle and MA decreased (P < 0.05). In group JEL, R time increased (P < 0.05), but K time, α angle and MA did not change significantly. In the present study, RL, 6% HES (130/0.4) and 4% JEL solutions caused changes in the coagulation system of all patients as measured by TEG, but these changes remained within normal limits.
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    Complications of lumbar sympathetic block
    (wiley, 2022) Yentür E.A.
    Lumbar sympathetic block (LSB) is a commonly performed procedure for the diagnosis and treatment of various clinical conditions. It can be performed by local anesthetics, neurolytic agents or a radiofrequency lesion generator, and the procedure can be applied according to the experience and education of the clinician by using fluoroscopy, computed tomography, and ultrasound. The genitofemoral nerve is the sensory nerve most at risk at LSB. A second nerve that might cause problems is the lateral femoral cutaneous nerve. The paravertebral approach under fluoroscopic guidance is the most commonly used technique. The complications of LSB may be categorized as needle trauma, intravascular injection, and anomalous spread of the injectate. Frequent complications are bruising, swelling, and soreness at the site of injection. Even after all precautions are taken into consideration, complications may happen. Therefore, precise attention should be required for all steps of the algorithm. © 2022 John Wiley & Sons Ltd. All rights reserved.