Browsing by Subject "Anesthetics, Intravenous"
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Item Assessment of neuromuscular and haemodynamic effects of cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia in elderly patients(2004) Keleş G.T.; Yentür A.; Çavuş Z.; Sakarya M.Background and objective: Neuromuscular block times, quality of muscle relaxation for tracheal tube insertion, and the haemodynamic effects after cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia were compared in elderly patients. Methods: The study was performed in 40 patients over 65 yr of age. Anaesthesia was induced with thiopental, and maintained with sevoflurane in N2O/O2 and remifentanil. Cisatracurium 0.15 mg kg-1 or vecuronium 0.1 mg kg-1 were administered after induction. Intubation was attempted when neuromuscular block was 95%. Onset time, clinical duration of action, recovery index, spontaneous recovery time and tracheal intubation conditions were assessed. Haemodynamic parameters were also monitored. Results: The average ages of the patients were 72.5 ± 5.1 and 73.6 ± 6.3 in the cisatracurium and vecuronium groups, respectively. Onset time was significantly shorter after vecuronium, 158 ± 34s vs. 200 ± 50s, respectively. Recovery index was significantly shorter after cisatracurium, 19.5 ± 7.5s vs. 33.7 ± 18.6s (P < 0.05). Clinical duration and spontaneous recovery time were similar in both groups as well as haemodynamic variables. Conclusions: In elderly patients, vecuronium has a faster onset time while cisatracurium has a shorter recovery index under sevoflurane-remifentanil anaesthesia.Item 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.Item Comparison of propofol and sevoflurane anesthesia by means of blood loss during endoscopic sinus surgery(2004) Sivaci R.; Yilmaz M.D.; Balci C.; Erincler T.; Unlu H.Objective: The purpose of the present investigation is to examine whether induced hypotension with propofol or sevoflurane anesthesia improves the dryness of surgical field in endoscopic sinus surgery (ESS). Methods: The study was performed between 1999 and 2002 in Celal Bayar University and Afyon Kocatepe University Hospitals, Turkey. Thirty-two patients (American Society of Anesthesiologists physical status I and III) with chronic sinusitis undergoing outpatient endoscopic sinus surgery under general anesthesia were studied to determine if anesthetic technique had an impact on estimated blood loss. The patients were allocated randomly into 2 groups. None of the patients were premedicated. Anesthesia was induced with propofol in both groups and maintained with propofol/fentanyl in the first group and sevoflurane/fentanyl in the second group. In both groups, controlled hypotension was used to improve surgical condition. Results: There were no differences between the duration of surgery and intraoperative mean arterial blood pressure when comparing the 2 groups. The average estimated blood loss in the propofol group was 128.1 ± 37.3 ml compared with an average estimated blood loss of 296.9 ± 97.8 ml in the sevoflurane group (p<0.01). Conclusion: General anesthesia based on propofol infusion may have the advantage of decreased bleeding compared with conventional inhalation agents. Therefore, making endoscopic surgery technically easier and safer by improving endoscopic visualization of the surgical field.Item Comparison of antimicrobial effects of dexmedetomidine and etomidate-lipuro with those of propofol and midazolam(2006) Keleş G.T.; Kurutepe S.; Tok D.; Gazi H.; Dinç G.Background and objectives: The aim of our study was to investigate the antimicrobial effects of dexmedetomidine and etomidate-lipuro, and to compare these effects with those of midazolam and propofol on Staphylococcus aureus, Escherichia coli, Pseudomonas aeroginosa, Acinetobacter baumannii and extended-spectrum beta-lactamase Escherichia coli ( E. coli ESBL). Methods: All hypnotic dilutions were exposed to micro-organisms for 0, 30, 60, 120 and 240 min at room temperature in vitro. The inoculums taken from diluted suspensions were re-inoculated on blood agar and incubated for 18-24 h at 35°C after which a count of the colonies was compared. Results: Midazolam reduced the viable cells of S. aureus at 30, 60, 120 and 240 min, and also completely inhibited the growth of E. coli, P. aeroginosa, A. baumannii and E. coli ESBL. Dexmedetomidine, etomidate-lipuro and propofol, however, did not inhibit any of the micro-organisms tested. Conclusion: In vitro, midazolam had an antimicrobial effect on E. coli, P. aeroginosa, A. baumannii and E. coli ESBL. Like propofol and dexmedetomidine, etomidate-lipuro had no antimicrobial effect on any of the micro-organisms tested. © 2006 Copyright European Society of Anaesthesiology.Item Postoperative beneficial effects of esmolol in treated hypertensive patients undergoing laparoscopic cholecystectomy(Oxford University Press, 2008) Ozturk T.; Kaya H.; Aran G.; Aksun M.; Savaci S.Background: In an attempt to decrease haemodynamic instability and early postoperative complications such as nausea, vomiting, and pain, esmolol was added to the routine alfentanil infusion of patients with treated hypertension undergoing laparoscopic cholecystectomy. Methods: Forty consecutive ASA class II patients with controlled hypertension about to undergo laparoscopic cholecystectomy were randomized into two groups: an esmolol group (Group E, n=20) was given a 1 mg kg-1 bolus of esmolol and a placebo group (Group P, n=20) was given an identical volume of Ringer's lactate. The rate of esmolol infusion was adjusted to keep the heart rate between 65 and 75 beats min-1 and was 5-10 μg kg-1 min-1 throughout the procedure. After operation, patients reported their nausea using a four-point scale. Results: Esmolol had an opioid-sparing effect intraoperatively (P=0.001). Postoperative requirements for antiemetics were significantly less in the esmolol group, with no antiemetics given to eight patients. In the placebo group, however, all patients required at least one dose of antiemetic (P=0.007). The frequency of PONV did not correlate to the amounts of alfentanil, propofol, postoperative antiemetics consumed, or to female gender, non-smoking status, and history of PONV or motion sickness. Postoperative analgesic consumption in Group E was significantly lower than in Group P (P=0.012). Conclusions: Esmolol had an opioid-sparing effect in the intraoperative and immediate postoperative period in hypertensive patients undergoing laparoscopy. When combined with alfentanil, it was more effective than placebo in decreasing early PONV. © The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved.Item Effects of conventional vs high-dose rocuronium on the QTc interval during anesthesia induction and intubation in patients undergoing coronary artery surgery: A randomized, double-blind, parallel trial(Associacao Brasileira de Divulgacao Cientifica, 2015) Öztürk T.; Ağdanlı D.; Bayturan Ö.; Çıkrıkcı C.; Keleş G.T.Myocardial ischemia, as well as the induction agents used in anesthesia, may cause corrected QT interval (QTc) prolongation. The objective of this randomized, double-blind trial was to determine the effects of high- vs conventional-dose bolus rocuronium on QTc duration and the incidence of dysrhythmias following anesthesia induction and intubation. Fifty patients about to undergo coronary artery surgery were randomly allocated to receive conventional-dose (0.6 mg/kg, group C, n=25) or high-dose (1.2 mg/kg, group H, n=25) rocuronium after induction with etomidate and fentanyl. QTc, heart rate, and mean arterial pressure were recorded before induction (T0), after induction (T1), after rocuronium (just before laryngoscopy; T2), 2 min after intubation (T3), and 5 min after intubation (T4). The occurrence of dysrhythmias was recorded. In both groups, QTc was significantly longer at T3 than at baseline [475 vs 429 ms in group C (P=0.001), and 459 vs 434 ms in group H (P=0.005)]. The incidence of dysrhythmias in group C (28%) and in group H (24%) was similar. The QTc after high-dose rocuronium was not significantly longer than after conventional-dose rocuronium in patients about to undergo coronary artery surgery who were induced with etomidate and fentanyl. In both groups, compared with baseline, QTc was most prolonged at 2 min after intubation, suggesting that QTc prolongation may be due to the nociceptive stimulus of intubation. © 2015, Associacao Brasileira de Divulgacao Cientifica. All rights reserved.Item Effects of low-dose propofol vs ketamine on emergence cough in children undergoing flexible bronchoscopy with sevoflurane-remifentanil anesthesia: a randomized, double-blind, placebo-controlled trial(Elsevier Inc., 2016) Ozturk T.; Acıkel A.; Yılmaz O.; Topçu I.; Çevıkkalp E.; Yuksel H.Study Objective To determine the effects of low-dose ketamine and propofol on cough during emergence and the recovery period when administered at emergence in children undergoing fiberoptic bronchoscopy for bronchoalveolar lavage (FOBL) with sevoflurane-remifentanil anesthesia. Design Randomized, double-blind, placebo-controlled trial. Setting Operating room, postoperative recovery area. Patients Sixty-eight children aged 1 to 8 years old undergoing elective diagnostic FOBL. Interventions After discontinuation of anesthetics at the end of FOBL, patients were randomly divided into 3 groups: in group K, children were administered 0.5 mg/kg of ketamine; in group P, 0.5 mg/kg of propofol; and in group C, 0.1 mL/kg of normal saline. Measurements Anesthesia time, procedure time, emergence time, and recovery time were recorded. Coughing and delirium scores were recorded as the patient fully emerged from anesthesia (time 0) and 5, 10, 15, and 20 minutes later. Main Results The percentage of children with moderate or severe cough during emergence was similar in all groups. Mean delirium scores at emergence (T0) were significantly lower in group K than those in group P and in group C (P =0001 and P =02). Mean delirium score at 5 minutes in group K (6 [5-10]) was significantly lower than that of group C (P =02) and similar to that of group P. The recovery time of group K was significantly longer than that of group C and group P (P =01 and P =03, respectively). Conclusions Ketamine or propofol given at the end of sevoflurane-remifentanil general anesthesia in children undergoing FOBL did not decrease cough more than normal saline during the emergence period. Ketamine and propofol, compared to normal saline, had a beneficial effect on decreasing the incidence of emergence delirium. Ketamine lengthened recovery time. © 2016 Elsevier Inc.