Browsing by Author "Demirel, C.B."

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Comparison of Bupivacaine With Bupivacaine Plus Fentanyl Administered Via Thoracic Epidural Catheter for Pain After Thoracotomy in Children
(2004) Demirel, C.B.; Kati, I.; Köseoǧlu, B.; Bakan, V.; Hüseyinoǧlu, Ü.A.; Silay, E.
In this study, we aimed to compare the analgesic and side effects of bupivacaine versus bupivacaine and fentanyl combination administered via epidural cathater. Sixty children, aged 3-12 years, ASA I or II physical status, undergoing thoracic surgery were studied. All patients were monitorized routinely. Anaesthesia induced with sevoflurane or thiopenton, atracurium and fentanyl, and meintained with O2 + air, sevoflurane, atracurium and fentanyl. At the end of the operations, epidural catheters were placed below two dermatomes of the surgical incision. In the First Group, 0.3 mL kg-1 bupivacaine 0.125 % was administered as a bolus through the catheter, and infusion in a dose of 0.3 mL kg-1 h-1 added. In the Second Group, 2 mg mL-1 fentanyl and bupivacaine 0.125% was administered as a bolus in a dose of 0.3 mL kg-1 and infusion in a dose of 0.3 mL kg-1 h-1 added. Pain scores were decreased lower than four points in all patients except two patients in the first group, and three patients in the second group. In the second group, sedation scores were higher and pupil's diameters were smaller than the first group. In conclusion, thoracal epidural analgesia seems to be favorable method for pain relief after thoracotomy. However, we must be careful for sedation if opioids will be added to local anesthetics.
Comparison of Preemptive Analgesic Effects of Epidural Tramadol and Morphine
(2001) Kati, I.; Demirel, C.B.; Abbasov, U.H.; Silay, E.
In this study we aimed to compare the efficiency of epidural tramadol versus morphine in preemptive analgesia and their side effects. We studied 45 ASA I-II class randomised 20-60 years old patients in three equal groups. After five minutes of the test dose 5 mL of 2 % lidocaine, 100 mg tramadol 75 mg tramadol, 4 mg morphine all diluted in 10 mL saline were administered epiduraly consequetively to the first, second and third group. After ten minutes sensorial block was controlled and anaesthesia induction and intubation was provided with thiopenthone (5 mg/kg), vecuronium (0.08 mg/kg), and fentanyl (2 μg/kg). Anaesthesia was maintained with O2/N2O and isoflurane. No other analgesic were given to the patients intraoperatively. In all patients, the visual analogue pain score was monitored every two hours, PaO2, PaCO2 and respiratory rate were monitored every six hours and SpO2 was continuously monitored every hour for the first 24 hours postoperatively. VAS was not found statistically significant during the first 15 hours among the groups. VAS was significantly different in the morphine group (p<0.01) during the following hours. PaO2, PaCO2 and breathing rates and side effects among all groups were not found statistically significant. We conclude that different doses of epidural tramadol are safe and efficient as a single dose of morphine for postoperative pain relief.
Difficult Tracheal Extubation (Case Report)
(2003) Demirel, C.B.; Kati, I.; Çankaya, H.; Hüseyinoǧlu, Ü.A.; Egeli, E.
Difficult tracheal extubation is hardly recognized by anesthesiologists as it is rarely encountered in comparison to difficult tracheal intubation. In patients, trials of extubation can be fatal when the real reason is not found. In most cases, the problem arises from an inability to deflate the cuff, commonly as a result of failure in the cuff-deflating mechanism. We present a patient who had operation for laryngo-fissur and chordectomy. The patient was intubated orally by direct laryngoscopy with a spiral endotracheal tube, which was used for the second time due to economical reasons. At the end of operation, the cuff could not be deflated via normal procedure. The patient was given anesthesia again and the cuff was exploded by a stile under direct laryngoscopy and extubation was performed. In patients with difficult tracheal extubation, it is better to do extubation after finding the real reason.
The Effects of Volatile Anaesthetic Agents in Myocardial Repolarization During Induction of Anaesthesia
(1999) Guler, N.; Bilge, M.; Eryonucu, B.; Demirel, C.B.; Kati, I.; Sayarlioglu, M.
QT dispersion may serve as a measure of variability in ventricular repolarization time and may be a means of identifying patients at risk of arrhythmias and sudden death after different clinical settings. The acute responses of QTc dispersion were assessed in 47 American Society of Anesthesiology (ASA) class 1 or 2 patients receiving volatile anaesthetic agents. Anaesthesia was induced with sevoflurane (n=16), halothane (n=17), or isoflurane (n=14), and the inspired concentration increased to reach an end- tidal concentration of 1% to 6%. Recordings of ECG, heart rate, blood pressures were obtained at the following times: prior to induction of anaesthesia, 1 min and 3 min after stable end-tidal concentration, 1 min and 3 min later vecuronium administration, and 1 min and 3 min after tracheal intubation. All the patients studied had normal values of QTc interval and QTc dispersion at rest. All anaesthetic agents significantly increased QTc dispersion compared with baseline values. Both isoflurane and sevoflurane increased QTc interval compared with baseline in contrast to halothane which did not change it significantly. Thus, anaesthetic agents cause myocardial repolarization abnormalities in man in terms of increased QTc dispersion. This may be relevant in the aetiology of arrhythmias in patients receiving anaesthesia without cardiovascular disease.
Epidural Analgesia After Lumbar Disc Surgery With Ropivacaine Plus Fentanyl or Bupivacaine Plus Fentanyl
(2005) Kati, I.; Demirel, C.B.; Cirak, B.; Huseyinoglu, U.A.
We compared the efficacy and safety of continuous epidural infusion of ropivacaine plus fentanyl versus bupivacaine plus fentanyl in the management of postoperative pain after lumbar laminectomy. Twenty-two patients who underwent elective lumbar laminectomy were randomly allocated to one of two groups. The patients were treated with ropivacaine 0.1% plus fentanyl 2 μg/ml in group 1, and with bupivacaine 0.1% plus fentanyl 2 μg/ml in group 2 via bolus epidural infusion (6-10 ml/h). General anesthesia was standardized. Postoperative pain was evaluated using VAS at 0, 1, 2, 3, 8, 20, 32, 48 hours after surgery. The amount of ropivacaine plus fentanyl or bupivacaine plus fentanyl used over the 48-h postoperative period was documented. The postoperative pain and sedation scores were not significantly different between groups throughout the study period. The total consumption of ropivacaine plus fentanyl over the 48-h period was significantly lower (p < 0.05) than that of bupivacaine plus fentanyl. There was no difference in the incidence of side effects. No patient developed respiratory depression or wound infection. We conclude that the use of ropivacaine-fentanyl mixture for patient epidural analgesia after lumbal disc surgery provides similar succesful pain relief as bupivacaine plus fentanyl, but patients receiving bupivacaine-fentanyl need a higer dose. © 2005 VSP.
The Histopathological Effects of Intraarticular Administration of Tramadol on Rabbit's Sinovia
(2003) Kati, I.; Demirel, C.B.; Uǧraş, S.; Abbasov, U.H.; Silay, E.; Timurkan, H.
The analgesic effect of tramadol is due to it's effect on opioid receptor together with the enhancing function of the spinal descending inhibitory pathway by inhibition of reuptake of both 5 hydroxytryptamine and norepinephrine. In this study we aim to invastigate the effects of intraarticular tramadol on synovia. Eighteen healtyh rabbits 0.5-1 years old and weighted between 1.8-2.5 kg were included in the study. All rabbits were divided into five groups as follow; Group 1 (n=4), group 2 (n=4), Group 3 (n=4), Group 4 (n=4), and control group (n=2). Tramadol (12.5 mg/0.5 mL), or saline (0.5 mL) were given, intraarticularly in to the back knees of the rabbits in the study groups and control group respectively. Rabbits in group 1 and control groups were sacrified at first day, group 2 at 7th day, group 3 at 15th day, and group 4 at 21 th day by letal dose of sevoflurane. Examination of sinovia of the all rabbits were normal and there was no differences between groups. In conclusion; Tramadol has no histopathological effect on rabbits sinovia and may be safely administered intraarticularly in human.