Browsing by Author "Goktas, U."

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Anesthesia Management of Jansen’s Metaphyseal Dysplasia
(Yuzuncu Yil Universitesi Tip Fakultesi, 2016) Goktas, U.; Tekin, M.; Kati, I.
Metaphyseal chondrodysplasia is a rare autosomal dominant disorder characterized by accumulation of cartilage in specifically metaphysis of tubular bones. Hyperkalemia and hypophosphatemia were seen most of these patients. In this article we intended to draw attention to some issues releated with anesthesia hereby that a 9 year-old patient with Jansen’s metaphyseal dysplasia. © 2016, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Bilateral Superficial and Deep Cervical Plexus Block for Thyroidectomy in Pregnancy
(Elsevier Sci Ltd, 2013) Goktas, U.; Isik, Y.; Kati, I.; Aytekin, O. C.; Bartin, S.
Effect of N 2o on Nausea and Vomiting Via Intraabdominal Pressure
(2012) Yuce, H.H.; Goktas, U.; Kati, I.; Cegin, M.B.; Soyoral, L.
Background and objective: In this study we aimed to investigate whether there is an effect of N 2O on postoperative nausea and vomiting (PONV) via intraabdominal pressure (IAP). Methods: A total of 40 patients with risk class ASA I-II and age ranging between 20 and 50 years were enrolled in the study. The patients were monitored for electrocardiography (ECG), peripheral oxygen saturation (SpO 2), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), end-tidal carbon dioxide (ETCO 2) and body temperature. IAP was measured by a central venous pressure manometer placed in the urine catheter. Heart rate (HR), SpO 2, SBP, DBP, MBP, ETCO 2, body temperature and IAP were measured before the induction of anesthesia and every 10 minutes throughout the operation. Nausea and vomiting were questioned at the first and second postoperative hours. The patients were randomly grouped into two groups. Induction in both groups was provided using 2 mg/kg propofol, 2 pg/kg fentanyl and 0.1 mg/kg vecuronium, and endotracheal intubation was performed. The maintenance of anesthesia was provided by 40 % O 2+ 60 % N 2O, 1-2 % sevoflurane and 50 g fentanyl + 2 mg vecuronium every 45 minutes in the first group. In the second group, 60 % dry air was used instead of 60 % N 2O. Results: There was no significant difference in terms of HR, SpO 2, SBP, MBP, ETCO 2, body temperature, nau-sea-vomiting and IAP. Conclusions: In conclusion, we think that N 2O usage during the general anesthesia in patients without intraab-dominal problems may increase IAP level for some degree whereas it does not increase PONV. In addition, N 2O usage does not change ETCO 2 values (Tab. 3, Fig. 3, Ref. 32). Full Text in PDF www.elis.sk.
Effect of N2o on Nausea and Vomiting Via Intraabdominal Pressure
(Comenius Univ, 2012) Yuce, H. H.; Goktas, U.; Kati, I; Cegin, M. B.; Soyoral, L.
Background and objective: In this study we aimed to investigate whether there is an effect of N2O on postoperative nausea and vomiting (PONV) via intraabdominal pressure (IAP). Methods: A total of 40 patients with risk class ASA I-II and age ranging between 20 and 50 years were enrolled in the study. The patients were monitored for electrocardiography (ECG), peripheral oxygen saturation (SpO(2)), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), end-tidal carbon dioxide (ETCO2) and body temperature. IAP was measured by a central venous pressure manometer placed in the urine catheter. Heart rate (HR), SpO(2), SBP, DBP, MBP, ETCO2, body temperature and IAP were measured before the induction of anesthesia and every 10 minutes throughout the operation. Nausea and vomiting were questioned at the first and second postoperative hours. The patients were randomly grouped into two groups. Induction in both groups was provided using 2 mg/kg propofol, 2 mu g/kg fentanyl and 0.1 mg/kg vecuronium, and endotracheal intubation was performed. The maintenance of anesthesia was provided by 40 % O-2 + 60 % N2O, 1-2 % sevoflurane and 50 mu g fentanyl + 2 mg vecuronium every 45 minutes in the first group. In the second group, 60 % dry air was used instead of 60 % N2O. Results: There was no significant difference in terms of HR, SpO(2), SBP, MBP, ETCO2, body temperature, nausea-vomiting and IAP. Conclusions: In conclusion, we think that N2O usage during the general anesthesia in patients without intraabdominal problems may increase IAP level for some degree whereas it does not increase PONV. In addition, N2O usage does not change ETCO2 values (Tab. 3, Fig. 3, Ref. 32). Full Text in PDF www.elis.sk.
The Efficiency of Hemodialysis in Transfusion-Related Acute Lung Injury (Trali): a Case Report
(Yuzuncu Yil Universitesi Tip Fakultesi, 2016) Goktas, U.; Yuzkat, N.; Soyoral, L.; Cegin, M.B.; Kahraman, A.
Transfusion-Related Acute Lung Injury (TRALI) is an important life-threatening complication that is related with blood transfusion. The frequency is reported as 1/5.000. It is generally characterized with hypoxia that appears at the 2-6th hours after the blood transfusion, bilateral infiltration in the chest radiography, and non-cardiogenic pulmonary edema. Acute respiratory distress, hypotension, tachycardia and fever accompany the clinical picture. Past surgery, blood transfusion, and sepsis are among the factors that trigger the disease. In this study, the efficiency of the hemodialysis applied in the right time in the treatment of a heavy TRALI case developed after a blood transfusion has been presented. © 2017 Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Knowns and Unknowns About Regional Anesthesia Techniques and Local Anesthetics
(2013) Isik, Y.; Goktas, U.; Bilal Cegin, M.; Yuzkat, N.; Kati, I.
In this study, a questionnaire was used to obtain information about the ideas and experiences of doctors working as operating staff from several specialties in regards to regional anesthesia and local anesthetic drugs to determine the extent to which their knowledge corroborates these types of application and to obtain data for studies to fulfill the future needs of this field. The questionnaire consisted of 18 questions about the use of regional anesthesia and local anesthetic drugs at the time of an operation at nearby hospitals. In total, 109 doctors from 12 branches were included in this study. Although the preference of doctors regarding the selection of regional anesthesia as the first priority varied by field, this choice was not affected by variables such as age, being a research assistant or specialist and working in a state or private hospital. Doctors who were 25-30 years old had more information about local anesthetic drugs than doctors who were 40 years old and older, and this difference was significant. Because doctors aged 40 years and older had less information about local anesthetic drugs among all the doctors studied, training doctors via postgraduate education about this subject would be a better decision.
Management of Anesthesia in Biotinidase Deficiency
(2014) Goktas, U.; Cegin, M.B.; Kati, I.; Palabiyik, O.
Misplacement of Nasogastric Tube in Two Different Cases: Case Report
(2013) Palabiyik, O.; Goktas, U.; Isik, Y.; Kati, I.; Sozen, D.; Avcu, S.
Although the insertion of nasogastric tube has been described as an easy and simple procedure, it may cause severe complications and death. It is therefore important to verify correct nasogastric tube placement. Placement of a nasogastric tube is confirmed using several methods, including auscultation over the epigastric area, aspiration of gastric content from the tube, measuring pH of gastric content and radiological methods. We present the inadvertent insertion of nasogastric tube into the airways, that resulted in respiratory distress, in two different patients to serve as a reminder that malpositioning may cause severe complications.
Platelet Dysfunction and Gross Bleeding Associated With Uremia
(Yuzuncu Yil Universitesi Tip Fakultesi, 2015) Goktas, U.; Yuzkat, N.; Isik, Y.; Çegin, M.; Palabiyik, O.; Kati, I.
Patients with chronic kidney disease (CKD) are prone to bleeding due to the platelet dysfunction caused by uraemia. Therefore, the mortality and morbidity in patients with chronic kidney disease increase. The 81-year-old female patient, in dialysis dependent CKD, had an emergency cholecystitis operation with uremia-induced platelet dysfunction has evolved. Patient with gross bleeding intraoperatively had a cardiac arrest during operation. After cardiopulmonary resusitation cardiac impulses were started and patient was taken into intensive care unit. After the administration of estrogen and Factor VIII Inhibitor Bypass Activity treatment for the bleeding diathesis, bleeding has reduced and after 6 days from the operation patient was externed to his service. The chronic kidney disease may lead to hemorrhagic diathesis and unexpected abundant bleeding by creating a platelet dysfunction. Such being the case, the utilization of desmopressin and Factor VIII concentrate during the treatment is an efficient treatment option. © 2015, Yuzuncu Yil Universitesi Tip Fakultesi, Universitas Indonesia. All rights reserved.
Pregabalin Administered as an Anxiolytic Agent in Ultrasound-Guided Infraclavicular Block: a Controlled, Double-Blind, Dose-Ranging Trial
(verduci Publisher, 2016) Cegin, M. B.; Soyoral, L.; Yuzkat, N.; Baydi, V.; Goktas, U.
OBJECTIVE: Adjuvant agents, given with local anesthetics or via venous, oral, or rectal routes for peripheral nerve blocking, have been in use for a long time. Literature studies about pregabalin usage in peripheral nerve blocking are limited in number. In this study, we aimed to reveal the blocking quality of pregabalin administered orally in various doses as an anxiolytic agent and its effective dose range. PATIENTS AND METHODS: Eighty patients who underwent upper extremity bone surgery were included in the study. The cases were divided into 4 randomized groups of 20 patients. The group that did not receive any medication before the surgery was named the Control Group (Group C), the group that received 75 mg pregabalin per os was named Group P75, the group that received 150 mg pregabalin per os was named Group P150, and the group that received 300 mg pregabalin per os was named Group P300. The study had a controlled and double-blind design. Before, during and after routine peripheral nerve blocking, vital signs, Ramsey Sedation Scale, Patient Satisfaction, Visual Analog Scale, and termination durations of sensorial and motor blocks were recorded. RESULTS: Motor block initiation durations of all groups given pregabalin were significantly shorter than those of Group C. Sensorial block termination durations were similar in Group P150 and Group P300, and both were significantly longer than those in Group C and Group P75. First analgesic requirement time for Group P150 and Group P300 were significantly longer than that of Group P75. Although there was no significant difference between postoperative patient satisfaction and VAS values, first analgesic requirement times of the pregabalin administered groups were longer than those of the control group. CONCLUSIONS: The patients, who are about to undergo surgery, generally develop anxiety about death, not waking up from anesthesia, disability, pain and loss of ability to work. Pre-gabalin is an anti-epileptic, analgesic and anxiolytic agent. With these characteristics, it can be used to reduce pre-operative anxiety, for prophylaxis against convulsions and post-operative analgesia. One hundred fifty mg of pregabalin provides sufficient and effective analgesia, and this dose positively affects the quality of the block.
Should Ureteroscopy Be Considered as the First Choice for Proximal Ureter Stones of Children
(verduci Publisher, 2013) Gecit, I.; Pirincci, N.; Gunes, M.; Bilici, S.; Taken, K.; Goktas, U.; Ceylan, K.
OBJECTIVES: In this study, we aimed to analyze the ureter stones that had been treated using rigid ureteroscopy and pneumatic lithotripsy without mechanically dilating the ureteral orifice. PATIENTS AND METHODS: Records of 110 patients who had undergone rigid ureteroscopy and pneumatic lithotripsy due to ureteral stone between February 2005 and May 2011 were retrospectively analyzed. The location and size of the stone and additional anomalies in the urinary tract on the preoperative direct urinary system (DUS) X-Ray, urinary system ultrasonography (USG), intravenous pyelography (IVP) if performed, and computed tomography (CT), were found from the records of the patients. RESULTS: The mean age of the patients was 5.2 (range 1-17 years). 74 (67.2%) of the patients were males and 36 (32.8%) were females. A total of 115 rigid ureteroscopies were performed on 110 patients. 72 (65%) of the stones were located in the lower ureter, 21 (19%) were located in the middle part of the ureter, and 17 (15.4%) were located in the upper ureter. The mean stone size was determined as 7.5 mm (range 5-15). The mean stone size was determined as 7.4 mm in the lower ureter, as 8.3 mm in the middle ureter, and 8.4 mm in the upper ureter. No difference was found between the sizes of the stones in different locations (p = 0.121). The stone free rate was found as 92.2% for all ureteral stones. The total stone free rate according to the location of the stones was determined as 79.2% in the upper ureter, as 94.4% in the middle ureter and 93,8% in the lower ureter (p = 0.022). The total complication rate was 7.6%. Complication rates were 7.2%, 4.1% and 10.7% for the lower, middle and upper ureter, respectively (p = 0.411) (Table I). No difference was found in terms of complication rates according to location of the stone in the ureter. No major perioperative or postoperative complications developed. A double J stent was inserted in 36 (32%) patients for 2-3 weeks. CONCLUSIONS: We suggest that rigid ureteroscopy may be considered as the first choice for treatment of not only distal-middle ureter stones, but also for proximal ureter stones.
Uretherorenoscopic Stone Therapy in Children: Our 5 Years of Experience
(Elsevier Science Bv, 2010) Gecit, I; Pirincci, N.; Taken, K.; Bilici, S.; Goktas, U.; Tanik, S.; Ceylan, K.