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Browsing by Author "Oguz, Ali Kendal"

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    Article
    Comparison of Dexmedetomidine-Propofol and Ketamine-Propofol Administration During Sedation-Guided Upper Gastrointestinal System Endoscopy
    (Lippincott Williams & Wilkins, 2020) Tekeli, Arzu Esen; Oguz, Ali Kendal; Tuncdemir, Yunus Emre; Almali, Necat
    Background: Dexmedetomidine and ketamine popular sedative agents that result in minimal respiratory depression and the presence of analgesic activity. We aimed to compare the effectiveness and safety of a dexmedetomidine-propofol combination and a ketamine-propofol combination during upper gastrointestinal system endoscopy. Methods: The study commenced after receiving approval from the local ethics committee. Patients between 18 and 60 years in the American Society of Anesthesiologists (ASA) I and II groups were included. Patients who had severe organ disease, who had allergies to the study drugs, and who refused to participate were excluded. Cases were randomized into a dexmedetomidine-propofol group (Group D, n = 30) and a ketamine-propofol group (Group K, n = 30). Cardiac monitoring, peripheral oxygen saturation, and bispectral index (BIS) monitoring were performed. Group D received 1 mg/kg dexmedetomidine + 0.5 mg/kg propofol intravenous (IV) bolus, 0.5 mu g/kg/h dexmedetomidine + 0.5 mg/kg/h propfol infusion. Group K received 1 mg/kg ketamine + 0.125 mL/kg propofol iv bolus, 0.25 mg/kg/h ketamine + 0.125 mL/kg/h propfol infusion. Patients were followed up with a Ramsay Sedation Scale (RSS) of >= 4. Means, standard deviations, lowest and highest frequency values, and ratio values were used for descriptive statistics, and the SPSS 22.0 program was used for statistical analyses. Results: In Group K, recovery time and mean blood pressure (MBP) values were significantly shorter. Furthermore, coughing rate, pulse, and BIS values were higher than in Group D (P < .05). Although there were no significant differences between the groups in terms of endoscopic tolerance and endoscopist satisfaction, we observed that the dexmedetomidine group experienced more comfortable levels of sedation. Conclusion: Dexmedetomidine-propofol and ketamine-propofol combinations may be suitable and safe for endoscopy sedation due to their different properties. It was observed that the dexmedetomidine-propfol combination was superior in terms of sedation depth and that the ketamine-propofol combination was superior in terms of early recovery. As a result, we suggest the dexmedetomidine-propofol combination for upper gastrointestinal system endoscopy sedation due to hemodynamic stability and minimal adverse effects.
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    Sedoanalgesia With Dexmedetomidine in Daily Anesthesia Practices: a Prospective Randomized Controlled Trial
    (Bmc, 2025) Oguz, Ali Kendal; Soyalp, Celaleddin; Tuncdemir, Yunus Emre; Tekeli, Arzu Esen; Yuzkat, Nureddin
    BackgroundPatient safety is important in daily anesthesia practices, and providing deep anesthesia is difficult. Current debates on the optimal anesthetic agents highlight the need for safer alternatives. This study was justified by the need for safer and more effective anesthetic protocols for outpatient hysteroscopic procedures, particularly those conducted outside the operating room. Propofol, while widely used, has significant limitations, including respiratory depression, hemodynamic instability, and delayed recovery when higher doses are required for adequate sedation. The addition of opioids to propofol, though beneficial for analgesia, introduces risks such as hypoxemia and hypotension. These challenges necessitate exploring alternative combinations that balance sedation depth with fewer side effects. ObjectiveTo assess the efficacy and safety of deep sedoanalgesia achieved with dexmedetomidine-propofol versus remifentanil-propofol combinations in daily anesthesia practices. DesignProspective randomized clinical study. SettingsThis study was carried out at Dursun Odaba & scedil; Medical Center. PatientsEighty ASA I-II patients, aged 18-65, scheduled for elective hysteroscopic interventions under sedoanalgesia were included in the study. Main outcome measuresThe primary aim of our study was to identify an anesthetic agent combination capable of delivering effective and safe deep sedation, with sedation depth assessed via the Ramsey Sedation Score (RSS) and respiratory safety evaluated through desaturation rates. Secondary endpoints included Visual Analogue Scale (VAS) scores, oxygen saturation (SpO2), patient, surgeon, and anesthesiologist satisfaction scores, hemodynamic parameters, the time to achieve an RSS > 4, the time to reach a Modified Aldrete Score (MAS) > 9, and the requirement for mask ventilation and jaw thrust maneuvers. InterventionsPatients were randomized into two groups (n = 40 each):Group DP (Dexmedetomidine-Propofol): A bolus of 1 mg/kg IV propofol and 1 mcg/kg IV dexmedetomidine over 10 min, followed by a continuous infusion of 0.2-1.4 mcg/kg/hour.Group RP (Remifentanil-Propofol): A bolus of 1 mg/kg IV propofol and 0.25 mcg/kg IV remifentanil, followed by a continuous infusion of 0.025-0.1 mcg/kg/minute. InterventionsPatients were randomized into two groups (n = 40 each):Group DP (Dexmedetomidine-Propofol): A bolus of 1 mg/kg IV propofol and 1 mcg/kg IV dexmedetomidine over 10 min, followed by a continuous infusion of 0.2-1.4 mcg/kg/hour.Group RP (Remifentanil-Propofol): A bolus of 1 mg/kg IV propofol and 0.25 mcg/kg IV remifentanil, followed by a continuous infusion of 0.025-0.1 mcg/kg/minute. ResultsPatients in the DP group exhibited significantly lower VAS scores and desaturation rates (p = 0.003) compared to the RP group. Satisfaction scores (patient, surgeon, anesthesiologist) and integrated pulmonary index (IPI) values were significantly higher in the DP group (p < 0.05). ConclusionThe dexmedetomidine-propofol combination is an effective and safe anesthetic regimen for deep sedation in outpatient hysteroscopic procedures, offering adequate sedation and superior preservation of respiratory function. Additionally, the dexmedetomidine-propofol combination ensures more stable hemodynamics, with a lower incidence of hypoxia, and results in higher satisfaction rates among patients, surgeons, and anesthesiologists. Trial registrationClinical Trials ID is NCT05674201 Date 2022.12.07.