Browsing by Author "Silay, E."

Now showing 1 - 6 of 6

Anaesthetic and Hemodynamic Effects of Continuous Spinal Anaesthesia Versus Single Dose Spinal Anaesthesia in Elderly Patients
(2001) Dimirel, C.B.; Kati, I.; Cem Tuncer, Y.; Hüseyinoǧlu, Ü.A.; Silay, E.
Forty patients (>70 years old) scheduled for retropubic transvesical prostatectomy were prospectively evaluated in order to compare quality of anaesthesia, complications and hemodynamic tolerance of titrated doses of plain bupivacaine using continuous spinal anaesthesia versus single dose spinal anaesthesia. Patients were randomized into two groups (Group K: continuous spinal anaesthesia, n: 20, Group S: single dose spinal anaesthesia, n: 20). The group S patients received 3 mL of 0.5% plain bupivacaine, and the group K patients received a starting dose of 1.5 mL of 0.5% plain bupivacaine, followed after 10 min by optional reinjection of 0.5 mL every 5 min until T10 level sensory block was reached. Onset of anaesthesia, hemodynamic variables, the need for ephedrine and complications were registered. Spinal anaesthesia was successful in all patients of both groups. Decreases in mean arterial pressure were significantly less pronounced in the group K than in the group S. The variations in heart rate were small and there was no significant difference between the two groups. The mean dose of ephedrine was significantly less in the group K than in the group S. No neurological complications related to the spinal anaesthesia technique were observed in either group. As a result of this study, the continuous spinal anaesthesia, using small titrated doses of 0.5% plain bupivacaine, is safe, efficient, and provides better hemodynamic stability than single dose spinal anaesthesia in elderly patients.
Ankylosis of Temporomandibular Joint, Micrognathia and Difficult Intubation (Case Report)
(2004) Kati, I.; Tekin, M.; Hüseyinoǧlu, Ü.A.; Silay, E.
Fiberoptic bronchoscopy is widely used for tracheal intubation in cases where direct laryngoscopy could not be achieved. In this case report we have discussed the anaesthetic management of a 17-years-old male with temporomandibular joint ankylosis and micrognathia developed following a trauma in childhood. We concluded that; although several methods can be used in cases of difficult intubation, following a careful preoperative preparation and by taking preventive measures, fiberoptic intubation can be performed providing spontaneous breathing without any problem in patients having micrognathia and restricted mouth opening.
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.
Comparison of the Effects of Lma Inflated With Room-Air or N 2o+o2 on the Oropharyngeal Structures
(2003) Kati, I.; Çankaya, H.; Tekin, M.; Abbasov, Ü.H.; Silay, E.
In this study, we aimed to evaluate the effects of between different gases for LMA cuff inflation cuff pressure, oropharyngeal lesions and sore throat incidence. Fifty-five ASA I-II patients that underwent general anaesthesia were divited into two groups randomly. The patients were premedicated with midazolam 0.05 mg kg-1 intravenously. Routine monitors were placed, and anaesthesia was induced with intravenous propofol and fentanyl. LMA were inserted after loss of eyelash reflex. LMA cuff inflation was achieved with appropriate volume of 50 % N2O+50 % O2 and room-air respectively in groups I and II. The intracuff pressure was measured at initial, 30th, 60th and 90th minutes during surgery. At the end of the operation, LMA was removed after spontaneous respiration began and oropharyngeal examination was carried out immediately by rigid optic telescope. One hour later, the patients were questioned postoperatively about sore throat. Cuff pressures were significantly lower in group I when compared to group II at 30th, 60th and 90th minutes except for initial cuff pressure. In group II, cuff pressure was gradually and significantly dropped during the course. In group I, there was a negative linear correlation between time and lesion and positive linear correlation between lesion and sore throat. In group II, there was a positive linear correlation between pressure and lesion, pressure and sore throat and lesion and sore throat. Sore throat was significantly more frequent in group II. In conclusion, we suggested that usage of N2O-O2 mixture instead of room-air is suitable for LMA cuff inflation because of decreased sore throat and laryngeal mucous membrane injury.
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.