Browsing by Author "Soyalp, C."

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Attitudes of Anesthesiology and Reanimation Specialists Towards Pediatric Anesthesia Outside of the Operating Room Practices: a Survey Analysis
(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Soyalp, C.; Yüzkat, N.
There is a growing demand for safe and effective sedation/anesthesia of pediatric patients outside the operating room. This study was designed to investigate the practices and resources of pediatric anesthesia outside the operating room. A total of 219 anesthesiology and reanimation specialists (mean±SD age: 38.3±7.2 years, 50.7% female) voluntarily completed this online questionnaire survey. The questionnaire included items on demographic data, professional characteristics, type of hospital, and the characteristics of anesthesia applied outside the operating room. Most respondents reported that they performed pediatric anesthesia outside the operating room frequently, ranging from a couple of days per week (47.2%) to every day (27.3%), mostly for MRI (87.7%), endoscopy (60.1%), pediatric angiography (58.9%) and biopsy (54.6%) procedures. Overall, 60.1% and 25.8% of the anesthetists stated that they use ASA criteria (inclusion of ASA I-II patients, 39.9%) and age criteria for candidacy, respectively. The professors were determined to be the group with the highest rates for the procedure (66.7%) on a daily basis, while state hospitals were associated with less frequent implementation of the procedure (p<0.001 for each). In conclusion, this questionnaire-based survey revealed frequent and guideline-adherent application of pediatric anesthesia outside the operating room by anesthesiology and reanimation specialists. Together with the likelihood of professional training and hospital type influencing the frequency of the procedure and recovery strategies, these findings emphasize the need for improved practice regarding consideration of appropriate candidacy for ASA physical status and patient age as well as a uniform and standardized recovery practice among anesthesiology and reanimation specialists. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Comparison of the Error Rates of an Anesthesiologist and Surgeon in Estimating Perioperative Blood Loss in Major Orthopedic Surgeries: Clinical Observational Study
(Anestezi Dergisi, 2019) Yüzkat, N.; Soyalp, C.; Gülhas, N.
Objective: Since the anesthesiologist and surgeon have different observation angles in the intraoperative period, their predictions based on clinical observation vary greatly. Whether these predictions accurately reflect actual blood loss is still a matter of debate. The aim of this study was to compare the clinical observations of anesthesiologists and surgeons on perioperative blood loss and transfusion requirements with laboratory results. Methods: Sixty patients who were scheduled for major orthopedic surgery were included in the study. Same anesthesiologist and the same surgeon were asked to estimate the amount of blood loss, and whether blood transfusion was needed during the perioperative period. The amount of blood loss was calculated synchronously using the perioperative hemoglobin value and the total blood volume. The blood loss estimates of the anesthesiologist and the surgeon were compared, with blood loss calculated in the laboratory. Results: The anesthesiologist's and the surgeon's estimates of perioperative mean blood loss volume were found to be lower than the blood volume calculated in the laboratory (p=0.01). When the estimated blood loss was less than 600 mL, it was considered as overestimation, and when it was more than 600 mL then it was interpreted as 20% underestimation (p=0.01). According to our findings, the rate of error in the perioperative blood loss estimates was 28.72%. When the blood loss was more than 1000 mL, the error rate of predictions was 34.03%; when it was less than 1000 mL, the error rate of predictions was 25.18%. Conclusion: We believe that when blood loss is more than 1000 mL in major orthopedic surgeries, the error in the estimation is increased, the amount of blood loss is difficult to predict, and the anesthesiologist makes a better prediction than the surgeon. © Copyright Anesthesiology and Reanimation Specialists' Society.
Effects of Increasing Positive End-Expiratory Pressure (Peep) Values on Intraabdominal Pressure and Hemodynamics: a Prospective Clinical Study
(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Dumanlidağ, U.S.; Yuzkat, N.; Soyalp, C.; Gülhas, N.
In the present study, the purpose was to compare the effects of Positive End-Expiratory Pressure (PEEP), which is applied to intensive care patients, on Intraabdominal Pressure (IAP) and hemodynamic parameters. The patients were selected from among the patients who received mechanical ventilator support and PEEP at various levels in Intensive Care Unit, who were between 18-80 years of age, who did not have abdominal surgery. In the present study, a total of 64 patients were divided into 3 groups. Those who had PEEP value at 4 cmH2O were included as Group 4, those with PEEP value between 5-8 cmH2O were included in Group 8, and those with PEEP value between 9-12 cmH2O were included in Group 12. The intraabdominal pressures, central venous and arterial blood pressures, heart rates, peripheral oxygen saturation values, body temperatures, fluid balances and urine volumes were measured at 0, 6, 12, 18 and 24th hours. The Intra-Bladder Pressure Measurement Method was employed to measure the intra-abdominal pressure. The lowest IAP values were measured in Group 4, and the highest values were measured in Group 12. The IAP values that were measured in Group 12 were higher than the other groups at a significant level. The intra and inter-group blood pressures, body temperatures, urine outputs, central venous pressures, and fluid balance values were similar in all groups. In the present study, it was concluded that IAP was low in low PEEP values, and the IAP was high in higher PEEP levels; and this increase caused mild intrabdominal hypertension; however, did not affect hemodynamics. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Effects of Sedation Doses of Propofol and Midazolam on Levels of Ngal, Cystatin-C, Kim-1 in Rats
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Soyalp, C.; Kömüroğlu, A.U.; Yuzkat, N.; Basbugan, Y.; Tunçdemir, Y.E.
Limited data are available regarding the impact of their sedation doses midazolam and propofol on early biomarkers of acute kidney injury (AKI). This study aimed to investigate the effects of sedation doses propofol and midazolam on early biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CyC) and kidney injury molecule 1 (KIM-1) of AKI. A total of 24 Wistar albino rats were separated into three groups (n = 8 per group): a control group (intraperitoneal injecti on [IP] saline injection once daily for 7 days), a propofol group (IP injection of 2.5 mg/kg propofol once daily for 7 days), and a midazolam group (IP injection of 5 mg/kg midazolam once daily for 7 days). For each group, urinalysis (for urea, creatinine, total protein, NGAL, CyC, and KIM-1) was performed on Day 0 and Day 7; serum analysis (for urea, creatinine, total protein, albumin globulin, ALT, AST, NGAL, CyC, and KIM-1) was performed on day 7. No significant difference was noted between control, propofol and midazolam groups in terms of Day 7 serum KIM-1, CyC, and NGAL levels and Day 0 and Day 7 urinalysis findings (KIM-1, CyC, NGAL, urea, and creatinine levels). DISCUSSION AND CONCLUSION: The findings revealed a similar safety profile for seven-day propofol and midazolam administration in rats in terms of the traditional (creatinine, urea) and early biomarkers (NGAL, CyC, KIM-1) of AKI. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Safe Inhalational Anesthetics in Patients With Coronary Artery Disease: Effects of Sevoflurane and Desflurane on Ischemia-Modified Albumin Levels
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Soyalp, C.; Turk, O.; Oksüz, E.; Yuzkat, N.; Demir, C.; Demir, H.
Introduction: Sevoflurane and desflurane are commonly used anesthetic agents with known cardiac side effects. Ischemia-modified albumin (IMA) is a useful biomarker that increases in cardiac conditions. This study investiga tes the effects of desflurane and sevoflurane on cardiac parameters and IMA levels in patients with coronary artery disease (CAD). Materials and Methods: Sixty CAD patients aged over 18 years scheduled for elective surgery were enrolled. Patients were rand omly divided into two groups: group I, desflurane (D) (n=30) and group II, sevoflurane (S) (n=30). Pre-and post-operative cardiac parameters were recorded for each patient. IMA measurement in serum was determined spectrophotometrically. Results: Postoperative IMA levels were significantly higher than preoperative IMA levels in both groups. The rate of change between post-and pre-operative IMA levels was significantly lower in group S than in group D. Postoperative heart rate (HR) and mean arterial pressure (MAP) levels were significantly lower than preoperative HR and MAP levels in both groups, whereas no significant differenc es were found between the two groups with regard to pre-and post-operative HR and MAP levels. Conclusions: Sevoflurane is safer and has fewer cardiac side effects in CAD patients than desflurane. However, there is a need for comprehensive new studies evaluating large patient groups investigating this situation. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Thiopenthal for Propofol Related Extrapyramidal Movements: Case Report
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Demirkiran, H.; Dalkilinç, B.; Yardimci, C.; Soyalp, C.; Yuzkat, N.; Kiliç, M.
Many drugs are used in outpatient anesthesia procedures. One of them, propofol, is used frequently because of its advantages like fast effect and short duration. Involuntary tonic-clonic movements similar to epilepsy are rarely seen when using propofol. A 41-year old male patient weighing 80 kg and admitted with acute appendicitis presented hemiballismus like severe extrapyramidal movements in all his extremities when propofol was administered. In this article, we discuss how we treated these undesired propofol side effects. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Thoracic Sympathetic Nuclei Ischemia: Effects on Lower Heart Rates Following Experimentally Induced Spinal Subarachnoid Hemorrhage
(Masson Editeur, 2020) Koza, Y.; Bayram, E.; Koza, E. Armagan; Aydin, M. Dumlu; Soyalp, C.; Atalay, C.; Sipal, S.
Background. - The neuropathological mechanism of heart rhythm disorders, following spinal cord pathologies, to our knowledge, has not yet been adequately investigated. In this study, the effect of the ischemic neurodegeneration of the thoracic sympathetic nuclei (TSN) on the heart rate (HR) was examined following a spinal subarachnoid hemorrhage (SSAH). Methods. - This study was conducted on 22 rabbits. Five rabbits were used as a control group, five as SHAM, and twelve as a study group. The animals' HRs were recorded via monitoring devices on the first day, and those results were accepted as baseline values. The HRs were remeasured after injecting 0.5 cc of isotonic saline for SHAM and 0.5 cc of autolog arterial blood into the thoracic spinal subarachnoid space at T4-T5 for the study group. After a three-week follow-up with continuous monitoring of their HRs, the rabbit's thoracic spinal cords and stellate ganglia were extracted. The specimens were evaluated by histopathological methods. The densities of degenerated neurons in the TSN and stellate ganglia were compared with the HRs. Results. - The mean HRs and mean degenerated neuron density of the TSN and stellate ganglia in control group were 251 + 18/min, 5 + 2/mm(3), and 3 + 1/mm(3), respectively. The mean HRs and the mean degenerated neuron density of the TSN and stellate ganglia were detected as 242 + 13/min, 6 + 2/mm(3), and 4 + 2/mm(3) in SHAM (P > 0.05 vs. control); 176 + 19/min, 94 + 12/mm(3), and 28 + 6/mm(3) in the study group (P< 0.0001 vs. control and P < 0.005 vs. SHAM), respectively. Conclusions. - SAH induced TSN neurodegeneration may have been responsible for low HRs following SSAH. To date this has not been mentioned in the literature. (C) 2020 Elsevier Masson SAS. All rights reserved.