Browsing by Author "Tekin, M."

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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.
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 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.
Effects of Dexmedetomidine on the Duration of Anaesthesia and Wakefulness in Bupivacaine Epidural Block
(Lippincott Williams & Wilkins, 2007) Coskuner, I.; Tekin, M.; Kati, I.; Yagmur, C.; Elcicek, K.
Background. The purpose of this study was to examine the effects of intravenous dexmedetomidine on the duration of bupivacaine-induced epidural anaesthesia and level of wakefulness and the respective side-effects. Methods: Sixty ASA I-II patients were included in the study. Consecutive patients were allocated to groups according to the last digit (odd/even) of their admission numbers. All patients had epidural anaesthesia with bupivacaine 0.5% performed by the same experienced anaesthesiologist. In the first group, the patients were administered intravenous dexmedetomidine infusion just after the epidural block and continued during the operation, while those in the second group were administered physiologic saline infusion at the same amount and duration. Results: The recovery time of sensory block was significantly longer in the first group. The bispectral index values were lower in the first group than in the second. Also, heart rate was significantly lower in Group I than in Group II. Regarding side-effects, shivering was significantly less frequent in the first group, whereas there was a significant increase in the requirement of atropine in the first group as dexmedetomidine caused bradycardia. Conclusion: Intravenous administration of dexmedetomidine prolonged the duration of epidural anaesthesia, provided sedation and had few side-effects.
Factor Vii Deficiency and Anesthesia
(2008) Göktaş, U.; Kati, I.; Tekin, M.; Çeǧin, M.B.; Korkut, M.
We suggest that recombinant factor VII concentrate could be used to prevent bleeding in the patients with congenital factor VII deficiency in the anesthesia procedure.
Histopathological Effects of Desflurane on the Liver and the Kidney Using Light Microscopy
(2010) Kati, I.; Tekin, M.; Tas, A.; Ragbetli, C.; Ugras, S.
The aim of this study was to histopathologically assess the toxic effect of desflurane on the liver and the kidney. The rats (n = 150) were grouped into five main and three subgroups according to the exposure time to the anesthetic agent. The first group was planned as 1 MAC Desflurane+N2O+O2, the second group as 1 MAC Desflurane+O2, the third group as 2 MAC Desfiurane+N2O+O2, the fourth group as 2 MAC Desflurane+O2 and the 5th group as the control group. Each group was given the anesthetic agent for 1, 3 or 6 h. The rats that were exposed to the anesthetic agent with an adequate dose and for an adequate period of time were sacrificed properly. Livers and kidneys were resected and examined by light microscopes following the routine tissue follow-up procedures. Significant histopathological changes were observed in all groups compared to the control group. However, the pathological findings of the group 2 MAC Desflurane+N2O+O2 at the 6th h with the light microscope was significantly more than those of other groups at all times. It was concluded that although, desflurane caused cellular changes in liver and kidney tissue, it did not cause any clinical changes. Nevertheless, further studies are required to support this opinion. © Medwell Journals, 2010.
Hyperthermia
(2009) Göktaş, U.; Tekin, M.; Kati, I.; Toprak, K.; Yusuf Güneş, H.
Rapid and progressively increasing body temperature during anesthesia reminds us many conditions, predominantly malignant hyperthermia. In this report, it is aimed to investigate the reason of progressively increasing fever during and after the anesthesia in a total of 8 patients from 2 different clinics (n=3, and n=respectively).
An Interesting Misplacement of Central Venous Catheter in an Infant: (Case Report)
(2006) Tekin, M.; Kati, I.; Tomak, Y.
Central venous catheterization may be required in pediatric patients both for surgical and medical purposes. In addition, these catheters are also used for short or long term nutritional therapy. A 1.5 year-old male infant was admitted to the Anesthesiology Intensive Care Unit because of status epilepticus. A central venous catheter was placed in the right subclavian vein for fluid replacement and parenteral nutrition. On the x-ray taken to confirm the placement of the catheter, it was detected that the tip of the catheter had been misplaced in the left internal jugular vein, so the catheter was pulled back and replaced with a new one through the J-guide. This case draws attention to the need for confirmation of the location of the central venous catheter using radiography, especially in infants.
Investigation of Acute Toxicity, Anti-Inflammatory, and Analgesic Effect of Urtica Dioica L
(2009) Tekin, M.; Özbek, H.; Him, A.
In our study, we aimed to investigate the acute toxicity and analgesic effect of Urtica dioica L fixed oil (UD) in mice, and its anti-inflammatory effect in rats. The acute toxicity of UD was tested for the increasing doses between 0.2 and 12.8 mL/kg. The anti-inflammatory effect was studied in carrageenan induced tissue inflammation model and the effect of two different doses of UD was compared with that of isotonic saline, ethyl alcohol, and indomethacin. The analgesic effect was evaluated by tail-flick response and the effect of UD was compared with that of morphine hydrochloride and isotonic saline. It was found that the reduction in inflammation was 95.70% with indomethacin (3 mg/kg i.p.), 47.40 % with 0.05 mL/kg UD i.p. and 56.97% with 0.15 mL/kg UD i.p. Both UD doses showed statistically significant anti-inflammatory effect compared to the control groups but weaker than indomethacin. UD showed no significant analgesic effect compared to the control group. Fixed oil of UD was non-toxic. Our preliminary data show that UD fixed oil extract has a mild anti-inflammatory effect but it is not analgesic or toxic in the dose range examined.
Investigation of the Effects of Intravenous Dexmedetomidine on Desflurane Mac Value Using by Bis Monitorisation
(2008) Yaǧmur, C.; Tekin, M.; Kati, I.; Coşkuner, I.; Elçiçek, K.
Aim: In this study, we aimed to investigate the effects of intravenous dexmedetomidine on desflurane MAC value by BIS monitorisation. Materials and Methods: Sixty adult patients with ASA I-II groups were participated in this study. Patients were randomly divided to two groups with thirty patients in each group. Patients were not prcmedicad. The depth of the anesthesia was monitorised by BIS. The induction of anesthesia was performed with 2 μg kg-1 fentanyl, 2.5 mg kg-1 propofol and 0.1 mg kg -1 vecuronyum. A bolus injection of dexmedetomidine was administered at a rate of 1 μg kg-1 in ten minutes, and then infused at a rate of 0.5 μg kg-1 hr-1 to group I. However, physiological saline was administered to group II in the same manner. Anesthesia was maintained with a mixture of. 40% O2 and 60% N2O with desfluran in order to keep BIS values between 40-50. Heart rate, blood pressure, MAC values of the agent were measured with five minutes intervals. Central temperature, SpO2, ETCO2, and BIS values were measured with ten minutes intervals . Results: No statistically significant difference were seen between groups according to demographic data. BIS values in group I was lower than group II during the first ten minutes (p<0,05) MAC values in group I were lower than group II (p<0,001). There were no difference between two groups in respect to mean arterial pressure. Atropin was given to eleven patients in Group I, but not given to any patient in Group II (p<0,001). No statistically difference was seen between groups in respect to ETCO2 and temperature values. SpO2 values in group I were found lower than group II at the tenth minute before the induction (p<0.05). Conclusion: Dexmedetomidine can be used adjuvantly in general anesthesia, as it decreases MAC values and confirms a stable haemodynamy during induction. However, dexmedetomidine should be made cautiously regarding to its bradycardic effect.
Misplacements of Central Venous Catheters: Internal Jugular Versus Subclavian Access in Critical Care Patients
(TIP ARASTIRMALARI DERNEGI, 2007) Tekin, M.; Özbay, B.; Kati, I.; Arslan, H.
Aim; In central venous catheterization (CVC), misplacement is not a rare complication since this is a blinded procedure. The aim of this study was to compare the misplacement risks of the access of internal jugular vein with that of subclavian vein catheterizations. Methods;The records of a total of 1092 patients in whom central venous catheters were placed between 2002 and 2006 in Anesthesiology Intensive Care Unit and the location of the tips was confirmed radiologically were retrospectively evaluated. Neck and infraclavicular region were cleaned by antiseptic solution after routine monitorization. CVC were easily inserted with Seldinger's technique after blood aspiration through internal jugular vein or subclavian vein. Results; In adult patients, six internal jugular catheter misplacements were seen (0.80%); among them five were kinking and one was intrapleural location of the catheter tip. Six subclavian misplacements (2.02 %) were detected, five of them were located in contralateral subclavian vein, and one was located in ipsilateral internal jugular vein. In children, two subclavian misplacements were seen as crossing to contraleteral subclavian vein, and there were no internal jugular misplacement. There was no statistically difference for misplacement between the access sites (in adult p= 0.110, in children p=0.501). Conclusion; We have concluded that experience of operator should be taken into account for choice of catheterization site.
A Pregnant Developed Cardiac Arrest Due To Anaphylaxis
(TIP ARASTIRMALARI DERNEGI, 2010) Göktaş, U.; Kati, I.; Tekin, M.; Güneş, Y.
We present a pregnant developed cardiac arrest due to a severe anaphylactic reaction to i.v. sulbactam-ampicillin, who had no history of allergy to penicillin and cephalosporin. Ampicillin is one of the most common drugs to elicit a rash, with an overall incidence of 3% to 8%. Five to ten percent of people on ampicillin develop eruptions between the 5th and 14th day following initiation of therapy. The incidence of immediate hypersensitivity reaction or anaphylactic reaction to cephalosporin antibiotics has been estimated at 0.02% and most of these patients have a history of allergy to penicillin and/or adverse reactions to cephalosporins. We present a case of immediate systemic reaction to sulbactam-ampicillin in a pregnant women whom exposed to intravenous sulbactam-ampicillin several times in past. The patient manifested a severe reaction which included anaphylactic shock, requiring orotracheal intubation and epinephrine. In this case, we emphasized the importance of early, fast, effective,and proper cardiac resusitation for anaphylaxis which may improve the prognosis.
Variations in Multiple Syndromic Deafness Genes Mimic Non-Syndromic Hearing Loss
(Nature Portfolio, 2016) Bademci, G.; Cengiz, F. B.; Foster, J., II; Duman, D.; Sennaroglu, L.; Diaz-Horta, O.; Tekin, M.
The genetics of both syndromic (SHL) and non-syndromic hearing loss (NSHL) is characterized by a high degree of genetic heterogeneity. We analyzed whole exome sequencing data of 102 unrelated probands with apparently NSHL without a causative variant in known NSHL genes. We detected five causative variants in different SHL genes (SOX10, MITF, PTPN11, CHD7, and KMT2D) in five (4.9%) probands. Clinical re-evaluation of these probands shows that some of them have subtle syndromic findings, while none of them meets clinical criteria for the diagnosis of the associated syndrome (Waardenburg (SOX10 and MITF), Kallmann (CHD7 and SOX10), Noonan/LEOPARD (PTPN11), CHARGE (CHD7), or Kabuki (KMT2D). This study demonstrates that individuals who are evaluated for NSHL can have pathogenic variants in SHL genes that are not usually considered for etiologic studies.