Browsing by Author "Yuzkat, Nureddin"

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Comparison of Ketamine, Fentanyl and Remifentanyl in Terms of Sedoanalgesia for Colonoscopy: a Randomized Prospective Double-Blind Study
(Galenos Yayincilik, 2019) Simsek, Lokman; Yuzkat, Nureddin; Soyalp, Celaleddin; Gulhas, Nurcin
Aim: The aim of this study was to compare the effects of fentanyl, remifentanyl and ketamine applied for analgesia during colonoscopy on hemodynamics and sedo-analgesia quality. Methods: A total of 81 patients, who were scheduled for elective colonoscopy, were included in the study. Groups were randomized according to closed envelope method. Group K received 0.5 mg/kg ketamine, group F, 1 mu g/kg fentanyl, and group R received 1 mu g/kg remifentanil. Anaesthetist administered the analgesic agents at a dose of 1 mL/10 kg body weight without knowing the ingredient. Hemodynamic variables, total amount of propofol consumed, time of the endoscope to reach the cecum, and duration of colonoscopy were recorded. After the procedure, Modified Aldrete Score, patient, colonoscopist and anesthesiologist satisfaction were evaluated. Statistical analysis of the data was performed. Results: The demographic characteristics of the patients included in the study and the distribution of the patients between the groups were similar. There were no significant differences in duration of colonoscopy, hemodynamic changes, oxygen saturation, satisfaction scores, quality of analgesia, recovery and recovery after the procedure between the groups. Conclusion: As a result, ketamine, fentanyl, and remifentanyl applied for analgesia during colonoscopy have similar hemodynamic alterations and analgesic quality, therefore these agents may be substituted for one another for colonoscopy procedures.
Comparison of the Effects of Desflurane and Sevoflurane on Cerebral Oxygen Saturation in Patients Undergoing Thyroidectomy: a Randomised Controlled Clinical Study
(Aves, 2019) Akcay, Lerzan; Soyalp, Celaleddin; Yuzkat, Nureddin; Gulhas, Nurcin
Objective: The commonly performed sitting position with head extended during thyroidectomy has been shown to cause adverse effects on cerebral regional oxygen saturation (CrSO2). Therefore, the present study aimed to investigate the effects of two well-known anaesthetic agents, desflurane and sevoflurane, on CrSO2 in patients undergoing thyroidectomy in the semi-sitting position by near-infra-red spectroscopy monitoring. Methods: The study included 60 patients aged 18-65 years, with an American Society of Anesthesiologists (ASA) physical status classification score I-III, who underwent elective thyroidectomy in the semi-sitting position. The patients were randomly divided into two groups, depending on the anaesthetic agent administered: (1) sevoflurane group (Group S; n=30) and (2) desflurane group (Group D; n=30). After intubation, the patients were placed in a 45-degree semi-sitting position. Vital signs and the CrSO2 levels in both hemispheres were recorded both pre-induction and at the induction minute 1, post-intubation, post-positioning, every 5 minutes intraoperatively and in the case of sudden changes. Results: No significant difference was found between the groups in terms of age, height, body weight, the ASA score, operative time and left- and right-hemisphere CrSO2 (p>0.05). Moreover, the two groups were statistically similar to each other with regard to peripheral capillary oxygen saturation, heart rate, systolic and diastolic blood pressure, mean artery pressure and end-tidal CO2 (ETCO2) levels. Conclusion: Desflurane and sevoflurane had similar effects in the preservation of CrSO2 in patients undergoing thyroidectomy in the semi-sitting position.
Cost Analysis on Intensive Care Unit Costs Based on the Length of Stay
(Aves, 2019) Kilic, Mehmet; Yuzkat, Nureddin; Soyalp, Celaleddin; Gulhas, Nurcin
Objective: The present study aimed to determine the profit/loss ratio and the service casts in intensive care unit (ICU) based on the length of ICU stay. Methods: This retrospective study reviewed the medical records of 458 patients who were admitted to ICU between August 2016 and August 2017. Depending on the length of their ICU stay, the patients were divided into six groups: (I) 1 day, (II) 2 days, (III)3 days, (IV) 4 days, (V) 5 days and (VI) more than 5 days. These charges were evaluated under six categories: surgery, laboratory tests, drugs, tools and equipment, radiographic workup and others. Results: This study reviewed the medical records of patients including 273 (59.6%) men and 185 (40.4%) women. The mean age of the patients was 53.87 +/- 22.6 years. The profit/loss ratio was in favour of loss in group I (12,870.82 TL), group II (9,384.61 TL) and group III (371.18 TL). The ration was in favour of profit in group IV (16,505.4 TL). Total service costs comprised 38.31% drug costs, 24.45% tools/equipment, 13.14%, laboratory tests, 10% other costs, 4.92% surgical costs and 3.1% radiographic tests. Conclusion: The cost analysis based on the service costs in ICU with regards to the length of ICU stay revealed that due to the greater use of diagnostic, surgical and medical tools and equipment and laboratory and radiographic tests, the profit/loss ratio was in favour of loss within the first three days in ICU. This ratio turned to profit beginning from day 4 in ICU due to the decrease in the use of these equipment and tests. Moreover total ICU costs comprised 38.51% drug costs and 24.45% medical tools and equipment.
Effect of Using the Suction Above Cuff Endotracheal Tube (Sacett) on Postoperative Respiratory Complications in Rhinoplasty: a Randomized Prospective Controlled Trial
(Dove Medical Press Ltd, 2019) Yuzkat, Nureddin; Demir, Canser Yilmaz
Background: The Suction Above Cuff Endotracheal Tube (SACETT) has a dorsal port above the cuff designed to enable the continuous or intermittent suctioning of secretions from the subglottic space. Thus, it facilitates the suctioning of excessive secretions above the cuff and around the glottis. Objectives: In this study, we investigated the effect of the using the SACETT on laryngospasm and postoperative complications in rhinoplasty operations. Methods: This randomized controlled clinical trial enrolled 132 patients undergoing rhinoplasty. The patients were randomly divided into two groups: Suction above Cuff Endotracheal Tube (n=66; Group SA) and classic endotracheal tube (n=66; Group C). Complications following general anesthesia were statistically analyzed among the two groups. Results: The incidence of postoperative laryngospasm (p=0.02) and respiratory complications was found to be lower in Group SA than in Group C. In addition, the incidence of agitation (p=0.035), postoperative nausea, and vomiting (PONV) (p=0.041), which required antiemetic drug administration, swallowing difficulty (p=0.012), and sore throat (p=0.027) were found to be lower in Group SA than in Group C. Conclusion: We suggest that using the SACETT in rhinoplasty reduces the incidence of postoperative respiratory complications as well as the incidence of agitation, sore throat, swallowing difficulty, and PONV.
Effects of Menstrual Cycle Phases on Preoperative Anxiety: a Randomized Prospective Observational Trial
(Bayrakol Medical Publisher, 2020) Yuzkat, Nureddin; Soyalp, Celaleddin; Demir, Canser Yilmaz; Kilic, Mehmetlig; Gulhas, Nurcin
Aim: Women experience physical and psychological changes as a result of their menstrual cycle. This study aimed to investigate whether the menstrual cycle had any effect on the preoperative anxiety experienced by women who were scheduled to have an operation. Material and Method: One hundred female patients who were scheduled to undergo a septorhinoplasty, and who met the inclusion criteria, were enrolled in the present study. The patients were divided into two groups according to the phase of their menstrual cycle: Group F (follicular phase) and Group L (luteal phase). The patients' anxiety level was measured preoperatively using the State-Trait Anxiety Inventory Scale. The patients' heart rate and blood pressure measurements were performed preoperatively as well as at 1 min, 5 min, and 10 min after intubation. Results: The preoperative anxiety scores of the patients in the luteal phase (41.14) were statistically significantly higher than those of the patients in the follicular phase (36.04). The blood pressure, heart rate, and peripheral oxygen saturation values were found to be similar between the two groups. Discussion: We believe that preoperative anxiety is higher during the luteal phase of the menstrual cycle than during the follicular phase, but the hemodynamic data were similar in both phases.
Effects of Showing the Operating Room on Preoperative Anxiety and Hemodynamics Among Patients With Hypertension: a Randomized Controlled Trial
(Taylor & Francis inc, 2020) Yuzkat, Nureddin; Soyalp, Celaleddin; Turk, Omer; Keskin, Siddik; Gulhas, Nurcin
Purpose: Anxiety is one of the most important causes of hypertension, increasing direct blood pressure and affecting postoperative morbidity and mortality. The aim of this study was to investigate the effects of showing the operating room on preoperative anxiety and hemodynamics among patients with hypertension. Methods: We enrolled 90 patients with hypertension undergoing cholecystectomy in this trial. Patients were randomly divided into two groups using a sealed-envelope system. Group STOR was shown the operating room the day before surgery, while Group No STOR was not shown the operating room. Results: State-Trait Anxiety Inventory scores measured on the day of surgery were lower for Group STOR (43.2 +/- 6.0) than Group No STOR (49.8 +/- 7.9) (p = .001). Systolic (p = .001, p = .006, respectively), diastolic (p = .001, p = .004, respectively), and heart rate (p = .018, p = .031, respectively) values in the operation room and preoperative unit were lower in Group STOR than in Group No STOR. The number of postponed operations in Group STOR was lower than in Group No STOR (p = .043), and the patient satisfaction score in Group STOR was higher than in Group No STOR (p = .031). Conclusion: In patients with hypertension, preoperative anxiety, blood pressure, heart rate, and respiratory rate all increase in the preoperative unit and operation room. Our findings indicate that showing the operating room to patients with hypertension decreases preoperative anxiety, as well as blood pressure and heart rate inside the operating room and preoperative unit. It also reduces the number of postponed operations and increases patient satisfaction.
Effects of Theophylline With Methylprednisolone Combination Therapy on Biomechanics and Histopathology in Diaphragm Muscles of Rats
(Springer/plenum Publishers, 2016) Yuzkat, Nureddin; Kati, Ismail; Isik, Yasemin; Kavak, Servet; Goktas, Ugur; Cengiz, Nurettin
The purpose of this study was to investigate the effects of theophylline and methylprednisolone on the mechanical response and histopathology of hemidiaphragm muscle in rats. In the current study, we aimed to investigate the effects of theophylline and methylprednisolone, which are frequently used in clinics and which have different effects on the respiratory system and on the biomechanics and histopathology of the diaphragm muscle. The study included four groups of rats. Group T received 1 mg/kg of intraperitoneal theophylline, group M received 2 mg/kg of intraperitoneal methylprednisolone, group TM received 1 mg/kg of intraperitoneal theophylline plus 2 mg/kg of intraperitoneal methylprednisolone, and group K received of 1 mL intraperitoneal isotonic solution (of 0.9 % NaCl). The medications were continued for 7 days in each group. The rats underwent cervical dislocation under anesthesia on the eighth day, and their diaphragm samples were extracted. The left hemidiaphragm was used for the investigation of biomechanical parameters, and the right hemidiaphragm was used for the histopathological evaluation. It was observed that the medication administered in group T increased the contraction strength and duration compared with that in group M. Additionally, the duration of semi-relaxation was prolonged in group T compared with group M. The highest contraction strength and the longest contraction period among all of the groups were observed in group TM. It was concluded that the combined use of theophylline and methylprednisolone had positive effects on the contraction strength and the durations of contraction and semi-relaxation of the diaphragm muscle. In addition, both drugs had synergistic effects on each other.
Fournier Gangrene: Association of Mortality With the Complete Blood Count Parameters
(Lippincott Williams & Wilkins, 2018) Demir, Canser Yilmaz; Yuzkat, Nureddin; Ozsular, Yavuz; Kocak, Omer Faruk; Soyalp, Celaleddin; Demirkiran, Hilmi
Background: The authors studied the alterations in mean platelet volume, neutrophil-to-lymphocyte ratio, and red blood cell distribution width values together with the platelet count in hospitalized patients diagnosed with Fournier gangrene to determine their association with disease prognosis. Methods: Records of patients diagnosed with Fournier gangrene were analyzed retrospectively. Results: Seventy-four patients (49 men and 25 women) with a mean age of 57.60 +/- 15.34 years (range, 20 to 95 years) were included. Sixty-eight participants were discharged and six died during follow-up. In the discharged group, during hospitalization, there was a trend downward in neutrophil-to-lymphocyte ratio and mean platelet volume values, whereas platelet count increased significantly. In the nonsurvivor group, the neutrophil-to-lymphocyte ratio and mean platelet volume after first debridement and at the end of hospitalization were significantly higher; platelet counts at admission, after the first debridement, and at the end of hospitalization were significantly lower compared with the survivor group (p < 0.05). In correlation analysis, mortality rate was negatively correlated with platelet count at admission and after first debridement and positively correlated with the neutrophil-to-lymphocyte ratio and mean platelet volume after first debridement. Regarding the receiver operating characteristic curve analyses, a platelet count of 188,500/mu l at admission and 196,000/mu l after the first debridement, a neutrophil-to-lymphocyte ratio of 13.71, and a mean platelet volume of 9.25 fl after the first debridement were defined as the cutoff levels having the best sensitivities and specificities. Conclusions: This study suggests that platelet count at admission and platelet count, mean platelet volume, and neutrophil-to-lymphocyte ratio after first debridement and during discharge may be included among the prognostic scores of Fournier gangrene. The authors defined some threshold values that can be used during patient follow-up. Larger prospective studies are warranted to determine the exact role of those parameters in the prognosis of Fournier gangrene.
Hungry Bone Syndrome as a Cause of Recurrent Laryngospasm After Parathyroidectomy
(Lippincott Williams & Wilkins, 2011) Isik, Yasemin; Goktas, Ugur; Yuzkat, Nureddin; Kati, Ismail
Laparoscopic Cholecystectomy Under Thoracic Epidural Anaesthesia in Patients With Situs Inversus Totalis
(Galenos Yayincilik, 2015) Yuzkat, Nureddin; Cegin, M. Bilal; Soyoral, Lokman
Operative and Prognostic Parameters Associated With Elective Versus Emergency Surgery in a Retrospective Cohort of Elderly Patients
(Springer, 2019) Soyalp, Celaleddin; Yuzkat, Nureddin; Kilic, Mehmet; Akyol, Mehmet Edip; Demir, Canser Yilmaz; Gulhas, Nurcin
AimTo evaluate operative and prognostic parameters associated with elective versus emergency surgery in a retrospective cohort of elderly patients.MethodsA total of 533 geriatric patients (aged65 years, median age: 73.0 years, 50.7% were females) who underwent either elective surgery (n=285) or emergency surgery (n=248) were included in this study. Data on patient demographics, co-morbid disorders, type of surgery and anesthesia, American Society of Anesthesiologists (ASA) physical status (PS) classification, length of hospital stay, length of ICU stay, hospitalization outcome, prognosis (survivor, non-survivor) were obtained from medical records.ResultsEmergency surgery group was associated with higher prevalence of ASA-PS III (48.8 vs. 25.6%, p<0.001) and ASA-PS IV (19.0 vs. 0.4%, p<0.001) categories and higher mortality rates (20.6 vs. 4.9% vs. p<0.001) when compared to the elective surgery group. ASA-PS IV category was associated with oldest patient age (median 82.0 vs. 71.0years for ASA-PS I and II, p<0.001 for each and versus 75.0years for ASA-PS III, p<0.05) and highest mortality rate (35.4 vs. 3.4% for ASA-PS I, 6.0% for ASA-PS II and 16.5% for ASA-PS III, p<0.001) as compared with other categories.ConclusionIn conclusion, our findings in a retrospective cohort of elderly surgical patients revealed high prevalence of co-morbidities, predominance of ASA-PS II or ASA-PS III classes and an overall in-hospital mortality rate of 12.2%. Emergency as compared with elective surgery seems to be associated with older age, male gender, ASA-PS III and IV classes, higher likelihood of postoperative ICU transfer and higher mortality rates.
Prevention of Emergence Agitation With Ketamine in Rhinoplasty
(Springer, 2018) Demir, Canser Yilmaz; Yuzkat, Nureddin
Background Emergence agitation (EA), defined as restlessness, disorientation, excitation, and/or inconsolable crying, is a common phenomenon during early recovery from general anesthesia. In this study, we aimed to determine the (1) EA incidence after rhinoplasty operations in adults; (2) the effects of ketamine administered at sub-anesthetic doses just 20 min before the end of the surgery in rhinoplasty operations on agitation level, postoperative pain, side effects, and complications; and (3) to determine the risk factors for EA in adults after rhinoplasty. Materials and Methods Totally 140 patients scheduled to undergo elective rhinoplasty were enrolled in this prospective study. Patients were equally and randomly divided into two groups: saline group (control group) (n = 70) and ketamine group (n = 70). Twenty minutes before surgery completion, 1 ml saline was administered via the intravenous (i.v.) route to the saline group, while 0.5 mg/kg ketamine was administered via i.v. patients in the ketamine group. The emergence agitation level of the patients was evaluated using the Richmond Agitation-Sedation Scale just after extubation and in the post-anesthesia care unit (PACU). For postoperative pain evaluation, the Numerical Rating Scale (NRS) was scored (from 0 to 10) every 10 min until the patients were discharged from PACU. Results EA incidence in the control group was as high as 54.3%, while in the ketamine group it was 8.6% just after extubation (p < 0.001). In the PACU, EA incidence was 28.6% in the control group, while none of the patients had EA in the PACU in the ketamine group (p < 0.001). Male gender, severe pain (NRS >= 5), and smoking were defined as significant risk factors for EA both after extubation and during follow-ups in the PACU (p < 0.001). Conclusions Emergence agitation after rhinoplasty is a common complication, likely disturbing operative outcomes in adults. Ketamine at sub-anesthetic doses is highly effective in preventing EA. Further, larger-scale prospective studies are warranted to determine preventive measures for EA development in rhinoplasty.
The Role of Surgical Diagnosis in The Choice of Anesthetic Technique
(Modestum Ltd, 2016) Yuzkat, Nureddin; Soyoral, Lokman; Cegin, M. Bilal; Ozkan, Burhan; Goktas, Ugur
Spinal anesthesia is a regional anesthetic technique applied by the anesthesiologist, more than a hundred years. The growing popularity of ambulatory surgical procedures have led to more frequent use of spinal anesthesia. This is an anesthetic technique which enhances the satisfaction of the patient and surgeon with this aspect. Chordoma is a rare, slow growing primary malignant tumor of the axial skeleton. It is seen at sacrum and skull base in the spine especiallay sacrococcygeal area (%50). In this paper, we presented a rare case of sacral chordoma up our spinal anesthesia. Perioperative potential risks can be minimized by close monitoring and good preoperative evaluation. Thus; anesthesic technique which even thought as an unappropriate method can be prefered and we believe that diagnosis can remain in the secondary plan in this decision.
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.