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Öğe A Needle-Free Injection System (INJEX™) with lidocaine for epidural needle insertion: A randomized controlled trial(Professional Medical Publications, 2016) Gozdemir, Muhammet; Demircioglu, Ruveyda Irem; Karabayirli, Safinaz; Sert, Huseyin; Muslu, Bunyamin; Usta, Burhanettin; Yazici, UmmugulsumObjectives: Local anesthetic infiltration is also a process of a painful process itself. INJEX (TM) technology, known as Needle-free drug delivery system, was designed for reducing the pain associated with cutaneous procedures. We conducted a prospective, randomized trial to evaluate the application of lidocaine with INJEX (TM) system and 27-gauge needle. Methods: A total of 60 consecutive patients were allocated to receive either INJEX group or 27-gauge needle group. Local anesthetic infiltration was applied two minutes before epidural needle insertion. Results: Mean VAS, at the time of local anesthetic injection was 0 for group I and 2 for group II. When the effect of epidural needle insertion was compared, the mean VAS score was one versus two for Group-I versus Group-II, respectively. Lidocaine applied with the INJEX (TM) system before epidural needle insertion significantly reduced the intensity of pain during that procedure and was least effective the lidocaine applied with the 27-gauge needle and patients felt less pain during at the time of local anesthetic injection in Group-I. Conclusion: Needle-free delivery of lidocaine is an effective, easy to-use and noninvasive method of providing local anesthesia for the epidural needle insertion.Öğe Assessment of fetal antioxidant and oxidant status during different anesthesia techniques for elective cesarean sections(Medknow Publications & Media Pvt Ltd, 2015) Karabayirli, Safinaz; Keskin, Esra Aktepe; Kaya, Ahmet; Koca, Cemile; Erel, Ozcan; Demircioglu, Ruveyda Irem; Muslu, BunyaminBackground: We aimed to investigate the effects of general, spinal and epidural anesthesia on fetal total antioxidant status (TAS) and total oxidant status (TOS), and oxidative stress index (OSI) during elective cesarean section in this study. Materials and Methods: Forty-seven parturients scheduled for elective cesarean section were randomly allocated into three groups: Group spinal (n = 15), group epidural (n = 17), and group general (n = 15), This prospective randomized study was performed in Faculty of Medicine, Turgut Ozal University, Turkey. After the baby was delivered; TAS, TOS levels, and arterial blood gases parameters were analyzed in an umbilical arterial blood sample. OSI values are calculated by a ratio of TOS to the TAS. Results: The levels of TAS and TOS in umbilical arterial blood sample were not statistically different among three. However, OSI values were significantly different among the three groups (P = 0.042). Median OSI values is 24 (interquartile range [IQR], 2-37) in group spinal, 19 (IQR, 4-44) in group epidural, and 8 (IQR, 4-36) in group general. There was no significant difference in OSI values in the comparison of group spinal with group general and group epidural, but it was significantly lower in group general when compared with group epidural with Bonferroni correction (P = 0.017). Umbilical cord arterial blood gas values (pH, PaCO2 , PaO2 , SaO(2) , HCO3 , and CtO(2) ), glucose, lactate, and hemoglobin levels were similar in three groups. Conclusion: General anesthesia may be more favorable than epidural in those undergoing cesarean section when fetal oxidative status gains importance.Öğe Assessment of nasal mucociliary clearance in anesthetists(Tubitak Scientific & Technological Research Council Turkey, 2015) Horasanli, Eyup; Acar, Aydin; Muslu, Bunyamin; Cayonu, Melih; Cimencan, Murat; Kayabasi, SerkanBackground/aim: To assess mucociliary clearance in anesthetists who were exposed to waste anesthetic gases occupationally. Materials and methods: The first group consisted of 30 anesthetists who had been working at least 2 years. The control group of 30 subjects was selected from hospital staff with no history of occupational exposure to waste anesthetic gases. Mucociliary clearance time was assessed by measuring the saccharine nasal transit time (SNTT). Results: Thirty-six women and 24 men aged between 25 and 60 years were enrolled in the study. There were no differences between the anesthetist and control groups in terms of age, sex, height, or weight. The median SNTT for the anesthetists (10 min) was longer than that for the control group (8.3 min). The difference was significant (P = 0.025). In addition, there was a significant correlation between the SNTT and the working time (P = 0.02). Furthermore, anesthetists who had worked for 4 years or more had prolonged SNTT compared to those who had worked less than 4 years (P < 0.001). Conclusion: The present study demonstrated the impairment of mucociliary clearance in anesthetists. Increasing impairment with increasing working time was also detected.Öğe Comparison of intrathecal plain articaine and levobupivacaine with fentanyl for Caesarean section(Canadian Soc Clinical Investigation, 2016) Demircioglu, Ruveyda I.; Gozdemir, Muhammet; Usta, Burhanettin; Sert, Huseyin; Karabayirli, Safinaz; Muslu, Bunyamin; Keskin, Esra A.Purpose: Articaine is used as a local anesthetic for outpatient surgery because it offers rapid onset of anesthesia and short duration motor block. Levobupivacaine is often preferred for Caesarean section. We evaluated the anesthetic characteristics of fentanyl-supplemented plain articaine and levobupivacaine for Caesarean section under combine spinal epidural anesthesia. Methods: Patients undergoing Caesarean section received in random order plain articaine 40 mg (Group A, n=50) or plain levobupivacaine 10 mg (Group L, n=50) mixed with fentanyl 20 mu g intrathecally. The onset and duration of sensory and motor block, first analgesic request, and hemodynamic parameters were recorded. Results: Onset times of maximum motor block were longer in Group L than Group A (P=0,001). Time to two-segment regression of sensory block were 70 min for Group A and 90 min group L (P=0.001). Times to complete regression of motor blockade were significantly longer in group L than group A (P =0,001). Conclusion: To have a faster onset and shorter duration of spinal anesthesia, we recommend the use of plain articaine for Caesarean section.Öğe Comparison of neck ultrasonography with a pH meter to confirm correct position of nasogastric tube(Canadian Soc Clinical Investigation, 2016) Muslu, Bunyamin; Sert, Huseyin; Demircioglu, Ruveyda I.; Gozdemir, Muhammet; Usta, BurhanettinPurpose: The aim of this study was to compare pH meter and neck ultrasonograph for evaluation of nasogastric tube (NGT) position. Methods: A total of 35 adult patients who required NGT insertion were included. The NGT was inserted by an anesthetist after endotracheal intubation, and the transducer was placed transversely on the neck, just superior to the suprasternal notch. The passage of the NGT in the esophagus was evaluated by a sonographer, and the stomach was emptied by nasogastric suction. Secretion from inside the NGT was analyzed using a pH meter. The tip of the NGT was accepted as being in the stomach if the pH measured between 1 and 5. Neck ultrasonography was compared with the pH meter analysis for confirmation of NGT position. Results: Ultrasonography was highly sensitive (100% (95% CI 89.6-100%) and specific (97.2% (95% CI 85.4-99.5%) for evaluation of NGT position. The specificity for the pH meter was 100% (95% CI 16.6-100%), while the sensitivity was 76.5% (95% CI 58.8-89.2%). Conclusions: This study showed that neck ultrasonography is more sensitive than the pH meter for confirmation of NGT position.Öğe Effect of positive end-expiratory pressure administration on intraocular pressure in laparoscopic cholecystectomy Randomised controlled trial(Lippincott Williams & Wilkins, 2016) Karabayirli, Safinaz; Cimen, Nuran Kavun; Muslu, Bunyamin; Tenlik, Aylin; Gozdemir, Muhammet; Sert, Huseyin; Hepsen, Ibrahim Feyzi[Abstract Not Available]Öğe Effects of remifentanil, nitroglycerin, and sevoflurane on the corrected QT and Tp-e intervals during controlled hypotensive anesthesia(Elsevier Science Inc, 2016) Cimen, Nuran Kavun; Kosem, Bahadir; Cimen, Tolga; Kartal, Seyfi; Muslu, Bunyamin; Karabayirli, Safinaz; Gozdemir, MuhammetStudy objective: Controlled hypotension is a preferred method in various surgical operations, but limited data are available for the effects of drug combinations that are used to ensure the desired level of hypotension on cardiac repolarization. Design: Randomized, prospective, double-blinded study. Patients: The study comprised 65 patients undergoing septorhinoplasty surgery under general anesthesia. Interventions: Group S received sevoflurane inhalation alone, group R received sevoflurane and remifentant and group N received sevoflurane and nitroglycerine in a way that a mean arterial pressure of 60 +/- 5 mm Hg was achieved. Measurements: Electrocardiogram was performed before induction (T1), 30 minutes after induction (T2), and 5 minutes after extubation (T3). Corrected QT (QTc), QT dispersion (QTd), and corrected Tp-e (Tp-ec) intervals and Tp-e/corrected QT (Tp-e/QTc) ratio were calculated. Main results: QTc prolongation was observed at T2 and T3 in all groups, but only QTc prolongation at T2 was statistically significant in group S (P> .05). Significant prolongation of QTd interval at T2 and T3 was observed in group S (P< .05). In all groups, Tp-ec decreased at T2. However Tp-ec decrease was not statistically significant in group S (P= .103) and group R (P= .058). Tp-e/QTc was significantly decreased on T2 in all 3 groups, and it was returned to baseline at T3 (P< .05). Conclusion: The present study demonstrated that none of the 3 hypotensive anesthesia methods has an overall negative effect on Tp-e and Tp-e/QTc. Therefore, we conclude that all 3 methods can be used safely in terms of proarrhythmic risk, but increased sevoflurane consumption may require more attention due to significant prolongation of QTc and QTd. (C) 2016 Elsevier Inc. All rights reserved.Öğe New hemostatic agent: the effect of Ankaferd Blood Stopper on healing wounds in experimental skin incision model(Tubitak Scientific & Technological Research Council Turkey, 2014) Yuce, Serdar; Candirli, Celal; Yenidunya, Sibel; Muslu, BunyaminAim: To conduct a histopathological evaluation of the effects of Ankaferd Blood Stopper (ABS) on healing wounds in a rabbit skin incision model. Materials and methods: Incisions were performed on the backs of rabbits. The first incision was allowed to undergo normal secondary healing. ABS (1 mL) was applied to the second incision, which was subsequently allowed to undergo secondary healing. The third incision was sutured. ABS (1 mL) was applied to the fourth incision, which was subsequently sutured. During the wound healing period, the histopathologic signs of ulceration, inflammation, the proliferative phase, and the extent of early remodeling were comparatively evaluated by performing biopsies on days 5, 10, and 30. Results: For all of the ABS-treated wounds, the appearance of the cavities during the early stage and the disappearance of the cavities during the late stage were observed. In addition, on days 5-10, the inflammatory granulation tissue in the ABS-treated wounds was less than in the normal wounds. By day 30, all of the wounds had achieved the same symptomatic state. Conclusion: As ABS does not exert any negative effects on wound healing, this agent is a secure and effective method for achieving hemostasis.Öğe Surgical conditions during FESS; comparison of dexmedetomidine and remifentanil(Springer, 2017) Karabayirli, Safinaz; Ugur, Kadriye Serife; Demircioglu, Ruveyda Irem; Muslu, Bunyamin; Usta, Burhanettin; Sert, Huseyin; Ark, NebilTo compare dexmedetomidine with remifentanil in functional endoscopic sinus surgery (FESS) in regards to intra-operative bleeding, anesthetic consumption and post-operative recovery. Randomized, double blind study. Tertiary care medical center. Fifty patients with nasal polyposis who had been scheduled for FESS were randomly divided into two groups. In group D (n = 25), dexmedetomidine 1 A mu g/kg infused intravenous (IV) over 10 min before anesthesia induction, followed by a continuous of 0.7 A mu g/kg/h infusion during operation. In group R (n = 25), 1 A mu g/kg remifentanil IV bolus, was administered with induction of anesthesia and continued 0.25-0.50 A mu g/kg/min during operation. Heart rates, mean arterial pressure, end tidal CO2, end tidal sevoflurane were recorded. The amount of bleeding, surgical field condition for bleeding and the time to reach Aldrete recovery score 9-10 were recorded. Postoperative nausea, vomiting, pain, shivering, sedation were followed up over 24 h. There was no significant difference between groups according to the amount of bleeding during surgery, assessment of surgical field condition, consumption of sevoflurane, scores of postoperative VAS, rates of nausea and vomiting, shivering, demands of additional analgesic medication (P > 0.05). The time to reach Aldrete recovery score 9-10, sedation scores at the postoperative first hour were significantly higher in group D (P = 0.001). We concluded that in comparison to remifentanil, dexmedetomidine during FESS for controlled hypotension is of limited value as it has no additional benefits in terms of control of hypotension and amount of bleeding in the surgical field and it is associated with higher recovery time and first-hour postoperative sedation scores.Öğe The comparison of preincisional peritonsillar infiltration of ketamine and tramadol for postoperative pain relief on children following adenotonsillectomy(Elsevier Ireland Ltd, 2013) Ugur, Kadriye Serife; Karabayirli, Safinaz; Demircioglu, Ruveyda Irem; Ark, Nebil; Kurtaran, Hanifi; Muslu, Bunyamin; Sert, HuseyinObjective: To investigate and compare the effectiveness of preincisional peritonsillar infiltration of ketamine and tramadol for post-operative pain on children following adenotonsillectomy. Study design: Prospective randomized double blind controlled study. Methods: Seventy-five children aged 3-10 years undergoing adenotonsillectomy were included in study. Patients received injections in peritonsillar fossa of tramadol (2 mg/kg-2 ml), ketamine (0.5 mg/kg-2 ml) or 2 ml serum physiologic. During operation heart rate, oxygen saturation, average mean blood pressures were recorded in every 5 min. Operation, anesthesia and the time that Alderete scores 9-10, patient satisfaction, analgesic requirements were recorded. Postoperatively nausea, vomiting, sedation, dysphagia, bleeding scores were recorded at 0, 10, 30, 60 min and 2, 4, 8, 12, 18, 24 h postoperatively. Pain was evaluated using modified Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS) at fixed intervals after the procedure (15 min and 1, 4, 12, 16, and 24 h postoperatively). Results: The recordings of heart rate, mean arterial pressure, nausea, vomiting, sedation and bleeding scores were similar in all groups (p > 0.05). The mCHEOPS scores at 10 min, 30 min, 1 h, 8 h were significantly lower in both tramadol and ketamine group when compared with control (p < 0.05). Use of additional analgesia at 10 min and 18 h were higher in control group than ketamine, tramadol group (p < 0.05). Dysphagia scores were significantly lower for both ketamine and tramadol group when compared with control group (p < 0.05). mCHEOPS, additional analgesia, dysphagia, patient satisfaction scores were similar in tramadol, ketamine groups (p > 0.05). Conclusions: Preincisional injection of ketamine and tramadol prior to tonsillectomy is safe, effective method and equivalent for post-tonsillectomy pain, patient satisfaction, postoperative nausea, vomiting, dysphagia. (C) 2013 Elsevier Ireland Ltd. All rights reserved.Öğe The effects of adding ischemic preconditioning during desflurane inhalation anesthesia or propofol total intravenous anesthesia on pneumoperitoneum-induced oxidative stress(Acta Medical Belgica, 2017) Karabayirli, Safinaz; Surgit, Onder; Kasikara, Hulya; Bicer, Cemile Koca; Ergin, Merve; Demircioglu, Ruveyda Irem; Muslu, BunyaminBackground: The aim of the study was to explore the differences in oxidative stress during anesthesia with desflurane/N2O or propofol/remifentanil in patients undergoing laparoscopic cholecystectomy and additionally to evaluate the differential effects of desflurane and propofol on ischemic preconditioning (IP). Materials and methods: One hundred patients were randomly allocated to four groups. For anesthesia maintenance, the inhalation group (Group I) and the inhalation plus IP group (Group IIP) received desflurane at an end-tidal concentration of 4-6 vol% in oxygen/N2O, and the TIVA group (Group T) and TIVA plus IP group (Group TIP) received infusions of propofol and remifentanil. In Groups IIP and TIP, IP was carried out by 10 min of pneumoperitoneum followed by 10 min of deflation. Preoperative and postoperative plasma total antioxidant status (TAS), total oxidant status (TOS), paraoxonase, stimulated paraoxonase, arylesterase, ceruloplasmin, and myeloperoxidase levels were analyzed; oxidative stress index (OSI) was calculated. Results: When oxidative stress parameters were compared between groups, myeloperoxidase values in Group I were statistically significantly lower compared to Group TIP (p = .004 with Bonferroni's correction). There were no differences between preoperative and postoperative TAS, paraoxonase, stimulated paraoxonase, arylesterase, or ceruloplasmin levels (p>.05). In intragroup evaluations, postoperative paraoxonase and stimulated paraoxonase levels were found to be lower than preoperative values in Group TIP (p = .021 and .012, respectively). Conclusion: In laparoscopic cholecystectomy lasting less than 60 min, there were no differences in the measured oxidative stress parameters between maintenance of anesthesia by desflurane/ N2O and propofol/remifentanil/N2O. The addition of 10 min IP administration during both anesthesia techniques did not result in additional changes in the analyzed oxidative stress.Öğe Transient neurological symptoms after spinal anesthesia(Canadian Soc Clinical Investigation, 2016) Gozdemir, Muhammet; Muslu, Bunyamin; Sert, Huseyin; Usta, Burhanettin; Demircioglu, Ruveyda Irem; Kasikara, HulyaPurpose: The aim of this study was to investigate the incidence of transient neurological symptoms (TNS) after spinal anesthesia with levobupivacaine, bupivacaine, articaine or lidocaine. Methods: The patients (n=400)were randomly assigned to receive spinal anesthesia with levobupivacaine, bupivacaine, articaine or isobaric lidocaine. Onsets of sensory and motor block were recorded. On postoperative days 1, 2 and 3, patients were interviewed by an investigator blinded to the spinal anaesthetic agent used. The patients were classified as having TNS if there was pain in the hips, thighs and/or lower limbs following recovery from anesthesia. Results: Time to maximum sensory block was significantly longer in the articaine group than the lidocaine group. The incidence of TNS was much less after spinal anesthesia with levobupivacaine, bupivacaine and articaine than after lidocaine.
