Browsing by Author "Demir, Guray"

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Comparison of the Efficacy of Intrathecal Bupivacaine and Levobupivacaine in Artroscopic Knee Surgery
(2014) Altun, Dilek; Demir, Guray; Cetingok, Halil; Tilluba, Evrim Kucur; Cukurova, Zafer; AAR-7467-2020
Objective: In our study, we aimed to compare the degree of sensorial and motor block efficiency of intratechal bupivacaine and levobupivacaine in artroscopic knee surgery. Materials and methods: ASA I-III 100 patients, were divided in two groups. Spinal anesthesia was achieved with 10 mg of bupivacaine 0.5% in Group BPV and 10 mg of levobupivacaine 0.5% in Group LVB. Sensorial block increment time of T10, maximum level of sensorial block, maximum level of motor block and its formation time, total motor and sensorial block time, pain degree with VAS, complications and side effects were recorded. Results: The sensorial block incerement time of T10 was shorter in group BPV, the time of sensorial block was longer. Group LVB increment time of T10, increment time of maximum upper dermatome and the increment time of maximum motor block levels were higher in Group BPV than the Group LVB (p<0.01). Sensorial increment time, level of motor block was longer in group BPV then group LVB (p<0.01). Motor block time of Group BPV was longer then group LVB (p<0.01). Group LVB's VAS score during the initial operation was higher than Group BPV (p<0.01). Hypotension probability was higher in Group LVB than Group BPV (p<0.05). Conclusion: Sensorial and motor block existence was happened in a short time with a longer continuation by bupivakanin instead of levobupivacaine. Because of the longer motor block existence of bupivacaine, levobupivacaine might be preferred in case of the motor block demands during the operation but in case of short-time operations like artroscopic knee surgery, levobupivacain should be more suitable because of the early cover of motor block.
A Paratyhroid Adenoma Case in Intensive Care Unit: Prognosis and Treatment Approach
(2015) Altun, Dilek; Demir, Guray; Tulubas, Evrim; Cukurova, Zafer; Turhan, Ahmet; AAR-7467-2020
Parathyroid adenoma is the most common cause of primary hyperparathyroidism. More than 80% of the patients are asymptomatic and are usually diagnosed with incidentally detected high serum calcium levels. Concominant elevated levels of serum calcium (Ca++) and parathyroid hormone (PTH) is important in definitive diagnosis. Parathyroidectomy is the definitive treatment for primary hyperparathyroidism. Here, we report a patient with high serum calcium levels related to parathyroid adenoma and treated in intensive care unit (ICU). 54 years old female patient who is under treatment of osteoporosis had the symptoms of muscle weakness, fatigue, dizziness, vomiting, dehydration, polyuria and depression. High serum Ca+ and PTH levels were returned to normal after surgical excision.
Successful anesthetic and airway management in Coffin-Siris syndrome with congenital heart disease: Case report
(2016) Altun, Dilek; Demir, Guray; Ayhan, Asude; Turkoz, Ayda; 0000-0003-3299-6706; AAR-7467-2020; AAJ-2066-2021; AAJ-2057-2021
Introduction: Coffin-Siris Syndrome (CSS) is a rare congenital malformation syndrome characterized with mild to severe developmental and cognitive delay, coarse facial features, fifth digit aplasia or hypoplasia associated with ectodermal, constitutional and organ-related (cardiac/neurolo gical/gastrointestinal/genitourinary...) anomalies. Here, we have reported a successful anesthetic and airway management in a case of 5-year old boy with CSS who underwent congenital heart surgery. Case report: A 5-year old male child weighing 14 kg, who was diagnosed as CSS underwent operation for the repair of partial atrioventricular septal defect and secundum atrial septal defect. This case report pertains to the successful anesthetic and airway management in the background of difficult airway and presence of various cardiac abnormalities. Although patient was anticipated to be difficult for intubation due to laryngomalacia, micrognathia, macroglossia, tracheal intubation was performed without any difficulty using fiber-optic laryngoscopy. At the end of the operation, the patient was transferred to the cardiovascular intensive care unit and was extubated when his spontaneous breathing was satisfactory 4 h later after the operation without any complication. Results and discussion: CSS often requires surgery and anesthetic intervention. The abnormal facial and airway as well as mental related features may lead intubation difficult, potentially due to short neck, large tongue and lips, poor dentition and poor communication. Thinking that the practicing anesthetist needs to have appropriate knowledge for this entity and the equipment for managing difficult airway should readily be available. One of these patients which successfully managed without any complication was described in this brief report. (C) 2016 Publishing services by Elsevier B.V. on behalf of Egyptian Society of Anesthesiologists.