Browsing by Author "Pinar, Huseyin Ulas"

Now showing 1 - 15 of 15

Acetamiprid Poisoning Followed By Prolonged Muscle Weakness
(2017) Pinar, Huseyin Ulas; Dogan, Rafi; Konuk, Mine; Sener, Aylin; Karaca, Omer; 0000-0003-0473-6763; 0000-0003-1933-2075; Q-2420-2015; AAU-6923-2020
Neonicotinoids, a new insecticide group, are considered to possess a low toxicity profile for humans. In this paper, a 41-year-old female patient who was treated for prolonged muscle weakness at an intensive care unit for 22 days and discharged without any sequela following oral acetamiprid intake for suicidal purposes is reported. After developing a clinical picture similar to the intermediate syndrome seen in organophosphate poisoning, the patient recovered with the help of symptomatic and supportive treatment.
The Application of Infraclavicular Brachial Plexus Block with Retroclavicular Approach for Arterio-Venous Fistula Aneurysm
(2021) Karaca, Omer; Pinar, Huseyin Ulas; 33913132
Infraclavicular block provides adequate anesthesia to the arm, forearm, and antecubital region. There are many different approaches to infraclavicular brachial plexus block. Corocoid approach which is mostly preferred is not appropriate in some cases that needle orientation disappear. In this case report, we performed a newly defined retroclavicular approach to infraclavicular brachial plexus block and discussed in the light of information in literature. The patient who has 79 year old man, 29.36 body mass index, American Society of Anesthesiologists 3 with chronic renal failure was admitted to the operation room with complaint of aneurysmatic arteriovenous fistula in the left antecubital area. We planned the infraclavicular brachial plexus block with retroclavicular approach for better visibility of need le. The needle insertion point was posterior to the clavicle and the needle was advanced from cephalad to caudal. The block was effectuated after median nerve stimulation as the needle was advanced toward posterior of axillar artery. In our case with excess weight and life-threatening disease, it is highly reliable to perform infraclavicular block with retroclavicular approach indicated spread of local anesthetic, needle tip, and orientation without damage to nerve and vascular structures under ultrasound-guided.
Can Ondansetron Be Used in the Treatment of Subdural Block
(2016) Pinar, Huseyin Ulas; Karaca, Omer; Dogan, Rafi; 0000-0003-1933-2075; 0000-0003-1933-2075; 0000-0003-0473-6763; 27555154; AAU-6923-2020; GQO-9198-2022; Q-2420-2015
Effect of Hydroxyethyl Starch 130/0.4 on Ischemia-Reperfusion Determinants in Minor Lower Extremity Surgery with Tourniquet Application
(2015) Pinar, Huseyin Ulas; Pinar, Asina; Mavioglu, Omur; Yener, Nilgun; 0000-0003-0473-6763; 25577032; Q-2420-2015
Study Objective: To investigate the effect of 6% hydroxyethyl starch (HES) (130/0.4) infusion on ischemia-reperfusion determinants in minor lower extremity operations with tourniquet application. Design: Prospective, randomized, clinical trial. Setting: University hospital operation room. Patients: American Society of Anesthesiologists I and II 40 patients between 18 and 65 years of age who were scheduled to undergo knee arthroscopy and below-knee minor orthopedic surgery. Interventions: Patients were randomized into 2 groups (normal saline [NS] group and HES group). Unilateral spinal anesthesia with 2-mL 0.5% hyperbaric bupivacaine after 10 mL/kg NS intravenous infusion to NS group and 10 mL/kg 6% HES intravenous infusions to HES group. Main Outcome Measures: Blood samples were obtained from antecubital vein for malondialdehyde, xanthine oxidase, and hypoxanthine before tourniquet inflation and after 10 minutes of tourniquet deflation. Results: There was no significant difference between groups with respect of hemodynamic data. There were no significant differences between 2 groups in terms of malondialdehyde values before tourniquet inflation and after tourniquet deflation. In the HES group, xanthine oxidase levels after tourniquet deflation were significantly lower than xanthine oxidase levels before tourniquet inflation (P < .05). In the HES group, hypoxanthine levels after tourniquet deflation were similar with the basal levels; however, they were significantly higher than levels obtained before tourniquet inflation in the SF group (P < .05). Conclusion: HES infusion may be beneficial for reduction of tourniquet-associated ischemia-reperfusinn injury; however, further large-scale studies are needed to fully elucidate its mechanism. (C) 2014 Elsevier Inc. All rights reserved.
The effect of pneumoperitoneum on the cross-sectional areas of internal jugular vein and subclavian vein in laparoscopic cholecystectomy operation
(2016) Pinar, Huseyin Ulas; Dogan, Rafi; Konuk, Ummu Mine; Cifci, Egemen; Duman, Enes; Karagulle, Erdal; Turk, Emin; Karaca, Omer; 27515323
Background: Increased central venous pressure secondary to an increase in intraabdominal pressure has been reported during laparoscopic surgery. However, no study has yet determined the effect of pneumoperitoneum on cross-sectional area (CSA) of central veins by ultrasonography during laparoscopic cholecystectomy. Herein, we aimed to quantify changes in CSAs of internal jugular (IJV) and subclavian veins (SCV) by ultrasonography during this surgery. Methods: This study included 60 ASA I-II patients scheduled for laparoscopic cholecystectomy surgery under general anesthesia. Pneumoperitoneum was performed with CO2 at 12 mmHg. The CSAs of right IJV and right SCV were measured using a 6 Mhz ultrasonography transducer in supine and neutral positions before anesthesia induction (T1), 5 min after connecting to mechanical ventilator (T2), 5 min after creation of pneumoperitoneum (T3), at the end of pneumoperitoneum (T4), and 5 min after desufflation and before extubation (T5) both at end-expiration and end-inspiration. Results: The comparison of IJV CSA at inspiration showed significant increase in T3 value compared to T2 value (p < 0.001). Similarly the expiratory measurements of IJV CSA demonstrated significant increase in T3 value compared to T2 value (p < 0.001). The comparison of inspiratory CSA measurements of SCV showed significantly increased in T3 (p = 0.009) than T2 value. In expiratory measurements there was a significant increase in T3 (p = 0.032) value compared to T2. All measurements of IJV and SCV SCAs both end-inspiration and end-expiration T5 values significantly decreased compared to T4 values (p < 0.001). Conclusions: Pneumoperitoneum with an intraabdominal pressure of 12 mmHg produces significant increases in IJV and SCV CSAs during laparoscopic cholecystectomy procedure. We believe that this finding may enhance our understanding of pneumoperitoneum-induced hemodynamic changes and facilitate catheterization attempts.
The effect of pregabalin on tourniquet-induced ischemia-reperfusion injury: a prospective randomized study
(2019) Karaca, Omer; Pinar, Huseyin Ulas; Ozgur, Ahmet Fevzi; Kulaksizoglu, Sevsen; Dogan, Rafi; 0000-0003-0473-6763; 31655508; Q-2420-2015
Background/aim: The aim of this study was to investigate the efficacy of pregabalin on ischemia-reperfusion injuries. Materials and methods: Fifty-four patients were randomly assigned into 2 groups. A 150-mg tablet of pregabalin was given the night before and then 1 h before the operation for patients in Group P (pregabalin group, n = 27). A placebo was given to patients in Group C (control group, n = 27) at the same times. After combined spinal-epidural anesthesia was performed, venous blood samples were taken before tourniquet inflation (t(1)), just before tourniquet deflation (t(2)), and 20 min after tourniquet deflation (t(3)) for the analysis of total antioxidant status (TAS), total oxidant status (TOS), catalase (CAT), and ischemia-modified albumin (IMA). Results: There was no significant difference in TAS levels between the groups for the t(3) period. However, the TAS in Group P was significantly higher in the t(3) period than the t(2) period (mean +/- SD, 0.46 +/- 0.1 vs. 0.38 +/- 0.2 mmol of Trolox equivalent/L, respectively; P < 0.05). The CAT level in the C period was significantly higher in Group P than Group C (mean +/- SD, 53.04 +/- 32.1 vs. 35.46 +/- 17.2 mu mol/formaldehyde, respectively; P < 0.05). In the t(3) period, the TOS was significantly lower in Group P than Group C (mean +/- SD, 11.97 +/- 5 vs. 18.29 +/- 9.9 pg/mL, respectively; P < 0.05). The TOS in Group P was significantly lower in the t(3) period than the t(2) period (mean +/- SD, 11.97 +/- 5 vs. 18.98 +/- 10.7 pg/mL, respectively; P < 0.0001). Conclusion: Pregabalin has no marked antioxidant activity, but it contributes to the antioxidant defense system of an organism.
The Effect of Spinal Versus General Anesthesia on İntraocular Pressure in Lumbar Disc Surgery in The Prone Position: A Randomized, Controlled Clinical Trial
(2018) Pinar, Huseyin Ulas; Kasdogan, Zumrut Ela Arslan; Basaran, Betul; Coven, Ilker; Karaca, Omer; Dogan, Rafi; https://orcid.org/0000-0003-0473-6763; https://orcid.org/0000-0003-1933-2075; 29414618; Q-2420-2015; GQO-9198-2022
Objective: To compare IOP changes between spinal anesthesia (SA) and general anesthesia (GA) in patients who underwent lumbar disc surgery in the prone position. Design: Prospective, randomized, controlled trial. Setting: Operating room. Patients: Forty ASA I-II patients scheduled for lumbar disc surgery in prone position. Intervention: Patients were randomly allocated to the SA or GA groups. Measurements: IOP was measured before anesthesia (IOP1), 10 min after spinal or general anesthesia in supine position (IOP2), 10 min after being placed in the prone position (IOP3), and at the end of the operation in the prone position (IOP4). Main results: There was no significant difference between baseline IOP1 (group GA = 19.4 +/- 3.2 mmHg; group SA = 18.6 +/- 2.4 mmHg) and IOP2 values (group GA = 19.7 +/- 4.1 mmHg; group SA = 18.4 +/- 1.9 mmHg) between and within the groups. IOP values after prone positioning and group GA measurements (IOP3 = 21.6 +/- 3.1 mmHg; IOP4 = 33.9 +/- 3.1 mmHg) were significantly higher when compared with the SA group (IOP3 = 19.3 +/- 2.7 mmHg, IOP4 = 26.9 +/- 2.4 mmHg) (p = 0.018 and p < 0.001, respectively). Furthermore, IOP3 was significantly increased when compared with IOP2 in the GA group but not in the SA group (p = 0.019 and p = 0.525, respectively). In both groups, IOP4 values were significantly higher than the other three measurements (p < 0.001). Conclusion: The results indicated that IOP increase is significantly less in patients who undergo lumbar disc surgery in the prone position under SA compared with GA.
Effects of Addition of Preoperative Intravenous Ibuprofen to Pregabalin on Postoperative Pain in Posterior Lumbar Interbody Fusion Surgery
(2017) Pinar, Huseyin Ulas; Karaca, Omer; Karakoc, Fatma; Dogan, Rafi; 0000-0003-0473-6763; 0000-0002-5904-3932; 0000-0003-1933-2075; 28951663; Q-2420-2015; AAJ-7677-2021; AAU-6923-2020
Objective. Ibuprofen and pregabalin both have independent positive effects on postoperative pain. The aim of the study is researching effect of 800 mg i.v. ibuprofen in addition to preoperative single dose pregabalin on postoperative analgesia and morphine consumption in posterior lumbar interbody fusion surgery. Materials and Methods. 42 adult ASA I-II physical status patients received 150 mg oral pregabalin 1 hour before surgery. Patients received either 250 ml saline with 800 mg i.v. ibuprofen or saline without ibuprofen 30 minutes prior to the surgery. Postoperative analgesia was obtained by morphine patient controlled analgesia (PCA) and 1 g i.v. paracetamol every six hours. PCA morphine consumption was recorded and postoperative pain was evaluated by Visual Analog Scale (VAS) in postoperative recovery room, at the 1st, 2nd, 4th, 8th, 12th, 24th, 36th, and 48th hours. Results. Postoperative pain was significantly lower in ibuprofen group in recovery room, at the 1st, 2nd, 36th, and 48th hours. Total morphine consumption was lower in ibuprofen group at the 2nd, 4th, 8th, 12th, and 48th hours. Conclusions. Multimodal analgesia with preoperative ibuprofen added to preoperative pregabalin safely decreases postoperative pain and total morphine consumption in patients having posterior lumbar interbody fusion surgery, without increasing incidences of bleeding or other side effects.
Efficacy of ultrasound-guided bilateral erector spinae plane block in pediatric laparoscopic cholecystectomy: Case series
(2019) Karaca, Omer; Pinar, Huseyin Ulas; 0000-0003-0473-6763; 31741347; Q-2420-2015
Postoperative opioid administration can cause various side effects, such as drowsiness, respiratory distress, postoperative nausea, and vomiting. The use of non-opioid medications as part of a multimodal analgesia method has been increasingly suggested in the management of acute postsurgical pain. Erector spinae plane block (ESPB), which is a regional anesthesia technique, blocks both visceral and somatic nerve fibers.Though it is infrequently used in young patients, presently described is a series of cases in which ESPB was successfully used in the performance of pediatric laparoscopic cholecystectomy. Ultrasound-guided bilateral ESPB was performed on 4 patients who underwent a laparoscopic cholecystectomy. An injection of 0.25% bupivacaine was administered into the interfascial area on each side in the pre-incisional period after the anesthesia induction (total anesthetic: 2.5 mg/kg). Postoperative pain control was planned at 10 mg/kg intravenous paracetamol every 8 hours. Numeric rating scale pain scores were less than 3 points in the post-anesthetic care unit, and at 1, 2, 4, 8, 12, and 24 hours. No rescue analgesic (1 mg/kg tramadol) was needed. None of the typical complications, such as drowsiness or nausea, were observed and no block-related complications were recorded. Bilateral ESPB that is a part of multimodal analgesia regimen can provide effective analgesia for pediatric laparoscopic cholecystectomy patients in the first 24 hours postoperatively.
High Prolactin Level as a Predictor of Vasospasm in Aneurysmal Subarachnoidal Hemorrhage
(2017) Kircelli, Atilla; Coven, Ilker; Duman, Enes; Pinar, Huseyin Ulas; Basaran, Betul; 0000-0003-0473-6763; 0000-0003-2109-1274; 28784938; Q-2420-2015; AAK-5299-2021
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a destructive syndrome with a mortality rate of 50%. Recent studies have also suggested a high pervasiveness of hypothalamic-pituitary insufficiency in up to 45% of patients after aSAH. Prolactin has been associated with the pathogenesis of hypertensive irregularities that are linked to pregnancy. Material/Methods: We identified a group of 141 patients with spontaneous SAH due to a ruptured cerebral aneurysm; these patients were operated on at our institution's Neurosurgery and Interventional Radiology Department between 2011 and June 2015. All of the data were obtained retrospectively from medical records. Results: The hormonal abnormalities observed in the initial 24 h after ictus in subjects with subarachnoid SAH were caused by stressful stimulation aggravated by intracranial bleeding. Conclusions: The elevated prolactin levels that occur in patients with aSAH can be used in conjunction with other auxiliary factors that we believe may be beneficial to vasospasm.
Laparoscopic gastrostomy under awake thoracic epidural anesthesia: A successful experience
(2018) Pinar, Huseyin Ulas; Karaca, Omer; Duman, Enes; Dogan, Rafi; 30028480
General anesthesia is the first choice as an anesthesia method particularly for abdominal operations. However, because neuromuscular blockade induced during general anesthesia will increase atelectasis in a patient with pulmonary disease, it will also increase postoperative ventilator dependence, which will be even more apparent in cases of chronic obstructive pulmonary disease (COPD) that pose a risk, particularly for postoperative complications. Herein, thoracic epidural anesthesia (TEA) was found to be a better option for our patient with severe COPD and stage IV lung cancer, as it provided sufficient anesthesia and better postoperative care for laparoscopic gastrostomy.
Smartphone use habits of anesthesia providers during anesthetized patient care: a survey from Turkey
(2016) Pinar, Huseyin Ulas; Karaca, Omer; Dogan, Rafi; Konuk, Ummu Mine; 0000-0003-0473-6763; 0000-0003-1933-2075; 27716076; Q-2420-2015; AAU-6923-2020
Background: Smartphones are used in many areas of anesthesia practice. However, recent editorial articles have expressed concerns about smartphone uses in the operating room for non-medical purposes. We performed a survey to learn about the smartphone use habits and views of Turkish anesthesia providers. Methods: A questionnaire consisting of 14 questions about smartphone use habits during anesthesia care was sent anesthesia providers. Results: In November-December 2015, a total of 955 participants answered our survey with 93.7 % of respondents responding that they used smartphones during the anesthetized patient care. Phone calls (65.4 %), messaging (46.4 %), social media (35.3 %), and surfing the internet (33.7 %) were the most common purposes. However, 96.7 % of respondents indicated that smartphones were either never or seldom used during critical stages of anesthesia. Most respondents (87.3 %) stated that they were never distracted because of smartphone use; however, 41 % had witnessed their collagues in such a situation at least once. Conclusions: According to the results of the survey, smartphones are used in the operating room often for non-medical purposes. Distraction remains a concern but evidence-based data on whether restrictions to smartphone use are required are not yet available.
Total spinal block, bupivacaine toxicity or else under epidural anaesthesia?
(2017) Karaca, Omer; Pinar, Huseyin Ulas; Dogan, Rafi; 0000-0003-0473-6763; 0000-0003-1933-2075; 29039158; Q-2420-2015; AAU-6923-2020
Tremor on the same extremity after axillary brachial plexus block
(2019) Pinar, Huseyin Ulas; 0000-0003-0473-6763; 31736027; Q-2420-2015
Ultrasound-Guided versus Conventional Caudal Block in Children: A Prospective Randomized Study
(2019) Karaca, Omer; Pinar, Huseyin Ulas; Gokmen, Zeynel; Dogan, Rafi; 0000-0003-0473-6763; 0000-0003-1933-2075; 30602192; Q-2420-2015; AAU-6923-2020
Background Injection to the accurate area without any complications is the main factor for the efficiencies of caudal block. The aim of this study was to compare success and the complications of conventional and ultrasound method for caudal block in children. Materials and Methods Two-hundred sixty-six American Society of Anesthesiologists (ASA) category 1 children aged between 6 months and 6 years undergoing hypospadias, circumcision, or both surgeries were randomly allocated two groups (Group C or Group H, n =133). About 0.25% bupivacaine with 1/200000 adrenaline (total volume: 0.5 mL/kg) was injected after the needle was inserted into the sacral canal in Group C, or right after the needle pierced the sacrococcygeal ligament under longitudinal ultrasound view in Group H. Success rate of block, block performing time, number of needle puncture, success at first puncture, complication rate, age and weight of the patients encountering these complications were recorded. Results The success rate of block was similar between two groups (94.7% in Group C vs 96.2% in Group U, p >0.05). Success at first puncture was higher in Group U than in Group C (90.2 vs 66.2%, respectively; p <0.001). Number of needle puncture, blood aspiration, subcutaneous bulging, and bone contact was higher in Group C but none in Group U ( p <0.001) and these complications were occurred in children weighing<16kg and less younger than 6 years old. Conclusion We observed that the complications were not encountered, number of needle puncture was lesser, and the success rate of first puncture was higher under ultrasound with longitudinal view.