Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Impact of Multimodal Analgesia Timing on Postoperative Pain in Cesarean Delivery. A Prospective Randomized Study(2023) Ozmete, Ozlem; Sener, Mesut; Bali, Cagla; Caligan, Esla; Durdag, Gulsen Dorgan; Aribogan, Anis; 38131366AIM: The issue of preemptive or preventive use of paracetamol still raises questions in terms of multimodal analgesia in cesarean delivery. A combination of paracetamol and opioid is commonly used for pain management after cesarean delivery. This study aims to compare postoperative pain level and analgesic consumption when using paracetamol at two different perioperative times in cesarean section. MATERIAL AND METHODS: Sixty patients recruited for elective cesarean section under general anesthesia were included in this prospective study. Patients were randomly assigned to receive iv 1 g paracetamol 15 minutes before incision (Group PE) or after delivery of newborn (Group PV). Visual analog scale (VAS) values, 24-hour morphine consumption, additional analgesic requirement, side effects, and patient and surgeons' satisfaction were recorded. RESULTS: Demographic data and hemodynamic values of the patients were similar in both groups. There was no differences between groups in terms of VAS scores at rest and during movement, additional analgesic requirement during the postoperative 1st hour, and 24-hour total morphine consumption. There was no difference in side effects, and patient and surgeon satisfaction scores postoperatively. CONCLUSIONS: Preemptive and preventive use of paracetamol provides the same quality of analgesia and opioid sparing effect without increasing the frequency of adverse effects.Item Oral 30% Glucose Provides Sufficient Sedation in Newborns During(2017) Eker, H. Evren; Cok, Oya Yalcin; Cetinkaya, Bilin; Aribogan, Anis; 0000-0003-0866-7339; 0000-0003-3004-2626; 0000-0002-7901-0185; 0000-0002-4419-5693; 27999970; AAF-1346-2021; AAI-7998-2021; AAI-8769-2021; S-8336-2019Newborns are often sedated during MRI but sedation itself creates adverse events and management is more challenging in this environment. Oral glucose/sucrose administration has been studied in newborns during painful procedures; however, its effectiveness in keeping newborns sleepy and motionlessness during painless procedures has not been demonstrated. The objective of this study was to describe effectiveness of oral 30% glucose administration by comparing with intravenous midazolam sedation for newborns during MRI. One hundred twelve ASA II-III newborns who required care in the ICU and were scheduled for MRI with sedation were included. Group I received 30% glucose solution orally with 0.5-1 ml increments up to 2 ml/3 kg doses and group II received intravenous 0.1 mg/kg midazolam with 0.05 mg/kg repetition. The procedure was considered satisfactory when MRI images were not disturbed by patient movement after oral glucose or intravenous midazolam administration. The efficiency of the techniques, additional dose and rescue sedation requirements, blood glucose levels following oral 30% glucose suckling and presence of adverse events were recorded. Demographic data was similar between groups. The efficiency of the procedures were similar between groups (78.9%, in group I and 66.1%, in group II). The blood glucose levels were within normal range in group I whereas transient desaturation and apnea occurred in 8 neonates in group II (p = 0.006). Oral 30% glucose administration for newborns during MRI is as effective as standard sedation protocol with midazolam. Thereby, we recommend and support the integration of this safe and reliable technique into routine practice for newborns during MRI.Item Preoperative Paracetamol Improves Post-Cesarean Delivery Pain Management: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial(2016) Ozmete, Ozlem; Bali, Cagla; Cok, Oya Yalcin; Ergenoglu, Pinar; Ozyilkan, Nesrin Bozdogan; Akin, Sule; Kalayci, Hakan; Aribogan, Anis; 0000-0003-3004-2626; 0000-0002-4973-8132; 0000-0002-6366-941X; 0000-0001-5845-699X; 0000-0001-6423-1076; 0000-0003-2615-1918; 0000-0002-4419-5693; 27555133; AAI-8790-2021; S-8336-2019; AAI-7998-2021; J-5282-2013; AAI-7779-2021; AAJ-2094-2021; AAI-7880-2021; GON-8465-2022Study Objective: To evaluate the analgesic effect of preoperative single dose intravenous paracetamol on postoperative pain and analgesic consumption within 24 hours after elective cesarean surgery. Design: Prospective, randomized, double-blind, placebo-controlled clinical trial. Setting: University Teaching Hospital. Patients: American Society of Anesthesiologists (ASA) I and II 60 patients between 18-40 years of age who were scheduled to undergo elective cesarean section. Interventions: Patients were randomized into two groups to receive either intravenous 1 g paracetamol (100 mL) (Group P) or 0.9% NaCl solution (100 mL) (Group C) 15 minutes before the induction of general anesthesia. After delivery of newborn 0.15 mg kg(-1) morphine was administered to all patients in both groups. Postoperative analgesia was provided with patient-controlled intravenous analgesia with morphine in the postoperative period. Measurements: Pain which is the primary outcome measure was assessed at 15th, 30th minutes and 1st, 2nd, 4th, 6th, 12th, 24th hours by the Visual Analogue Scale. Patients' demographics, hemodynamics, Apgar score, additional analgesic requirement, side effects, patients' satisfaction and postoperative total morphine consumption within 24 hours were recorded. Main Results: Median visual analogue scale for pain in Group P was significantly lower compared to Group C at all time points except for the score at 24th h postoperatively (P <.05). Additional analgesic requirement during postoperative first hour was lower in Group P (P <.05). Total morphine consumption was higher in Group C compared with Group P (P <.05). There was no difference between groups with respect to Apgar scores, side effects, and patient satisfaction (P >.05). Conclusions: Preoperative use of single-dose intravenous 1 g paracetamol was found to be effective in reducing the severity of pain and opioid requirements within 24 hours after cesarean section. (C) 2016 Elsevier Inc. All rights reserved.Item Postoperative Analgesic Efficacy of Fascia Iliaca Block Versus Periarticular Injection for Total Knee Arthroplasty(2016) Bali, Cagla; Ozmete, Ozlem; Eker, H. Evren; Hersekli, Murat A.; Aribogan, Anis; 0000-0002-7901-0185; 0000-0003-2615-1918; 0000-0001-5845-699X; 0000-0002-4419-5693; 27871565; AAW-9940-2021; AAI-8769-2021; AAI-8790-2021; AAI-7779-2021; S-8336-2019Study objective: This study evaluated the postoperative analgesic efficacies of fascia iliaca block and periarticular drug injection techniques after TKA (total knee arthroplasty) surgeries. Design: Prospective, randomized clinical trial. Setting: University Teaching and Research Center. Patients: Seventy-one American Society of Anesthesiologists (ASA) I-III patients between 48 and 70 years of age who underwent total knee arthroplasty were randomized. Interventions: Tenoxicam (20 mg) was administered intramuscularly to both groups of patients 30 minutes before surgery. Patients were randomized into two groups to receive fascia iliaca block before the induction of anesthesia (Group FI) or periarticular drug injection during the surgery (Group PI). All surgeries were performed under general anesthesia using standard techniques. Postoperative analgesia was provided with patient-controlled intravenous morphine. Measurements: Total morphine consumption was the primary outcome measure and was recorded postoperatively at 1, 2, 6,12 and 24 hours. Pain levels at rest and on movement (knee flexion) were evaluated using the Visual Analogue Scale (VAS) and recorded at the same time points. Patients' demographics, rescue analgesic demands, side effects, hemodynamics, and satisfaction scores were also recorded. Main results: The groups had similar VAS scores both at rest and on movement (P > .05). However, the amount of cumulative morphine and use at each follow-up period was higher in Group PI (P < .0001). The groups did not differ significantly in rescue analgesic use or side effects, such as nausea/vomiting, hemodynamic variables, and patient satisfaction scores (P > .05). Conclusions: Fascia iliaca block may be used as an alternative method to periarticular injection, and it effectively reduces the amount of morphine used to relieve post-TKA pain. (C) 2016 Elsevier Inc. All rights reserved.Item Protective Effect of Curcumin on Carbapenem-Resistant Escherichia coli-Induced Lung Injury in Rats(2016) Bali, Cagla; Altintas, Nejat; Ozmete, Ozlem; Gelincik, Ibrahim; Yabanoglu, Hakan; Tekin, Neslihan; Altinsoy, Bulent; Turan, Bunyamin Cuneyt; Aribogan, Anis; https://orcid.org/0000-0002-1161-3369; AAI-8790-2021; AAI-7779-2021; AAJ-7865-2021; S-8336-2019Curcumin has remarkable anti-inflammatory and antioxidant properties. The aim of this study was to investigate the protective effects of curcumin on a rat model of carbapenemresistant Escherichia coli-induced acute lung injury (ALI). Thirty-two rats were randomly allocated to 4 groups to induce an ALI: negative control group (rats not infected with E coli with no antibiotic treatment), positive control group (rats infected with E coli with no antibiotic treatment), imipenem group (rats infected with E coli that received intraperitoneal injection of imipenem), and the imipenem+curcumin group (rats infected with E coli that received intraperitoneal injection of imipenem and were fed on curcumin). The rats were killed, and lung tissues samples were harvested for biochemical analyses and histopathologic examination. Total antioxidant status (TAS), total oxidant status (TOS), tumor necrosis factor alpha (TNF alpha), and interleukin-6 (IL6) were measured. TOS increased in the positive control group (P < 0.001) and decreased in the imipenem and imipenem+curcumin groups (P < 0.001 and P < 0.001, respectively). TAS decreased in the positive control group (P = 0.005). Imipenem treatment did not increase TAS, but the imipenem+curcumin group increased TAS (P = 0.014). TNF alpha and IL6 increased in the positive control group compared with the negative control group (P < 0.001 and P = 0.010, respectively). Imipenem decreased TNF alpha (P < 0.001), but did not decrease IL6 (P = 0.418). Imipenem+curcumin decreased TNF alpha (P < 0.001); this decrease was more pronounced compared with the imipenem group (P = 0.008). IL6 decreased in the curcumin group compared with the positive control group (P = 0.011). Curcumin combined with imipenem can be an alternative therapeutic agent to overcome the resistance of E coli strains.Item Sugammadex Given for Rocuronium-Induced Neuromuscular Blockade in Infants: A Retrospective Study(2016) Ozmete, Ozlem; Bali, Cagla; Cok, Oya Yalcin; Turk, Hatice Evren Eker; Ozyilkan, Nesrin Bozdogan; Civi, Soner; Aribogan, Anis; 0000-0002-1055-5152; 0000-0003-3004-2626; 0000-0002-7901-0185; 0000-0002-4973-8132; 0000-0003-2615-1918; 0000-0002-4419-5693; 0000-0001-5845-699X; 27871583; AAI-7779-2021; U-2400-2018; AAI-7998-2021; AAI-8790-2021; AAI-8769-2021; S-8336-2019; AAI-7880-2021Study Objective: To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients. Design: Retrospective observational study. Setting: University teaching hospital. Patients: Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study. Interventions: Anesthesia was induced with 5 mg/kg thiopental, 1 mu g/kg fentanyl and 0.6 mg/kg rocuronium. Sevoflurane was administered to all patients after intubation. Methods: The neuromuscular block was monitored with acceleromyography using train-of-four (TOF) stimuli. Patients received additional doses of rocuronium to maintain a deep block during surgery. If profound neuromuscular block (TOF, 0) persisted at the end of the surgery, 3 mg/kg sugammadex was administered. Measurements: The demographic data, surgeries, and anesthetic agents were recorded. The time from sugammadex administration to recovery of neuromuscular function (TOF ratio, >0.9) and complications during and after extubation were also recorded. Main results: Twenty-six infants who had a deep neuromuscular block (TOF, 0) at the end of surgery received 3 mg/kg sugammadex. The mean recovery time of the T4/T1 ratio of 0.9 was 112 seconds. No clinical evidence of recurarization or residual curarization was observed. Conclusions: The efficacy and safety of sugammadex were confirmed in infant surgical patients for reversal of deep neuromuscular block induced by rocuronium. (C) 2016 Elsevier Inc. All rights reserved.Item The Efficacy of Intra-Articular Lidocaine Administration in Chronic Knee Pain Due To Osteoarthritis: A Randomized, Double-Blind, Controlled Study(2017) Eker, H. Evren; Cok, Oya Yalcin; Aribogan, Anis; Arslan, Gulnaz; https://orcid.org/0000-0002-7901-0185; https://orcid.org/0000-0003-3004-2626; https://orcid.org/0000-0002-4419-5693; 27485803; AAI-8769-2021; AAI-7998-2021; S-8336-2019Background: Intra-articular injections for the treatment of knee pain due to osteoarthritis are performed when conservative therapies have failed. The intra-articular injection of lidocaine may be an effective treatment modality due to its neuronal membrane-stabilizing effect and long-lasting anti-inflammatory action. In this study, we compared the efficacy of intra-articular 0.5% lidocaine versus saline injection on pain, stiffness and physical function in patients with osteoarthritis. Methods: Patients with osteoarthritis were randomly allocated to two groups. Group I (n = 26) received 7 mL 0.5% lidocaine and group II (n = 26) received 7 mL saline into the painful knee for a series of three injections spaced by 1 week intervals under ultrasound guidance. Knee pain was measured with a numeric rating score (NRS) at baseline and 3 months after the 3rd injection. WOMAC scales, including pain (WOMAC-P), stiffness (WOMAC-S) and physical function (WOMAC-F), were assessed and recorded at baseline, 30 minutes after the 1st injection, immediately prior to the 2nd and 3rd injections and 3 months after the 3rd injection. Results: Demographic data were comparable between groups. The NRS after 3 months was significantly lower in group I (P = 0.001). The WOMAC-P, immediately prior to the 3rd injection and 3 months afterwards, was significantly lower in group I (P = 0.006, P = 0.001, respectively). The WOMAC-S was improved prior to the 3rd injection and sustained until 3 months in group I (P = 0.035, P = 0.004, respectively). The WOMAC-F was improved after the 1st injection and sustained until 3 months in group I (P = 0.002, P < 0.0001 and P < 0.0001, respectively). Conclusions: Intra-articular 0.5% lidocaine injection under ultrasound guidance has a potential role in the management of chronic knee pain due to osteoarthritis for a 3-month period. (C) 2016 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.Item Evaluation Of Perioperative Parameters In Patients Undergoing Radical Cystectomy Urinary Diversion Surgery For Bladder Cancer(2022) Ergenoglu, Pinar; Ersoy, Zeynep; Aribogan, Anis; https://orcid.org/0000-0003-0767-1088; AAF-3066-2021Purpose: The aim of this study was to evaluate the effect of red blood cell transfusion and/or inotropic/vasopressor agent infusion during intraoperative and postoperative first 24-hour period on 30-day and one-year survival. Materials and Methods: In the final analysis, 133 patients who underwent radical cystectomy and urinary diversion surgery between November 2011 and January 2019 were included in this study. Perioperative anesthesia management early postoperative intensive care patient follow-ups were based on. Results: A statistically significant relationship was found between intraoperative red blood cell transfusion and one-year mortality rates. A statistically significant relationship was found between red blood cell transfusion in the intensive care unit and postoperative 30-day mortality rates. The relationship between vasopressor/inotrope agent infusion in intensive care unit and postoperative 30-day mortality was statistically significant. Conclusion: In radical cystectomy and urinary diversion, intraoperative red blood cell and/or inotrope/vasopressor drug administration, and red blood cell transfusion within first 24 postoperative hours in intensive care unit are associated with lower survival rates in both early and late periods. Future studies should focus on developing and implementing different strategies for perioperative blood management and maintenance of patient hemodynamics that may affect early and late outcomes.Item Comparison of the clinical course of COVID-19 infection in sickle cell disease patients with healthcare professionals(2021) Boga, Can; Asma, Suheyl; Leblebisatan, Goksel; Sen, Nazan; Tombak, Anil; Demiroglu, Yusuf Ziya; Yeral, Mahmut; Akin, Sule; Yesilagac, Hasan; Habesoglu, Mehmet Ali; Aribogan, Anis; Kasar, Mutlu; Korur, Asli; Ozdogu, Hakan; 0000-0002-9866-2197; 34032899; AAZ-9711-2021; AAY-2668-2021It is highly expected that COVID-19 infection will have devastating consequences in sickle cell disease (SCD) patients due to endothelial activation and decreased tissue and organ reserve as a result of microvascular ischemia and continuous inflammation. In this study, we aimed to compare the clinical course of COVID-19 in adult SCD patients under the organ injury mitigation and clinical care improvement program (BASCARE) with healthcare professionals without significant comorbid conditions. The study was planned as a retrospective, multicenter and cross-sectional study. Thirty-nine SCD patients, ages 18 to 64 years, and 121 healthcare professionals, ages 21 to 53, were included in the study. The data were collected from the Electronic Health Recording System of PRANA, where SCD patients under the BASCARE program had been registered. The data of other patients were collected from the Electronic Hospital Data Recording System and patient files. In the SCD group, the crude incidence of COVID-19 was 9%, while in healthcare professionals at the same period was 23%. Among the symptoms, besides fever, loss of smell and taste were more prominent in the SCD group than in healthcare professionals. There was a significant difference between the two groups in terms of development of pneumonia, hospitalization, and need for intubation (43 vs 5%, P < 0.00001; 26 vs 7%, P = 0.002; and 10 vs 1%, P = 0.002, respectively). Prophylactic low molecular weight heparin and salicylate were used more in the SCD group than in healthcare professionals group (41 vs 9% and 28 vs 1%; P < 0.0001 for both). The 3-month mortality rate was demonstrated as 5% in the SCD group, while 0 in the healthcare professionals group. One patient in the SCD group became continously dependent on respiratory support. The cause of death was acute chest syndrome in the first case, hepatic necrosis and multi-organ failure in the second case. In conclusion, these observations supported the expectation that the course of COVID-19 in SCD patients will get worse. The BASCARE program applied in SCD patients could not change the poor outcome.Item Administration of paracetamol versus dipyrone by intravenous patient-controlled analgesia for postoperative pain relief in children after tonsillectomy(2015) Sener, Mesut; Kocum, Aysu; Caliskan, Ebru; Yilmaz, Ismail; Caylakli, Fatma; Aribogan, Anis; 25443442Background and objective: We compared the efficacy of intravenous (iv) paracetamol versus dipyrone via patient-controlled analgesia (PCA) for postoperative pain relief in children. Methods: The study was composed of 120 children who had undergone elective tonsillectomy after receiving general anesthesia. Patients were divided into 3 groups according to the dosage of postoperative intravenous-patient-controlled analgesia: paracetamol, dipyrone, or placebo. Pain was evaluated using a 0- to 100-mm visual analog scale and 1- to 4-pain relief score at 30 min, 1, 2, 4, 6, 12, and 24h postoperatively. Pethidine (0.25 mg kg 1) was administered intravenously to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24h postoperatively, and treatment related adverse effects were noted. Results: Postoperative visual analog scale scores were significantly lower with paracetamol group compared with placebo group at 6h (p < 0.05), dipyrone group compared with placebo group at 30 min and 6 h (p <0.05). No significant differences regarding visual analog scale values at 1, 2, 4, 12, and 24h were found. No significant differences were found between groups with respect to pain relief score (p >0.05). Postoperative pethidine requirements were significantly lower with paracetamol and dipyrone groups compared with placebo group (62.5%, 68.4% vs 90%, p < 0.05). No significant differences were found between groups with respect to nausea, vomiting and the any other adverse effects of the drugs (p >0.05). Conclusions: Paracetamol and dipyrone have well tolerability profile and effective analgesic properties when administered iv-PCA for postoperative analgesia in children after tonsillectomy. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.