Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Author: search.filters.author.Tuncali, Bahattinsearch.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/closedAccess

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    Addition of Low-Dose Ketamine to Midazolam-Fentanyl-Propofol-Based Sedation for Colonoscopy: A Randomized, Double-Blind, Controlled Trial
    (2015) Tuncali, Bahattin; Pekcan, Yonca Ozvardar; Celebi, Arzu; Zeyneloglu, Pinar; 0000-0002-7898-2943; 0000-0002-0991-7435; 0000-0003-2312-9942; 25801162; AAJ-7840-2021; AAD-5696-2021; C-3736-2018
    Study Objective: To evaluate the effects of low-dose ketamine on midazolam-fentanyl-propofol-based sedation for outpatient colonoscopy. Design: Prospective, randomized, double-blinded, placebo-controlled trial. Setting: Gastroenterology unit at a practice and clinical research center. Subjects: Ninety-seven healthy American Society of Anesthesiology physical status 1 volunteers. Interventions: Subjects were randomized to receive midazolam (0.02 mg/kg), fentanyl (1 mu g/kg), and ketamine (0.3 mg/kg) and midazolam (0.02 mg/kg), fentanyl (1 mu g/kg), and placebo (0.9% sodium chloride) in group K and group C, respectively. In both groups, incremental doses of propofol were used to maintain a Ramsay sedation score of 3 to 4. Measurements: Values of heart rate, blood pressure, oxygen saturation, and respiratory rate were measured. Procedure times, recovery times, drug doses used, complications associated with the sedation, and physician and patient satisfaction were also recorded. Main Results: In group K, mean amount of propofol used and mean induction time (P < .001), the need for the use of jaw thrust maneuver and mask ventilation, and the incidence of disruptive movements were significantly lower (P < .05) and gastroenterologist satisfaction at the beginning of the procedure was significantly superior (P < .05). Mean systolic blood pressures at 4, 6, 8, and 10 minutes (P < .01); diastolic blood pressures at 4, 6, and 8 minutes (P < .05); respiratory rates at 4, 6, 8, 10, 15, 20, and 25 minutes (P < .01); and oxygen saturation at 6, 8, 10, 15, and 20 minutes (P < .05) were significantly lower in group C. Patient satisfaction scores, recovery times, and discharge times were similar. No patient in either group experienced unpleasant dreams or hallucination in the postanesthesia care unit and on the first postoperative day. Conclusions: Addition of low-dose ketamine to midazolam-fentanyl-propofol-based sedation for outpatient colonoscopy resulted in more rapid and better quality of sedation, less propofol consumption, more stable heinodynamic status, and less adverse effects with similar recovery times in adult patients. (C) 2015 Elsevier Inc. All rights reserved.
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    Changes in Serum Lipid Levels After Laparoscopic Sleeve Gastrectomy in Morbidly Obese Dyslipidemic and Normalipidemic Patients
    (2018) Erol, Varlik; Yilmaz, Tugba Han; Tuncali, Bahattin; Arslan, Baha; Gulay, Huseyin; https://orcid.org/0000-0002-9590-0276; https://orcid.org/0000-0002-7898-2943; https://orcid.org/0000-0003-4461-4904; https://orcid.org/0000-0002-0442-6178; 29251221; AAJ-6354-2021; AAJ-7840-2021; AAD-6127-2021; AAJ-6407-2021
    Background: This study investigated the effect of laparoscopic sleeve gastrectomy (LSG) performed for morbid obesity on serum lipid levels of dyslipidemic and normolipidemic patients. Methods: 141 patients who underwent LSG between September 2014 and January 2016 were included in the study. Results: The patients' mean body mass index was 46.27 +/- 6.79 kg/m(2) preoperatively, 31.60 +/- 5.37 kg/m(2) in the 6th month postoperatively and 27.80 +/- 4.25 kg/m(2) in the 12th month (p < .001). Preoperatively and 12 months after the operation, mean total cholesterol (TC) levels and mean LDL cholesterol, mean HDL cholesterol, and mean triglyceride (TG) levels were statistically significantly decreased (p < .01). Comparing TC levels in the 12th month with preoperative levels, dyslipidemic patients showed a statistically more significant decrease than normolipidemic patients. LDL cholesterol levels were significantly decreased in both the groups. HDL cholesterol levels increased significantly in both groups while mean TG levels decreased significantly in patients with high preoperative TG levels, but not in patients with normal preoperative TG levels. Conclusions: Although this technique exerts its effect primarily by reducing gastric volume, besides its metabolic and hormonal effects, it also improves serum lipid levels (decreasing TC, LDL cholesterol and TG levels, and increasing HDL cholesterol levels). It therefore contributes to decreasing cardiovascular diseases.
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    Removal of an Epidural Catheter Without Discontinuation of Dual Antiplatelet Therapy in A Patient with Postoperative Urgent Coronary Stenting
    (2016) Tuncali, Bahattin; Boya, Hakan; https://orcid.org/0000-0002-7898-2943; https://orcid.org/0000-0001-6110-4004; 26256721; AAJ-7840-2021; W-7391-2019
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    Caudal Block Combined with Propofol Infusion Using Laryngeal Mask Airway in A Spontaneously Ventilating Child with Merosin-Positive Occidental Type Congenital Muscular Dystrophy
    (2016) Tuncali, Bahattin; Boya, Hakan; Arac, Sukru; 0000-0002-7898-2943; 0000-0001-6110-4004; 27290974; AAJ-7840-2021; W-7391-2019
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    Continuous veno-venous hemodiafiltration in metformin-associated lactic acidosis caused by a suicide attempt: A report of two cases
    (2021) Tuncali, Bahattin; Kirkayak, Ayse Gul Temizkan; Zeyneloglu, Pinar; 34476786
    Lactic acidosis is the most important and life-threatening side effect of metformin that is widely used in the treatment of type 2 diabetes mellitus. In this case report, two cases who were treated in our intensive care unit for lactic acidosis due to high-dose metformin intake for suicidal purposes are presented. The first patient could be successfully treated with continuous venous-venous hemodiafiltration (CVVHDF) and supportive therapy. The second case required endotracheal intubation and mechanical ventilation in addition to CVVHDF and supportive therapy due to delay in treatment.
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    Vertebroplasty in Vertebral Compression Fractures: Single Institute Experience with 49 Cases
    (2017) Altınel, Faruk; Soylev, Gozde Ozcan; Tuncali, Bahattin; Altinors, Mehmet Nur; 0000-0002-7898-2943; 0000-0001-8742-5543; 0000-0002-8326-3900; AAJ-7840-2021; AAJ-4917-2021; AAJ-5382-2021
    Objective: Percutaneous vertebroplasty (PVP) is the preferred treatment option for vertebral compression fractures (VCF). In this study, the efficacy and complications of PVP were investigated among 49 patients with VCF. Methods: Forty-nine patients with VCF due to osteoporosis, trauma, osteolytic bone tumors, metastases or leukemia who were admitted to our hospital between 2012 and 2015 and treated with PVP were included in the study. In patients' preoperative and postoperative evaluation, a visual analogue scale (VAS) was used to assess back and leg pain, preoperative routine lumbar vertebral radiography was used for fracture morphology, lumbar magnetic resonance imaging was performed, and the segmental kyphotic angle, vertebral corpus compression rate, polymethylmethacrylate (PMMA) cement volume, and diffusion of PMMA were recorded. Results: Preoperative and postoperative VAS scores were 8.6 +/- 0.9 vs. 1.13 +/- 1.1 (p < 0.01). The approximate compression rate was 24.72 +/- 13.99 %, the ratio of approximate restoration height was 3.47 +/- 5.36, and the mean kyphosis angle was 7.35 +/- 6.81 degrees. The mean pre- and postoperative values of vertebral height were 1.83 +/- 0.39 cm vs1.88 +/- 0.36 cm (P <.01). Conclusion: In this study, preoperative pain in patients with VCF prominently diminished in the postoperative early and late phase. After PVP, vertebral height showed a subtle increase.