Tıp Fakültesi / Faculty of Medicine

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

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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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    Investigation of the Possible Protective Effects of Ketamine and Dantrolene on the Hippocampal Apoptosis and Spatial Learning in Rats Exposed to Repeated Electroconvulsive Seizures as a Model of Status Epilepticus
    (2020) Gursoy, Ibrahim Devrim; Barun, Sureyya; Erdem, Remzi; Keskin, Ulya; Kiziltas, Murat; Atilla, Pergin; Muftuoglu, Sevda; Yuce, Deniz; Narin, Firat; Ertunc, Mert; Sara, Yildirim; Canpinar, Hande; 0000-0002-7537-2170; 32705669
    AIM: To evaluate the possible neuroprotective effects of ketamine and dantrolene on the hippocampal apoptosis and spatial learning in rats exposed to repeated electroconvulsive seizures (ECS) as a model of status epilepticus (SE). MATERIAL and METHODS: Twenty-four rats were assigned to 4 groups. 1st Group was Sham. 2nd Group was ECS: ECS was induced by ear electrodes via electrical stimulation. The same ECS protocol was applied to the 3th and 4th Groups which received ketamine (40 mg/kg s.c.) or dantrolene (5 mg/kg i.p.) 1 h before each ECS, respectively. Following 30 days of recovery, the cognitive status of the animals was evaluated via Morris Water Maze (MWM). The same experimental protocol was repeated 14 days afterward to evaluate the retention of the memory. Hippocampal apoptosis was examined in corresponding experimental groups. RESULTS: All the animals in four groups learned the task with no significant difference between groups in MWM. The ECS+ketamine group showed memory impairment 14 days afterward. ECS+dantrolene group was not different from controls. ECS caused long term apoptotic processes in dentate gyrus (DG) and non-apoptotic neuronal injury in CA1 and CA2. CONCLUSION: Dantrolene and ketamine inhibited apoptosis and showed neuroprotective effects. Although ketamine and dantrolene inhibited ECS-induced apoptosis and non-apoptotic injury, they did not produce similar effects on memory retention. It will be warranted to evaluate cognitive dysfunction by taking into consideration the other factors in addition to apoptosis and neurodegenerative changes.
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    Ketamine dosing for sedation during repeated radiotherapy sessions in children
    (2018) Yalcin Cok, Oya; Evren Eker, Hatice; Aribogan, Anis; 30119163
    Background/aim: We report the analysis of ketamine doses needed and the recovery tones in pediatric oncology patients undergoing repeated radiotherapy sessions. Materials and methods: In a single-blind prospective study design, thirty-three pediatric patients undergoing radiotherapy due to oncologic disorders received 2 mg/kg ketamine and 10 mu g/kg atropine intravenously and the rescue drug to be administered was ketamine at 0.5 mg/kg when the sedation level was inadequate. Total ketamine consumption, additional doses, and recovery time were recorded. Results: Data of 635 consecutive radiotherapy sessions were evaluated. There was no significant alteration in total ketamine consumption required to complete the radiotherapy periods during consecutive procedures (P > 0.05). However, the recovery times started to decrease by the fourth session (P = 0.02) and continued to decrease onwards during the whole study period (P = 0.001). The mean of the first recovery time was 13.68 +/- 3.99 min, whereas the mean of the last recovery time was 7.66 +/- 6.35 min. Conclusion: A requirement for an incremental increase in ketamine dose after subsequent administrations was not detected, despite a significant decrease in recovery times being anticipated when ketamine is used repeatedly for sedative purposes in consecutive radiotherapy sessions.