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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    Effects of Music on Sedation Depth and Sedative Use During Pediatric Dental Procedures
    (2016) Ozkalayci, Ozlem; Araz, Coskun; Cehreli, Sevi Burcak; Tirali, Resmiye Ebru; Kayhan, Zeynep; 0000-0002-4927-6660; 0000-0001-6487-3984; 0000-0003-0579-1115; 27687464; AAJ-4576-2021; AAD-6138-2021; HZK-4947-2023; AAD-2907-2020; AAJ-4623-2021
    Study objective: The study aimed to investigate the effects of listening to music or providing sound isolation on the depth of sedation and need for sedatives in pediatric dental patients. Design: Prospective, randomized, and controlled study. Setting: Tertiary, university hospital. Patients: In total, 180 pediatric patients, American Society of Anesthesiologists physical status I and II, who were scheduled for dental procedures of tooth extraction, filling, amputation, and root treatment. Interventions: Patients were categorized into 3 groups: music, isolation, and control. During the procedures, the patients in the music group listened to Vivaldi's The Four Seasons violin concertos by sound isolating headphones, whereas the patients in the isolation group wore the headphones but did not listen to music. All patients were sedated by 0.1 mg/kg midazolam and 1 mg/kg propofol. During the procedure, an additional 0.5 mg/kg propofol was administered as required. Measurements and main results: Bispectral index was used for quantifying the depth of sedation, and total dosage of the propofol was used for sedative requirements. The patients' heart rates, oxygen saturations, and Observer's Assessment of Alertness and Sedation Scale and bispectral index scores, which were monitored during the operation, were similar among the groups. In terms of the amount of propofol used, the groups were similar. Prolonged postoperative recovery cases were found to be significantly frequent in the control group, according to the recovery duration measurements (P = .004). Conclusions: Listening to music or providing sound isolation during pediatric dental interventions did not alter the sedation level, amount of medication, and hemodynamic variables significantly. This result might be due to the deep sedation levels reached during the procedures. However, listening to music and providing sound isolation might have contributed in shortening the postoperative recovery duration of the patients. (C) 2016 Elsevier Inc. All rights reserved.