Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item Ultrasound-guided bilateral greater occipital nerve block on headache seen after endovascular treatment of ruptured or unruptured intracranial aneurysms: A case report(2020) Dogan, Rafi; Pinar, Wiseyin Ulas; Karaca, Omer; Karakoc, Fatma; 0000-0002-5904-3932; 0000-0003-0473-6763; 33398867; AAJ-7677-2021Headache is a common symptom in subarachnoid hemorrhage (SAH). Often, pain control is difficult and opioid use can have a complicated effect on the patient's state of consciousness. In this study of 2 cases, opioid consumption was reduced while effective pain control of headache occurring after endovascular treatment of an intracranial aneurysm was achieved using an ultrasound-guided, bilateral greater occipital nerve (GON) block. Case 1 was a 59-year-old male patient with a Glasgow Coma Scale (GCS) of 13 who was diagnosed with Fisher scale grade 3 SAH. Coiling and stenting were performed for an anterior communicating artery aneurysm. Cerebrospinal fluid drainage was provided with a lumbar spinal catheter. Case 2 was a 55-yearold male patient with a GCS of 15 who underwent coiling of a fusiform aneurysm in the left basilar artery and stenting of the stenotic region due to a basilar artery aneurysm. After the procedure, the visual analog score (VAS) of the patients was 9 and 7, respectively, and a bilateral GON block was performed with ultrasound guidance.The VAS score of both patients decreased to 3 and did not exceed 3 during follow-up in the intensive care unit, eliminating the need for additional analgesics. A bilateral GON block provided effective analgesia and significantly reduced the need for other pain relief in both cases.Item 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-2420-2015Background/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.Item 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; 27515323Background: 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.Item 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-6923-2020Background: 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.Item 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-6923-2020Objective. 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.Item 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-6923-2020Neonicotinoids, 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.Item 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-6923-2020Item Laparoscopic gastrostomy under awake thoracic epidural anesthesia: A successful experience(2018) Pinar, Huseyin Ulas; Karaca, Omer; Duman, Enes; Dogan, Rafi; 30028480General 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.