PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item The efficacy of ultrasound-guided type-I and type-II pectoral nerve blocks for postoperative analgesia after breast augmentation: A prospective, randomised study(2019) Karaca, Omer; Pinar, Huseyin U.; Arpaci, Enver; Dogan, Rafi; Cok, Oya Y.; Ahiskalioglu, Ali; 0000-0002-8467-8171; 0000-0003-0473-6763; 0000-0003-1933-2075; 29627431; B-7473-2016; Q-2420-2015; AAU-6923-2020Purpose: The present study was planned to evaluate the efficacy and safety of ultrasound-guided Pecs I and II blocks for postoperative analgesia after sub-pectoral breast augmentation. Methods: Fifty-four adult female patients undergoing breast augmentation were randomly divided into two groups: the control group (Group C, n = 27) who were not subjected to block treatment and Pecs group (Group P, n = 27) who received Pecs I (bupivacain 0.25%, 10 mL) and Pecs II (bupivacain 0.25%, 20 mL) block. Patient-controlled fentanyl analgesia was used for postoperative pain relief in both groups, and the patients were observed for the presence of any block-related complications. Results: The 24-h fentanyl consumption was smaller in Group P [mean +/- SD, 378.7 +/- 54.0 mu g and 115.7 +/- 98.1 mu g, respectively; P < 0.001]. VAS scores in Group P were significantly lower at the time of admission to the post-anaesthetic care unit and at 1, 2, 4, 8, 12, and 24 h (P < 0.001). The rates of nausea and vomiting were higher in Group C than in Group P (9 vs 2, P = 0.018). Hospital stay duration was shorter in Group P than in Group C (24.4 +/- 1.2 h vs 27.0 +/- 3.1 h, P < 0.001). No block-related complications were recorded. Conclusions: Combine used of Pecs I and II blocks provide superior postoperative analgesia in patients undergoing breast augmentation and shortens hospital stay. (C) 2018 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.Item Effects of Single-Dose Preemptive Pregabalin and Intravenous Ibuprofen on Postoperative Opioid Consumption and Acute Pain after Laparoscopic Cholecystectomy(2019) Karaca, Omer; Pinar, Huseyin U.; Turk, Emin; Dogan, Rafi; Ahiskalioglu, Ali; Solak, Sezen K.; 0000-0003-1933-2075; 0000-0002-8467-8171; 0000-0003-0473-6763; 29157034; AAU-6923-2020; B-7473-2016; Q-2420-2015Purpose: Non-opioid medications as a part of multimodal analgesia has been increasingly suggested in the management of acute post-surgical pain. The present study was planned to compare the efficacy of the combination of pregabalin plus iv ibuprofen. Methods: 58 patients were included in this prospective, randomized, double-blinded study. The pregabalin group (Group P, n = 29) received 150 mg pregabalin, the pregabalin plus ibuprofen group (Gropu PI, n = 29) received 150 mg pregabalin and 400mg iv ibuprofen before surgery. Postoperative fentanyl consumption, additional analgesia requirements and PACU stay were recorded. Postoperative analgesia was performed with patient-controlled IV fentanyl. Results: VAS scores in the group PI were statistically lower at PACU, 1and 2 hours at rest, at PACU, 1, 2, 4, 12 and 24 hours on movement compared to the group P (P < 0.05). Opioid consumption was statistically significantly higher in the group P compared to the group PI (130.17 +/- 60.27 vs 78.45 +/- 60.40 mu q, respectively, P < 0.001) and reduced in the 4th 24 hours by 55% in group PI. Rescue analgesia usage was statistically significantly higher in the group P than in the group PI (16/29 vs 7/29, respectively, P < 0.001). Four patient in the group PI did not need any opioid drug. Besides, PACU stay was shorter in the group PI than the group P (10.62 +/- 2.38 vs 15.59 +/- 2.11 min, respectively, P < 0.001). Conclusion: Preemptive pregabalin plus iv ibuprofen in laparoscopic cholecystectomy reduced postoperative opioid consumption. This multimodal analgesic aproach generated lower pain scores in the postoperative period.Item Ultrasound-Guided versus Conventional Caudal Block in Children: A Prospective Randomized Study(2019) Karaca, Omer; Pinar, Huseyin Ulas; Gokmen, Zeynel; Dogan, Rafi; 0000-0003-0473-6763; 0000-0003-1933-2075; 30602192; Q-2420-2015; AAU-6923-2020Background Injection to the accurate area without any complications is the main factor for the efficiencies of caudal block. The aim of this study was to compare success and the complications of conventional and ultrasound method for caudal block in children. Materials and Methods Two-hundred sixty-six American Society of Anesthesiologists (ASA) category 1 children aged between 6 months and 6 years undergoing hypospadias, circumcision, or both surgeries were randomly allocated two groups (Group C or Group H, n =133). About 0.25% bupivacaine with 1/200000 adrenaline (total volume: 0.5 mL/kg) was injected after the needle was inserted into the sacral canal in Group C, or right after the needle pierced the sacrococcygeal ligament under longitudinal ultrasound view in Group H. Success rate of block, block performing time, number of needle puncture, success at first puncture, complication rate, age and weight of the patients encountering these complications were recorded. Results The success rate of block was similar between two groups (94.7% in Group C vs 96.2% in Group U, p >0.05). Success at first puncture was higher in Group U than in Group C (90.2 vs 66.2%, respectively; p <0.001). Number of needle puncture, blood aspiration, subcutaneous bulging, and bone contact was higher in Group C but none in Group U ( p <0.001) and these complications were occurred in children weighing<16kg and less younger than 6 years old. Conclusion We observed that the complications were not encountered, number of needle puncture was lesser, and the success rate of first puncture was higher under ultrasound with longitudinal view.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 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.