Browsing by Author "Karasu, Derya"

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A comparision of the effect of sugammadex on the recovery period and postoperative residual block in young elderly and middle-aged elderly patients
(Galenos Yayıncılık, 2015-10-20) Yazar, Emine; Yılmaz, Canan; Karasu, Derya; Apaydın, Yılmaz; Sayan, Halil Erkan; Bilgin, Hülya; Bayraktar, Selcan; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; 0000-0001-6639-5533; A-7338-2016; 6701663354; 34879358300
Background: The importance of the characteristics of anesthesia and postoperative residual curarization (PORC) in the elderly population should be a growing concern in this century. Aims: To investigate the effect of sugammadex on the duration of the recovery from neuromuscular blocking agents and postoperative residual curarization in the young elderly and middle-aged elderly patients who underwent elective laparoscopic cholecystectomy, followed by a train of four (TOF) watch monitorization. Study Design: Prospective clinical trial study. Methods: Sixty patients over the age of 65 with American Society of Anesthesiologists I-III were divided into two groups according to their age (65-74 years old and >= 75 years old). Patients received sugammadex (2.0 mg/kg iv) at the reappearance of the second twitch of the TOF as an agent for reversal of neuromuscular blockage at the end of surgery. Patients were extubated at the time of TOF >= 0.9. The patients' TOF responses were evaluated with regards to PORC in at the 5th minute and were followed up for one hour in the recovery room. Reintubation was applied for those patients who developed PORC and had peripheric oxygen saturation <90% despite being given 6 L oxygen per min with a face mask. Results: The onset time of neuromuscular blocking agent and time from T-2 to achieve TOF ratio 90% (the duration of sugammadex effect) or over were found to be longer in the middle-aged elderly group than in the young elderly group. A statistically significant relationship was found between age and the duration of TOF ratio to reach 0.9 in the same direction. The PORC incidence and rate of reintubation were found to be 1.7% in all patients. Conclusion: In our opinion, it is necessary to remember that the duration of sugammadex effect on the recovery period is prolonged for patients who are aged >= 75 years compared to patients aged between 65-74 years.
Evaluation of diaphragm functions in laparoscopic bariatric surgeries
(Mary Ann Liebert, 2021-12-02) Asan, Ezgi Unal; Karasu, Derya; Ozgunay, Seyda Efsun; Yilmaz, Canan; Uguz, Ilken; Gamli, Mehmet; Asan, Selcuk; ASAN, SELÇUK; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; 0000-0003-1867-9018; 0000-0003-1501-9292; 0000-0002-6626-3626; 0000-0002-5618-2734; HKW-6300-2023; HJH-7549-2023; AAF-7245-2019; F-1579-2017; HGC-2960-2022
Background: Obesity, laparoscopic surgeries, and pain are factors that negatively affect postoperative diaphragm functions. We aimed to evaluate the diaphragm function using ultrasonography (USG) and spirometry in patients who underwent bariatric surgery and to investigate the effect of postoperative pain score on diaphragm function.Methods: Diaphragm inspiratory amplitude (DIA), expiratory velocity, and inspiratory velocity values were measured using USG in the preoperative period, in the recovery room on postoperative day 1 in 45 patients who underwent laparoscopic bariatric surgery under general anesthesia. Preoperative and postoperative spirometry measurements were performed.Results: In all patients, spirometry and USG measurements showed a significant decrease in recovery on postoperative day 1 compared with preoperative values. A negative correlation was found between the 1st-day pain score measured at rest and movement and DIA values measured in the sniffing position (p = 0.049 and 0.024, respectively). A significant correlation in the same direction was found between the duration of surgery and anesthesia and the change in the DIA being measured at normal respiration on postoperative day 1 compared with the preoperative values (p = 0.004 and p = 0.005, respectively).Conclusions: In our study, diaphragm and spirometry measurements significantly decreased in the postoperative period compared with the baseline.The Clinical Trial Registration number: NCT04828408.
The frequency of emergence delirium in children undergoing outpatient anaesthesia for magnetic resonance imaging
(Wiley, 2021-08-27) Karasu, Derya; Karaca, Ümran; Özgünay, Şeyda Efsun; Yılmaz, Canan; Yetik, Ferit; Özkaya, Güven; ÖZKAYA, GÜVEN; Bursa Uludağ Üniversitesi/Tıp Fakülktesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016
Aim The aim of this study was to investigate the effect on the occurrence of emergence delirium of propofol and ketofol with intranasal dexmedetomidine and midazolam applied as premedication to paediatric patients during magnetic resonance imaging (MRI). Methods The study included children aged 2-10 years who received sedation for MRI, separated into four groups. Group MP (midazolam-propofol) received intranasal midazolam (0.2 mg/kg) for premedication and intravenous (IV) propofol (1 mg/kg) as the anaesthetic agent. Group MK (midazolam-ketofol) received intranasal midazolam (0.2 mg/kg) for premedication and IV ketofol (1 mg/kg) as the anaesthetic agent. Group DP (dexmedetomidine-propofol) received intranasal dexmedetomidine (1 mcg/kg) for premedication and IV propofol (1 mg/kg) as the anaesthetic agent. Group DK (dexmedetomidine-ketofol) received intranasal dexmedetomidine (1 mcg/kg) for premedication and IV ketofol (1 mg/kg) as the anaesthetic agent. The Paediatric Anaesthesia Emergence Delirium (PAED) scale was used to evaluate delirium. A PAED score >= 10 was accepted as delirium. Results Statistical analysis was made of 140 paediatric patients. Delirium developed in 1.42% of all the patients, and in 5.7% of Group MP. The mean Aldrete and PAED scores were lower and the length of stay in the recovery room was shorter in Group DP than in the other groups. The need for additional anaesthetic was highest in Group DP at 94.3% and lowest in Group DK at 14.3%. The groups administered ketofol were observed to have a lower requirement for additional anaesthetic. Conclusion Delirium was seen at a very low rate only in the Group MP and it is difficult to say the best combination in terms of delirium frequency. However, intranasal dexmedetomidine and IV ketofol seem to be better and safer than the other groups in terms of the need for additional doses and the number of side effects. The addition of ketamine to propofol reduces the need for additional doses with a synergistic effect.
Ultrasound-guided transversus abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy: A retrospective study
(Kare Publ, 2021-01-01) Karasu, Derya; Yılmaz, Canan; Özgünay, Seyda Efsun; Yalçın, Demet; Özkaya, Güven; ÖZKAYA, GÜVEN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Bölümü; IVU-2672-2023
OBJECTIVE: This study aimed to investigate the effects on postoperative pain of ketamine and dexmedetomidine addition to bupivacaine in a transversus abdominis plane (TAP) block in laparoscopic cholecystectomy.METHODS: A retrospective study was conducted patients who underwent ultrasound-guided TAP block in laparoscopic cholecystectomy. The patients were divided into three groups: Group BD (Bupivacaine+Dexmedetomidine), Group BK (Bupivacaine+Ketamine), and Group B (Bupivacaine). Our primary outcomes were pain scores with Visual Analogue Scale (VAS), postoperative first analgesic time and tramadol consumption in 24 hours postoperatively. Secondary outcomes were intraoperative hemodynamic changes, rescue analgesic requirement and side effects.RESULTS: The first analgesic administration time was significantly shorter in Group B and significantly longer in Group BD than the other two groups. Pain score at rest in Group B at 0th hours was significantly higher than that of Group BD and VAS pain score Group BD at 2nd hours was significantly lower than the other two groups. There was no significant difference between the groups regarding tramadol consumption and the requirement of rescue analgesics.CONCLUSION: Dexmedetomidine and ketamine can be added to the bupivacaine for the TAP block without major side-effects. The combination of dexmedetomidine and bupivacaine provides better analgesia in the first postoperative 2nd hour than other groups and hence extends the time to the first analgesic demand.