Browsing by Author "Kaya, Fatma Nur"
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Item Akciğer rezeksiyonu sonrası postoperatif pulmoner komplikasyon gelişimini etkileyen risk faktörleri: Retrospektif değerlendirme(Bursa Uludağ Üniversitesi, 2023) Candemir, Muhammed Musa; Kaya, Fatma Nur; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.Amaç: Bu retrospektif çalışmamızda, akciğer rezeksiyonu geçiren olgularda; birincil olarak postoperatif pulmoner komplikasyon (PPK) insidansı ve ilişkili risk faktörlerini, ikincil olarak ise PPK gelişiminin hastanede kalış süresi ve ilk bir aylık mortaliteye olan etkisini değerlendirmeyi amaçladık. Metod: Etik kurul onayı alındıktan sonra, Bursa Uludağ Üniversitesi Tıp Fakültesi Hastanesi, göğüs cerrahisi ameliyathanesinde 1 Ocak 2016 - 31 Aralık 2021 tarihleri arasında akciğer rezeksiyonu uygulanan 651 olgunun verileri değerlendirildi. PPK için risk faktörleri, Melbourne Grup Skalası (MGS) üzerinden değerlendirildi. Ayrıca PPK’lar konvansiyonel tanımlamalar üzerinden sınıflandırıldı. Bulgular: Olguların %58,1’ine torakotomi, %41,9’una video yardımlı torasik cerrahi uygulandı. Olguların %36,7’sinde postoperatif komplikasyon saptandı. %35,5’inde ise konvansiyonel tanımlamalar üzerinden PPK saptandı. En sık PPK, uzamış hava kaçağıydı (%31,3). Olguların %6,9’unda MGS ile ≥4 kriterin pozitif olduğu belirlendi. En sık saptanan kriterler %10 “yoğun bakıma tekrar yatış veya uzamış yoğun bakım ihtiyacı (>36 sa)”, %6,6 “pürülan balgam” ve %6,5 “vücut ısısı >38°C” idi. Çok değişkenli lojistik regresyon analizi modeline göre, aritmi varlığı (OR: 5,894 [%95GA: 1,25 – 27,786], p = 0,025), albümin düzeyi (OR: 0,383 [%95GA: 0,168 - 0,874], p = 0,023) ve DLCO değerinin azalması (OR: 0,962 [%95GA: 0,94 - 0,985] ve p = 0,001), cerrahi süresinin uzaması (OR: 1,005 [%95GA: 1,001 – 1,009], p = 0,020) PPK için bağımsız risk faktörleri olarak belirlendi. Bu olgularda, hastanede kalış süresi 24,07 ± 18,29 gün ve mortalite oranı ise %15,6 idi. Sonuç: Çalışmamızda, akciğer rezeksiyonu uygulanan yaklaşık her üç olgudan birinde PPK gelişti. Operasyon öncesi aritmi varlığı, albümin düzeyi ve DLCO değerinin düşük olması ve operasyon süresinin uzaması PPK gelişimi ile ilişkili bulundu.Item Anestezi asistanlarında nöbetin bilişsel işlevler ve ruhsal durum üzerine etkisi(Uludağ Üniversitesi, 2007-11-30) Yavaşcaoğlu, Belgin; Aydın, Birgül; Karataş, Ebru Gökçen; Kaya, Fatma Nur; Özcan, Berin; Kırlı, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.Bu çalışmada 32 saat ve 8 saat çalışan anestezi asistanlarının psikolojik ve bilişsel fonksiyonlarının karşılaştırılması amaçlanmıştır. Bilişsel ve psikolojik durumu değerlendiren nöropsikolojik ve psikolojik testler aynı anestezi asistanına 32 saat ve 8 saatlik çalışma sonrası uygulandı. 32 saat çalışan asistanların nöropsikolojik bozulma gösterdiği bulundu. Uygulanan psikolojik testler 32 saatlik çalışma sonrası depresif duygu durum, anksiyete ve stresin 8 saatlik çalışmaya göre daha sık bulunduğunu gösterdi. Bu bulgular ışığında, hataları azaltmak ve hasta güvenliğini arttırmak amacıyla, anestezi asistanlarının çalışma programlarının yeniden düzenlenmesinin uygun olduğu düşünüldü.Item Çarpan kalpte koroner arter bypass cerrahisinde farklı anestezik ilaç kombinasyonlarının karşılaştırılması: hemodinami, oksijenasyon ve derlenme profiline etkileri(Uludağ Üniversitesi, 2005-06-13) Kaya, Fatma Nur; Gören, Suna; Şahin, Şükran; Korfalı, Gülsen; Canbulat, Atilla; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.Çarpan kalpte koroner arter bypass (ÇKKAB) cerrahisinde farklı anestezik ilaç kombinasyonlarının hemodinami, oksijenasyon ve derlenme profiline etkilerini karşılaştırmayı amaçladık. ÇKKAB cerrahisi planlanan, 60 olgu (EF>%40) rastgele beş gruba ayrıldı (n=12). Grup I’de anestezi indüksiyonu ketamin (2 mg/kg) ve fentanil (5 µg/kg), idamesi izofluran (%0.5-1.2) ile sağlandı. Grup II ve V’de indüksiyonda etomidat (0.3 mg/kg) ve fentanil (5 µg/kg), idamede Grup II’de izofluran (%0.5-1.2), Grup V’de ise sevofluran (%0.8-2.5) kullanıldı. Grup III ve IV’de indüksiyonda midazolam (0.15 mg/kg) ve fentanil (5-7 µg/kg), idamede Grup IV’de izofluran (%0.5-1.2), Grup III’de midazolam infüzyonu (0.1 µg/kg/dk) verildi. Grup I, II ve V’de indüksiyon öncesi sedasyon amacıyla midazolam, bölünmüş dozlar halinde (0.1 mg/kg’e kadar) uygulanırken, Grup III ve IV’de 1-3 mg verildi. Tüm gruplarda idamede fentanil infüzyonu (2-5 µg/kg/sa) uygulandı. Hemodinamik parametreler, oksijen tüketimi ve şant fraksiyonu farklı dönemlerde kaydedildi. Spontan solunum, ekstübasyon, mobilizasyon ve yoğun bakımdan çıkış için geçen süreler kaydedildi. İndüksiyon sonrası kardiyak debideki azalma, Grup I ve IV’e göre Grup II’de daha az (p<0.01 ve p<0.05), diğer parametreler ise benzer bulundu. Sonuç olarak, ÇKKAB cerrahisinde farklı anestezik ilaç kombinasyonları ile benzer hemodinamik ve postoperatif derlenme özellikleri gözlenmesine rağmen, anestezi indüksiyonu sonrası gözlenen kardiyak debi değişiklikleri dikkate alındığında, ventrikül fonksiyonları korunmuş kardiyak olgularda, etomidat, fentanil ve izofluran kombinasyonunun iyi bir seçim olacağı kanısındayız.Item A comparison of esmolol and dexmedetomidine for attenuation of intraocular pressure and haemodynamic responses to laryngoscopy and tracheal intubation(Lippincott Williams & Wilkins, 2008-06) Yavaşçaoǧlu, Belgin; Kaya, Fatma Nur; Baykara, Mehmet; Bozkurt, Merlin; Korkmaz, Serdar; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; AAG-9356-2021; AAI-8213-2021; AAI-8213-2021; 6602742300; 7003619647; 23093006700; 16202046200; 24171259800Item Comparison of peritonsillar levobupivacaine and bupivacaine infiltration for post-tonsillectomy pain relief in children: Placebo-controlled clinical study(Elsevier Ireland, 2011-03) Kasapoǧlu, Fikret; Kaya, Fatma Nur; Tüzemen, Gökhan; Özmen, Ömer Afşin; Kaya, Atila; Onart, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji Anabilim Dalı.; 0000-0002-9698-0546; AAI-8213-2021; AAI-3877-2021; A-1452-2019; 56254721200; 7003619647; 30267939800; 55407733900; 36922282800; 7801637934Objectives: To compare the effects of preincisional peritonsillar infiltration of levobupivacaine and bupivacaine on post-tonsillectomy pain in children. Methods: Sixty children undergoing elective tonsillectomy or adenotonsillectomy were randomly allocated into three groups before tonsillectomy: peritonsillar infiltrations with 0.25% levobupivacaine with 1:200,000 epinephrine (group levobupivacaine, n = 20), 0.25% bupivacaine with 1:200,000 epinephrine (group bupivacaine, n = 20), and normal saline (group saline, n = 20) were applied. Pain was evaluated by using a modified Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS). Choice of additional analgesic was acetaminophen for all patients. Results: mCHEOPS values at 0th (immediately) and 30th minute after arrival the PACU were lower in both the local anesthetics groups than the saline group (p < 0.001, p < 0.01 for the group levobupivacaine; p < 0.001. p < 0.05 for the group bupivacaine, respectively). In addition, mCHEOPS values at 1st hour in the ward was lower in the group bupivacaine when compared to the group saline (p < 0.05). Analgesic requirements and the time to first analgesia required, were also significantly different between the local anesthetic and saline groups (p < 0.05 for both local anesthetics groups). Time to first mobilization was shorter in both local anesthetic groups when compared to the saline group (p < 0.05 for both local anesthetic groups). Conclusion: Preincisional peritonsillar infiltration with levobupivacaine or bupivacaine before tonsillectomy, are effective than saline, in reducing early post-tonsillectomy pain, where as bupivacaine had slightly longer effect. Compared to saline, with both anesthetic infiltrations, lesser medication for analgesia is required. The clinical trial registration number (Research Ethics Committee of Medical Faculty, Uludag University): 2008-4/36, 19 February 2008.Item Comparison of postoperative analgesic efficacy of intraoperative single-dose intravenous administration of dexketoprofen trometamol and diclofenac sodium in laparoscopic cholecystectomy(Elsevier, 2016-02-18) Anıl, Ali; Kaya, Fatma Nur; Yavaşcaoğlu, Belgin; Efe, Esra Mercanoğlu; Türker, Gürkan; Demirci, Abdurrahman; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; 0000-0002-3019-581X; AAI-6642-2021; AAI-7914-2021; AAI-8213-2021; 55899362600; 7003619647; 6602742300; 57188989249; 7003400116; 55898600900Study objective: The aim of this study is to compare the effects of intravenous single-dose dexketoprofen trometamol and diclofenac sodium 30 minutes before the end of the surgery on relief of postoperative pain in patients undergoing laparoscopic cholecystectomy. Design: A randomized fashion. Setting and patients: Sixty (American Society of Anesthesiologist class I-II) patients undergoing laparoscopic cholecystectomy were divided into 2 groups. Intervention: Patients in group DT received 50 mg dexketoprofen trometamol, whereas patients in group DS received 75 mg diclofenac sodium, intravenously 30 minutes before the end of surgery. Measurements: Postoperative pain intensity, morphine consumption with patient-controlled analgesia, time to first analgesic requirement, complications, rescue analgesic (intravenous tenoxicam 20 mg) requirement, and duration of hospital stay were recorded. Main results: Postoperative pain visual analog scale scores were similar in the follow-up periods (P>.05). Patient-controlled analgesia morphine consumption was significantly less in group DT compared with group DS in all postoperative follow-up periods (2 and 4 hours: P <.01; 8, 12, 18, and 24 hours: P<.001). In the postoperative period, the first analgesic requirement time was significantly longer in group DT compared with group DS (P <.01). In addition, the number of patients requiring rescue analgesic was higher in group DS compared with group DT (P <.01). Other follow-up parameters were similar. Conclusion: In our study, administration of intravenous single-dose dexketoprofen trometamol 30 minutes before the end of surgery provided effective analgesia with reduced consumption of opioids and requirement for rescue analgesic compared with diclofenac sodium in patients undergoing laparoscopic cholecystectomy. For this reason, we believe that, as a part of multimodal analgesia, dexketoprofen trometamol provides more effective analgesia than diclofenac sodium in patients undergoing laparoscopic cholecystectomy.Item Comparison of SPECT findings and neuropsychological sequelae in carbon monoxide and organophosphate poisoning(Taylor, 2008) Özyurt, Gürayten; Kaya, Fatma Nur; Kahveci, Sohret Ferda; Alper, Eray; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; 0000-0003-4820-2288; AAG-9356-2021; AAI-8213-2021; 6603035486; 7003619647; 6602405968; 7006827670Abnormal regional cerebral blood flow in patients with acute carbon monoxide (CO) and organophosphate (OP) poisoning was examined using (99m) Tc-hexamethylpropylene amine oxime (HMPAO) brain single photon emission computed tomography (SPECT) in fourteen patients. We evaluated the predictive significance of acute phase brain SPECT findings for long-term neuropsychological sequelae. Changes were found in the frontal, temporal, parietal lobes within the first week after both types of poisoning. The distribution of the hypoperfused cerebral areas as demonstrated by (99m) Tc-HMPAO imaging was similar in the two groups during the acute phase. Neuropsychological sequelae developed in five patients poisoned with OP and six with CO. Patients who had SPECT findings heterogeneously or in the temporal or frontal lobes displayed disorientation. Those with fronto-parietal and frontal lobe changes displayed mental confusion. Parkinsonism also was observed in patients with parieto-occipital, parietal and frontal lobe lesions. The distribution of these lesions appears to predict the long term sequelae of these poisonings, though additional studies with larger numbers of patients are needed to confirm the role of SPECT imaging in both OP and CO poisonings.Item Comparison of the efficacy of dexmedetomidine and esmolol in the treatment of increased hemodynamic response during the recovery period(Elsevier, 2012-03) Günay, Hülya; Başağan, Elif Moğol; Kaya, Fatma Nur; Türker, Gürkan; Yavaşçaoğlu, Belgin; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; AAI-7914-2021; AAI-6642-2021; AAI-8213-2021Publication Cricothyroidotomy performed by seldinger method in the management postoperative sputum retention and atelectasis after lung resection(Bayçınar Medikal Yayın, 2015-01-01) Melek, Hüseyin; Çetinkaya, Gamze; Erol, Mehmet Muharrem; Kaya, Fatma Nur; Bayram, Ahmet Sami; MELEK, HÜSEYİN; Çetinkaya, Gamze; Erol, Mehmet Muharrem; KAYA, FATMA NUR; BAYRAM, AHMET SAMİ; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı; Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı; 0000-0003-0684-0900; 0000-0002-4848-1566; JDW-2654-2023; AAI-5039-2021; ABB-7580-2020; KHE-8874-2024; CXE-4995-2022Mini-tracheotomy is a safe and effective method in the prevention and treatment of postoperative sputum retention and atelectasis. It can be applied under general anesthesia or local anesthesia. Minitracheotomy-related complications are usually preventable and are rare. In this article, we present the outcomes of Mini-Trach II (R) Portex Seldinger kit application technique under the guidance of rigid bronchoscopy in patients with atelectasis and sputum retention after lung resection.Item Effect of hydroxyethyl starch 6% (130/0.4) which is a colloid solution on blood glucose(Elsevier, 2012-03) Uzunalioğlu, Semiha; Başağan, Elif Moğol; Türker, Gürkan; Kaya, Fatma Nur; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; AAI-6642-2021Hydroxyethyl Starch (HES) 6% (130/0.4) solutions are widely used in clinical practice. This solution has quite long half-life and most of HES particles were held by reticuloendothelial system. It was catabolized by sucrose-isomaltase complex.1 These features of HES solu- tions could influence the blood glucose level. Objective: We aimed to investigate the effect of HES 6% (130/0.4) solution on blood glucose level in patients who received a standard type of anesthesia and surgery. Methods: After Ethics Committee approval and informed consent sixty non-diabetic patients (age 18-75, ASA I-II) scheduled for elective surgery under spinal anesthesia were included in this study. Patients were randomly divided into two groups: Group HES and Group S. Thirty min before spinal anesthesia, fluid infusion was administered to the patients for preloading according to study groups. The patients received 500 ml (HES) 6% (130/0.4) solution in group HES and 1000 ml 0.9% NaCl solution in group S. Capillary blood sugar measurements using a regularly cali- brated standard blood sugar measurement instrument were done before infusion of the fluids (T1), immediately after the infusion (T2), 45 min, 6 h and 12 h after the infusion (T3, T4, T5). Mean blood pressure(MBP), heart rate(HR) and peripheric oxygen saturation (SpO2) were recorded at mentioned meas- urement periods. Spinal anesthesia using 25G Quincke spinal needle and 12.5 mg 0.5% hyperbaric bupivacaine was applied to all prehydrated patients at the left lateral position, through L3-4 or L4-5 intervertebral spaces. The duration of anesthesia and surgery, and complications were recorded. Results: ASA classification, gender, age, duration of surgery and anesthesia were not significant between the groups (p.0.05). Blood sugar levels were higher in group HES at all measurement times(p,0.001, p,0.01, p,0.001, p,0.01, respectively) but in group S it was only higher 6 h after infusion (p,0.05) compared to the values before infusion. At 6th h after infusion, there was a significant differ- ence in blood glucose level between the groups (p,0.001). Discussion and Conclusion: This study showed that blood sugar levels were higher in patients who have infusion of 500 ml (HES) 6% (130/0.4) solution. Infusion of HES 6% (130/0.4) solution altered blood sugar levels of the patients. Six h after HES 6% (130/0.4) infusion, blood sugar was at the highest level. These findings could be carefully taken into consideration in patients whose blood sugar level mea- suremet is important.Item Effect of oral gabapentin on the intraocular pressure and haemodynamic responses induced by tracheal intubation(Wiley, 2008-09) Kaya, Fatma Nur; Yavaşçaoǧlu, Belgin; Baykara, Mehmet; Altun, Gülbin Töre; Gülhan, Nevra; Ata, Filiz; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; AAI-7914-2021; AAI-8213-2021; AAG-9356-2021; 7003619647; 6602742300; 23093006700; 57224710693; 6504394933; 35168461500Background: Laryngoscopy and tracheal intubation may cause undesirable increases in blood pressure, heart rate (HR) and intraocular pressure (IOP). Gabapentin has been used effectively to attenuate the pressor response to laryngoscopy and tracheal intubation. We investigated whether the pre-treatment with gabapentin attenuates the IOP in addition to a haemodynamic response to tracheal intubation. Methods: Sixty ASA I-II patients were randomly allocated into two groups who received either gabapentin (800 mg) or placebo 2 h before surgery. IOP, mean arterial pressure (MAP) and HR were measured before and after the induction of anaesthesia as well as at 0, 1, 3, 5, 10 and 15 min following intubation. Results: IOP and MAP increased from baseline immediately after intubation in the placebo group (P = 0.001 and 0.002, respectively). When compared with the placebo group, IOP values of the gabapentin group were significantly lower for the first 15 min after tracheal intubation (P = 0.002 at 0 min, P = 0.006 at 1 min, P < 0.001 at 3 min, P < 0.001 at 5 min, P < 0.001 at 10 min and P = 0.003 at 15 min) while MAP was lower in the first 10 min (P = 0.001 at 0 min, P = 0.002 at 1 min, P < 0.001 at 3 min, P < 0.001 at 5 min and P = 0.028 at 10 min). These results showed that gabapentin effectively suppresses the increase in IOP secondary to endotracheal intubation and attenuates the increases in MAP. Conclusion: It is suggested that gabapentin is a useful adjuvant in order to prevent an increase in the IOP in response to laryngoscopy and tracheal intubation.Item The effects of levobupivacaine infiltration on post-tonsillectomy pain relief in adults: A single-blinded, randomized, and controlled clinical study(Springer, 2013-02) Kasapoǧlu, Fikret; Demir, Uygar Levent; Kaya, Fatma Nur; Çetin, Yaser Said; Yavaşçaoǧlu, Belgin; Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; 0000-0002-7684-4600; AAG-9356-2021; AAI-7914-2021; AAI-3877-2021; AAI-8213-2021; 56254721200; 56868421800; 7003619647; 57202732676; 6602742300The aim of this prospective single-blinded and controlled study is to evaluate the efficacy of levobupivacaine infiltration on post-tonsillectomy pain relief in adults. The study was conducted with 40 adult patients who underwent tonsillectomy. These patients were randomized in either study group (SG) who received levobupivacaine infiltration to peritonsillary fossae prior to surgery or control group (CG) with no medication. After surgery, all the patients were queried for pain scores by visual analog scale. In addition, the volume of intraoperative bleeding, the duration of operation, the severity of postoperative complications, and the amount of analgesic requirement were the other outcome measures of this study. There were significant differences between groups regarding pain scores for the first 24 h in favor of SG. The analgesic requirement was also significantly lower in SG (p = 0.009). Although there was a sustained decrement at pain score during first 24 h for SG, however, the change from baseline score (immediate score) for each time interval revealed no significance compared to CG. In addition, the duration of operation and the volume of intraoperative bleeding were similar (p = 0.64 and p = 0.165). In conclusion, preincisional infiltration of levobupivacaine is a safe and reliable method for post-tonsillectomy pain reduction in adults. However, more in-depth, double-blinded and placebo controlled studies are required to elucidate its long term benefits.Item The effects of preanesthetic, different two single-doses dexmedetomidine on the onset time of rocuronium(Elsevier, 2012-03) Yıldırım, Arzu; Kaya, Fatma Nur; Yavaşçaoğlu, Belgin; Başağan-Moğol, Elif; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.Item The effects of preoperative single-dose gabapentin on postoperative pain after inguinal hernia surgery under spinal anesthesia(Elsevier, 2012-03) Kaymak, Serdar; Kaya, Fatma Nur; Kutlay, Belgin Yava Cao Lu Oya; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; AAI-8213-2021Item Effects of the non-dependent high-frequency jet ventilation on quality of operative field and oxygenation during one-lung ventilation for video-assisted thoracoscopic surgery(Lippincott Williams & Wilkins, 2016-09) Kaya, Fatma Nur; Bayram, Ahmet Sami; Terkanlıoğlu, Serkan; Bilgin, Hülya; Basağan-Moğol, Elif; Gören, Suna; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; 0000-0003-0684-0900; 0000-0001-6639-5533; 0000-0002-1190-6831; AAI-8213-2021; ABB-7580-2020; GGC-2556-2022; A-7338-2016; EMB-1552-2022; AAI-3551-2021Item The effects of the Trendelenburg position and the valsalva manoeuvre on internal jugular vein diameter and placement in children(Singapore Medical Association, 2015-08) Dinçyürek, Gamze Naime; Moğol, Elif Basağan; Türker, Gürkan; Yavascaoğlu, Belgin; Gurbet, Alp; Kaya, Fatma Nur; Moustafa, Bachri Ramadan; Yazıcı, Tolga; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji Anabilim Dalı.; 0000-0002-6503-8232; 0000-0002-3019-581X; AAI-6642-2021; A-7994-2018; AAI-7914-2021; AAG-9356-2021; AAI-8213-2021; CMM-0680-2022; DHL-3236-2022; IOJ-8866-2023; 56786378700; 23982134100; 7003400116; 6602742300; 35618853300; 7003619647; 56786155100; 56682825100INTRODUCTION We compared the effects of various surgical positions, with and without the Valsalva manoeuvre, on the diameter of the right internal jugular vein (RIJV). METHODS We recruited 100 American Society of Anesthesiologists physical status class I patients aged 2-12 years. The patients' heart rate, blood pressure, peripheral oxygen saturation and end-tidal CO2 pressure were monitored. Induction of anaesthesia was done using 1% propofol 10 mg/mL and fentanyl 2 mu g/kg, while maintenance was achieved with 2% sevoflurane in a mixture of 50/50 oxygen and air (administered via a laryngeal mask airway). The RIJV diameter was measured using ultrasonography when the patient was in the supine position. Thereafter, it was measured when the patient was in the supine position + Valsalva, followed by the Trendelenburg, Trendelenburg + Valsalva, reverse Trendelenburg, and reverse Trendelenburg + Valsalva positions. A 15 degrees depression or elevation was applied for the Trendelenburg position, and an airway pressure of 20 cmH(2)O was applied in the Valsalva manoeuvre. During ultrasonography, the patient's head was tilted 20 degrees to the left. RESULTS When compared to the mean RIJV diameter in the supine position, the mean RIJV diameter was significantly greater in all positions (p < 0.001) except for the reverse Trendelenburg position. The greatest increase in diameter was observed in the Trendelenburg position with the Valsalva manoeuvre (p < 0.001). CONCLUSION In paediatric patients, the application of the Trendelenburg position with the Valsalva manoeuvre gave the greatest increase in RIJV diameter. The reverse Trendelenburg position had no significant effect on RIJV diameter.Item Efficacy of antiseptic-impregnated catheters on catheter colonization and catheter-related bloodstream infections in patients in an intensive care unit(W. B. Saunders, 2006) Osma, Selcan; Kahveci, Ferda; Kaya, Fatma Nur; Akalın, Halis; Özakın, Cüneyt; Yılmaz, Emel; Kutlay, Oya; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim.; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji Anabilim Dalı.; 0000-0003-4820-2288; AAI-8213-2021; AAG-9356-2021This study was conducted to evaluate the impact of central venous catheters impregnated with chlorhexidine and silver sulphadiazine on the incidence of colonization and catheter-related bloodstream infection in critically ill patients. One hundred and thirty-three patients requiring central venous catheterization were chosen at random to receive either an antiseptic-impregnated triple-lumen catheter (N = 64) or a standard triple-lumen catheter (N = 69). The mean (SD) durations of catheterization for the antiseptic and standard catheters were 11.7 (5.8) days (median 10; range 3-29) and 8.9 (4.6) days (median 8.0; range 3-20), respectively (P = 0.006). Fourteen (21.9%) of the antiseptic catheters and 14 (20.3%) of the standard catheters had been colonized at the time of removal. (P = 0.834). Four cases (6.3%) of catheter-related bloodstream infection were associated with antiseptic catheters and one case (1.4%) was associated with a standard catheter (P = 0.195). The catheter colonization rates were 18.7/1000 catheter-days for the antiseptic catheter group and 22.6/1000 catheter-days for the standard catheter group (P = 0.640). The catheter-related bloodstream infection rates were 5.3/1000 catheter-days for the antiseptic catheter group and 1.6/1000 catheter-days for the standard catheter group (P = 0.452). In conclusion, our results indicate that the use of antiseptic-impregnated central venous catheters has no effect on the incidence of either catheter colonization or catheter-related bloodstream infection in critically ill patients.Item Endoskopik retrograd kolanjiopankreatografi işlemi için bilinçli sedasyon uygulamasında propofol ile deksmedetomidinin hemodinami ve kognitif fonksiyonlara etkisinin karşılaştırılması(Uludağ Üniversitesi, 2011-01-27) Ceylan, Gürkan; Yavaşcaoğlu, Belgin; Korfalı, Gülsen; Kaya, Fatma Nur; Moğol, Elif Başağan; Türker, Gürkan; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.Bu çalışmada endoskopik retrograd kolonjiopankreatografi (ERKP) işlemi sırasında bilinçli sedasyon için uygulanan propofol ve deksmedetomidinin hemodinamik ve respiratuar etkileri, yan etkileri, kognitif fonksiyonlara etkileri ile hasta ve hekim memnuniyeti açısından karşılaştırılması amaçlandı. 18-80 yaşları arasında, Amerikan Anestezistler Birliği’nin (ASA) sınıflamasına göre I ve II anestezi risk grubuna giren 50 olgu çalışmaya alındı. Olguların demografik verileri ve çalışma süresince vital bulguları kaydedildi. Sedasyon skorları takibinde Ramsay sedasyon skoru (RSS) kullanıldı. Olgular randomize olarak iki gruba ayrıldı: Grup P’deki olgulara yükleme dozu olarak 75µg kg-1 propofol iv infüzyon 10 dakika süre ile uygulandı. Olguların RSS’u 3-4 olacak şekilde, 12.5-100.0 µg kg-1dk-1 hızında propofol iv infüzyonuna devam edildi. Grup D’deki olgulara yükleme dozu olarak 1 µg kg-1 sa-1 hızında deksmedetomidin iv infüzyon olarak 10 dakikada uygulandı. Olguların RSS’u 3-4 olacak şekilde, 0.2-0.7 µg kg-1sa-1 hızında deksmedetomidin infüzyonuna devam edildi. Girişimin sonunda ilaç infüzyonları durduruldu. Olgulara sedasyon öncesinde ve derlenme odasında modifiye Aldrete skoru (MAS) 9-10 olduğunda Mini mental test (MMT) uygulandı. Girişimi takiben yüz ağrı ölçeği (YAÖ) ile ağrı değerlendirilmesi yapıldı. Deksmedetomidin grubunda kalp hızı (KH) değeri başlangıç değerine göre 5., 10., 15., 20., 25., 30., 35. ve 40. dakikalarda anlamlı olarak daha düşük bulundu (p<0.001). Tüm bu zamanlarda Grup D olgularda KH değerleri Grup P’ye göre düşük bulundu (p<0.05). Grup D’de ortalama arteriyel kan basıncının kontrol değerine göre daha düşük olduğu saptandı (p<0.05). Her iki grup arasında hasta ve hekim memnuniyeti arasında istatistiksel fark bulunmadı. Derlenme döneminde Grup D’de MMT değerleri daha yüksek bulundu (p<0.05). Endoskopik retrograd kolonjiopankreatografi gibi kısa süreli invaziv girişimlerde bilinçli sedasyon için deksmedetomidin uygulaması propofole alternatif olarak kullanılabilir.Item Erişkinlerde anestezi sonrası görülen komplikasyonların retrospektif değerlendirilmesi(Uludağ Üniversitesi, 2009-09-25) Yavaşcaoğlu, Belgin; Kaya, Fatma Nur; Özcan, Berin; Uzunalioğlu, Semiha; Güven, Tahir; Yazıcı, Şule; Ocakoğlu, Gökhan; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.Uludağ Üniversitesi Tıp Fakültesi Sağlık Uygulama ve Araştırma Merkezi’nde (SUAM), 1 Temmuz 2006-31 Ocak 2009 tarihleri arasında, genel anestezi ve santral rejyonal blok uygulanarak operasyona alınan 18-65 yaş arasındaki 40 822 olgunun verileri retrospektif olarak değerlendirildi. UÜ-SK Anestezi Kritik Olay Formu kayıtları esas alınarak, derlenme ünitesinde, postoperatif 12. ve 24. saatlerde görülen anestezi komplikasyonları incelenerek 1458 olguda komplikasyon kaydedildi. Genel anestezi sonrası 1344, santral rejyonal blok sonrası 114 olguda komplikasyon geliştiği saptandı. En fazla komplikasyonun Genel Cerrahi Anabilim Dalı olgularında ve genel anestezi sonrası geliştiği gözlendi. Santral rejyonal blok sonrası en fazla komplikasyonun Ortopedi Anabilim Dalı olgularında geliştiği saptandı. Ağrı, en sık karşılaşılan komplikasyondu. Komplikasyonların en sık postoperatif 12. saatte geliştiği saptandı. Santral rejyonal blok uygulananlarda hipotansiyon, ASA I-II olgularda disritmi, ASA III-IV olgularda kardiak arrest oranları anlamlı yüksek bulundu. Komplikasyonların kadınlarda daha sık görüldüğü saptandı. Sonuç olarak; postoperatif dönemde komplikasyonlarla hızlı ve etkin mücadelede anestezistler tarafından olguların tekrarlayan değerlendirilmeleri, postoperatif bakımın iyileştirilmesine katkıda bulunabilir.Item Esmolot pretreatment reduces the frequency and severity of pain on injection of rocuronium(Elsevier Science, 2007-09) Yavaşçaoğlu, Belgin; Kaya, Fatma Nur; Özcan, Berin; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji Anabilim Dalı.; AAG-9356-2021; AAI-7914-2021; AAI-8213-2021; 6602742300; 7003619647; 6603825848Objective: To determine the effect of esmolol on the frequency and severity of pain and withdrawal reactions after injection of rocuronium and to compare it with lidocaine and placebo. Design: Prospective, randomized, double-blind, placebo-controlled study. Setting: Single university hospital. Patients: 120 ASA physical status I and 11 patients undergoing general anesthesia for elective surgery. Interventions: Patients were randomized to receive esmolol (0.5 mg/kg), lidocaine (0.5 mg/kg), or placebo, followed by a subparalyzing dose of rocuronium. After induction of anesthesia with propofol and fentanyl, an intubating dose of rocuronium 0.6 mg/kg was given. Measurements: Patients were observed after injection of rocuronium 0.05 mg/kg, then immediately asked if they had pain in the arm. The response was assessed; discomfort, pain, and withdrawal of the hand were recorded and graded using a 4-point scale (none, mild, moderate, or severe). After the intubating dose of rocuronium, withdrawal reactions were scored as follows: (a) no pain response, (b) pain limited to the wrist, (c) pain limited to the elbow/shoulder, or (d) generalized pain response. Results: 31 patients (77.5%) in the esmolol group, 32 (80%) in the lidocaine group, and 15 (37.5%) in the placebo group reported no pain (both groups vs placebo, P < 0.001). Moderate pain was seen in only one patient receiving lidocaine, in 6 placebo patients, but in none in the esmolol group (esmolol vs placebo, P < 0.05). Severe pain was felt by 8 patients receiving placebo, but by none receiving esmolol or lidocaine (P < 0.01). Frequency of withdrawal response after rocuronium was 2.5%, 17.5%, and 40% in the esmolol, lidocaine, and placebo groups, respectively (esmolol group vs placebo, P < 0.001; lidocame group vs placebo, P < 0.05). Conclusion: Esmolol, like lidocame, reduces the frequency of pain and withdrawal reaction associated with rocuronium injection.
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