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Öğe Ailevi akdeniz ateşi ve çölyak hastalığı birlikteliğinde anestezi deneyimimiz(2014) Sargın, Mehmet; Borazan, Hale; Hacıbeyoğlu, Gülçin; Otelcioğlu, ŞerefAilevi Akdeniz Ateşi, akdeniz orjinli toplumlarda sık görü- len, inflamasyon kontrolünde bozulma ile seyreden otozomal resesif geçişli bir hastalıktır. Çölyak hastalığı duyarlı kişilerde otoimmün mekanizmalar ile glutene karşı intolerans olarak gelişen, proksimal ince barsak hastalığıdır. Ailevi Akdeniz Ateşi ile Çölyak hastalığının birlikteliği nadirdir. Bu makalede Ailevi Akdeniz Ateşi ile Çölyak hastalığı birlikte bulunan bilateral septik artritli bir vakadaki anestezi deneyimimiz sunulmuştur.Öğe A Comparison of Ketamine and Paracetamol for Preventing Remifentanil Induced Hyperalgesia in Patients Undergoing Total Abdominal Hysterectomy(Ivyspring Int Publ, 2012) Yalcin, Naime; Uzun, Sema Tuncer; Reisli, Ruhiye; Borazan, Hale; Otelcioglu, SerefBackground: The aim of this prospective, randomized, placebo-controlled study was to compare the effects of ketamine and paracetamol on preventing remifentanil induced hyperalgesia. Methods: Ninety patients undergoing total abdominal hysterectomy were randomly assigned to one of three groups to receive (I) either saline infusion; (II) 0.5 mg/kg ketamine iv bolus or (III) 1000 mg iv paracetamol infusion before induction of anesthesia. Until the skin closure, anesthesia was maintained with 0.4 mu g/kg/min remifentanil infusion in all groups, additionally Group II received 5 mu g/kg/min ketamine infusion. Pressure pain thresholds were measured the day before surgery during the preoperative visit for baseline measurements and repeated postoperatively at 24 and 48 hours (hrs). Pressure pain thresholds were established by digital algometer on three different peri-incisional regions for calculating mean pressure pain threshold values. The visual analogue scale (VAS), sedation scores, total morphine consumption and side effects were assessed postoperatively. Results: Demographic characteristics, duration of surgery and anesthesia were similar in the three groups. Pain thresholds at the incision region were significantly lower at 24 and 48 hrs postoperatively in Group I than the other Groups (p<0.05). In Group., pain thresholds were lower compared with preoperative baseline values. Thresholds in Group II and Group III were higher compared with preoperative baseline values (p<0.05) The VAS scores at all evaluation times were significantly higher in Group. when compared to Group.. and at 2, 4, 6,12 hrs were higher in Group I than Group III (p<0.05). The morphine consumption was higher in Group III at 24 and 48 hrs postoperatively (p<0.05). Conclusion: It was shown that ketamine and paracetamol were both effective in preventing remifentanil induced hyperalgesia.Öğe Comparison the effects of prilocaine and the addition of dexketoprofen and dexamethasone to prilocaine for intravenous regional anesthesia(Kare Publ, 2014) Borazan, Hale; Sahin, Osman; Uluer, Mehmet Selcuk; Kececioglu, Ahmet; Saritas, Tuba Berra; Otelcioglu, SerefObjectives: The aim of this study was to compare the anesthetic and analgesic effects of prilocaine alone, prilocaine added dexketoprofen and dexamethasone during intravenous regional anesthesia (IVRA). Methods: Forty five patients undergoing forearm or hand surgery were randomly assigned to one of three groups to receive (Group P) 3 mg/kg 0.5% prilocaine; (Group PDK) 3 mg/kg 0.5% prilocaine plus 50 mg dexketoprofen; (Group PDM) 3 mg/kg 0.5% prilocaine plus 8 mg dexamethasone in total 40 ml volume for IVRA. The onset and duration of sensory and motor blocks, hemodynamic datas, duration of analgesia and tourniquet, time to first analgesic requirement, visual analog scale (VAS), total analgesic consumption in 24 hours and patient satisfaction score were assessed and recorded. Results: Time to onset of sensory block was found to be longer in Group P (p<0.05), though no significance was found according to sensory block recovery times amoung groups. Time to onset of motor block was found to be longer and recovery time of motor block was found to be shorter in Group P (p<0.05). Time to first analgesic requirement was found to be longer in Group PDK, and was found to be high in Group PDM than Group PDK(p<0.05). The VAS scores was found to be high and patient satisfaction scale was found to be low in Group P (p<0.05). Conclusion: The addition of dexketoprofen and dexamethasone to prilocaine during IVRA improves the quality of both anesthesia and analgesia moreover dexketoprofen provides beter postoperative analgesia during the first 24 hour after surgery.Öğe Developing bone cement implantation syndrome under regional anesthesia: case report(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2017) Sargin, Mehmet; Borazan, Hale; Otelcioglu, SerefBone cement implantation syndrome is associated with hypoxia, hypotension, cardiac arrhythmias, increase in pulmonary vascular resistance and cardiac arrest and is a cause of mortality and morbidity in orthopedic patients when cement is used. Because it is rare and isn't well identified, literature is limited to case reports. In this article, bone cement implatation syndrome developed in a patient who had undergone surgery for hip replacement is reported with literature.Öğe Effects of anesthesia type on short-term postoperative cognitive function in obstetric patients following cesarean section(Galenos Yayincilik, 2015) Altun, Celalettin; Borazan, Hale; Sahin, Osman; Gezginc, KazimObjective: We aimed to compare the effects of general and spinal anesthesia on cognitive functions in pregnant patients undergoing elective cesarean section. Material and Methods: Seventy-five American Society of Anesthesiology (ASA) I pregnant patients aged 18-40 years who were scheduled to undergo elective cesarean section were divided into three groups. Group sevoflurane (Group S) and Group desflurane (Group D) were administered general anesthesia, whereas Group regional (Group R) was administered spinal anesthesia. Hemodynamic variables, bispectral index, oxygen saturation were measured at baseline, after induction, spinal injection, and during the surgery. Extubation and eye opening time and Aldrete scores were recorded. Mini-mental state examination, Trieger dot test, and clock drawing test were performed one day before the surgery and repeated at the 1st, 3rd and 24th h postoperatively. Results: There was no statistically significant difference among the groups in terms of demographic data and duration of surgery (p>0.05). Durations of anesthesia for Group S, Group R, and Group D were significantly different (p<0.05). Duration of anesthesia for Group R was significantly longer than for Groups S and D (p<0.0001). Aldrete recovery scores and total remifentanil consumption were significantly higher in Group D than in Group S (p<0.05). Extubation and eye opening times were significantly shorter in Group D than in Group S (p<0.01). According to TDT, statistical significance was found among Group S, Group R, and Group D at the 3rd and 24th h postoperatively (p<0.05), and there was a statistically high significant difference in Groups S and R (p<0.0001). Conclusion: We concluded that general anesthesia with sevoflurane or desflurane and spinal anesthesia had no effects on cognitive functions in patients undergoing cesarean operation.Öğe Hemodynamic responses to endotracheal intubation performed with video and direct laryngoscopy in patients scheduled for major cardiac surgery(E-Century Publishing Corp, 2015) Sarkilar, Gamze; Sargin, Mehmet; Saritas, Tuba Berra; Borazan, Hale; Gok, Funda; Kilicaslan, Alper; Otelcioglu, SerefThis study aims to compare the hemodynamic responses to endotracheal intubation performed with direct and video laryngoscope in patients scheduled for cardiac surgery and to assess the airway and laryngoscopic characteristics. One hundred ten patients were equally allocated to either direct Macintosh laryngoscope (n = 55) or indirect Macintosh C-MAC video laryngoscope (n = 55). Systolic, diastolic, and mean arterial pressure, and heart rate were recorded prior to induction anesthesia, and immediately and two minutes after intubation. Airway characteristics (modified Mallampati, thyromental distance, sternomental distance, mouth opening, upper lip bite test, Wilson risk sum score), mask ventilation, laryngoscopic characteristics (Cormack-Lehane, percentage of glottic opening), intubation time, number of attempts, external pressure application, use of stylet and predictors of difficult intubation (modified Mallampati grade 3-4, thyromental distance <6 cm, upper lip bite test class 3, Wilson risk sum score >= 2, Cormack-Lehane grade 3-4) were recorded. Hemodynamic parameters were similar between the groups at all time points of measurement. Airway characteristics and mask ventilation were no significant between the groups. The C-MAC video laryngoscope group had better laryngoscopic view as assessed by Cormack-Lehane and percentage of glottic view, and a longer intubation time. Number of attempts, external pressure, use of stylet, and difficult intubation parameters were similar. Endotracheal intubation performed with direct Macintosh laryngoscope or indirect Macintosh C-MAC video laryngoscope causes similar and stable hemodynamic responses.Öğe Incidence of Propofol Injection Pain and Effect of Lidocaine Pretreatment During Upper Gastrointestinal Endoscopy(Springer, 2012) Borazan, Hale; Saritas, Tuba Berra; Sarkilar, Gamze[Abstract Not Availabe]Öğe Incidence of Propofol Injection Pain and Effect of Lidocaine Pretreatment During Upper Gastrointestinal Endoscopy Reply(Springer, 2012) Borazan, Hale; Saritas, Tuba Berra; Sarkilar, Gamze[Abstract Not Availabe]Öğe İntravenöz rejyonel anestezi tekniğinde prilokain, prilokaine eklenen deksketoprofen ve deksametazonun etkinliklerinin karşılaştırılması(2014) Borazan, Hale; Şahin, Osman; Uluer, Mehmet Selçuk; Sarıtaş, Tuba Berra; Otelcioğlu, Şeref; Keçecioğlu, AhmetAmaç: Bu çalışmada intravenöz rejyonel anestezide (IVRA) prilokain ve buna eklenen deksketoprofen ve deksametazonun anestezik ve analjezik etkinliklerinin karşılaştırılması amaçlandı. Gereç ve Yöntem: El ve el bileği cerrahisi geçirecek 18-60 yaş, ASA I-II 45 olgu rastgele üç gruba ayrıldı. Grup Pye 3 mg/ kg %0.5 prilokain, Grup PDKya 3 mg/kg %0.5 prilokain ile 50 mg deksketoprofen, Grup PDMye 3 mg/kg %0.5 prilokain ile 8 mg deksametazon total 40 ml verildi. Duyusal ve motor blok başlama ve dönüş zamanları, hemodinamik veriler, analjezi süresi, turnike süresi, intraoperatif fentanil alan hasta sayısı, ilk analjezik zamanı, vizüel analog skala (VAS), 24 saat analjezik tüketimi ve hasta memnuniyet skorları kaydedildi. Bulgular: Duyusal blok başlama zamanı Grup P de uzun bulunurken, motor blok başlama zamanı daha uzun ve motor blok dönme zamanı daha kısa bulundu (p0.05). Duyusal blok dönme zamanları açısından üç grup arasında anlamlı fark bulun- madı. İntraoperatif turnike ağrısı başlama zamanı Grup PDM ve Grup PDK da daha uzun bulunurken (p0.05), intraope- ratif fentanil ihtiyacı olan hasta sayısı Grup P de daha fazlaydı (p0.05). İlk analjezi verilme zamanı Grup PDK da her iki gruptan uzun bulunurken (p0.05), total analjezik tüketimi Grup P de diğer iki gruptan daha fazla (p0.05), Grup PDM de de Grup PDK dan fazla bulundu (p0.05). Grup P de intraoperatif VAS değerleri daha yüksek (p0.05) bulunurken, hasta memnuniyet skorları daha düşük bulundu (p0.05). Sonuç: İntravenöz rejyonel anestezide prilokaine eklenen deksketoprofen ve deksametazonun hem analjezik hem de aneste- zik kaliteyi artırdığı ancak deksketoprofenin ameliyat sonrası ilk 24 saatte daha iyi analjezi sağladığı gösterilmişÖğe Is intra-articular magnesium effective for postoperative analgesia in arthroscopic shoulder surgery?(Pulsus Group Inc, 2015) Saritas, Tuba Berra; Borazan, Hale; Okesli, Selmin; Yel, Mustafa; Otelcioglu, SerefBACKGROUND: Various medications are used intra-articularly for postoperative pain reduction after arthroscopic shoulder surgery. Magnesium, a N-methyl-D-aspartate receptor antagonist, may be effective for reduction of both postoperative pain scores and analgesic requirements. METHODS: A total of 67 patients undergoing arthroscopic shoulder surgery were divided randomly into two groups to receive intra-articular injections of either 10 mL magnesium sulphate (100 mg/mL; group M, n=34) or 10 mL of normal saline (group C, n= 33). The analgesic effect was estimated using a visual analogue scale 1 h, 2 h, 6 h, 8 h, 12 h, 18 h and 24 h after operation. Postoperative analgesia was maintained by intra-articular morphine (0.01%, 10 mg) + bupivacaine (0.5%, 100 mL) patient-controlled analgesia device as a 1 mL infusion with a 1 mL bolus dose and 15 min lock-out time; for visual analogue scale scores > 5, intramuscular diclofenac sodium 75 mg was administered as needed during the study period (maximum two times). RESULDS: Intra-articular magnesium resulted in a significant reduction in pain scores in group M compared with group C 1 h, 2 h, 6 h, 8 h and 12 h after the end of surgery, respectively, at rest and with passive motion. Total diclofenac consumption and intra-articular morphine + bupivacaine consumption were significantly lower in group M. Postoperative serum magnesium levels were significantly higher in group M, but were within the normal range. CONCLUSION: Magnesium causes a reduction in postoperative pain in comparison to saline when administered intra-articularly after arthroscopic shoulder surgery, and has no serious side effects.Öğe Limited-Form Wegener Granulomatosis Case: Anaesthetic Approach and Literature Review(Aves, 2014) Saritas, Tuba Berra; Sahin, Osman; Borazan, Hale; Otelcioglu, SerefWegener granulomatosis (WG) is a kind of vasculitis that affects small and medium-sized arteries. Necrotizing granulomatous vasculitis of the upper and lower respiratory tracts and necrotizing glomerulonephritis of the kidneys are present. WG affects mainly Caucasian individuals between 15-75 years old, with a mean age of onset of 41 years. It affects both males and females equally. Kidney involvement is not present in the limited form of WG. Peripheral nerve blocks are good alternatives when general anaesthesia is risky. Popliteal block is blockade of the sciatic nerve at the popliteal region. Popliteal block is a kind of peripheral block for surgeries below the knee level. In this article, we report on the anaesthesia management of a 61-year-old limited-form WG patient for whom general anaesthesia was risky because of lung involvement.Öğe A novel modified PAIR technique using a trocar catheter for percutaneous treatment of liver hydatid cysts: a six-year experience(Aves, 2016) Nayman, Alaaddin; Guler, Ibrahim; Keskin, Suat; Erdem, Tuba Berra; Borazan, Hale; Kucukapan, Ahmet; Ozbiner, HuseyinPURPOSE We aimed to demonstrate the success and reliability of a novel puncture, aspiration, injection, and reaspiration (PAIR) technique in liver hydatid cysts. METHODS Percutaneous treatment with ultrasonographic guidance was performed in 493 hepatic hydatid cysts in 374 patients. Patients were treated with a new PAIR technique by single puncture method using a 6F trocar catheter. The results of this novel technique were evaluated with regards to efficacy and safety of the procedure and complication rates. RESULTS Out of 493 cysts, 317 were Gharbi type I (WHO CE 1) and 176 were Gharbi type II (WHO CE 3A). Of all cysts, 13 were referred to surgery because of cystobiliary fistulization. Recurrence was observed in 11 cysts one month later. Therefore, the success rate of the PAIR technique was 97.7% (469/480). Minor complications (fever, urticaria-like reactions, biliary fistula) were seen in 44 treated patients (12%, 44/374); the only major complication was reversible anaphylactic shock which was observed in two patients (0.5%, 2/374). CONCLUSION This novel modified PAIR technique may be superior to catheterization by Seldinger technique due to its efficiency, easier application, lower severe complication rate, and lower cost. Further comparative studies are required to confirm our observations.Öğe Oral Magnesium Lozenge Reduces Postoperative Sore Throat A Randomized, Prospective, Placebo-controlled Study(Lippincott Williams & Wilkins, 2012) Borazan, Hale; Kececioglu, Ahmet; Okesli, Selmin; Otelcioglu, SerefBackground: Postoperative sore throat (POST) is an undesirable complaint after orotracheal intubation. Magnesium is a noncompetitive N-methyl-D-aspartate receptor antagonist thought to be involved in the modulation of pain. The present study aimed to investigate the effect of preoperative administration of oral magnesium lozenge on POST. Methods: Seventy patients undergoing orthopedic surgery were randomly allocated into two groups, to either receive placebo (control) or magnesium lozenges (magnesium) to be dissolved by sucking 30 min preoperatively. Patients were assessed for incidence and severity (four-point scale, 0-3) of POST at 0, 2, 4, and 24 h postoperatively. The primary outcome was sore throat at 4 h after surgery. The secondary outcome was the severity of POST at four evaluation time-points postoperatively. Results: The incidence of POST at 4 h was higher in control group than in magnesium group (95% CI: 26%, 14-42%; P = 0.032). The highest incidence of POST occurred at the second hour after surgery, with the rate of 23% in the magnesium group and 57% in the control group (95% CI: 34%, 20-51%; P = 0.007). The severity of POST was significantly lower in the magnesium group at 0 (P = 0.007) and 2 h (P = 0.002). The incidences of POST at 0 and 24 h and severity scores at 4 and 24 h were not significantly different between the groups. Conclusions: The administration of magnesium lozenge 30 min preoperatively is effective to reduce both incidence and severity of POST in the immediate postoperative period.Öğe Predictors of postoperative sore throat in intubated children(Wiley-Blackwell, 2012) Borazan, Hale; Saritas, Tuba Berra[Abstract Not Availabe]Öğe Prevention of pain on injection of propofol: a comparison of lidocaine with different doses of paracetamol(Lippincott Williams & Wilkins, 2010) Borazan, Hale; Erdem, Tuba B.; Kececioglu, Melahat; Otelcioglu, SerefBackground and objective The aim of this study was to compare the efficacy of pretreatment with paracetamol 0.5 mg kg(-1), 1 mg kg(-1), 2 mg kg(-1) and lidocaine 0.5 mg kg(-1) for prevention of propofol induced pain. Methods In this double-blind, placebo-controlled study, 250 adult patients ASA I or II, scheduled to undergo elective surgery, were randomly assigned into five groups of 50 each. Group P-0.5, group P-1 and group P-2 received 0.5, 1 and 2 mg kg(-1) paracetamol respectively; group L received 0.5 mg kg(-1) lidocaine; and the control group, group C, received isotonic saline pretreatment in the dorsum of the hand, followed by propofol 1 min later. A blinded researcher assessed the patient's pain level via a four-point scale. Results There were no significant differences in patient characteristics among the groups. The incidence of propofol injection pain in all treatment groups was significantly lower than in the control group (P < 0.001). When the paracetamol 0.5 mg kg(-1) group was compared with both the paracetamol 1 mg kg(-1) group (P < 0.01) and the paracetamol 2 mg kg(-1) group (P < 0.001), significant differences were observed. In the lidocaine 0.5 mg kg(-1) group propofol injection pain was significantly reduced compared with the paracetamol 0.5 mg kg(-1) group (P < 0.01). However, in the paracetamol 2 mg kg(-1) group pain was more significantly reduced than in the lidocaine 0.5 mg kg(-1) group (P < 0.001). In the paracetamol 2 mg kg(-1) group the incidence of pain was significantly less than in paracetamol 1 mg kg(-1) group (P < 0.001). Conclusion When given as venous retention pretreatments 1 min before propofol, paracetamol 1 mg kg(-1) and lidocaine 0.5 mg kg(-1) were equally effective in attenuating pain during intravenous (i.v.) injection of propofol whereas pretreatment with paracetamol 2 mg kg(-1) was shown to be the most effective treatment.Öğe Prevention of Propofol Injection Pain in Children: A Comparison of Pretreatment with Tramadol and Propofol-Lidocaine Mixture(Ivyspring Int Publ, 2012) Borazan, Hale; Sahin, Osman; Kececioglu, Ahmet; Uluer, M. Selcuk; Et, Tayfun; Otelcioglu, SerefBackground: The pain on propofol injection is considered to be a common and difficult to eliminate problem in children. In this study, we aimed to compare the efficacy of pretreatment with tramadol 1 mg.kg(-1) and propofol-lidocaine 20 mg mixture for prevention of propofol induced pain in children. Methods: One hundred and twenty ASA I-II patients undergoing orthopedic and otolaryngological surgery were included in this study and were divided into three groups with random table numbers. Group C (n=39) received normal saline placebo and Group T (n=40) received 1 mg. kg(-1) tramadol 60 sec before propofol (180 mg 1% propofol with 2 ml normal saline) whereas Group L (n=40) received normal saline placebo before propofol-lidocaine mixture (180 mg 1% propofol with 2 ml % 1 lidocaine). One patient in Group C was dropped out from the study because of difficulty in inserting an iv cannula. Thus, one hundred and nineteen patients were analyzed for the study. After given the calculated dose of propofol, a blinded observer assessed the pain with a four-point behavioral scale. Results: There were no significant differences in patient characteristics and intraoperative variables (p>0.05) except intraoperative fentanyl consumption and analgesic requirement one hr after surgery among the groups (p<0.05). Both tramadol 1 mg. kg-1 and lidocaine 20 mg mixture significantly reduced propofol pain when compared with control group. Moderate and severe pain were found higher in control group (p<0.05). The incidence of overall pain was 79.4% in the control group, 35% in tramadol group, 25% in lidocaine group respectively (p<0.001). Conclusions: Pretreatment with tramadol 60 sec before propofol injection and propofol-lidocaine mixture were significantly reduced propofol injection pain when compared to placebo in children.Öğe Rejyonel Anestezi Altında Gelişen Kemik Sement İmplantasyon Sendromu: Olgu Sunumu(2017) Sargın, Mehmet; Borazan, Hale; Otelcioğlu, ŞerefRejyonel anestezi altında gelişen kemik sement implantasyon sendromu: Olgu sunumu Kemik sement implantasyon sendromu hipoksi, hipotansiyon, kardiyak aritmiler, pulmoner vasküler direnç artışı ve kardiyak arrest ile ilişkilidir ve sement kullanılan ortopedik hastalarda mortalite ve morbidite sebebidir. Nadir görülmesi ve iyi tanımlanamamış olması nedeniyle literatür bilgileri vaka sunumları ile sınırlıdır. Bu makalede kalça protezi için opere olan bir hastada gelişen kemik sement implantasyon sendromunu literatür eşliğinde sunulmuştur.Öğe Where is the apex of the sacral hiatus for caudal epidural block in the pediatric population? A radio-anatomic study(Springer Japan Kk, 2014) Cicekcibasi, Aynur Emine; Borazan, Hale; Arican, Sule; Yilmaz, Mehmet Tugrul; Sakarya, Mehmet EminCaudal epidural block (CEB), administered through the sacral hiatus, is a regional anesthetic technique commonly used in children. To facilitate and optimize pediatric CEB, morphometric data that may be important for the sacral hiatus have been obtained using multidetector computed tomography (MDCT). This study is the first radio-anatomic study designed to address this topic in children. Images of 79 children (39 girls and 40 boys between 1 and 9 years old) were divided into three groups according to age [group I (ages 1-3), group II (ages 4-6), and group III (ages 7-9)] and were retrospectively examined. Data were gathered via 3D volume-rendered images. Measurements included the height and width of the sacral hiatus, S2-S4 (sacral vertebra) distance, the distances between the poles of the unfused spinous process of each sacral vertebra, and the dimensions of an imaginary triangle formed between the right and left posterior superior iliac spines (PSIS) and the apex of the sacral hiatus. The most frequently fused spinous process was at S2 level. The mean S2-S4 distance was 1.36 cm for group I, 1.78 cm for group II, and 2.17 cm for group III. There was not the imaginary equilateral triangle used in the method of finding the sacral hiatus for CEB, and the apex of this triangle did not occur at the standard level (S4) in most of the children. It was observed that the apex deriving from the most distal fused spinous process was at the level of S2 in one of two children. Dural puncture is inevitable for CEB applied at the S2 level. Consequently, CEB should be applied below this level (range, 1.36-2.17 cm) from the midpoint of the interspinous distance between the PSIS (at the same level with S2) in children aged 1-9 years.
