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Öğe Anaesthetic Management with Thromboelastography in a Patient with Glanzmann Thrombasthenia(Aves, 2014) Topal, Ahmet; Kilicaslan, Alper; Erol, Atilla; Cankaya, Baris; Otelcioglu, SerefGlanzmann thrombastenia (GT) is a rare disease of an autosomal recessive inheritance characterized with fatal bleeding tendency. The anaesthesiologist should be cognizant of the risk involved and be prepared with necessary measures. In this paper, we present a GT case of a 9-year-old male with hypospadias, which was successfully repaired after platelet transfusions according to the thromboelastography tracings.Öğe Comparison of Hemodynamics Recovery Profile and Costs of Remifentanil Versus Fentanyl-Based Sevoflurane Anesthesia(Ortadogu Ad Pres & Publ Co, 2012) Uluer, Mehmet Selcuk; Topal, Ahmet; Tavlan, Aybars; Erol, Atilla; Kilicaslan, Alper; Otelcioglu, SerefObjective: This trial was designed to compare the effects of fentanyl and remifentanil on hemodynamic parameters, postoperative recovery, sevoflurane consumption and the cost of anesthetics. Material and Methods: Cases that were scheduled to undergo elective laparoscopic cholecystectomy surgery were assigned to two groups with simple random sampling method, as Group F (Fentanyl) and Group R (Remifentanil), each including 30 patients. The anesthetic induction was initiated by administering 1-2 mg/kg propofol bolus based on the bispectral index (BIS) value followed by 2 mu g/kg fentanyl in Group F patients and 1 mu g/kg remifentanil in Group R patients administered in 60 seconds as iv bolus; subsequently, 0.5 mg/kg iv atracurium was administered. For maintenance of anesthesia, 50% oxygen in-air was administered at 4 L/min; the end-tidal sevoflurane concentration was adjusted to achieve a BIS value of 45 to 55. In Group R, remifentanil 0.25 mu g/kg/min infusion was continued. The addition of 0.5 mu g/kg fentanyl was planned as required in Group F. Sevoflurane end-tidal concentration and the changing times were recorded. For each case, the sevoflurane consumption was calculated using the Dion formula. Results: In Group R, the hemodynamic control, particularly the suppression of response to intubation was more successful than in Group F. The eye opening times and Post Anesthesia Care Unit (PACU) transfer times were shorter in Group R relative to Group F (p=0.001 and p=0.001, respectively). Sevoflurane consumption was lower in the Group R (7.18 +/- 3.45 mL) compared to Group F (16.45 +/- 7.15 mL) (p=0.001). The total anesthetic drug cost was similar between the groups. Conclusion: Compared to fentanyl, remifentanil provided a better intraoperative hemodynamic control, faster postoperative recovery and a favorable effect on anesthetic drug cost by decreasing sevoflurane consumption, eliminating the disadvantages of its price.Öğe Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways(Aves, 2014) Kilicaslan, Alper; Topal, Ahmet; Erol, Atilla; Uzun, Sema TuncerObjective: Recently, to further enhance the potential in the management of difficult airways, the highly angulated D-Blade was added to the C-MAC system. The purpose of this study was to investigate the laryngoscopic view and intubation parameters using the new C-MAC D-Blade in comparison to the conventional C-MAC video laryngoscope and Macintosh direct laryngoscope in simulated easy and difficult airways. Methods: We recruited 26 experienced anaesthesia providers into a randomized trial. Each performed tracheal intubation of a Laerdal SimMan r manikin with each laryngoscope in the following laryngoscopy scenarios: (1) normal airway, (2) cervical spine immobilization, and (3) tongue edema. The intubation times, success rates, number of intubation attempts, laryngoscopic views, and severity of dental compression were recorded. Results: In all scenarios, video laryngoscopes provided better laryngeal exposure than the ML and appeared to produce less dental pressure. In the cervical spine immobilization scenario, D-Blade caused less dental pressure and showed better Cormack-Lehane (CL) classes than the other devices (p<0.001). There were no differences between video laryngoscopes in success of tracheal intubation (p>0.05). The CMAC provided the most rapid intubation. The rate of failure was 19% with ML. In the tongue edema scenario, the CMAC provided the most rapid and successful intubation (p<0.001). There were no differences between video laryngoscopes in laryngoscopic views according to CL classification and dental pressure (p>0.05). The rate of failure was 46% with the ML and 7% with the D-Blade. Conclusion: The CMAC D-Blade caused less dental pressure than the conventional C-MAC and ML in the cervical immobilization scenario. The conventional CMAC performed better than the D-Blade and ML in the tongue edema scenario. These two video laryngoscopes may complement each other in various difficult airway situations.Öğe A Comparison of the Effects of Postoperative CPAP and Nasal Oxygen Use on Arterial Blood Gas in Laparoscopic Cholecystectomy Performed in Obese Patients: A Prospective, Randomized Cinical Trial(Ortadogu Ad Pres & Publ Co, 2012) Kiziloz, Sema Peker; Tavlan, Aybars; Topal, Ahmet; Erol, Atilla; Kilicaslan, Alper; Otelcioglu, SerefObjective: This study was designed to compare the effects of continuous positive airway pressure (CPAP) and nasal oxygen use on postoperative blood gases in obese patients undergoing laparoscopic cholecystectomy. Material and Methods: A total of 40 patients with a body mass index (BMI) ranging between 30 and 40 were enrolled in this study. Patients were divided into two groups: Group C (n=20) = CPAP and Group N (n=20) = Nasal O-2. Baseline blood gas was sampled on spontaneous respiration (G(0)). The blood gas sampling was repeated before patients were admitted to the postoperative care unit (PACU) (G(1)). Following the operation, Group C received CPAP 5 cmH(2)O and Group N received 5 1/min O-2 via nasal cannula for 60 minutes. Blood gas sampling was repeated after 60 minutes in both groups (G(2)). Results: At the PACU, the SpO(2) values were higher in Group C relative to Group N at 30 minutes (p<0.05). In both groups, the in-group pH values at G(1) measurement time displayed a statistically significant reduction compared to those at the G(0) measurement time (p<0.05). At G(2), PaCO2 was higher in Group N compared to Group C (p<0.05). In both groups, the in-group PaCO2 values were significantly higher at G(1) relative to G(0) (p<0.01). In Group C, PaO2 was higher at G(2) compared to Group N (p<0.05). Conclusion: Postoperative CPAP use may increase the PaO2 more and provide a better CO2 elimination compared to nasal oxygen use in obese patients undergoing laparoscopic cholecystectomy.Öğe Determination of optimum time for intravenous cannulation after induction with sevoflurane and nitrous oxide in children premedicated with midazolam(Wiley-Blackwell, 2014) Kilicaslan, Alper; Gok, Funda; Erol, Atilla; Okesli, Selmin; Sarkilar, Gamze; Otelcioglu, SerefBackgroundIt has been shown that early placement of an intravenous line in children administered sevoflurane anesthesia increased the incidence of laryngospasm and movement. However, the optimal time for safe cannulation after the loss of the eyelash reflex during the administration of sevoflurane and nitrous oxide is not known. AimThe aim of the study was to determine the optimum time for intravenous cannulation after the induction of anesthesia with sevoflurane and nitrous oxide in children premedicated with oral midazolam. MethodWe performed a prospective, observer-blinded, up-down sequential, allocation study, and children, aged 2-6years, ASA physical status I, scheduled for an elective procedure undergoing inhalational induction were included in the study. Anesthesia was induced with sevoflurane and nitrous oxide after premedication with oral midazolam. For the first child, 4min after the loss of the eyelash reflex, the intravenous cannulation was attempted by an experienced anesthesiologist. The time for intravenous cannulation was considered adequate if movement, coughing, or laryngospasm did not occur. The time for cannulation was increased by 15s if the time was inadequate in the previous patient, and conversely, the time for cannulation was decreased by 15s if the time was adequate in the previous patient. The probit test was used in the analysis of up-down sequences. ResultsA total of 32 children were enrolled sequentially during the study period. The adequate time for effective intravenous cannulation after induction with sevoflurane and nitrous oxide in 50% and 95% of patients were 1.29min (95% confidence interval, 0.96-1.54min) and 1.86min (95% confidence interval 1.58-4.35min), respectively. ConclusionWe recommend waiting 2min for attempting intravenous placement following the loss of the eyelash reflex in children sedated with midazolam and receiving an inhalation induction with sevoflurane and nitrous oxide.Öğe Differences in tip visibility and nerve block parameters between two echogenic needles during a simulation study with inexperienced anesthesia trainees(Springer Japan Kk, 2014) Kilicaslan, Alper; Topal, Ahmet; Tavlan, Aybars; Erol, Atilla; Otelcioglu, SerefNeedle tip visualization during ultrasound-guided regional anesthesia (UGRA) is necessary for safety and efficacy. However, disruption of the image of the needle tip driven toward the target is a general problem, especially for beginners. The purpose of this study was to compare performance parameters between using the Sonoplex and Stimuplex D-Plus echogenic needles in a simulated ultrasound-guided interventional task by inexperienced anaesthesia residents. After a standardized training session, 28 anesthesiology residents performed simulated nerve blocks in a beef phantom with each needle. All ultrasound images were digitally stored for analysis. The absolute time the needle tip was in view, total procedure time, and angle of needle insertion were subsequently measured objectively by two single investigators. The procedures that used the Sonoplex echogenic needle had significantly better tip visibility and shorter total procedure time at insertion angles between 42A degrees and 64A degrees relative to the phantom surface. We have demonstrated that inexperienced users who used the Sonoplex echogenic needle were able to complete the procedure more quickly. Needles with improved visibility would be a very useful addition to UGRA for inexperienced users.Öğe The effect of low dose ionizing radiation exposure on dynamic thiol-disulfide homeostasis and ischemia modified albumin levels: an observational study(Elsevier Science Inc, 2020) Arican, Sule; Dertli, Ramazan; Baktik, Suleyman; Hacibeyoglu, Gulcin; Erol, Atilla; Ulukaya, Sinan Oguzhan; Goger, EsraBackground: The primary objective of this study was to investigate the effect of low dose ionizing radiation exposure on thiol/disulfide homeostasis and ischemia modified albumin levels. The secondary objective is to compare thiol/disulfide homeostasis and ischemia modified albumin levels among the personnel exposed to low dose ionizing radiation in anesthesia application areas, in and out of the Operation room. Methods: The study included a total of 90 volunteers aged between 18 and 65 years old, with 45 personnel working in a setting with potential for radiation exposure (Exposed Group) and 45 personnel in a setting without radiation exposure (Control Group). Their native thiol, total thiol, disulphide, albumine and IMA levels were measured. Exposed group included personnel who were exposed to radiation outside the operating room - Operation room (-) Group and inside the Operating room - Operation room (+) Group. Results: Albumin, native and total thiol levels were significantly lower in the participants exposed to radiation in the anesthesia application area, no statistically significant difference was found in terms of disulfide and ischemia modified albumin levels. In the Operation room (-) group exposed to radiation, native thiol and total thiol values were significantly lower compared to the Operation room (+) groups. Conclusion: Awareness of being in danger of oxidative stress should be established in personnel exposed to radiation in the anesthesia application area following low dose ionizing radiation exposure, and the necessary measures should be taken. (C) 2020 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.Öğe The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients(2013) Tavlan, Aybars; Topal, Ahmet; Kılıçaslan, Alper; Erol, Atilla; Çobanoğlu, Halit; Otelcioğlu, ŞerefOur aim was to compare the effects of desflurane and sevoflurane on cognitive functions of geriatric patients that were planned for elective surgery under general anestesia. After national ethical committee approval, 40 patients (aged 65-75 yr) were enrolled. Patients were allocated to either the desflurane (n20) or the sevoflurane (n20) group. In all patients anaesthesia will be induced with propofol and remifentanyl, and maintained with the anaesthetics desflurane, or sevoflurane, and remifentanyl. Emergence times from anaesthesia and Aldrete scores were recorded. Cognitive function will be evaluated with two cognitive test; Blessed Short Orientation Memory Concentration Test (BOMC) and standardized mini mental test (SMMT) preoperatively and postoperatively at 60, and 180 minute after extubation. The mean extubation time, eye opening time and Aldrete scores were similar in the desflurane and sevoflurane groups (p0,05). There were no significant differences between the desflurane and the sevoflurane groups when the BOMC and MMST scores were compared preoperatively, and postoperatively at 60, and 180 min (p0,05).The result of this study indicate that there is no difference between effects of desflurane and sevoflurane anesthesia on postoperatif cognitive functions in the elderly.Öğe The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions In Geriatric Patients(Modestum Ltd, 2013) Cobanoglu, Halit; Tavlan, Aybars; Topal, Ahmet; Kilicaslan, Alper; Erol, Atilla; Otelcioglu, SerefOur aim was to compare the effects of desflurane and sevoflurane on cognitive functions of geriatric patients that were planned for elective surgery under general anestesia. After national ethical committee approval, 40 patients (aged 65-75 yr) were enrolled. Patients were allocated to either the desflurane (n= 20) or the sevoflurane (n= 20) group. In all patients anaesthesia will be induced with propofol and remifentanyl, and maintained with the anaesthetics desflurane, or sevoflurane, and remifentanyl. Emergence times from anaesthesia and Aldrete scores were recorded. Cognitive function will be evaluated with two cognitive test; Blessed Short Orientation Memory Concentration Test (BOMC) and standardized mini mental test (SMMT) preoperatively and postoperatively at 60, and 180 minute after extubation. The mean extubation time, eye opening time and Aldrete scores were similar in the desflurane and sevoflurane groups (p> 0,05). There were no significant differences between the desflurane and the sevoflurane groups when the BOMC and MMST scores were compared preoperatively, and postoperatively at 60, and 180 min (p> 0,05). The result of this study indicate that there is no difference between effects of desflurane and sevoflurane anesthesia on postoperatif cognitive functions in the elderly.Öğe Effectiveness of videolaringoscopy C-MAC in managing intubations that have failed unexpectedly(Elsevier Science Inc, 2014) Kilicaslan, Alper; Topal, Ahmet; Tavlan, Aybars; Erol, Atilla; Otelcioglu, Seref[Abstract Not Availabe]Öğe The Effects of Sugammadex on Progesterone Levels in Pregnant Rats(2015) Et, Tayfun; Topal, Ahmet; Erol, Atilla; Tavlan, Aybars; Kılıçaslan, Alper; Tuncer Uzun, SemaBackground: Sugammadex has been shown to de- crease the efficiency of progesterone-containing oral contraceptive drugs which possess a steroid structure. Aims: The aim of the present study was to evaluate the effects of sugammadex on progesterone levels in pregnant rats as well as on the physiological course of the pregnancy. Study Design: Animal experiment. Methods: This study was approved by the Selçuk Uni- versity Ethical Committee for Experimental Animal Research. Pregnant Winster Albino rats (n26) were divided into three groups and administered with vari- ous intravenous injections on the 7th day of pregnancy. The control group (Group K, n6) received 1.5 mL serum physiologic, the sugammadex group (Group S, n10) received 30 mg/kg sugammadex and the sugam- madex rocuronium group (Group SR, n10) received 30 mg/kg sugammadex and 3.5 mg/kg rocuronium. Progesterone levels were measured and the offspring were monitored for morphologic status. Results: Mean progesterone levels were 94.16±15.54 ng/mL in Group K, 87.86±12.48 ng/mL in Group S, and 94.53±16.10 ng/mL in Group SR (p<0.05). No stillbirth or miscarriage was observed in the rats. The mean number of offspring was 6.8±1.47 in Group K, 6.5±1.35 in Group S, and 6.4±1.17 in Group SR. The offspring appeared macroscopically normal. Conclusion: Sugammadex does not appear to affect the progesterone levels in pregnant rats in the first trimes- ter and the clinical course. Successful completion of pregnancy and the absence of stillbirth or miscarriage will guide future studies about the use of sugammadex, particularly in the first trimester of the pregnancy.Öğe The effects of the administration of subfacial levobupivacaine infusion with the ON-Q pain pump system on postoperative analgesia and tramadol consumption in cesarean operations(Kare Publ, 2010) Tuncer, Sema; Aysolmaz, Gokhan; Reisli, Ruhiye; Erol, Atilla; Yalcin, Naime; Yosunkaya, AlperObjectives: In this study, the effects of administration of subfacial levobupivacaine infusion with the ON-Q pain pump system were investigated in elective cesarean operations for postoperative pain control and tramadol-sparing effect. Methods: Fifty ASA I-II patients scheduled for cesarean operation were enrolled into this study. Patients were randomly divided into two groups: Group I served as a control group, without the ON-Q pain pump system, whereas Group II received the ON-Q pain pump system with subfacial 0.25% levobupivacaine infusion for 24 hours at 4 ml/hour. All patients received a standard anesthetic protocol. At the end of the surgery, all patients received tramadol i.v. via a PCA (Patient Controlled Analgesia) device. Pain scores were assessed at 2, 6, 12 and 24 hours postoperatively. Tramadol consumption and adverse effects were noted in the first 24 hours following surgery. Results: The pain scores were significantly lower in the levobupivacaine group when compared with the control group (p<0.05). The cumulative tramadol consumption was lower in the levobupivacaine group than in the control group (p<0.05). Group II used less antiemetic and had less postoperative nausea and vomiting, and the difference was statistically significant (p<0.05). Conclusion: No complication occurred as a result of the ON-Q pain pump system. Subfacial levobupivacaine infusion with the ON-Q pain pump system diminished postoperative pain and the need for tramadol use following cesarean operations.Öğe Fulminant Liver Failure Due to Amanita Phalloides Toxicity Treated with Emergent Liver Transplantation(Modestum Ltd, 2015) Gok, Funda; Topal, Ahmet; Hacibeyoglu, Gulcin; Erol, Atilla; Biyik, Murat; Kucukkartallar, Tevfik; Yosunkaya, AlperThe clinical picture secondary to amanita phalloides, which began with gastrointestinal complaints, advanced to fulminant hepatic failure in two days. Emergency liver transplantation was decided for the case of a 48-year-old male patient, who at the same time had renal failure and acute pancreatitis. Bridge treatment with plasma diafiltration was applied until the liver transplantation, which was successfully performed on the fifth day of admission to the hospital. Acute pancreatitis and renal failure also resolved and the patient was discharged in a healthy condition on the 30th day of admission. The timing of the transplant in fulminant liver failure and criteria used to select the timing are particularly important. Transplantation should be performed not too early, nor too late. In addition, the development of multiple organ failure during the period until transplantation may result in the death of the patient. Therefore, extra corporeal liver support systems are suggested as an important treatment tool at this stage.Öğe Fulminant Liver Failure Due to Amanita Phalloides Toxicity Treated with Emergent Liver Transplantation(Modestum Ltd, 2015) Gok, Funda; Topal, Ahmet; Hacibeyoglu, Gulcin; Erol, Atilla; Biyik, Murat; Kucukkartallar, Tevfik; Yosunkaya, AlperThe clinical picture secondary to amanita phalloides, which began with gastrointestinal complaints, advanced to fulminant hepatic failure in two days. Emergency liver transplantation was decided for the case of a 48-year-old male patient, who at the same time had renal failure and acute pancreatitis. Bridge treatment with plasma diafiltration was applied until the liver transplantation, which was successfully performed on the fifth day of admission to the hospital. Acute pancreatitis and renal failure also resolved and the patient was discharged in a healthy condition on the 30th day of admission. The timing of the transplant in fulminant liver failure and criteria used to select the timing are particularly important. Transplantation should be performed not too early, nor too late. In addition, the development of multiple organ failure during the period until transplantation may result in the death of the patient. Therefore, extra corporeal liver support systems are suggested as an important treatment tool at this stage.Öğe Glanzmann Trombastenili Olguda Tromboelastografi Eşliğinde Anestezi Yönetimi(2014) Topal, Ahmet; Kılıçaslan, Alper; Erol, Atilla; Çankaya, Barış; Otelcioğlu, ŞerefGlanzmann trombastenisi (GT) ölümcül kanamalara yol açabilen, nadir görülen otozomal resesif geçişli bir hastalıktır. Anestezistler bu kanama riskinin farkında olmalı ve gerekli önlemleri almalıdırlar. Bu yazıda, tromboelastografi traseleri rehberliğinde trombosit transfüzyonu sonrası başarılı hipospadias tamiri yapılan 9 yaşındaki GT tanılı erkek olgu sunulmuştur.Öğe The Impact of Surgical Procedures During Septorhinoplasty on the Intraoperative Pain Response(Oxford Univ Press Inc, 2021) Ince, Bilsev; Zuhour, Moath; Yusifov, Merve; Erol, Atilla; Dadaci, MehmetBackground: During septorhinoplasty, many different surgical procedures are employed to bring the nose to the desired shape and solve breathing complaints. As a matter of course, intraoperative pain response occurs due to these procedures. Objectives: With this study, the authors aimed to evaluate the intraoperative pain formed during septorhinoplasty surgery with numerical values and to determine which stage of surgery is more painful. Methods: Between April 2019 and March 2020, a total of 30 female patients who were planned to undergo septorhinoplasty were included in this prospective study. Standard anesthesia and analgesia were applied to all patients. During surgery, state entropy measure was utilized to evaluate the depth of anesthesia, and Surgical Pleth Index was employed to evaluate the response of the central nervous system to pain nociception. Results: The age of the patients ranged from 18 to 42 years (average, 25.3+/-6.1 years). The average value of state entropy recorded during the surgery for all patients was found to be 45.43+/-5.37. The mean beginning Surgical Pleth Index value recoded from all of the patients was 23.4 +/- 8.84 compared with the beginning value; the values recorded during periost dissection, lateral osteotomy, and lower turbinate lateralization were statistically significantly higher (P<0.005). Conclusions: Although sufficient depth of anesthesia and standard protocol of analgesia were applied, pain response was found to be significantly higher at some procedures during septorhinoplasty. The authors think that increasing the depth of anesthesia during these procedures will increase the comfort of this operation by inhibiting pain response. Level of Evidence: 4Öğe Management of the Difficult Paediatric Airway with a Simple Fiberoptic-Assisted Laryngoscope: A Report of Two Cases with Pierre Robin and Patau's (Trisomy 13) Syndrome(Aves, 2014) Kilicaslan, Alper; Erol, Atilla; Topal, Ahmet; Et, Tayfun; Otelcioglu, SerefAirway management of children with congenital craniofacial anomalies is a challenge for paediatric anaesthesiologists. We do not have any video-assisted airway device in our department for difficult paediatric intubations. We decided to attach a regular fiberoptic (outer diameter; 3.7 mm, Karl Storz, Germany) scope to a conventional Macintosh Laryngoscope (size 1). We describe two cases of Pierre Robin and Patau's (Trisomy 13) syndrome successfully intubated with a fiberoptic-assisted laryngoscope (FOL). A fiberoptic scope and any size of a laryngoscope blade can be easily assembled in the operating room. The FOL may be a useful device in the setting of difficult paediatric intubation.Öğe Normal ve zor havayolu simülasyonlarında C-MAC D-Blade, Konvansiyonel C-MAC ve Macintosh Laringoskopların karşılaştırılması(2014) Kılıçaslan, Alper; Topal, Ahmet; Erol, Atilla; Tuncer Uzun, SemaAMAÇ: Yakın bir zamanda zor havayolu yönetiminin mevcut potansiyelini daha da geliştirmek için CMAC sistemine, bladei daha fazla açılandırılmış CMAC D-blade eklendi. Bu çalışmanın amacı, normal ve zor havayolu simülasyonlarında yeni CMAC D-blade in laringoskopik görüntü ve entübasyon parametrelerini konvansiyonel CMAC video laringoskop ve Macintosh direkt laringoskop (ML) ile karşılaştırarak araştırmaktı. YÖNTEMLER: Bu randomize kontrollü çalışma 26 deneyimli anestezi uygulayıcısı tarafından gerçekleştirildi. Endotrakeal entübasyon işlemleri Laerdal SimMan mankeninde: (1) normal havayolu, (2) servikal omurga immobilizasyonu, (3) dil ödemi senaryolarında gerçekleştirildiler. Entübasyon süreleri, başarı oranları, entübasyon deneme sayıları, laringoskopi görüntüleri, diş kompresyonunu şiddeti kaydedildi. BULGULAR: Tüm senaryolarda videolaringoskoplar Macintosh laringoskoptan daha iyi görüntü sağladılar ve daha az diş kompresyonuna neden oldular. Servikal omurga immobilizasyonu senaryosunda D-blade diğer laringoskoplara göre daha az diş kompresyonuna neden oldu (p0,001). Entübasyon başarısı açısından videolaringoskoplar arasında fark yoktu (p0,05). CMAC ile en kısa entübasyon süreleri elde edildi. ML ile başarısızlık oranı %19 idi. Dil ödemi senaryosunda, CMAC ile daha başarılı ve daha hızlı entübasyon sağlandı (p0,001). Videolaringoskoplar arasında laringoskopik görüntü skorları ve diş basısı açısından fark yoktu (p0,05). Başarısız entübasyon oranı ML ile %46 ve D-blade ile %7 idi. SONUÇ: CMAC D-blade servikal omurga immobilizasyonu senaryosunda konvansiyonel CMAC ve MLa göre daha az diş kompresyonuna neden olmuştur. Konvansiyonel CMAC ile dil ödemi senaryosunda D-blade ve MLa göre daha iyi entübasyon şartları sağlanmıştır. Bu iki videolaringoskop farklı zor havayolu şartlarında birbirlerini tamamlayabilirlerÖğe A randomised-controlled, prospective study on the effect of dorsal penile nerve block after TURP on catheter-related bladder discomfort and pain(Wiley, 2021) Goger, Yunus Emre; Ozkent, Mehmet Serkan; Goger, Esra; Kilinc, Muzaffer Tansel; Ecer, Gokhan; Piskin, Mehmet Mesut; Erol, AtillaPurpose: In the present study, the impact of penile nerve block (PNB) on postoperative pain and Catheter-Related Bladder Discomfort (CRBD) in the transurethral resection of prostate(TURP) patients were evaluated. Methods: Participants of the present study were selected from patients who performed TURP under spinal anaesthesia for benign prostatic hyperplasia (BPH) between January 2018 and July 2020. The present study was planned as a single-centre, randomised-controlled prospective study in which the patients were divided into two groups. Group 1 was administered Control (n:40), and Group 2 ultrasonography(USG) guided PNB (n:40). The patients were included in the Groups, respectively. Visual analogue scale (VAS) scores were questioned and recorded in order to evaluate the postoperative pain complaints of the patients after the operation. In addition, in order to evaluate the CRBD, VAS scores were questioned and recorded as 0th, 0-1th hour, 1st-2nd hour, 2nd-4th hour, 4th-8th hour, 8th-12th hour, and 12th-24th hour. In addition, postoperative pain and need for analgesic drug were recorded. Tramadol was given to patients with moderate to severe CRBD. The findings were compared between the Groups. Results: There was no statistical difference demographic and per-operative data between Group 1 and Group 2. The CRBD and pain-related VAS scores were significantly higher in Group 1 between the 0 and 8th hours. There was no difference between VAS scores in the postoperative 8-24th hours. In total 24 hours, Group 2's need for tramadol was significantly less than Group 1. On examining the factors affecting CRBD in the multivariate analysis, age, body mass index(BMI), prostate volume, operation time do not affect CRBD statistically, and only PNB reduces CRBD (P: .029). While less drug-related complications were observed in Group 2, no serious complications related to PNB were observed. Conclusion: Penile nerve block is an effective method for the decrease pain and CRBD after urological surgery. It will also reduce the need for analgesics, and provide painless patients in the postoperative period.Öğe Response to Makkar and Singh's comment on our article 'Determination of optimum time for intravenous cannulation after induction with sevoflurane and nitrous oxide in children premedicated with midazolam'(Wiley, 2015) Kilicaslan, Alper; Gok, Funda; Erol, Atilla; Okesli, Sermin; Sarkilar, Gamze; Otelcioglu, Seref[Abstract Not Availabe]
