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Öğe Diyabetik Vakalarda Roküronyumun Nöromusküler Blok Özellikleri(2014) Topal, Ahmet; Sargın, Mehmet; Et, Tayfun; Tuncer Uzun, SemaAmaç: Diyabetik hastalarda motor sinir liflerinde fonksiyonel kayıplar ortaya çıkmakta ve bu durum anestezi yönetimini birçok yönden etkileyebilmektedir. Bu çalışmada roküronyumun nöromusküler blok etkilerinin non-diyabetik hastalara göre tip II diyabetli hastalarda farklı olup olmadığını araştırmayı amaçladık. Materyal ve Metod: 18 diyabetik ve 21 non-diyabetik hastanın, 0,6 mg kg-1 roküronyum uygulanmasından sonra nöromüsküler transport monitörü kullanılarak nöromusküler fonksiyonları değerlendirildi.Etki başlama süresi, klinik etki süresi, derlenme süresi, toplam roküronyum dozu, supramaksimal uyarı şiddeti ve Goldberg entübasyon skoru karşılaştırıldı. Bulgular: Etki başlama (118,3341,61 sn. & 142,0028,68 sn.) ve derlenme (13,339,83 dak. & 22,3811,64 dak.) süreleri diyabetik hastalarda daha uzundu (p0,05), etki süresi ve supramaksimal uyarı şiddeti benzerdi (p0,05). Sonuç: Diyabetik hastalarda etki başlama ve derlenme sürelerinde görülen uzamanın, diyabete bağlı gelişen nöropatik bir komplikasyon olduğunu ve roküronyumun farmakodinamiğinde diyabetin etkili olduğunu düşünmekteyiz.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 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 Neuromuscular Characteristics of Rocuronium in Diabetic Patients(Cukurova Univ, Fac Medicine, 2014) Topal, Ahmet; Sargin, Mehmet; Et, Tayfun; Uzun, Sema TuncerPurpose: In diabetic patients, there may be obsserved functional loss of motor nerve fibers and this fact may affect the management of anesthesia in many ways. In our study we aimed to research if there is any differences between nondiabetic patients and the patients who have type 2 diabetes on the side of nueromuscular blockade characteristics of rocuronium. Material and Methods: 18 diabetic and 21 non-diabetic patients included to study, each patient evaluated by the NMT device after administiration of 0,6 mg/kg rocuronium intravenously. The onset of action time, clinical acting time, recovery time, total rocuronium dosage for each patient, amplitude of supramaximal excitation and Goldberg score were compared in the two groups. Results: Time of action (118,33 +/- 41,61 sn. & 142,00 +/- 28,68 sn.) and recovery time (13,33 +/- 9,83 dak. & 22,38 +/- 11,64 dak.) were longer than in diabetic patients (p<0,05), time of action and amplitude of supramaximal excitation were similar in two groups (p>0,05). Conclusion: We consider that the prolongation of onset of action time and recovery time in diabetic patients, is a complicaiton of diabetic neuropathy and diabetes may effect the pharmacodynamics of rocuronium.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.
