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Öğe Canavan hastalığında anestezi yönetimi: İki olgu sunumu(2017) Yediyıldız Bulun, Merve; Yılmaz, Resul; Tosun, Osman Mücahit; Reisli, Ruhiye; Tuncer Uzun, SemaCanavan hastalığı, aspartoaçilaz enzim eksikliği ile karakterize, otozomal resesif kalıtılan ilerleyici bir lökodisitrofidir. Canavanhastalığında makrosefali, kas güçsüzlüğü, yutma bozukluğu, gastroözefageal reflü ve epilepsi görülebilecek bulgulardandır. Tedavisisemptomatiktir. Bu yazıda Canavan hastalığı olan iki olguda uyguladığımız anestezi deneyiminin tartışılması amaçlanmıştır.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 of pupillometer, critical care pain observation scale, and vital findings in the evaluation of pain in intensive care patients without oral communication(Kare Publ, 2023) Yaman Gulper, Rabia; Reisli, Ruhiye; Arican, Sule; Yosunkaya, Alper; Tuncer Uzun, SemaObjectives: The aim of this study was to investigate the effects of portable infrared Pupillometer, Critical Care Pain Observation Scale (CPOT), and vital sign changes during painful procedures on patients with mechanical ventilators in the intensive care unit (ICU), and comparing the efficacy of these methods to detect the presence of pain. Methods: In 50 patients who could not verbally state pain, admitted to Necmettin Erbakan University Meram Faculty of Medicine ICU, aged 18-75 years, and connected to a mechanical ventilator, vital sign changes, CPOT scale assessments, and pain evaluation with a portable infrared pupillometer were performed during endotracheal aspiration and position changes, which are defined as painful stimuli. Results: Data were collected from 50 patients with a mean age of 57.4 +/- 17.9 years and 48% of males. The systolic, diastolic, and mean arterial pressure and heart rate values, CPOT scores, and pupillometric measurements of the patients increased significantly at the time of aspiration and change of position (p<0.05). Neurological pupil index scores showed a significant decrease at the time of painful stimulation (p<0.05). Conclusion: It was found that pupil diameter changes evaluated using a portable infrared pupillometric measuring device can be used effectively and reliably in pain assessment in patients who are treated in the ICU, supported by mechanical ventilation and who cannot communicate verbally.Öğe Comparison of pupillometer, critical care pain observation scale, and vital findings in the evaluation of pain in intensive care patients without oral communication(Kare Publ, 2023) Yaman Gulper, Rabia; Reisli, Ruhiye; Arican, Sule; Yosunkaya, Alper; Tuncer Uzun, SemaObjectives: The aim of this study was to investigate the effects of portable infrared Pupillometer, Critical Care Pain Observation Scale (CPOT), and vital sign changes during painful procedures on patients with mechanical ventilators in the intensive care unit (ICU), and comparing the efficacy of these methods to detect the presence of pain. Methods: In 50 patients who could not verbally state pain, admitted to Necmettin Erbakan University Meram Faculty of Medicine ICU, aged 18-75 years, and connected to a mechanical ventilator, vital sign changes, CPOT scale assessments, and pain evaluation with a portable infrared pupillometer were performed during endotracheal aspiration and position changes, which are defined as painful stimuli. Results: Data were collected from 50 patients with a mean age of 57.4 +/- 17.9 years and 48% of males. The systolic, diastolic, and mean arterial pressure and heart rate values, CPOT scores, and pupillometric measurements of the patients increased significantly at the time of aspiration and change of position (p<0.05). Neurological pupil index scores showed a significant decrease at the time of painful stimulation (p<0.05). Conclusion: It was found that pupil diameter changes evaluated using a portable infrared pupillometric measuring device can be used effectively and reliably in pain assessment in patients who are treated in the ICU, supported by mechanical ventilation and who cannot communicate verbally.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 Evaluation of pupil diameter for pain assessment in interventional headache management(Kare Publishing, 2023) Yılmaz, Resul; Kocadağ, Gökhan; Arıcan, Şule; Özdemir, Mustafa; Reisli, Ruhiye; Tuncer Uzun, SemaObjectives: Pain is a subjective experience. Besides, sensory, affective and behavioral responses, and autonomic response are part of pain response to noxious stimuli. Evaluation of pupil diameter by pupillometry has been used as an alternative method for pain assessment. In algologic procedures like interventional headache management have not been addressed in the literature. Herein, we investigated changes in pupil diameter during interventional headache management as an objective method for pain assessment. Methods: Demographic data of the patients were collected before the bilateral major occipital nerve blockage (MONB) pro-cedure. Numeric rating score (NRS) and pupil diameter measurements by pupillometer were recorded before MONB. Standard MONB procedure was applied to all patients. Pain assessment and pupillary diameter measurements were obtained after nerve blockage. Results: Twenty-eight patients were included in this study. Mean age was 41.03 +/- 12.63 years. There is no difference between the hemodynamic parameters before and after the procedure. Post-procedure NRS and pupil diameter values were signifi-cantly lower than pre-procedure values. There was a positive correlation between changes in NRS scores and changes in the right and left pupil diameters. Conclusion: There was a significant correlation between NRS score and pupil diameter in patients who underwent MONB. Monitoring of pupil diameter can be used for pain assessment during headache treatment. Evaluation of pupil diameter is a new approach in pain palliation. Future research is needed to study the effect of other parameters, that is, gender, age, origin of pain, acute, and chronic pain on pupil diameter and to evaluate its application in different algological procedures.Öğe Evaluation of the efficacy of erector spinae plane block and intercostal nerve block in the postherpetic neuralgia(Kare Publ, 2020) Hacibeyoglu, Gulcin; Arican, Sule; Ulukaya, Sinan Oguzhan; Yilmaz, Resul; Reisli, Ruhiye; Uzun, Sema TuncerObjectives: The aim of this study was to compare the efficacy of an intercostal nerve block, which has been used for many years in the treatment of postherpetic neuralgia, and the more recent alternative of an erector spinae plane (ESP) block. Methods: The records of 39 patients who were treated in the algology department for postherpetic neuralgia between May 1, 2015 and May 1, 2018 were evaluated retrospectively. Patients who received an intercostal nerve block constituted Group 1 and those who received an ESP block were categorized as Group 2. The change in numeric rating scale (NRS) and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scores in the short term and in the long term were the primary results of the study. Results: The NRS, LANSS, and sleep interference scale (SIS) scores of the patients in Group 1 and Group 2 were found to be significantly lower at the 24th hour, week 4, and week 12 compared with the values obtained before block application. In Group 1, the scores recorded at week 4 and week 12 were significantly higher than the 24th hour values, whereas no difference was observed between these results in Group 2.There was no significant difference between the groups in the week 4 and week 12 scores. Similarly, no significant difference was observed in the NRS, LANSS, or SIS scores before the block application or at the 24th hour. However, the scores at week 4 and week 12 were significantly lower in Group 2 compared with Group 1. Conclusion: The results indicated that an ESP block significantly decreased neuropathic pain symptoms and the need for additional treatment in postherpetic neuralgia treatment in the long term.Öğe Evaluation of the efficacy of erector spinae plane block and intercostal nerve block in the postherpetic neuralgia(Kare Publ, 2020) Hacibeyoglu, Gulcin; Arican, Sule; Ulukaya, Sinan Oguzhan; Yilmaz, Resul; Reisli, Ruhiye; Uzun, Sema TuncerObjectives: The aim of this study was to compare the efficacy of an intercostal nerve block, which has been used for many years in the treatment of postherpetic neuralgia, and the more recent alternative of an erector spinae plane (ESP) block. Methods: The records of 39 patients who were treated in the algology department for postherpetic neuralgia between May 1, 2015 and May 1, 2018 were evaluated retrospectively. Patients who received an intercostal nerve block constituted Group 1 and those who received an ESP block were categorized as Group 2. The change in numeric rating scale (NRS) and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scores in the short term and in the long term were the primary results of the study. Results: The NRS, LANSS, and sleep interference scale (SIS) scores of the patients in Group 1 and Group 2 were found to be significantly lower at the 24th hour, week 4, and week 12 compared with the values obtained before block application. In Group 1, the scores recorded at week 4 and week 12 were significantly higher than the 24th hour values, whereas no difference was observed between these results in Group 2.There was no significant difference between the groups in the week 4 and week 12 scores. Similarly, no significant difference was observed in the NRS, LANSS, or SIS scores before the block application or at the 24th hour. However, the scores at week 4 and week 12 were significantly lower in Group 2 compared with Group 1. Conclusion: The results indicated that an ESP block significantly decreased neuropathic pain symptoms and the need for additional treatment in postherpetic neuralgia treatment in the long term.Öğe Fluoroscopy-guided genicular nerves pulsed radiofrequency for chronic knee pain treatment(Kare Publ, 2020) Arican, Sule; Hacibeyoglu, Gulcin; Akkoyun, Ozlem; Tuncer Uzun, Sema; Reisli, RuhiyeObjectives: The primary objective of this study was to investigate the effects of Pulsed RF application in the genicular nerve on pain and function in patients with osteoarthritis (OA) and its side effects. Methods:This study was conducted between February 2018 and June 2018. Patients who were previously administered diagnostic blocks were evaluated a day later; a drop of at least 50% in numeric pain scores was considered a positive response, and these patients were included in the Pulsed RF neurotomy procedures. Radiofrequency (RF) cannula was advanced towards targeted nerves under the guidance of fluoroscopy. RF lesions were created by applying Pulsed RF treatment to the three genicular nerves three times with five minutes intervals at 42 degrees C using NT1000 RF Generator. Following the Pulsed RF application, 2 mL 0.5% bupivacaine was injected into each genicular nerve as an anesthetic agent. VAS, pain DETECT scores, WOMAC scores were evaluated preoperative baseline and postprocedure weeks 1, 4, and 12. Patient Global Impression of Change (PGIC) score was evaluated postprocedure weeks 12. Results:This study included 20 patients who were administered genicular nerve Pulsed RE The mean age was 55.2 +/- 3.24 years, and F/M ratio was 12/8. Compared to the pre-procedure period, patients' pain and function evaluation, WOMAC and VAS values decreased by approximately 50% at the end of the 12th week. No side effect was observed in any patients. Conclusion: Our findings suggest that Pulsed RF neurotomy of the genicular nerves is an efficient and safe treatment method for patients with chronic knee osteoarthritis.Öğe Fluoroscopy-guided genicular nerves pulsed radiofrequency for chronic knee pain treatment(Kare Publ, 2020) Arican, Sule; Hacibeyoglu, Gulcin; Akkoyun, Ozlem; Tuncer Uzun, Sema; Reisli, RuhiyeObjectives: The primary objective of this study was to investigate the effects of Pulsed RF application in the genicular nerve on pain and function in patients with osteoarthritis (OA) and its side effects. Methods:This study was conducted between February 2018 and June 2018. Patients who were previously administered diagnostic blocks were evaluated a day later; a drop of at least 50% in numeric pain scores was considered a positive response, and these patients were included in the Pulsed RF neurotomy procedures. Radiofrequency (RF) cannula was advanced towards targeted nerves under the guidance of fluoroscopy. RF lesions were created by applying Pulsed RF treatment to the three genicular nerves three times with five minutes intervals at 42 degrees C using NT1000 RF Generator. Following the Pulsed RF application, 2 mL 0.5% bupivacaine was injected into each genicular nerve as an anesthetic agent. VAS, pain DETECT scores, WOMAC scores were evaluated preoperative baseline and postprocedure weeks 1, 4, and 12. Patient Global Impression of Change (PGIC) score was evaluated postprocedure weeks 12. Results:This study included 20 patients who were administered genicular nerve Pulsed RE The mean age was 55.2 +/- 3.24 years, and F/M ratio was 12/8. Compared to the pre-procedure period, patients' pain and function evaluation, WOMAC and VAS values decreased by approximately 50% at the end of the 12th week. No side effect was observed in any patients. Conclusion: Our findings suggest that Pulsed RF neurotomy of the genicular nerves is an efficient and safe treatment method for patients with chronic knee osteoarthritis.Öğe Immunological mechanism of postherpetic neuralgia and effect of pregabalin treatment on the mechanism: a prospective single-arm observational study(Korean Pain Soc, 2021) Mercan, Aysel; Uzun, Sema Tuncer; Keles, Sevgi; Hacibeyoglu, Gulcin; Yilmaz, Resul; Reisli, RuhiyeBackground: Although neuropathic pain is a severe and common pain, its pathophysiology has not been elucidated yet. Studies in recent years have focused on the immune system's role in the pathogenesis of neuropathic pain. The aim of this study was to investigate the role of immunological mechanisms in neuropathic pain and the effect of pregabalin by measuring immunological marker levels in peripheral blood before and after pregabalin treatment in postherpetic neuralgia (PHN) patients with neuropathic pain. Methods: Forty patients diagnosed with PHN were included in the study. CD4, T follicular cells (If h: CD4(+)CXCR5(+)PD1(+)), Th17 (CD4(+)CCR6(+) and CD4(+)IL17A(+)), regulatory T cells (Treg: CD4(+)CD25(+)foxp3(+)), Th1 (CD4(+) CXCR3(+) and CD4(+ )IFN-gamma(+)) and Th2 (CD4(+) IL-4(+)) cell ratios were measured in peripheral blood samples before treatment and after 3 months of treatment. Results: When immunological marker and inflammation parameter levels were compared before and after treatment, the helper T cell ratio (CD3(+), CD4(+)) was 30.28 +/- 12.27% before treatment and 34.93 +/- 11.70% after treatment, so there was a statistically significant increase (P = 0.028). Th17 was 4.75 +/- 5.02% before treatment and 5.80 +/- 3.13% after treatment, and there was a statistically significant increase (P = 0.036). Conclusions: Immunological mechanisms play an essential role in the pathogenesis of neuropathic pain, immunologically based treatment approach will be the critical point of treatment.Öğe Ischemia-modified albumin (IMA) and dynamic thiol-disulfide homeostasis in patients with postherpetic neuralgia(Walter De Gruyter Gmbh, 2019) Arican, Sule; Hacibeyoglu, Gulcin; Ulukaya, Sinan Oguzhan; Avcioglu, Gamze; Reisli, Ruhiye; Uzun, Sema Tuncer; Erel, OzcanBackground: Ischemia-modified albumin (IMA) is an isotype of albumin that increases under oxidative stress, and plasma thiols are main defense mechanisms against oxidative stress. The objective of this study was to investigate thiol-disulfide homeostasis and serum IMA levels in postherpetic neuralgia (PHN) patients. Methods: A total of 29 PHN patients and 30 healthy controls were included in the study. Serum total and native thiol concentrations and serum disulfide concentration were measured using the method described by Erel and Neselioglu. The albumin cobalt binding test was used to measure serum IMA levels. Results: Serum IMA levels were 1.21 +/- 0.58 AU and 0.75 +/- 0.09 AU in the PHN and control groups, respectively (p <0.001). Serum total thiol concentrations were found to be 421.62 +/- 90.28 mu mol/L and 598.36 +/- 73.63 mu mol/L in the PHN and control groups, respectively (p <0.001). Serum native thiol concentrations were found to be 365.75 +/- 92.07 mu mol/L and 531.90 +/- 72.9 mu mol/L in the PHN and control groups, respectively (p < 0.001). Serum disulfide concentrations were found to be 33.23 +/- 5.33 mu mol/L and 27.93 +/- 7.81 mu mol/L in the PHN and control groups, respectively (p= 0.003). The native thiol/total thiol ratio was significantly lower, and the disulfide/total thiol and disulfide/native thiol ratios were significantly higher in the PHN group compared to the controls. Conclusions: IMA levels are high and dynamic thiol/disulfide homeostasis is disrupted in PHN patients.Öğe Ischemia-modified albumin (IMA) and dynamic thiol-disulfide homeostasis in patients with postherpetic neuralgia(Walter De Gruyter Gmbh, 2019) Arican, Sule; Hacibeyoglu, Gulcin; Ulukaya, Sinan Oguzhan; Avcioglu, Gamze; Reisli, Ruhiye; Uzun, Sema Tuncer; Erel, OzcanBackground: Ischemia-modified albumin (IMA) is an isotype of albumin that increases under oxidative stress, and plasma thiols are main defense mechanisms against oxidative stress. The objective of this study was to investigate thiol-disulfide homeostasis and serum IMA levels in postherpetic neuralgia (PHN) patients. Methods: A total of 29 PHN patients and 30 healthy controls were included in the study. Serum total and native thiol concentrations and serum disulfide concentration were measured using the method described by Erel and Neselioglu. The albumin cobalt binding test was used to measure serum IMA levels. Results: Serum IMA levels were 1.21 +/- 0.58 AU and 0.75 +/- 0.09 AU in the PHN and control groups, respectively (p <0.001). Serum total thiol concentrations were found to be 421.62 +/- 90.28 mu mol/L and 598.36 +/- 73.63 mu mol/L in the PHN and control groups, respectively (p <0.001). Serum native thiol concentrations were found to be 365.75 +/- 92.07 mu mol/L and 531.90 +/- 72.9 mu mol/L in the PHN and control groups, respectively (p < 0.001). Serum disulfide concentrations were found to be 33.23 +/- 5.33 mu mol/L and 27.93 +/- 7.81 mu mol/L in the PHN and control groups, respectively (p= 0.003). The native thiol/total thiol ratio was significantly lower, and the disulfide/total thiol and disulfide/native thiol ratios were significantly higher in the PHN group compared to the controls. Conclusions: IMA levels are high and dynamic thiol/disulfide homeostasis is disrupted in PHN patients.Öğe Limb-Girdle Musküler Distrofi’li Gebede Anestezi Yönetimi(2019) Yılmaz, Resul; Reisli, Ruhiye; Tosun, Osman Mücahit; Topal, Ahmet; Tuncer Uzun, SemaLimb-girdle musküler distrofiler (LGMD), otozomal dominant veya resesif geçiş özelliği gösteren,pelvis ve omuz çevresi kaslarında ilerleyici zayıflık ve atrofi ile ortaya çıkan, heterojen bir hastalıkgrubudur. Rejyonal anestezi sezeryan operasyonları için hem anne açısından hem de bebek açısından birçok avantajlara sahip olmakla birlikte, kas hastalığı öyküsü bulunan hastalarda rejyonal anestezi uygulaması ile etkin bir anestezi sağlanabilmektedir. Bununla birlikte, genel anestezinin bu hastalar için öngörülen komplikasyonlarından uzak durmak da olasıdır. LGMD sık görülmemekle birlikte, anestezi yönetimi açısından özellikli noktalar içermektedir. Bu olguda, LGMD’li gebede anestezi yönetimimize ait klinik deneyimimizi sunmayı amaçladık.Öğe Pharmachologic treatment of acute postoperative pain: A clinical practice guideline of The Turkish Society of Algology(Kare Publ, 2021) Reisli, Ruhiye; Akkaya, Omer Taylan; Arican, Sule; Can, Ozlem Selvi; Cetingok, Halil; Gulec, Mehmet Sacit; Talu, Gul KoknelSatisfactory pain relief is a fundamental right of every patient suffering from pain. Despite the developments on pharmachologic treatment modalities and interventions for pain control, inadequacy of postoperative pain management is still a major problem. After surgical intervention, 66% of patients experience moderate to severe pain during discharge, 9% after two weeks. Untreated postoperative pain may lead to prolonged hospital stay, increased intensive care needs, development of chronic pain, and reduced the patients quality of life. In the following guideline all aspects of postoperative pain briefly evaluated. The clinical practice of postoperative analgesia, recommendations, the diagnosis, assessment and pharmachologic treatment of acute postoperative pain with the current available agents in Turkey are discussed in this article. Our aim is to promote awareness of effective, and safe postoperative pain management strategies to meet the needs of the patients; minor patient groups, such as paediatric population, pregnant patients, elderly, patient with high body mass index and covid 19 diesease. Despite all the recommendations, any guidelines special cases where standard modalities fail to treat postoperative pain management as in patients with chronic pain who previously used opioids, drug addicts, the patient should be consulted with an pain specialist.Öğe Pharmachologic treatment of acute postoperative pain: A clinical practice guideline of The Turkish Society of Algology(Kare Publ, 2021) Reisli, Ruhiye; Akkaya, Omer Taylan; Arican, Sule; Can, Ozlem Selvi; Cetingok, Halil; Gulec, Mehmet Sacit; Talu, Gul KoknelSatisfactory pain relief is a fundamental right of every patient suffering from pain. Despite the developments on pharmachologic treatment modalities and interventions for pain control, inadequacy of postoperative pain management is still a major problem. After surgical intervention, 66% of patients experience moderate to severe pain during discharge, 9% after two weeks. Untreated postoperative pain may lead to prolonged hospital stay, increased intensive care needs, development of chronic pain, and reduced the patients quality of life. In the following guideline all aspects of postoperative pain briefly evaluated. The clinical practice of postoperative analgesia, recommendations, the diagnosis, assessment and pharmachologic treatment of acute postoperative pain with the current available agents in Turkey are discussed in this article. Our aim is to promote awareness of effective, and safe postoperative pain management strategies to meet the needs of the patients; minor patient groups, such as paediatric population, pregnant patients, elderly, patient with high body mass index and covid 19 diesease. Despite all the recommendations, any guidelines special cases where standard modalities fail to treat postoperative pain management as in patients with chronic pain who previously used opioids, drug addicts, the patient should be consulted with an pain specialist.Öğe Post-Spinal a Rare Complication and Treatment: Tinnitus and Epidural Blood Patch(Aves, 2015) Sarkilar, Gamze; Reisli, Ruhiye; Saritas, Tuba Berra; Gok, Funda; Sarigul, Ali; Otelcioglu, Seref[Abstract Not Availabe]Öğe A probable case of movement disorder (Tardive dyskinesia) due to duloive dxetine treatment(2018) Yılmaz, Resul; Üstün, Damlanur; Uzun, Sema Tuncer; Reisli, Ruhiye; Türk, ŞeydaTardive dyskinesia and tardive dystonia are caused by dopamine receptor blocking agents, mostly antipsychotics and sometimes antidepressants or calcium channel blockers. Duloxetine is a serotonin-noradrenaline reuptake inhibitor used in thetreatment of diabetic neuropathic pain and fibromyalgia, as well as major depression. In this case, we aimed to discuss the tardive dyskinesia-like appearance of a patient using duloxetine due to fibromyalgia.Öğe A probable case of pregabalin - related reversible hearing loss(Kare Publ, 2020) Yilmaz, Resul; Turk, Seyda; Reisli, Ruhiye; Tuncer Uzun, SemaPregabalin and gabapentin are similar compounds with analgesic, anticonvulsant, and anxiolytic characteristics. Due to these pharmacological features, they are commonly used throughout the world in neuropathic pain treatment and anxiety disorders. Mild to moderate side effects of the central nervous system, such as dizziness and somnolence, are important factors in deciding to terminate the use of pregabalin. Studies have also reported that the use of dose-dependent pregabalin resulted in peripheral edema and weight gain. Described in this case report is hearing loss occurring after an increase in the drug dose of a patient using pregabalin.Öğe Remifentanil infusion versus propofol and remifentanil patient controlled sedation/analgesia for moderate sedation during interventional radiological procedures: A prospective randomized trial(2018) Arıcan, Şule; Sarkılar, Gamze; Reisli, Ruhiye; Otelcioğlu, ŞerefAim: The use of intravenous sedation and analgesia during interventional radiological procedures is increasing. Sedation and analgesia should minimize patients’ negative psychological reactions caused by fears and anxiety. Also they should relieve pain and provide patients a safe and comfortable environment. The aim of this study was to compare the efficacy and safety of two drugs and methods used for moderate sedation during radiological procedures. Material and Methods: Sixty patients, with American Society of Anesthesiologists scores (ASA) I-II-III, undergoing interventional radiology procedures were included in this study. The patients were administered remifentanil bolus (0.2 ?g.kg-1) followed by remifentanil infusion (0.05 µg.kg-1.min-1) in Group R, 2.5mL loading dose (25 mg propofol–25 µg remifentanil) and a 1mL bolus dose (10 mg propofol–10 ?g remifentanil) via patient-controlled analgesia/sedation (PCAS) device in Group PR. All the patients’sedation levels were assessed with the Ramsey Sedation Scale (RSS), pain levels were assessed with Visual Analog Scale (VAS). Their recoveries were assessed with the modified Aldrete score (MAS) at 5?min intervals. Results: Although a significant difference was noted between the groups for RSS values at 5, 10, 20, 25, and 30th minutes during the procedure (P0.05), there was no significant difference in VAS, anxiety levels and MAS (P 0.05). Conclusion: Both propofol–remifentanil PCAS and remifentanil infusion provide sufficient moderate sedation.
