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Öğe Comparison of Bispectral Index and Vital Parameters in Rabbits Receiving Propofol or Isoflurane Anesthesia(Univ Fed Rio Grande Do Sul, 2013) Saritas, Tuba Berra; Saritas, Zulfikar Kadir; Korkmaz, Musa; Sivaci, Remziye GulBackground: Reflexes, muscle tonus, heart rate, respiratory frequency and blood pressure are parameters that can be used to evaluate the depth of anesthesia. Bispectral index (BIS) was developed with the objective of evaluating quantitatively the sedative and hypnotic effects of anesthetic drugs. It is widely used to assess central nervous system depression levels. The objective of this study was to compare changes in BIS and several vital parameters during general anesthesia achieved with either propofol or isoflurane, following premedication with dexmedetomidine. Materials, Methods & Results: Adult female New Zealand rabbits (Mean +/- SD body weight 3.6 +/- 0.4 kg) were procured from a commercial source certified for medical experimentation. The animal number in each of the two study groups was four, for a total of eight. The animals were checked before the study to ascertain their good health. The animals, randomly allocated to either of two study groups, were given dexmedetomidine, 20 mu g/kg i.v. Induction was realized by means of propofol, 8 mg/kg i.v. in the propofol group (n = 4), and by administration through a glove mask of isoflurane, 4%, in the isoflurane group (n = 4). Anesthesia maintenance was assured by propofol, 0.6 mg/kg/min or 2% isoflurane with oxygen, respectively. Both anesthetic applications were well tolerated by the rabbits. Before premedication (T0), at the time points of 1 (T1) and 5 min (T2) after dexmedetomidine injection, 1 min into anesthesia induction (T3), and 10 (T4), 30 (T5) and 60 min (T6) after start of maintenance, the following were recorded: BIS, systolic, diastolic and mean arterial blood pressure, heart rate and Anesthesia Score (AS). Blood gas analysis, serum sodium and potassium, blood glucose level, hemoglobin and hematocrit were measured at time points T0 and T6. MAP dropped significantly lower in the propofol group at times T-2, T-3 and T-4 (P < 0.05). Under BIS monitoring, BIS values were also found to be relatively lower in the propofol group at times T-1, T-2 and T-4, corresponding in this to AS. At T-4, the BIS values were, respectively, 69.5 +/- 6.24 and 68.25 +/- 3.59 in the isoflurane and propofol groups (P < 0.05). In summary, premedication with dexmedetomidine did not, differently than with humans, assure deep sedation; BIS values, in parallel with our AS evaluation, reached levels of deep anesthesia in the maintenance stage both in the propofol and isoflurane groups. BGA results in arterial blood (pH, PaO2, PaCO2, BE, HCO3) as well as hematocrit (Hct), Na+, K+, glucose, hemoglobin (Hb) were recorded and reported in Table 2. A significant increase in pH was noted at T-6 (P < 0.05) in the propofol groups compared to animals given isoflurane (7.39 +/- 0.01 vs 7.35 +/- 0.003, respectively), all measurements remaining within the normal values. Discussion: Vital parameters showed parallelism with the values of both our AS and BIS in this study, in which we administered general anesthesia with either propofol or isoflurane to rabbits premedicated with dexmedetomidine. Publications on humans show that surgical anesthesia is realized at BIS values under 60; BIS fell in rabbits in parallel to MBP at 10, 30 and 60 min of anesthesia, and AS also showed that the depth of anesthesia was adequate. No surgery having been performed in this study, we think that the parameters noted in this paper should be investigated in future studies that include surgery.Öğe Comparison of the Depth of Anesthesia Produced with Dexmedetomidine-Sevoflurane or Medetomidine-Sevoflurane by Using Bispectral Index Monitoring(Univ Fed Rio Grande Do Sul, 2014) Saritas, Zulfikar Kadir; Korkmaz, Musa; Saritas, Tuba Berra; Sivaci, Remziye GulBackground: Bispectral index (BIS) monitor was developed to utilize the depth of anesthesia by estimating electroencephalogram (EEG) signals. BIS, which is the numerical value of EEG derivative, is used for evaluation of depression of central nervous system (CNS) in human medicine. The depressive effect of sedative and anaesthetic agents on CNS in human is correlated to BIS. Dexmedetomidine (DEX) is administered as continuous infusion during anesthesia and surgery in humans. DEX is a hypnotic with high selectivity for alpha 2-adrenergic receptors. Materials, Methods & Results: Adult female New Zealand rabbits (mean +/- SD body weight 3.8 +/- 0.5 kg) were procured from a certified commercial source to use in medical researches. The animal number in each of the two study groups was four, for a total of eight. The rabbits were randomly divided into two equal groups (n = 4). The rabbits DEX group were administered 20 mcg/kg of i.v. DEX HCI for premedication. Medetomidine (MED) group was administered 20 mcg/kg of iv MED for premedication. Induction was provided by 5% of sevoflurane + 4 L/min oxygen via glove mask in the both groups. General anesthesia was maintained with 3% of sevoflurane + oxygen on spontaneous respiration for 30 min. The animals' temporomandibular region was shaved; its fat was eliminated with ether before the study. Human sensors were used as BIS sensor consisted of 5 electrodes. Three were placed into frontal area as the remaining two into the pre-auricular area. After ensuring the connection of the sensor to the BIS monitor, BIS value was continuously followed and recorded at 0 min (T0), 1st (T1), 5th (T5), 7th (T7), 9th (T9), 15th (T15) 20th (T20), 25th (T25) and at 30th min (T30) in both groups while the rabbits were awake. At T1 measure point, DEX and MED were applied; sedation was produced at T5; 5% of sevoflurane was administered through glove-mask method at T7 for induction; general anesthesia was obtained at T9 and continued during T15, T20, T25 and T30; they were awakened at the end of 30th min. On the day preceding the study, they were sedated; their femoral arteries were localized and catheterized under local anesthesia following sedation. At T0, T1, T5, T7, T9, T15, T20, T25 and T30 measure time points, the catheter-transducer connection was established for mean arterial blood pressure (MAP) measurement; for ECG monitoring, ECG electrodes were attached to all four extremities of the subjects and, ECG tracings from lead II were monitored and recorded on the multi-channel monitor. The pH was kept between 7.35 - 7.45, as PCO2 between 35 - 45 mmHg. All animals in both groups were documented during the study for Anesthesia Score (AS). MAP and BIS decline in DEX group at the end of 1st min at statistical significance (P < 0.05). At the same time point, AS was recorded higher in DEX group (P < 0.05). In the comparison of DEX group with MED group at T5; HR, MAP and BIS markedly declined in DEX group (P < 0.05); however, AS was found higher in DEX group as being statistically significant at the same time point (P < 0.05). As it was at T5, Heart Rate (HR), MAP and BIS were also found statistically significantly low in DEX group at T7 and T9; while AS was found higher as compared to MED group (P < 0.05). BIS value in MED group was low at a statistical significance level at T15, T20, T25 and T30 time points (P < 0.05). Discussion: In present study, sevoflurane administration with glove mask method provides sufficient anesthesia in the rabbits which were premedicated with DEX and MED in experimental studies or surgical procedures during veterinary practice. Besides the vital parameters and AS monitoring, BIS monitoring is also an effective method in determination of the depth of anesthesia in rabbits.Öğe Comparison of the effects of gabapentin and pregabalin on wound healing in rats(Wiley, 2016) Saritas, Tuba Berra; Korkmaz, Musa; Sevimli, Alper; Saritas, Zulfikar KadirGabapentinoids are effective adjunct drugs for reducing postoperative pain. However, the effects of gabapentinoids on wound healing have not been evaluated yet. In this study we evaluated their effects onwound healing. Atotal of 17 maleWistar-Albino rats, 250-350 g, were divided into three groups randomly: control group (n = 5, 2ml saline), gabapentin group (n = 6, 20 mg/kg gabapentin) and pregabalin group (n = 6, 20 mg/kg pregabalin). Until day 13 inflammation scores were significantly lower (P < 0.05) and wound healing was significantly better in the control group when compared with gabapentin and pregabalin groups (P < 0.001). Inflammation scores were significantly lower in pregabalin group when compared with gabapentin group until day 13. But wound healing was significantly better in gabapentin group than in pregabalin group between days 13 and 21. In conclusion when gabapentin and pregabalin were compared, although pregabalin decreases inflammation scores, gabapentin has better results in wound healing.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 The determination of histopathological and biochemical effects of the rabbit knee joint injected dexketoprofen trometamol(Wiley, 2015) Hacibeyoglu, Gulcin; Saritas, Tuba Berra; Saritas, Zulfikar Kadir; Korkmaz, Musa; Sevimli, Alper; Mehmetoglu, Idris; Otelcioglu, SerefThis study was conducted to investigate possible histopathological effects and biochemical reflections of intra-articular dexketoprofen trometamol. A total of 24 New Zealand rabbits were included in the study. Blood sampling was carried out from all animals on the first day, then they were randomly allocated either to the control group (GroupC, n=9) or the dexketoprofen trometamol group (GroupD, n=15). GroupC underwent each two intra-articular injections of saline, 0.25mL into right and 0.50mL into left knee. Group D was injected 0.25mL (6.25mg) dexketoprofen trometamol into the right knee and 0.50mL (12.5mg) into the left. The groups were divided randomly into three. Tissue and blood samples were collected from Groups C1 and D1 on the first day, C2 and D2 on the second day and C3 and D3 on the 10th day of the study. Interleukin-1 (IL-1), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-) and C-reactive protein (CRP) levels were studied. The histopathological examination of C and D groups did not present any deterioration. IL-6 basal levels were significantly higher in Group D2 compared with C2 and C3 compared with D3. Basal TNF- levels were higher compared with day 1 in Group C1, and IL-6 and CRP levels were higher in Group D3. Also, none of the increases in these values are supported by histopathological evaluation results. Consequently, we suppose that dexketoprofen trometamol does not cause histopathological deterioration in articular cartilage of rabbits, and the increases in biochemical parameters exclusively are not clinically significant.Öğe Determination of Propofol and Isoflurane Anesthesia Depth with Bispectral Index Monitorization in Dogs Undergoing Ovariohysterectomy Procedure(Kafkas Univ, Veteriner Fakultesi Dergisi, 2014) Saritas, Zulfikar Kadir; Saritas, Tuba Berra; Yilmaz, Oktay; Korkmaz, MusaIn this study, 12 bitches were used to compare anesthetic depth by bispectral index (BIS) monitoring and vital parameters under propofol and isoflurane anesthesia. The animals were randomly divided into two groups (n=6) for ovariohysterectomy. All animals were premedicated with atropine sulphate (0.04 mg/kg, sc) and midazolam (0.3 mg/kg, iv). The induction of anesthesia was achieved by propofol (5 mg/kg, iv) in groups. General anesthesia was maintained with propofol (0.4 mg/kg/min.) in first group (PRO group) and 2% isoflurane in second group (ISO group). Non-invasive systolic (SAP), diastolic (DAP), mean arterial blood pressure (MAP), heart rate (HR), respiratory rate (RR), haemoglobin oxygen saturation (SpO(2)) and BIS were measured before anesthesia (0 min, T0), maintenance of anesthesia (T5, T10, T15), end of anesthesia (T30) and additionally BIS also measured at 5 min after the terminating of anesthesia (T35). HR, RR, SAP and DAP did not significantly differ between groups. The MAP value did not show any significant difference within both groups. However, the MAP value detected on T5, T10, T15 and T30 was higher in PRO group than those detected in ISO group (P<0.05). The BIS values detected at all measured times in PRO and ISO groups were lower than those detected before anesthesia. The BIS value detected on T5 and T10 was higher in ISO group, whereas the value determined at T15 was higher in PRO group (P<0.05). In conclusion, it is suggested that bispectral index is a useful tool for monitoring depth of anesthesia in veterinary practice and total intravenous anesthesia with propofol may be used as an alternative to isoflurane anesthesia.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 Infraclavicular block experience in a case of multiple trauma patient(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2017) Sargin, Mehmet; Saritas, Tuba Berra; Sarkilar, Gamze; Otelcioglu, SerefAnesthetic applications in trauma patients have special features because of patient's traumatic reasons, preexisting systemic diseases and inappropriate fasting period as in most of the emergent multi traumatic patients. Ultrasound guided peripheral nevre blocks simplify anesthetic applications in suitable patients. In this article an ultrasound guided infraclavicular block in a multi traumatic patient was reported.Öğe 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 Ocular Surface Disorders in Intensive Care Unit Patients(Hindawi Publishing Corporation, 2013) Saritas, Tuba Berra; Bozkurt, Banu; Simsek, Baris; Cakmak, Zeynep; Ozdemir, Mehmet; Yosunkaya, AlperPatients in intensive care units (ICU) are at increased risk of corneal abrasions and infectious keratitis due to poor eyelid closure, decreased blink reflex, and increased exposure to pathogenic microorganisms. The aim of this retrospective study was to evaluate the ocular surface problems in patients who stayed in ICU more than 7 days and were consulted by an ophthalmologist. There were 26 men and 14 women with a mean age of 40.1 +/- 18.15 years (range 17-74 years). Conjunctiva hyperemia, mucopurulent or purulent secretion, corneal staining, and corneal filaments were observed in 56.25%, 36.25%, 15%, and 5% of the eyes, respectively. Keratitis was observed in 4 patients (10%) who were treated successfully with topical antibiotics. Mean Schirmers test results were 7.6 +/- 5.7 mm/5 min (median 6.5 mm/5 min) in the right, and 7.9 +/- 6.3 mm/5 min (median 7 mm/5 min) in the left eyes. Schirmers test results were <5 mm/5 min in 40% of the subjects. The parameters did not show statistically significant difference according to mechanical ventilation, sedation, and use of inotropes. As ICU patients are more susceptible to develop dry eye, keratopathy, and ocular infections, they should be consulted by an ophthalmologist for early diagnosis of ocular surface disorders.Öğe Olanzapine-Induced Malignant Neuroleptic Syndrome(Aves, 2014) Saritas, Tuba Berra; Cankaya, Baris; Yosunkaya, AlperNeuroleptic malignant syndrome (NMS), caused by antipsychotic therapy, shows itself with mental status alteration, high fever, autonomic dysfunction, and muscle rigidity. It is a rare idiosyncratic reaction with mortality risk. The etiology is still unknown. NMS- related mortality and morbidity can be decreased by cessation of the used drug and aggressive treatment. Olanzapine is a thienobenzodiazepine, a member of atypical antipsychotic drugs; its structure and effects on neurotransmitters resemble clozapine. Here we report a case of bipolar disorder receiving olanzapine therapy for 10 years, who developed NMS without rigidity. We emphasized the importance of early hydration and hemodiafiltration therapy.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 Predictors of postoperative sore throat in intubated children(Wiley-Blackwell, 2012) Borazan, Hale; Saritas, Tuba Berra[Abstract Not Availabe]
