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Öğe Anaesthetic Management of a Child with Limb-Girdle Muscular Dystrophy(Aves, 2014) Sarkilar, Gamze; Mermer, Aydin; Yucekul, Melike; Ceken, Bedia Mine; Altun, Celalettin; Otelcioglu, SerefLimb-girdle muscular dystrophies are a group of disorders with wide genetic and clinical heterogeneity. These disorders may lead to an increase in life-threatening complications related to surgery and anaesthesia. In this case, the anaesthetic management of a child with limb-girdle muscular dystrophy is presented.Öğe Comparison of the effect of the Trendelenburg and passive leg raising positions on internal jugular vein size in critically ill patients(E-Century Publishing Corp, 2015) Gok, Funda; Sarkilar, Gamze; Kilicaslan, Alper; Yosunkaya, Alper; Uzun, Sema TuncerCentral vein catheterization is a common procedure performed on patients under intensive care. The safe and successful placement of the central venous catheter depends on vein size. Although used for this purpose, the Trendelenburg position can be hazardous in some patients. The aim of this study was to compare the effects of the Trendelenburg and passive leg raising (PLR) positions on the size of the right internal jugular vein (IJV) in mechanically ventilated patients under intensive care. Seventy-eight mechanically ventilated patients under intensive care were included into the study. Sonographic images of the right IJV were recorded in supine (control), 10 degrees Trendelenburg and 40 degrees PLR positions. Anterior-posterior and transverse diameter, cross-sectional area (CSA), and depth were calculated from the recorded images. The size of the right IJV (CSA, transverse and vertical diameters) was significantly larger in the Trendelenburg and PLR positions than in supine position. An increase of 26% in the IJV CSA was obtained in the Trendelenburg position and 23% in the PLR position, compared to the supine position. There was no significant difference between the measurements obtained from the Trendelenburg and PLR positions. The study shows that the Trendelenburg and PLR positions increase the size of the IJV to a similar extent in mechanically ventilated patients under intensive care.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 Diaphragm and Lung Ultrasonography During Weaning From Mechanical Ventilation in Critically Ill Patients(Springernature, 2021) Gok, Funda; Mercan, Aysel; Kilicaslan, Alper; Sarkilar, Gamze; Yosunkaya, AlperAim: Optimum Liming is crucial to avoid negative outcomes of weaning. We aimed to investigate predictive values of diaphragmatic thickening fraction (DTF), diaphragmatic excursion (DE), and anterolateral lung ultrasound (LUS) scores in extubation success and compare with rapid shallow breathing index (RSBI) in patients extubated under traditional parameters. Methods: Patients undergoing mechanical ventilation for >48 hours were included in the study. In patients planned for extubation, sonographic evaluations of the diaphragm and lung were performed at the T-tube stage. RSBI was achieved in the pressure support (PS) ventilation stage. Predictive values of DTF, DE, and anterolateral LUS scores were compared with RSBI in extubation success. Results: Sixty-two patients were enrolled in the study. The study population consisted mostly of trauma patients (77%). A cut-off value of 64 was obtained for RSBI. The positive predictive value (PPV) was found at 97% in extubation success. Cut-off values of 27.5 for DTF, 1.3 cm for the DE, and 6.5 for LUS scores were obtained al the T-tube stage, respectively. PPVs of all sonographic parameters were found over 90%. At the first stage, weaning and extubation failures were determined as 35 and 9.6%, respectively. RSBI was found as a powerful parameter in determining extubation success (r=0.774, p <= 0.001) and moderately correlated with sonographic parameters. Conclusion: Investigating the lung and diaphragm via ultrasound provides real-time information to increase extubation success. Cut-off values of 64 for RSBI, 27.5 for DTF, 1.3 cm for the DE, and 6.5 for LUS scores were obtained, respectively, and PPVs of all sonographic parameters were found over 90%. We consider that sonographic evaluations accompanied by an RSBI will increase extubation success in the weaning process.Öğe THE EFFECT OF ULTRASOUND GUIDANCE ON CENTRAL VENOUS CATHETER-ASSOCIATED BLOODSTREAM INFECTION IN CRITICAL CARE PATIENTS(Carbone Editore, 2013) Gok, Funda; Kilicaslan, Alper; Sarkilar, Gamze; Kandemir, Bahar; Yosunkaya, AlperBackground and aims: The central venous catheterization can be performed according to anatomical references points or by using ultrasound guidance. In this study, our aim was to perform a comparison between the application of these two methods for internal vein catheterization, especially with regards to the incidence of catheter-related bloodstream infections. Materials and methods: 97 critical care patients who underwent real-time USG-guided cannulation (Grup 1) of the internal jugular vein were prospectively compared with 97 critical care patients in whom the landmark technique (Grup 2) was used. The parameters studied included average access time, time for insertion, attempts required, mechanical complications and catheter-related bloodstream infections. Results: There was no difference between the two groups with regards to demographic data (p>0.05). The mean skin-vein period, the total period of insertion, the number of attempts, the rate of mechanical complications, and the incidence of catheter-related bloodstream infections were significantly lower in Group 1 in comparison to Group 2 (p<0.0.5). Conclusions: USG-guided internal jugular vein catheterization reduced the number of attempts, and was more advantageous than the conventional method in terms of allowing a lower incidence of mechanical complications and catheter-related bloodstream infections.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 A novel ultrasound-guided technique in peri-paravertebral area: Subtransverse process interligamentary (STIL) plane block: The game has not ended yet(Elsevier Science Inc, 2020) Kilicaslan, Alper; Sarkilar, Gamze; Altinok, Tamer; Tulgar, Serkan[Abstract Not Availabe]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 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]Öğe Sutureless Aortic Valve Replacement with Minimally Invasive Method: Case Report(Gazi Univ, Fac Med, 2016) Ozer, Abdullah; Ugurlu, Okan; Sarkilar, Gamze; Ege, Erdal; Sarigul, AliTwo patients accepted to our clinic with the diagnosis of aortic stenosis were considered to have high risk for classic surgery and were planned to undergo aortic valve replacement by a minimally invasive procedure with anterior thoracotomy. We believe that, the minimally invasive procedure is much more convenient than classical surgical techniques in patients having high risk for severe aortic stenosis.Öğe Sutureless Aortic Valve Replacement with Minimally Invasive Method: Case Report(Gazi Univ, Fac Med, 2016) Ozer, Abdullah; Ugurlu, Okan; Sarkilar, Gamze; Ege, Erdal; Sarigul, AliTwo patients accepted to our clinic with the diagnosis of aortic stenosis were considered to have high risk for classic surgery and were planned to undergo aortic valve replacement by a minimally invasive procedure with anterior thoracotomy. We believe that, the minimally invasive procedure is much more convenient than classical surgical techniques in patients having high risk for severe aortic stenosis.Öğe Ultrasound guided fascia lata plane block: A novel anesthetic technique for percutaneous endovascular procedures(Elsevier Science Inc, 2020) Kilicaslan, Alper; Ince, Ilker; Sarkilar, Gamze; Dereli, Yuksel[Abstract Not Availabe]
