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    Comparison of the Perioperative and Postoperative Effects of Levobupivacaine and of Levobupivacaine plus Adrenaline in Pediatric Tonsillectomy: A Double-Blind Randomized Study
    (Hindawi Ltd, 2017) Cicekci, Faruk; Sizer, Cigdem; Atici, Sait Selcuk; Arican, Sule; Karaibrahimoglu, Adnan; Kara, Inci
    Objectives. We aimed to assess the effects of levobupivacaine and of levobupivacaine + adrenaline administered during pediatric tonsillectomy on the postoperative period. Methods. A total of 90 patients between the ages of five and twelve were divided randomly into two groups before tonsillectomy: levobupivacaine only (0.5%) 0.4 mg.kg(-1) or levobupivacaine (0.5%) 0.4 mg.kg(-1) + adrenaline (1 :200.000) administered by means of peritonsillar infiltration. Primary outcomes were postoperative pain scores recorded at various intervals until 24 hours postoperatively. Secondary outcomes included postoperative nausea and vomiting (PONV), time to first oral intake, time to the first administration of analgesics and total consumption of analgesics, and the amount of bleeding for all children. Results. In both groups, patients had the same postoperative pain scores and PONV rates, and equal amounts of analgesics were consumed up to 24 hours postoperatively. The two groups also had the same time until first oral intake, recovery time and time to the first analgesic request, and amount of bleeding. Conclusions. Perioperative levobupivacaine infiltration on its own is a valid alternative to the combination of levobupivacaine + adrenaline for perioperative and postoperative effectiveness in pediatric tonsillectomy.
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    Sedation for Colonoscopy: Comparison of Remifentanil and Alfentanil Combined with Propofol/Midazolam
    (Istanbul Training & Research Hospital, 2019) Ancan, Sule; Cicekci, Faruk; Hacibeyoglu, Gulcin; Sizer, Cigdem; Uzun, Sema Tuncer; Dertli, Ramazan; Keskin, Muharrem
    Introduction: Different drug combinations are used in patients who underwent colonoscopy for safe sedation and early discharge. Remifentanil and alfentanil are short-acting narcotic analgesic agents. A short-acting anxiolytic agent, midazolam has a potent sedative efficiency when combined with narcotic analgesics. In this study, we aimed to compare the effectiveness of the two opioids that have not been previously compared in the literature, combined with propofol/midazolam in patients who underwent colonoscopy. Methods: One hundred eighty-nine patients aged over 18 years who underwent diagnostic and/or therapeutic colonoscopy were included in the study. 1 mg midazolam + 5 mu g kg-1 alfentanil + 1 mg kg-1 propofol were administered in the alfentanil group (group A), while 1 mg midazolam + 0.1 mu g kg-1 min-1 remifentanil + 1 mg kg-1 propofol were administered in the remifentanil group (group R). Hemodynamic data, Modified Steward scale (MSS), Visual Analog scale (VAS), additional propofol doses, total procedure time, awake time, recovery time, and side effects were recorded during the procedure. After the procedure, all patients were transferred to the recovery room, and the Modified Aldrete scale (MAS) values were recorded. Results: There was a statistically significant difference between the groups in terms of total propofol and additional propofol doses (p<0.05), with additional propofol dose being higher in group A compared to group R (p<0.05). Awake time was similar between the groups. Recovery time was longer in group A compared to group R (p<0.05). No significant difference was observed in the side effects between both groups. Conclusion: Although the low dose of midazolam combined with propofol/remifentanil and propofol/alfentanil provided adequate sedation and analgesia, we believe that remifentanil is an ideal choice for daily procedures like colonoscopy because of its advantages resulting from its pharmacological properties.