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Öğe Comparison of Hemodynamics Recovery Profile and Costs of Remifentanil Versus Fentanyl-Based Sevoflurane Anesthesia(Ortadogu Ad Pres & Publ Co, 2012) Uluer, Mehmet Selcuk; Topal, Ahmet; Tavlan, Aybars; Erol, Atilla; Kilicaslan, Alper; Otelcioglu, SerefObjective: This trial was designed to compare the effects of fentanyl and remifentanil on hemodynamic parameters, postoperative recovery, sevoflurane consumption and the cost of anesthetics. Material and Methods: Cases that were scheduled to undergo elective laparoscopic cholecystectomy surgery were assigned to two groups with simple random sampling method, as Group F (Fentanyl) and Group R (Remifentanil), each including 30 patients. The anesthetic induction was initiated by administering 1-2 mg/kg propofol bolus based on the bispectral index (BIS) value followed by 2 mu g/kg fentanyl in Group F patients and 1 mu g/kg remifentanil in Group R patients administered in 60 seconds as iv bolus; subsequently, 0.5 mg/kg iv atracurium was administered. For maintenance of anesthesia, 50% oxygen in-air was administered at 4 L/min; the end-tidal sevoflurane concentration was adjusted to achieve a BIS value of 45 to 55. In Group R, remifentanil 0.25 mu g/kg/min infusion was continued. The addition of 0.5 mu g/kg fentanyl was planned as required in Group F. Sevoflurane end-tidal concentration and the changing times were recorded. For each case, the sevoflurane consumption was calculated using the Dion formula. Results: In Group R, the hemodynamic control, particularly the suppression of response to intubation was more successful than in Group F. The eye opening times and Post Anesthesia Care Unit (PACU) transfer times were shorter in Group R relative to Group F (p=0.001 and p=0.001, respectively). Sevoflurane consumption was lower in the Group R (7.18 +/- 3.45 mL) compared to Group F (16.45 +/- 7.15 mL) (p=0.001). The total anesthetic drug cost was similar between the groups. Conclusion: Compared to fentanyl, remifentanil provided a better intraoperative hemodynamic control, faster postoperative recovery and a favorable effect on anesthetic drug cost by decreasing sevoflurane consumption, eliminating the disadvantages of its price.Öğe A Comparison of the Effects of Postoperative CPAP and Nasal Oxygen Use on Arterial Blood Gas in Laparoscopic Cholecystectomy Performed in Obese Patients: A Prospective, Randomized Cinical Trial(Ortadogu Ad Pres & Publ Co, 2012) Kiziloz, Sema Peker; Tavlan, Aybars; Topal, Ahmet; Erol, Atilla; Kilicaslan, Alper; Otelcioglu, SerefObjective: This study was designed to compare the effects of continuous positive airway pressure (CPAP) and nasal oxygen use on postoperative blood gases in obese patients undergoing laparoscopic cholecystectomy. Material and Methods: A total of 40 patients with a body mass index (BMI) ranging between 30 and 40 were enrolled in this study. Patients were divided into two groups: Group C (n=20) = CPAP and Group N (n=20) = Nasal O-2. Baseline blood gas was sampled on spontaneous respiration (G(0)). The blood gas sampling was repeated before patients were admitted to the postoperative care unit (PACU) (G(1)). Following the operation, Group C received CPAP 5 cmH(2)O and Group N received 5 1/min O-2 via nasal cannula for 60 minutes. Blood gas sampling was repeated after 60 minutes in both groups (G(2)). Results: At the PACU, the SpO(2) values were higher in Group C relative to Group N at 30 minutes (p<0.05). In both groups, the in-group pH values at G(1) measurement time displayed a statistically significant reduction compared to those at the G(0) measurement time (p<0.05). At G(2), PaCO2 was higher in Group N compared to Group C (p<0.05). In both groups, the in-group PaCO2 values were significantly higher at G(1) relative to G(0) (p<0.01). In Group C, PaO2 was higher at G(2) compared to Group N (p<0.05). Conclusion: Postoperative CPAP use may increase the PaO2 more and provide a better CO2 elimination compared to nasal oxygen use in obese patients undergoing laparoscopic cholecystectomy.Öğe Differences in tip visibility and nerve block parameters between two echogenic needles during a simulation study with inexperienced anesthesia trainees(Springer Japan Kk, 2014) Kilicaslan, Alper; Topal, Ahmet; Tavlan, Aybars; Erol, Atilla; Otelcioglu, SerefNeedle tip visualization during ultrasound-guided regional anesthesia (UGRA) is necessary for safety and efficacy. However, disruption of the image of the needle tip driven toward the target is a general problem, especially for beginners. The purpose of this study was to compare performance parameters between using the Sonoplex and Stimuplex D-Plus echogenic needles in a simulated ultrasound-guided interventional task by inexperienced anaesthesia residents. After a standardized training session, 28 anesthesiology residents performed simulated nerve blocks in a beef phantom with each needle. All ultrasound images were digitally stored for analysis. The absolute time the needle tip was in view, total procedure time, and angle of needle insertion were subsequently measured objectively by two single investigators. The procedures that used the Sonoplex echogenic needle had significantly better tip visibility and shorter total procedure time at insertion angles between 42A degrees and 64A degrees relative to the phantom surface. We have demonstrated that inexperienced users who used the Sonoplex echogenic needle were able to complete the procedure more quickly. Needles with improved visibility would be a very useful addition to UGRA for inexperienced users.Öğe The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions in Geriatric Patients(2013) Tavlan, Aybars; Topal, Ahmet; Kılıçaslan, Alper; Erol, Atilla; Çobanoğlu, Halit; Otelcioğlu, ŞerefOur aim was to compare the effects of desflurane and sevoflurane on cognitive functions of geriatric patients that were planned for elective surgery under general anestesia. After national ethical committee approval, 40 patients (aged 65-75 yr) were enrolled. Patients were allocated to either the desflurane (n20) or the sevoflurane (n20) group. In all patients anaesthesia will be induced with propofol and remifentanyl, and maintained with the anaesthetics desflurane, or sevoflurane, and remifentanyl. Emergence times from anaesthesia and Aldrete scores were recorded. Cognitive function will be evaluated with two cognitive test; Blessed Short Orientation Memory Concentration Test (BOMC) and standardized mini mental test (SMMT) preoperatively and postoperatively at 60, and 180 minute after extubation. The mean extubation time, eye opening time and Aldrete scores were similar in the desflurane and sevoflurane groups (p0,05). There were no significant differences between the desflurane and the sevoflurane groups when the BOMC and MMST scores were compared preoperatively, and postoperatively at 60, and 180 min (p0,05).The result of this study indicate that there is no difference between effects of desflurane and sevoflurane anesthesia on postoperatif cognitive functions in the elderly.Öğe The Effect of Sevoflurane and Desflurane on the Early Postoperative Cognitive Functions In Geriatric Patients(Modestum Ltd, 2013) Cobanoglu, Halit; Tavlan, Aybars; Topal, Ahmet; Kilicaslan, Alper; Erol, Atilla; Otelcioglu, SerefOur aim was to compare the effects of desflurane and sevoflurane on cognitive functions of geriatric patients that were planned for elective surgery under general anestesia. After national ethical committee approval, 40 patients (aged 65-75 yr) were enrolled. Patients were allocated to either the desflurane (n= 20) or the sevoflurane (n= 20) group. In all patients anaesthesia will be induced with propofol and remifentanyl, and maintained with the anaesthetics desflurane, or sevoflurane, and remifentanyl. Emergence times from anaesthesia and Aldrete scores were recorded. Cognitive function will be evaluated with two cognitive test; Blessed Short Orientation Memory Concentration Test (BOMC) and standardized mini mental test (SMMT) preoperatively and postoperatively at 60, and 180 minute after extubation. The mean extubation time, eye opening time and Aldrete scores were similar in the desflurane and sevoflurane groups (p> 0,05). There were no significant differences between the desflurane and the sevoflurane groups when the BOMC and MMST scores were compared preoperatively, and postoperatively at 60, and 180 min (p> 0,05). The result of this study indicate that there is no difference between effects of desflurane and sevoflurane anesthesia on postoperatif cognitive functions in the elderly.Öğe Effectiveness of videolaringoscopy C-MAC in managing intubations that have failed unexpectedly(Elsevier Science Inc, 2014) Kilicaslan, Alper; Topal, Ahmet; Tavlan, Aybars; Erol, Atilla; Otelcioglu, Seref[Abstract Not Availabe]Öğe The effects of sevoflurane anesthesia on hemodynamics and cerebral artery diameters in endovascular treatment of intracranial aneurysm: A pilot study(Turkish Assoc Trauma Emergency Surgery, 2021) Arican, Sule; Bakdik, Suleyman; Hacibeyoglu, Gulcin; Yilmaz, Resul; Koc, Osman; Tavlan, Aybars; Uzun, Sema TuncerBACKGROUND: Cerebral autoregulation is a steady-state of cerebral blood flow despite major changes in arterial blood pressure. Inhalation anesthetics are cerebral vasodilators. In <1 MAC values, the net effect is a moderate decrease in cerebral blood flow and maintenance of responsiveness to carbon dioxide. This study aims to investigate the effects of steady-state sevoflurane anesthesia on hemodynamic and cerebral artery diameter measurements in patients undergoing flow diverter device placement under general anesthesia. METHODS: Forty-six patients aged 18-70 years who underwent flow diverter devices under general anesthesia were included in this study. Routine monitoring was performed on the patients. Mean arterial pressure (MAP) values were recorded. Internal carotid artery, middle cerebral artery and anterior cerebral artery diameter measurements were made from digital subtraction angiography (DSA) images of patients with anterior aneurysms. Baseline artery, right posterior cerebral artery and left posterior cerebral artery diameter measurements were made from DSA images of patients with posterior aneurysms. These measurements were recorded as preoperative measurements. The same measurements were made from the DSA images performed before the Flow diverter device placement procedure performed under steady-state sevoflurane anesthesia for the same patients. These measurements were recorded as peroperative measurements. RESULTS: The average age of the patients was 56.6 +/- 15.1. The MAP of the patients before induction was 76.28 +/- 5.13 mmHg, MAP after induction was 64.36 +/- 3.23 mmHg, and MAP during sevoflurane anesthesia was 68.26 +/- 4.30 mmHg, there was a statistically significant difference. There was a statistically significant difference between the preoperative and perioperative values of anterior cerebral artery diameters. There was a strong relationship between the MAP change percentage and the ICA diameter change percentage (p<0.001, p=-0.785) and a moderate relationship between the MCA diameter change percentage (p=0.033, p=-0.338). CONCLUSION: In patients undergoing flow diverter devices, <1 MAC sevoflurane has a hemodynamic effect and creates significant vasodilation in the cerebral artery diameters.Öğe The effects of sevoflurane anesthesia on hemodynamics and cerebral artery diameters in endovascular treatment of intracranial aneurysm: A pilot study(Turkish Assoc Trauma Emergency Surgery, 2021) Arican, Sule; Bakdik, Suleyman; Hacibeyoglu, Gulcin; Yilmaz, Resul; Koc, Osman; Tavlan, Aybars; Uzun, Sema TuncerBACKGROUND: Cerebral autoregulation is a steady-state of cerebral blood flow despite major changes in arterial blood pressure. Inhalation anesthetics are cerebral vasodilators. In <1 MAC values, the net effect is a moderate decrease in cerebral blood flow and maintenance of responsiveness to carbon dioxide. This study aims to investigate the effects of steady-state sevoflurane anesthesia on hemodynamic and cerebral artery diameter measurements in patients undergoing flow diverter device placement under general anesthesia. METHODS: Forty-six patients aged 18-70 years who underwent flow diverter devices under general anesthesia were included in this study. Routine monitoring was performed on the patients. Mean arterial pressure (MAP) values were recorded. Internal carotid artery, middle cerebral artery and anterior cerebral artery diameter measurements were made from digital subtraction angiography (DSA) images of patients with anterior aneurysms. Baseline artery, right posterior cerebral artery and left posterior cerebral artery diameter measurements were made from DSA images of patients with posterior aneurysms. These measurements were recorded as preoperative measurements. The same measurements were made from the DSA images performed before the Flow diverter device placement procedure performed under steady-state sevoflurane anesthesia for the same patients. These measurements were recorded as peroperative measurements. RESULTS: The average age of the patients was 56.6 +/- 15.1. The MAP of the patients before induction was 76.28 +/- 5.13 mmHg, MAP after induction was 64.36 +/- 3.23 mmHg, and MAP during sevoflurane anesthesia was 68.26 +/- 4.30 mmHg, there was a statistically significant difference. There was a statistically significant difference between the preoperative and perioperative values of anterior cerebral artery diameters. There was a strong relationship between the MAP change percentage and the ICA diameter change percentage (p<0.001, p=-0.785) and a moderate relationship between the MCA diameter change percentage (p=0.033, p=-0.338). CONCLUSION: In patients undergoing flow diverter devices, <1 MAC sevoflurane has a hemodynamic effect and creates significant vasodilation in the cerebral artery diameters.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 Hastanemiz Anestezi Polikliniğine Başvuran Hastaların Memnuniyet Durumlarının Değerlendirilmesi(2017) Hanedan, Bedia Mine; Tavlan, Aybars; Yılmaz, Resul; Tuncer Uzun, SemaSağlık hizmetlerinin geliştirilmesi için gerekli olan öğelerin en iyi şekilde kullanılmasında, hasta beklenti ve memnuniyetinin dikkate alınması çok önemlidir. Bu çalışmanın amacı, Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Hastanesi Anestezi Polikliniğine başvuran hastaların memnuniyet düzeyini değerlendirmek ve hasta memnuniyetini etkileyen faktörleri saptamaktır.Anket araştırması, Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Hastanesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı’nda Kasım 2015 - Şubat 2016 tarihleri arasında poliklinik hizmeti almak üzere başvuran hastalarda yapıldı. Söz konusu dönemde, polikliniğe başvuran ve araştırmaya katılmayı kabul ederek aydınlatılmış onam formunu onaylayan 200 hasta çalışmaya alındı. Anket formu, poliklinik işlemlerinin bitiminde yüz yüze görüşme tekniği ile dolduruldu. Hastaların anestezi polikliniğine başvuruları ile anestezi onamlarını almaları arasında geçen süre ve ASA skorları kaydedildi. Ayaktan hasta memnuniyet katsayısı 90.32 olarak bulundu. Hastaların %72’si kayıt işlemleri için, %68.5’i tahlil/tetkik için çok beklemediğini, %98’i doktorun, %96’sı personelin kibar ve saygılı olduğunu belirtti. Üniversite ve üstü eğitim seviyesinde ve okur yazar olmayan hastaların memnuniyet katsayısı diğer eğitim seviyelerine göre daha düşük bulundu (p0.01). Hastaların anestezi polikliniğine başvuruları ile anestezi onamlarını almaları arasında geçen ortalama süre 3.001,014 saat idi. ASA skoru ile anestezi onamını almaları için geçen süre arasında istatistiksel olarak anlamlı fark yoktu (p0.08). Hastanemiz anestezi polikliniğine başvuran hastaların memnuniyet düzeyinin yüksek, üniversite ve üstü eğitim seviyesinde ve okur-yazar olmayan hastalarda ise memnuniyet düzeyinin diğer eğitim seviyesindeki hastalara göre daha düşük olduğu saptandı. Tahlil/tetkik ve kayıt işlemlerindeki bekleme süresini kısaltacak çalışmalarında memnuniyet düzeyini arttırmada faydalı olacağı kanaatine varıldı.Öğe A simple, feedback-based simulation model for ultrasound-guided regional anaesthesia(Medknow Publications & Media Pvt Ltd, 2012) Kilicaslan, Alper; Topal, Ahmet; Tavlan, Aybars; Erol, Atilla[Abstract Not Availabe]Öğe Takayasu Arteritine Bağlı Serebral Perioperatif Komplikasyonları Önlemede Near Infrared Spectroscopy Kullanımı(2017) Topal, Ahmet; Türk, Şeyda; Tosun, Osman Mücahit; Karaarslan, Esma; Koyuncu, Mustafa; Koç, Hasan U.; Tavlan, AybarsTakayasu arteriti (TA); idiyopatik, kronik inflamatuvar, aorta ve dallarını tutabilen nadir bir hastalıktır. %80 oranında 40 yaşın altındaki kadınlarda görülür. TA aynı zamanda periferik nabızların alınamaması ile karakterizedir. TA hastalarının anestezi yönetimi ile ilgili bilgiler, literatürde çoğunlukla sezaryen vakaları olmak üzere, izole olgu sunumları ile sınırlıdır. Bu olgu sunumunda TA’li 69 yaşında bilateral karotis, pulmoner arter ve subklavian arter tutulumu olan, laparoskopik kolesistektomi operasyonu geçirecek hastamızda Near Infrared Spectroscopy (NIRS) gibi ileri monitörizasyon yöntemi uygulanmış, TA’ya bağlı olası postoperatif komplikasyonların önlenmesi ve uygun anestezi yönetiminin seçilmesi amaçlanmıştır.Öğe Use of laryngeal mask airway in flexible bronchoscopy in children(2019) Arıcan, Şule; Pekcan, Sevgi; Hacıbeyoğlu, Gülçin; Tavlan, Aybars; Atay, Turgay; Kolsuz Erdem, Feyza; Tuncer Uzun, SemaAim: Flexible bronchoscope is widely used by pediatric pulmonologists as a diagnostic and therapeutic tool. The objective of thisstudy was to present our anesthesia experience in pediatric flexible bronchoscopy in which airway management was provided withlaryngeal mask airway (LMA) and the complications developed.Material and Methods: This study was conducted in children aged between 2-15 years who underwent bronchoscopy for diagnosisand/or treatment between January 2017 and November 2018. Patients’ demographic data, diagnosis, anesthesia and airwaymanagement were recorded from the patient files. Times of anesthesia, operation and recovery were recorded. Complicationsduring the procedure, awakening and recovery were recorded. Patients’ sore throat and hoarseness during resting and swallowingwere recorded.Results: This study included 31 patients whose airway management was provided with LMA. The mean age was 8.584.14years. Persistent cough was the most common indication for bronchoscopy. Anesthesia time was 15.4610.99 minutes,bronchoscopy time 12.8710.57, awakening time 16.384.53 minutes, and recovery time 23.3210.24 minutes. The most commoncomplication was cough. Sore throats of the patients were observed as mild and moderate at the 0th and 2th hours. Bothresting and swallowing sore throats were observed as mild at the 4th hour, while no sore throat was seen in any patient at the 12thhour. Hoarseness was observed at mild level in 4 patients at the 0th hour.Conclusion: Providing airway with LMA in pediatric flexible bronchoscopy applications offers a safe anesthetic management, and ithas a low rate of complications.
