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    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, Seref
    Objective: 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.
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    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, Seref
    Objectives: 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.