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Öğe Caudal neostigmine for postoperative analgesia in paediatric surgery(Blackwell Publishing Ltd, 2003) Memis, D; Turan, A; Karamanlioglu, B; Kaya, G; Süt, N; Pamukçu, ZBackground: This study was conducted to evaluate analgesia and side-effects of caudal neostigmine coadministered with bupivacaine in paediatric surgery. Methods: We studied children, aged 1-5 years, undergoing elective surgery (inguinal hernia and hypospadias). After standard induction of anaesthesia, caudal anaesthesia was performed. Group 1 received 0.25% bupivacaine 0.5 ml.kg(-1) and Group 2 received 0.25% bupivacaine 0.5 ml.kg(-1) with 1 mug.kg(-1) neostigmine via the caudal route. Heart rate, mean arterial pressure, peripheral oxygen saturation were recorded before induction, after induction but before caudal anaesthesia, and then every 5 min after caudal anaesthesia. Haemodynamic, Toddler, Preschooler, Postoperative Pain Scale (TPPPS) pain score and sedation score values were recorded 30 min after extubation and at hours 2, 4, 6, 12 and 24. A pain score >3/10 resulted in administration of rectal paracetamol. The duration of postoperative analgesia was defined as the time between caudal drug injection and the first rectal paracetamol administration. Results: There were no differences between the groups in demographic and haemodynamic date, duration of surgery and anaesthesia, time to extubation or sedation scores. The duration of postoperative pain relief did not differ between the two groups; 15.40 +/- 10.97 h for group 1 vs. 15.45 +/- 10.99 h for group 2 (P > 0.05). The incidence of nausea (three patients in group 2 and one patient in group 1) was not statistically significant. No other side-effects were seen. Conclusions: We found that a single caudal injection of 1 mug.kg(-1) neostigmine mixed with bupivacaine offers no significant advantage over bupivacaine alone for postoperative pain relief in children undergoing genitourinary surgery.Öğe Comparison of the laryngeal mask (LMA™) and laryngeal tube (LT®) with the new perilaryngeal airway (CobraPLA®) in short surgical procedures(Lippincott Williams & Wilkins, 2006) Turan, A; Kaya, G; Koyuncu, O; Karamanlioglu, B; Pamukçu, Unewly introduced perilaryngeal airway (CobraPLA (R), PLA) with regard to haemodynamic responses induced by airway insertion, clinical performance and occurrence of postoperative sore throat after short surgical procedures. Methods: After premedication, 90 ASA I-II patients awaiting short surgical procedures were randomized to receive, LMA, LT or PLA. Anaesthesia was induced with intravenous propofol (2.5 mg kg(-1)) and mivacurium (0.2 mg kg(-1)). Number of attempts, time of insertion of the device, any other unwanted effect, mean aterial pressure, heart rate, oxygen saturation and end-tidal carbon dioxide were recorded. At the end of surgery, the cuff of the device was immediately deflated and the airway device was removed. The device was examined and noted for the presence of visible blood. Patients were asked to rate their throat soreness, dysphonia and dysphagla 1 and 24 h postoperatively. Results: There were no differences in haemodynamic variables. Insertion times for the devices were similar (LMA: 20 +/- 11 s, IT: 19 +/- 14 s and PLA: 21 +/- 12 s.) The success rates at first insertion were lower in the (LMA group (57%) when compared with the PLA (97%, P < 0.05). The number and type of airway interventions for achieving an effective airway were similar. When the airways were removed 50% of the PLA devices had positive blood traces, while only 17% of the LMA and IT devices had positive blood traces (P < 0.01). Fifty percent of the patients suffered from a sore throat in the PLA group, which was significantly higher than in the LMA and IT groups (P < 0.05). Conclusion: We conclude that haemodynamic, ventilation and oxygenation variables throughout the surgery were similar with, LMA, IT and PLA, but IT and PLA were easier to insert; LMA and IT caused less mucosal trauma.Öğe Effect of oral gabapentin on postoperative epidural analgesia(Elsevier Sci Ltd, 2006) Turan, A; Kaya, G; Karamanlioglu, B; Pamukçu, Z; Apfel, CCBackground. Gabapentin has been used successfully as a non-opioid analgesic adjuvant for postoperative pain management. We hypothesized that gabapentin might be a useful adjuvant for postoperative analgesia provided with patient-controlled epidural analgesia (PCEA). Methods. Forty patients undergoing lower extremity surgery procedures were randomly assigned to receive (i) placebo capsules (control) or (ii) gabapentin (1.2 g day(-1)) before and for 2 days after surgery. Anaesthetic technique was standardized. Postoperative assessments included verbal rating scale scoring for pain and sedation, PCEA usage, quality of recovery assessment, times of GI function recovery, and patient satisfaction scoring for pain management. Results. Pain scores at 1, 4, 8, 12, and 16 h (P < 0.001), PCEA bolus requirements (n) at 24 [21 (3), 14 (2)], 48 [15 (4), 10 (3)] and 72 [8 (5), 2 (3)] (P < 0.05) and paracetamol (mg) consumption [700 (523), 350 (400)]; P < 0.05), were significantly lower in the gabapentin-treated patients than in the control group. Patient satisfaction with postoperative pain management at 24 h was better in gabapentin-treated patients [85.5 (7.5), 66.5 (15)]; P < 0.001). Gabapentin-treated patients had less motor block when compared with control group. Times of return of bowel function, hospitalization, and resumption of dietary intake were similar in the groups. However, the incidence of dizziness was higher in the gabapentin group (35% vs 5%; P < 0.05). Conclusions. Oral gabapentin (1.2 g day(-1)) as an adjunct to epidural analgesia decreased pain and analgesic consumption. Despite an increased incidence of dizziness it also increased patient satisfaction.Öğe Effects of sevoflurane, isoflurane and propofol infusions on post-operative recovery criteria in geriatric patients(Sage Publications Ltd, 2005) Arar, C; Kaya, G; Karamanlioglu, B; Pamakçu, Z; Turan, NWe compared the effects of sevoflurane, isoflurane and propofol infusions on postoperative recovery criteria in geriatric patients. Sixty patients aged > 65 years, classified as American Society of Anesthesiologists (ASA) group 1 or 2 and undergoing gynaecological or urological procedures were randomized equally into three groups. Group 1 received 1 minimum alveolar concentration (MAC) sevoflurane in a 50% O-2/N2O mixture and group 2 received I MAC isoflurane in a 50% O-2/N2O mixture. Group 3 received a 50% O-2/N2O mixture plus propofol total intravenous anaesthesia (8 mg/kg for the first 30 min, followed by 6 mg/kg for maintenance). Recovery criteria comprising the times to spontaneous eye opening, extubation, response to verbal stimuli and orientation were recorded following the discontinuation of anaesthesia. Recovery times were significantly shorter in groups 1 and 3 compared with group 2. We conclude that sevoflurane and propofol had similar effects on recovery criteria and were associated with a faster recovery than isoflurane.Öğe Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption(Springer, 2005) Karamanlioglu, B; Turan, A; Memis, D; Kaya, G; Ozata, S; Ture, MPurpose: To compare efficacy and patient outcome of wound infiltration with ropivacaine, lornoxicam, or their combination for control of pain following thyroid surgery. Methods: Eighty patients underwent thyroid surgery were randomly assigned to one of four groups. Before skin closure, local tissues were infiltrated with 12 mL saline in Group S, with 10 mL of ropivacaine 0.75% plus 2 mL saline in Group R, with 2 mL of lornoxicam (8 mg) plus 10 mL saline in Group L, and with 10 mL ropivacaine 0.75% plus 2 mL lornoxicam (8 mg) in Group RL. Pain scores, total and incremental meperidine consumption were recorded at 30 min, one, two, three, four, six, eight, 12, 18, and 24 hr postoperatively. Time to first analgesic requirement, patient satisfaction, and duration of hospital stay were also compared after surgery. Results: The pain scores in Group RL were significantly lower in the first 12 hr than in Group S, and in the first four hours than in Groups R and L (P<0.01). The time to first analgesic requirement was significantly longer (14.8 +/- 8.4 hr vs 5.9 +/- 5.2 hr; P<0.0 1), the total pethidine consumption was significantly less than Group S (34.0 +/- 33.0 mg vs 78.0 +/- 29.8 mg; P<0.001), return of gastrointestinal function, ambulation time, length of hospital stay (P<0.05) were significantly shorter, and patient satisfaction (P<0.01) was significantly better in Group RL than in Group S (P<0.05). Conclusion: Wound infiltration with ropivacaine 0.75% plus lornoxicam 8 mg combination improved postoperative pain control and patient comfort, and decreased the need for opioids than the use of either drug alone.Öğe Intravenous regional anesthesia using prilocaine and neostigmine(Lippincott Williams & Wilkins, 2002) Turan, A; Karamanlioglu, B; Memis, D; Kaya, G; Pamukçu, ZNeostigmine has been added to local anesthetics for central and peripheral nerve blocks resulting in prolonged, increased anesthesia and improved analgesia. We conducted this study to evaluate the effects of neostigmine when added to prilocaine for IV regional anesthesia (IVRA). Thirty patients undergoing hand surgery were randomly assigned to two groups to receive IVRA. The control group received 1 mL of saline plus 3 mg/kg of prilocaine diluted with saline to a total dose of 40 mL; the study group received 0.5 mg of neostigmine plus 3 mg/kg of prilocaine diluted with saline to a total dose of 40 mL. Sensory and motor block onset and recovery, anesthesia quality determined by an anesthesiologist, anesthesia quality determined by a surgeon, and dryness of the operative field were noted. Heart rate, mean arterial blood pressure, and oxygen saturation values were noted at 1, 5, 10, 20, and 40 min before surgery and after tourniquet release. Time to first analgesic requirement was also noted. Shortened sensory and motor block onset times, prolonged sensory and motor block recovery times, improved quality of anesthesia, and prolonged time to first analgesic requirement were found in the neostigmine group. We conclude that neostigmine as an adjunct to prilocaine improves quality of anesthesia and is beneficial in IVRA.Öğe Preventing pain on injection of rocuronium: two doses of dexmedetomidine(Canadian Anesthesiologists Soc, 2005) Memis, D; Turan, A; Kaya, G; Karamanlioglu, B; Seker, S[Abstract Not Available]Öğe The prevention of pain from injection of propofol by dexmedetomidine and comparison witb lidocaine(Canadian Anesthesiologists Soc, 2005) Turan, A; Memis, D; Kaya, G; Karamanlioglu, B[Abstract Not Available]Öğe The prevention of propofol injection pain by tramadol or ondansetron(Lippincott Williams & Wilkins, 2002) Memis, D; Turan, A; Karamanlioglu, B; Kaya, G; Pamukçu, ZBackground and objective: To compare the efficacy of tramadol and ondansetron in minimizing the pain due to injection of propofol in 100 patients. Methods: An intravenous cannula was inserted in the dorsum of the hand. After tourniquet application to the forearm, tramadol 50 mg (Group 1, n = 50) or ondansetron 4 mg (Group 2, n = 50) was injected. The tourniquet was released after 20 s, and propofol 5 mL was administered over 5 s. The patients were observed and asked if they had pain in the arm and the response was assessed. Nausea and vomiting and degree of sedation were recorded for the first postoperative 24 h. Results: Twenty-one patients in Group 1 and 14 patients in Group 2 reported no pain. Slight pain was seen in 15 patients in Group 1 and in 14 patients in Group 2. Moderate pain was seen in 10 patients in Group 1 and 15 patients in Group 2. Severe pain was seen in four of the patients in Group 1 and three patients in Group 2. There was no significant difference of pain between Groups 1 and 2, but we found a significant reduction of nausea and vomiting in the ondansetron group compared with the tramadol group (P = 0.033). Conclusions: Tramadol or ondansetron are equally effective in preventing pain from propofol injection. The added benefit of a reduction in nausea and vomiting after operation in the ondansetron group may be a reason to prefer this drug.Öğe The use of intraarticular tramadol for postoperative analgesia after arthroscopic knee surgery(Springer, 2004) Alagöl, A; Çalpur, OU; Kaya, G; Pamukçu, Z; Turan, FNWe aimed to determine the optimal dose of tramadol when administered intraarticularly after arthroscopic knee surgery under general anesthesia in patients with an American Society of Anesthesiologists (ASA) physical status score of I-II. When the surgical procedure was completed, patients were assigned to one of seven groups (n=30 for each) in a double-blinded and randomized manner according to a table of random numbers. Group I received 100 mg tramadol, Group II received 50 mg tramadol, Group Ill received 20 mg tramadol and Group IV received 0.9% NaCl intraarticularly in 20 ml solutions. Group V received 100 mg tramadol, Group VI received 50 mg tramadol and Group VII received 20 mg tramadol intravenously. Pain was evaluated by using the Visual Analogue Scale (VAS) at 0 min (when the patient was cooperated after extubation), 3 0 min, 1 h, 4 h, 6 h, 12 h, 18 h and 24 h postoperatively. Patients were administered diclofenac sodium 75 mg intravenously (i.m.) when they experienced pain. The intraarticular tramadol groups had longer duration of analgesia than i.v. tramadol groups who were administered the same doses (I vs V, II vs VI; III vs VII; p <0.001). Group I had the longest duration of analgesia (p<0.001). Group II had a longer time to the first analgesic request than all other groups (p<0.001) except Group I. Consequently, Group I and II needed less analgesics than other groups (p<0.001). Pain scores were 0-3 on the VAS in Groups I, II and V at first assessment, in Groups I and II at 30 min and 1 h, and in Group I at 4 h and 6 h postoperatively (p<0.01). In Group V, vomiting was more a more frequent complication than with other groups (p<0.05). It is concluded that tramadol provides analgesia with a peripheral mechanism when administered intraarticularly. The side effects of intraarticular 100 mg tramadol were no more severe than those for intraarticular 50 mg tramadol. Moreover, intraarticular 100 mg tramadol provided excellent analgesia after arthroscopic surgery.