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    Continuous spinal anesthesia application in a patient with high cardiac risk
    (Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2007) Colak, Alkin; Inal, Mehmet Turan; Arar, Cavidan; Oguzhan, Nihal; Pamukcu, Zafer
    Regional techniques are preferred to general anesthesia in lower-extremity surgery. Especially in elderly patients with high cardiac risk, the main objective is to supply sufficient anesthesia preserving hemodynamic stability. A 63-year-old female patient in whom emergency right leg amputation above the knee was planned, was treated for myocardial infarction without ST elevation 6 days ago. She had type 2 diabetes mellitus for 15 years, and hypertension for 10 years. She underwent a coronary bypass operation for two vessels and mitral annuloplasty two years ago and right leg amputation below the knee two months ago. An intrathecal cathater was placed at the right lateral position from L3-4 intervertebral space through the cathater by the needle technique. After cerebrospinal fluid flow was observed, we administered 2,5 mg 0.5% bupivacaine. Anesthesia was maintained by performing 2.5 mg of bupivacain every five minutes at a total dose of 7.5 mg until adequate sensory block was reached. The patient was given a supine positione after the sensory block reached T-10 level. The patient was hemodynamically stable during-the-operation and did not require additional drug from the catheter. The patient was sent to the ward after removing spinal cathater at the end of a one hour operation. In conclusion, especially in old patients with high cardiac risk, we think that continuous spinal anesthesia should be the method of choice for anesthesia in lower-extremity surgery.
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    Horner's syndrome following uncomplicated internal jugular vein catheterization
    (Aves Yayincilik, Ibrahim Kara, 2008) Sahin, Sevtap Hekimoglu; Kaya, Gaye; Koyuncu, Onur; Pamukcu, Zafer
    Percutaneous cannulation of the internal jugular vein is widely used for central venous cannulations. Horner's syndrome may develop as a rare complication of internal jugular vein cannulation. We presented a 47-year-old female patient who developed Horner's syndrome one day after uncomplicated internal jugular venous cannulation, which was accompanied by miosis, ptosis, and anisocoria. The symptoms improved within a week.
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    The influence of N-acetyl-L-cysteine infusion on cytokine levels and gastric intramucosal pH during severe sepsis (vol 8, R172, 2004)
    (Biomed Central Ltd, 2016) Emet, Sayim; Memis, Dilek; Pamukcu, Zafer
    [Abstract Not Available]
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    Premedication with gabapentin
    (Lippincott Williams & Wilkins, 2007) Turan, Alparslan; White, Paul F.; Karamanlioglu, Beyhan; Pamukcu, Zafer
    BACKGROUND: Gabapentin, an oral non-opioid analgesic, has been used to decrease pain after a variety of surgical procedures. We hypothesized that premedication with gabapentin would minimize tourniquet-related pain in patients receiving IV regional anesthesia (IVRA). METHODS: Patients undergoing elective hand surgery with IVRA were randomly assigned to one of two study groups using a double-blind study design. The control group (n = 20) received placebo capsules I h before the surgery, and the, gabapentin group (n = 20) received gabapentin 1.2 g p.o. before the operation. IVRA was achieved in all patients with lidocaine, 3 mg/kg, diluted with saline to a total volume of 40 mL. Fentanyl, 0.5 mu g/kg TV, was administered as a rescue analgesic during surgery. Sensory and motor block onset and recovery times, tourniquet pain, and quality of anesthesia were assessed at specific time intervals during the perioperative period. Visual analog scale pain scores (0-10) were recorded during the 24 h follow-up period, and patients received diclofenac, 75 mg M, if their pain score was > 4. RESULTS: The onset of the sensory and motor block did not differ between the two study groups. However, tourniquet pain scores at 30, 40, 50, and 60 min after cuff inflation were lower in the gabapentin group (P < 0.05). The time to intraoperative analgesic rescue was prolonged in the gabapentin group (35 +/- 10 min vs 21 +/- 13 min, P < 0.05), and less supplemental fentanyl was required (35 +/- 47 mu g vs 83 73 mu g, P < 0.05). The quality of anesthesia, as independently assessed by the anesthesiologist and the surgeon, was significantly better in the gabapentin (versus control) group. In the gabapentin group, the time to requesting a rescue analgesic after surgery was prolonged (135 +/- 25 min vs 85 +/- 19 min, P < 0.05), and postoperative pain scores at 60 min (3.8 +/- 0.9 vs 2.2 +/- 0.5) and 120 min (3.2 +/- 1.4 vs 1.8 +/- 0.8), as well as diclofenac consumption (30 +/- 38 mg vs 60 +/- 63 mg), were reduced after surgery. CONCLUSIONS: Premedication with oral gabapentin (1.2 g) decreased tourniquet-related pain and improved the quality of anesthesia during hand surgery under IVRA. Gabapentin also reduced pain scores in the early postoperative period.