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Öğe Analgesic effects of rofecoxib in ear-nose-throat surgery(Lippincott Williams & Wilkins, 2002) Turan, A; Emet, S; Karamanlioglu, B; Memis, D; Turan, N; Pamukcu, ZIn this study we evaluated the analgesic efficacy and the opioid-sparing effect of rofecoxib in ear-nose-throat surgery patients. Patients undergoing nasal septal or sinus surgery were randomized to receive either oral placebo or rofecoxib 50 mg 1 h before surgery. All patients received propofol 0.8 mg/kg, fentanyl 1 mug/kg, and local anesthesia at the operative site. Sedation was maintained by a continuous infusion of propofol adjusted to maintain sedation at a 2-3 level on the Ramsey scale. Additional fentanyl 0.5-1 mug/kg was administered at the patient's request or if the verbal rating scale score was >4. Patient sedation and pain scores were obtained at 5, 15, 30 45, and 60 min during surgery and 30 min and 2, 4, 6, 12, and 24 h after completion of the procedure. During the postoperative period, diclofenac 75 mg IM was administered for analgesia at the patient's request or if the visual analog scale (VAS) rating for pain was more than 4. VAS pain scores, intraoperative fentanyl, and postoperative diclofenac requirements were significantly smaller in the rofecoxib group compared with the placebo group (P < 0.001). The times to first analgesic request were also significantly less in the rofecoxib group. We conclude that the preoperative administration of oral rofecoxib provided a significant analgesic benefit and decreased the need for opioids in patients undergoing nasal septal and nasal sinus surgery.Öğe Effect of aminophylline on recovery from sevoflurane anaesthesia(Lippincott Williams & Wilkins, 2002) Turan, A; Memis, D; Karamanlioglu, B; Çolak, A; Pamukçu, Z; Turan, NBackground and objective: In this randomized, double-blind study, we aimed to investigate the effect of aminophylline on recovery from sevoflurane. Methods: One-hundred ASA I-II patients scheduled for elective surgery were randomly divided into two groups receiving either NaCl 0.9% (Group 1, n = 50) or aminophylline 5 mg kg(-1) (Group 2, n = 50). All patients were premedicated with atropine 0.01 mg kg(-1) and midazolam 0.06 mg kg(-1) intramuscularly. Anaesthesia was induced with propofol 2 mg kg(-1) for muscle relaxation, and atracurium 0.5 mg kg(-1) was maintained with sevoflurane 2% in 50% oxygen and nitrous oxide. Further atracurium (0.1 mg kg(-1)) was given when needed. Aminophylline or saline was given after sevoflurane was discontinued. Heart rate, mean arterial pressure, peripheral oxygen saturation, the duration of anaesthesia and recovery times (eye opening, verbal response, extubation and successful performance of arithmetical calculations) were recorded. Results: There were no statistically significant differences in mean arterial pressure, peripheral oxygen saturation and anaesthesia time between the two groups. Heart rate increased significantly (P < 0.05) after aminophylline and was also higher than in the placebo group. Recovery times were significantly shorter (P < 0.001) in the patients receiving aminophylline. Conclusions: Aminophylline speeded recovery after sevoflurane anaesthesia and it may have some advantage in anaesthesia practice for patients.Öğe Effect of preoperative oral use of erythromycin and nizatidine on gastric pH and volume(Sage Publications Ltd, 2002) Memis, D; Turan, A; Karamanlioglu, B; Guler, T; Yurdakoc, A; Pamukcu, Z; Turan, NThis randomized controlled trial examined the effects of preoperative oral erythromycin or nizatidine on gastric pH and volume. Sixty patients, ASA I and 2 status scheduled for elective surgery were studied. All subjects received oral study medication with 10 ml of water 60 minutes prior to surgery. Patients in Group I (it = 20) were given erythromycin 200 mg, in Group 2 (n = 20) nizatidine 300 mg, and in Group 3 (n = 20) placebo capsule. A nasogastric tube was inserted immediately after anaesthesia induction. Gastric content was aspirated, and volume and pH recorded. pH values determined in Group I were 5.6+/-1.87, in Group 2, 5.65+/-1.92 and in Group 3, 3.5+/-1.93. There was no statistical difference between Groups I and 2, but there was a statistically significant difference between Group 3 and Groups I and 2 (P<0.001). The volume of gastric content was 10.25+/-6.65 ml in Group 1, 10.3+/-6.29 ml in Group 2, and 20.25+/-16.72 ml in Group 3. Again, there was no statistical difference between Groups I and 2, but there was a statistically significant difference between Group 3 and Groups I and 2 (P<0.05). The proportion of patients considered at risk of significant lung injury should aspiration occur was 10% of Group 1, 5% of Group 2 and 20% of Group 3 (not statistically different). We conclude that oral erythromycin and nizatidine given one hour prior to surgery are effective in reducing gastric pH and volume.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 Intraarticular analgesia after arthroscopic knee surgery: comparison of neostigmine, clonidine, tenoxicam, morphine and bupivacaine(Springer, 2005) Alagol, A; Calpur, OU; Usar, PS; Turan, N; Pamukcu, ZWe conducted a randomized, placebo-controlled, double blinded study to compare the analgesic effects of intraarticular neostigmine, morphine, tenoxicam, clonidine and bupivacaine in 150 patients undergoing arthroscopic knee surgery. General anaesthesia protocol was same in all patients. At the end of the surgical procedure, patients were randomized into six intraarticular groups equally. Group N received 500 mu g neostigmine, Group M received 2 mg morphine, Group T received 20 mg tenoxicam, Group C received 1 mu g kg(-1) clonidine, Group B received 100 mg bupivacaine and Group S received saline 20 ml. Visual analog scale scores 0, 30 and 60 min and 2, 4, 6, 12, 24, 48 and 72 h, time to first analgesic need, analgesic consumption at 48 h and 72 h and side effects were noted. Demographic and operational parameters were similar in six groups. All study groups provided analgesia when compared with saline group (P<0.05). Duration of analgesia in Group N and C was longer than other groups (P<0.001). Analgesic consumptions of Group N, C and T were lower than other groups (P<0.01). Pain scores during 2 h postoperatively were lower in all study groups than the control group (P<0.001). In Group B, median pain scores were higher than Groups N and C at 0 min and 30 min postoperatively (P<0.001). Side effects were not significantly different among the six groups. We conclude that the most effective drugs that are administered intraarticularly are neostigmine and clonidine among the five drugs we studied. Tenoxicam provided longer analgesia when compared with morphine and bupivacaine, postoperatively.
