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Sisman M, Kafadar MT, Surgit O, Gozdemir M, Inan A. Early-Term Pain Management After Laparoscopic Total Extraperitoneal Inguinal Hernia Repair. Istanbul Med J 2018. [DOI: 10.5152/imj.2018.67674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
Purpose: The aim of this study was to investigate the incidence of transient neurological symptoms (TNS) after spinal anesthesia with levobupivacaine, bupivacaine, articaine or lidocaine.
Methods: The patients (n=400) were randomly assigned to receive spinal anesthesia with levobupivacaine, bupivacaine, articaine or isobaric lidocaine. Onsets of sensory and motor block were recorded. On postoperative days 1, 2 and 3, patients were interviewed by an investigator blinded to the spinal anaesthetic agent used. The patients were classified as having TNS if there was pain in the hips, thighs and/or lower limbs following recovery from anesthesia.
Results: Time to maximum sensory block was significantly longer in the articaine group than the lidocaine group. The incidence of TNS was much less after spinal anesthesia with levobupivacaine, bupivacaine and articaine than after lidocaine.
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Demircioglu RI, Gozdemir M, Usta B, Sert H, Karabayirli S, Muslu B, Keskin EA. Comparison of intrathecal plain articaine and levobupivacaine with fentanyl for Caesarean section. ACTA ACUST UNITED AC 2016. [DOI: 10.25011/cim.v39i6.27516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: Articaine is used as a local anesthetic for outpatient surgery because it offers rapid onset of anesthesia and short duration motor block. Levobupivacaine is often preferred for Caesarean section. We evaluated the anesthetic characteristics of fentanyl-supplemented plain articaine and levobupivacaine for Caesarean section under combine spinal epidural anesthesia.
Methods: Patients undergoing Caesarean section received in random order plain articaine 40 mg (Group A, n=50) or plain levobupivacaine 10 mg (Group L, n=50) mixed with fentanyl 20 µg intrathecally. The onset and duration of sensory and motor block, first analgesic request, and hemodynamic parameters were recorded.
Results: Onset times of maximum motor block were longer in Group L than Group A (P=0,001). Time to two-segment regression of sensory block were 70 min for Group A and 90 min group L (P=0.001). Times to complete regression of motor blockade were significantly longer in group L than group A (P =0,001).
Conclusion: To have a faster onset and shorter duration of spinal anesthesia, we recommend the use of plain articaine for Caesarean section.
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Gozdemir M, Muslu B, Sert H, Usta B, Demircioglu RI, Kasikara H. Transient neurological symptoms after spinal anesthesia. CLIN INVEST MED 2016; 39:27512. [PMID: 27917802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The aim of this study was to investigate the incidence of transient neurological symptoms (TNS) after spinal anesthesia with levobupivacaine, bupivacaine, articaine or lidocaine. METHODS The patients (n=400) were randomly assigned to receive spinal anesthesia with levobupivacaine, bupivacaine, articaine or isobaric lidocaine. Onsets of sensory and motor block were recorded. On postoperative days 1, 2 and 3, patients were interviewed by an investigator blinded to the spinal anaesthetic agent used. The patients were classified as having TNS if there was pain in the hips, thighs and/or lower limbs following recovery from anesthesia. RESULTS Time to maximum sensory block was significantly longer in the articaine group than the lidocaine group. The incidence of TNS was much less after spinal anesthesia with levobupivacaine, bupivacaine and articaine than after lidocaine.
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Demircioglu RI, Gozdemir M, Usta B, Sert H, Karabayirli S, Muslu B, Keskin EA. Comparison of intrathecal plain articaine and levobupivacaine with fentanyl for Caesarean section. CLIN INVEST MED 2016; 39:27516. [PMID: 27917806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Articaine is used as a local anesthetic for outpatient surgery because it offers rapid onset of anesthesia and short duration motor block. Levobupivacaine is often preferred for Caesarean section. We evaluated the anesthetic characteristics of fentanyl-supplemented plain articaine and levobupivacaine for Caesarean section under combine spinal epidural anesthesia. METHODS Patients undergoing Caesarean section received in random order plain articaine 40 mg (Group A, n=50) or plain levobupivacaine 10 mg (Group L, n=50) mixed with fentanyl 20 µg intrathecally. The onset and duration of sensory and motor block, first analgesic request, and hemodynamic parameters were recorded. RESULTS Onset times of maximum motor block were longer in Group L than Group A (P=0,001). Time to two-segment regression of sensory block were 70 min for Group A and 90 min group L (P=0.001). Times to complete regression of motor blockade were significantly longer in group L than group A (P =0,001). CONCLUSION To have a faster onset and shorter duration of spinal anesthesia, we recommend the use of plain articaine for Caesarean section.
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Gozdemir M, Demircioglu RI, Karabayirli S, Sert H, Muslu B, Usta B, Yazici U. A Needle-Free Injection System (INJEX™) with lidocaine for epidural needle insertion: A randomized controlled trial. Pak J Med Sci 2016; 32:756-61. [PMID: 27375728 PMCID: PMC4928437 DOI: 10.12669/pjms.323.9174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objectives: Local anesthetic infiltration is also a process of a painful process itself. INJEX™ technology, known as “Needle-free” drug delivery system, was designed for reducing the pain associated with cutaneous procedures. We conducted a prospective, randomized trial to evaluate the application of lidocaine with INJEX™ system and 27-gauge needle. Methods: A total of 60 consecutive patients were allocated to receive either INJEX group or 27-gauge needle group. Local anesthetic infiltration was applied two minutes before epidural needle insertion. Results: Mean VAS, at the time of local anesthetic injection was 0 for group I and 2 for group II. When the effect of epidural needle insertion was compared, the mean VAS score was one versus two for Group-I versus Group-II, respectively. Lidocaine applied with the INJEX™ system before epidural needle insertion significantly reduced the intensity of pain during that procedure and was least effective the lidocaine applied with the 27-gauge needle and patients felt less pain during at the time of local anesthetic injection in Group-I. Conclusion: Needle-free delivery of lidocaine is an effective, easy to-use and noninvasive method of providing local anesthesia for the epidural needle insertion.
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Affiliation(s)
- Muhammet Gozdemir
- Muhammet Gozdemir, MD. Associate Professor, Anesthesiologist, Department of Anesthesiology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey
| | - Ruveyda Irem Demircioglu
- Ruveyda Irem Demircioglu, MD. Associate Professor, Anesthesiologist, Department of Anesthesiology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey
| | - Safinaz Karabayirli
- Safinaz Karabayirli, MD. Assistant Professor, Anesthesiologist, Department of Anesthesiology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey
| | - Huseyin Sert
- Huseyin Sert, MD. Associate Professor, Anesthesiologist, Department of Anesthesiology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey
| | - Bunyamin Muslu
- Bunyamin Muslu, MD. Associate Professor, Anesthesiologist, Department of Anesthesiology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey
| | - Burhanettin Usta
- Burhanettin Usta, MD. Associate Professor, Anesthesiologist, Department of Anesthesiology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey
| | - Ummugulsum Yazici
- Dr. Ummugulsum Yazici, MD. Anesthesiologist, Department of Anesthesiology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey
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Sert H, Muslu B, Usta B, Colak N, Irem Demircioglu R, Gozdemir M. A comparison of articaine and fentanyl-supplemented articaine for hemodialysis fistula creation under ultrasound-guided axillary block. Ren Fail 2011; 33:280-4. [PMID: 21401351 DOI: 10.3109/0886022x.2011.560502] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this prospective randomized, double-blinded study was to evaluate the effect of fentanyl addition to articaine on the duration of sensory as well as motor blocks, and the duration of analgesia during hemodialysis fistula creation under ultrasound-guided axillary block. Fifty patients were randomly allocated to two groups, an articaine group (A), receiving 40 mL of articaine HCI (20 mg/mL) with 2 mL of isotonic sodium chloride solution, and an articaine-fentanyl group (AF), receiving 40 mL of articaine HCI (20 mg/mL) with 2 mL (100 µg) of fentanyl. The onset as well as the duration of sensory and motor blocks, the time necessary for first analgesic administration, the hemodynamic parameters, and the side effects were recorded. Three patients in Group A and two patients in Group AF due to incomplete block were excluded from the study. The duration of sensory and motor blocks was significantly longer in the AF group than in the A group. The first time for analgesic need was also significantly longer in group AF (363 ± 134 min) than in group A (244 ± 84 min) (p = 0.001). The addition of fentanyl did not improve the onset of sensory and motor block times. Hemodynamic parameters were similar in the two groups. In conclusion, the addition of fentanyl to articaine in axillary block prolongs the duration of sensory and motor blocks, as well as the time of first analgesic requirement.
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Affiliation(s)
- Hüseyin Sert
- Department of Anesthesiology, Fatih University Faculty of Medicine, Ankara, Turkey.
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Sert H, Gozdemir M, Cimen NK, Muslu B. Airway Management of CHARGE Syndrome: Case Report. Turk J Anaesthesiol Reanim 2011. [DOI: 10.5222/jtaics.2011.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Sert H, Muslu B, Gozdemir M, Kurtaran H, Usta B, Kınacı S, Demircioglu Rİ. Evaluation of recovery and anesthetic gas consumption using remifentanil combined with low-flow sevoflurane anesthesia in tympanoplasty. ORL J Otorhinolaryngol Relat Spec 2011; 73:141-6. [PMID: 21508653 DOI: 10.1159/000327600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 03/21/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this study was to compare the effects of low-flow sevoflurane and low-flow sevoflurane supplemented with remifentanil anesthesia on the recovery time, consumption amount of the anesthetic drugs and hemodynamic differences. MATERIALS AND METHODS A prospective, randomized and double-blinded study with 50 patients was designed. Following intubation, group S received sevoflurane 1.8 vol%, oxygen, nitrous oxide at 4 l · min(-1) and normal saline continuous infusion; group SR received sevoflurane 1.2 vol%, oxygen, nitrous oxide at 4 l · min(-1) and 0.25 μg · kg(-1) · min(-1) remifentanil continuous infusions. Ten minutes after intubation the flow rates decreased to 1 l · min(-1). Consumption of each drug, postoperative recovery characteristics and visual analog scale (VAS) scores for pain were recorded. RESULT There were no significant differences in hemodynamic parameters, tramadol consumption and VAS scores for pain. The patients in group SR showed faster early recovery as compared to group S. The mean consumption of sevoflurane was 18 ml in group SR, while it was 25 ml in group S. CONCLUSIONS Low-flow sevoflurane anesthesia combined with remifentanil regimen in patients undergoing tympanoplasty surgery resulted in a faster early recovery and decreased sevoflurane consumption.
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Affiliation(s)
- Hüseyin Sert
- Department of Anesthesiology, Fatih University Faculty of Medicine, Ankara, Turkey.
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Gozdemir M, Usta B, Demircioglu RI, Muslu B, Sert H, Karatas OF. Magnesium sulfate infusion prevents shivering during transurethral prostatectomy with spinal anesthesia: a randomized, double-blinded, controlled study. J Clin Anesth 2011; 22:184-9. [PMID: 20400004 DOI: 10.1016/j.jclinane.2009.06.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Revised: 06/03/2009] [Accepted: 06/22/2009] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE To determine whether magnesium sulfate (MgSO(4)) infusion during surgery reduces shivering during spinal anesthesia. DESIGN Double-blinded placebo-controlled, randomized trial. SETTING Operation room of a university hospital. PATIENTS 60 patients, aged 40 to 70 years, scheduled for elective transurethral resection of the prostate (TURP) during spinal anesthesia. INTERVENTIONS Subarachnoid anesthesia consisting of hyperbaric bupivacaine three mL 0.5% was injected using a 25-G Quincke spinal needle. Patients received either saline (Group C, n = 30) or MgSO(4) (Group Mg, n = 30). Group Mg received an intravenous (IV) bolus of MgSO(4) 80 mg/kg via syringe pump over a 30-minute period, followed by a two g/hr infusion during the intraoperative period. Group C received an equal volume of saline. MEASUREMENTS Motor blockade was evaluated by Bromage motor scale. Sensory block level was assessed by pinprick test. Shivering was assessed after the completion of subarachnoid drug injection. Side effects were recorded. MAIN RESULTS Hypothermia was observed in all patients (100%) in Group Mg and in 24 patients (80%) in Group C (P = 0.024). The decrease in core temperature in Group Mg was significantly greater (P < 0.005). Shivering was observed in two patients (6.7%) in Group Mg and 20 patients (66.7%) in Group C (P = 0.0001). CONCLUSIONS MgSO(4) infusion in the perioperative period significantly reduced shivering during TURP with spinal anesthesia. MgSO(4) infusion prevents shivering in patients receiving spinal anesthesia but increases the risk of hypothermia.
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Affiliation(s)
- Muhammet Gozdemir
- Department of Anesthesiology and Reanimation, Fatih University School of Medicine, Ankara 06540, Turkey.
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Usta B, Gozdemir M, Demircioglu RI, Muslu B, Sert H, Yaldiz A. Dexmedetomidine for the prevention of shivering during spinal anesthesia. Clinics (Sao Paulo) 2011; 66:1187-91. [PMID: 21876972 PMCID: PMC3148462 DOI: 10.1590/s1807-59322011000700011] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 03/31/2011] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the effect of dexmedetomidine on shivering during spinal anesthesia. METHODS Sixty patients (American Society of Anesthesiologists physical status I or II, aged 18-50 years), scheduled for elective minor surgical operations under spinal anesthesia with hyperbaric bupivacaine, were enrolled. They were administered saline (group C, n = 30) or dexmedetomidine (group D, n = 30). Motor block was assessed using a Modified Bromage Scale. The presence of shivering was assessed by a blinded observer after the completion of subarachnoid drug injection. RESULTS Hypothermia was observed in 21 patients (70%) in group D and in 20 patients (66.7%) in group C (p = 0.781). Three patients (10%) in group D and 17 patients (56.7%) in group C experienced shivering (p = 0.001). The intensity of shivering was lower in group D than in group C (p = 0.001). Time from baseline to onset of shivering was 10 (5-15) min in group D and 15 (5-45) min in group C (p = 0.207). CONCLUSION Dexmedetomidine infusion in the perioperative period significantly reduced shivering associated with spinal anesthesia during minor surgical procedures without any major adverse effect during the perioperative period. Therefore, we conclude that dexmedetomidine infusion is an effective drug for preventing shivering and providing sedation in patients during spinal anesthesia.
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Affiliation(s)
- Burhanettin Usta
- Department of Anesthesiology, School of Medicine, Fatih University, Ankara, Turkey
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Sert H, Usta B, Karabayirli S, Gozdemir M, Demircioglu RI. A Case of ARDS Developed Because of in Uteroex Fetus. Turk J Anaesthesiol Reanim 2010. [DOI: 10.5222/jtaics.2010.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Usta B, Gozdemir M, Sert H, Muslu B, Demircioglu RI. Fluoroscopically guided ganglion impar block by pulsed radiofrequency for relieving coccydynia. J Pain Symptom Manage 2010; 39:e1-2. [PMID: 20538176 DOI: 10.1016/j.jpainsymman.2010.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 01/31/2010] [Accepted: 02/01/2010] [Indexed: 01/30/2023]
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Gozdemir M, Usta B, Sert H, Muslu B, Demircioglu IR, Uras I. Pulsed Radiofrequency Application in the Entrapment Neuropathy of a Sural Nerve. Eurasian J Med 2010; 42:44-5. [DOI: 10.5152/eajm.2010.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Accepted: 01/20/2010] [Indexed: 11/22/2022] Open
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Gozdemir M, Muslu B, Sert H, Usta B, Demircioglu RI, Karatas OF, Surgit O. Transient neurological symptoms after spinal anaesthesia with levobupivacaine 5 mg/ml or lidocaine 20 mg/ml. Acta Anaesthesiol Scand 2010; 54:59-64. [PMID: 19860749 DOI: 10.1111/j.1399-6576.2009.02141.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Transient neurological symptoms (TNS) after spinal anaesthesia have been reported most commonly in association with lidocaine, but have been observed with other local anaesthetics. The aim of this prospective, randomized, double-blind study was to investigate the incidence of TNS after spinal anaesthesia with either levobupivacaine or lidocaine. METHODS Patients undergoing inguinal hernia, appendectomy, varicose vein or minor orthopaedic operations were included in the study (60 patients; 47 male, 13 female, overall mean age 30 years). All patients had an American Society of Anesthesiologists score of I or II. The patients were randomly assigned to receive spinal anaesthesia with either 20 mg isobaric levobupivacaine (5 mg/ml) or 80 mg isobaric lidocaine (20 mg/ml). Onset of sensory and motor block and side effects were recorded. On post-operative days 1, 2, and 3, patients were interviewed by an investigator blinded to the spinal anaesthetic used. The patients were classified as having TNS if, following recovery from anaesthesia, there was pain in the buttocks, thighs and/or lower limbs. RESULTS In the levobupivacaine group, one patient (3.33%) experienced TNS, whereas in the lidocaine group, eight (26.6%) experienced TNS (P=0.002). Maximum times to arrival of sensory blocks were shorter with lidocaine (P<0.001). The levobupivacaine and lidocaine groups did not differ significantly in terms of the highest dermatome included in sensory block or motor block grade. CONCLUSION After spinal anaesthesia with levobupivacaine, the incidence of TNS was much less than after lidocaine. However, it appears that TNS may occur in association with levobupivacaine.
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Affiliation(s)
- M Gozdemir
- Department of Anaesthesiology, Fatih University School of Medicine, Ankara, Turkey.
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Rüveyda Irem Demircioglu, Usta B, Muslu B, Sert H, Okano Y, Onodera K, Gozdemir M. Combination of Small Doses of Subarachnoid Morphine with Systemic Diclofenac Improves Analgesia During 48 hours after Cesarean Delivery. J HARD TISSUE BIOL 2010. [DOI: 10.2485/jhtb.19.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Erdurmus M, Aydin B, Usta B, Yagci R, Gozdemir M, Totan Y. Patient comfort and surgeon satisfaction during cataract surgery using topical anesthesia with or without dexmedetomidine sedation. Eur J Ophthalmol 2008; 18:361-7. [PMID: 18465717 DOI: 10.1177/112067210801800308] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine the safety and efficacy of perioperative dexmedetomidine (Dex) sedation on patient comfort and surgeon satisfaction during cataract surgery under topical anesthesia. METHODS Forty-four patients having routine clear corneal phacoemulsification surgery under topical anesthesia were included in the study. Patients were randomly divided into two groups: Dex group (n=22) and control group (n=22). Patients in the Dex group were to receive intravenous Dex using an infusion pump and those in the control group were to receive 0.9% saline infusion. Primary outcome measures were patient comfort, surgeon satisfaction, and patient pain perception. RESULTS There was no significant difference between the groups in terms of baseline characteristics including age, sex, eye side, pupil diameter, and vital signs (p>0.05 for all). Patient comfort and surgeon satisfaction in Dex group was better than in control group (p=0.042 and p=0.003, respectively). The mean pain perception score was lesser in the Dex group (1.23+-.72) than control group (3.64+/-1.43), (p<0.001). The mean surgical time and intraoperative complications were similar in both groups (p>0.05). There was no significant effect of the Dex sedation on vital signs perioperatively (p>0.05 for all). CONCLUSIONS Dex sedation improved patient and surgeon satisfaction and decreased patients' pain perception while undergoing cataract surgery under topical anesthesia. It appears to be a safe and suitable choice of sedation for cataract surgery.
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Affiliation(s)
- M Erdurmus
- Department of Ophthalmology, Fatih University Medical School, Ankara - Turkey.
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Gozdemir M, Muslu B, Usta B, Sert H, Demircioglu RI, Gumus II. Generalized seizure in patient receiving epidural meperidine during cesarean section. Ann Pharmacother 2008; 42:1145. [PMID: 18523234 DOI: 10.1345/aph.1l021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract
BACKGROUND The aim of this prospective, randomized, double-blind study was to evaluate the effect of the addition of tramadol to ropivacaine on the onset and duration of sensory and motor block, and duration of analgesia, for axillary brachial plexus block. METHODS After institutional approval and informed consent had been obtained, 45 patients scheduled for forearm or hand surgery under axillary brachial plexus block were randomly allocated into two groups. The ropivacaine group received 40 ml of ropivacaine 7.5 mg/ml plus 2 ml of isotonic sodium chloride solution, and the tramadol group received 40 ml of ropivacaine 7.5 mg/ml plus 2 ml (100 mg) of tramadol. The onset and duration of sensory and motor block in the distribution of the musculocutaneous, radial, median and ulnar nerves, the duration of analgesia, the time to first pain medication, hemodynamics and side-effects were recorded. RESULTS The addition of tramadol did not improve the speed of onset or increase the duration of sensory and motor block. The durations of analgesia were 631 +/- 33 min and 633 +/- 37 min (mean +/- standard deviation) in the ropivacaine and tramadol groups, respectively (P > 0.05). Hemodynamic parameters and side-effects did not differ between the groups. CONCLUSION The addition of 100 mg of tramadol to 7.5 mg/ml of ropivacaine, for axillary brachial plexus block, does not prolong the duration of motor and sensory block and analgesia.
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Affiliation(s)
- E Kesimci
- Ataturk Training and Research Hospital, Ankara, Turkey.
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Izdes S, Sepici-Dincel A, Gozdemir M, Ozkan Y, Kanbak O. The effect of general and regional anaesthesia on ischaemia-reperfusion injury. Anaesth Intensive Care 2007; 35:451-2. [PMID: 17591150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Gozdemir M, Sert H, Yilmaz N, Kanbak O, Usta B, Demircioglu RI. Remifentanil-propofol in vertebral disk operations: hemodynamics and recovery versus desflurane-n(2)o inhalation anesthesia. Adv Ther 2007; 24:622-31. [PMID: 17660173 DOI: 10.1007/bf02848787] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to ascertain whether total intravenous anesthesia (TIVA) with propofol and remifentanil differs from inhalational anesthesia with desflurane and nitrous oxide in terms of hemodynamics, recovery profile, and postoperative analgesic demand in patients undergoing elective microsurgical vertebral disk resection. A total of 60 patients were randomly assigned to receive TIVA with propofol and remifentanil or inhalational anesthesia with desflurane and nitrous oxide. The TIVA group (n=30) then received 50%/50% N(2)O/O(2). A constant infusion of remifentanil was provided at 0.125 microg/kg/min accompanied by propofol at 10 mg/kg/h in the first 10 min, 6 mg/kg/h in the second 10 min, then 4 mg/kg/h. The desflurane group (n=30) received 50%/50% N(2)O/O(2), with 5% desflurane after intubation and 6% before incision; desflurane was administered in a minimum alveolar concentration 1 fashion during the operation. Hemodynamic, O(2) saturation, and end-tidal CO(2) data were recorded before induction, after intubation, after prone positioning, 5, 10, 15, 20, and 30 min into the operation, and at 15-min intervals thereafter until the end of the operation. Details on perioperative bradycardia, hypotension or hypertension, spontaneous breathing, extubation, eye opening, recovery time of ability to give name and date of birth, postoperative nausea and vomiting, shivering, agitation, and hypoxia were recorded. Patients anesthetized with desflurane responded to skin incision with increasing blood pressure and tachycardia; however, no other hemodynamic differences were noted between the 2 groups. In the TIVA group, recovery times were shorter for spontaneous ventilation (2.33-3.53 min), extubation (3.13-3.88 min), eye opening (4.06-6.23 min), and being able to give name and date of birth (5.4-7.9 min) compared with times in the desflurane group (P<.05). In the TIVA group, more postoperative shivering (16.7% of patients) and greater analgesic demand were seen than in the desflurane group. Although nausea and vomiting were more common in the desflurane group, no difference in bronchospasm was reported. In the TIVA group, a shorter recovery period and a greater demand for postoperative analgesia were seen. Because of the lack of residual analgesic effects, postoperative analgesic treatment should be initiated immediately in patients undergoing TIVA.
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Affiliation(s)
- Muhammet Gozdemir
- Ataturk Research and Training Hospital, Department of Anesthesiology, Ankara, Turkey.
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Usta B, Gozdemir M, Turgut F, Sert H, Kanbay M, Demircioglu RI, Akcay A. Does hypocalcemia trigger pulmonary embolism? Med Hypotheses 2006; 68:464-5. [PMID: 17011721 DOI: 10.1016/j.mehy.2006.07.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2006] [Accepted: 07/30/2006] [Indexed: 10/24/2022]
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