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Öğe Oral ketamine administration for radiation therapy in children(Scientific Publishers of India, 2017) Doğan E.; Güzel A.; Zincircioğlu S.B.; Arslan M.Ş.; Çelik F.; Yildirim M.B.; Yildirim Z.B.Background: Radiotherapy is a reliable and effective treatment for various malignancies and can be used for both curative and palliative/prophylactic ends. In order to achieve accuracy, reliability and success in the implementation of radiotherapy, it is imperative that patients adapt to the treatment and remain motionless. Material and methods: In this study, the records of anesthetic agents utilized in 26 patients aged 2-10 being treated by external beam radiotherapy were examined. Results: Radiotherapy under anesthesia was implemented in a total of 56 sessions conducted on 26 patients. During the radiotherapy applications, only 10 (17%) sessions required the use of an extra dose of ketamine. The radiotherapy session duration was 6.3 ± 2.4 minutes. (The anesthesia start time was 20.5 ± 4.6.) Additionally, the patients' recovery time from anesthesia was found to be 68.6 ± 6.2. 61.5% of the patients were administered prophylactic cranial radiotherapy due to acute lymphoblastic leukaemia (ALL). Before and after the procedure, hemodynamic and respiratory parameters were found to be stable. Conclusion: Since a combination of oral ketamine and midazolam provides effective sedation and comfort and can be administrated easily, we believe that it can be safely used in radiotherapy procedures on children. © 2017, Scientific Publishers of India. All rights reserved.Öğe The protective effect of dexmedetomidine on bupivacaineinduced sciatic nerve inflammation is mediated by mast cells(2013) Tüfek A.; Kaya S.; Tokgöz O.; Firat U.; Evliyaoğlu O.; Çelik F.; Karaman H.Purpose: This study was designed to assess the correlation between the neuroprotective effect of dexmedetomidine and oxidative stress, neural inflammation and mast cell stability in rats with bupivacaine-induced sciatic nerve toxicity. Methods: Forty adult Wistar Albino rats, eight rats per group, were used. Saline (0.3 ml of 0.9%), dexmedetomidine (20 ?g/kg), 0.5% bupivacaine or 0.5% bupivacaine+dexmedetomidine (20 ?g/kg) was injected into the sciatic nerve. A control group of rats received no injection. Fourteen days after injection, the sciatic nerves were harvested and total oxidant status, total anti-oxidant status, paraoxonase-1, galectin-3 and matrix metalloproteinase 2 and 9 levels were measured in the sciatic nerves. In addition, the presence and status of inflammation, edema, and mast cells were evaluated histopathologically. Results: The combination of dexmedetomidine and bupivacaine alleviated oxidative stress. In addition, it decreased matrix metalloproteinase 9 and galectin-3 levels and increased matrix metalloproteinase 2 levels. Moreover, it stabilized recruited mast cells at the injury site; however, it did not significantly decrease inflammation or edema. Conclusion: Dexmedetomidine may ameliorate bupivacaine-induced neurotoxicity by modulating mast cell degranulation. The neuroprotective effect of dexmedetomidine may make it a suitable adjuvant agent to local anesthetics in peripheral nerve blocks.Öğe Retrograde intubation in the patient with cystic tumor located at the base of tongue(2013) Çelik F.; Tokgöz O.; D?an E.; Güzel A.; Çiftçi T.; Tüfek A.Retrograde intubation is one of the methods used to maintain an airway in the event of a difficult intubation. Retrograde intubation has been successfully carried out on patient for whom intubation was not possible with a direct laryngoscope and fiber optic bronchoscope. The central venous catheter needle and guide wire are the materials that are the most practical to prepare and access for the retrograde intubation. To conclude, In conclusion, retrograde intubation may be good alternative to invasive airway management such as surgical tracheostomy for difficult or impossible intubations because it can be performed easily, quickly, and successfully.Öğe Tea (Camellia sinensis); composition, the preventive effects on health and consumption: Review(Turkiye Klinikleri, 2006) Çelik F.The beverage tea, derived from the top leaves of the plant Camellia sinensis is one of the most widely used beverages in the world, second only to water. The three main categories of tea- green, black and oolong- are the result of different processing procedures. Green tea and black tea have similar protective effects in most of the tests run. In recent years, tea has attracted more attention because of reported health benefits. Tea contains more than 4000 chemical compounds that may affect the human body in many aspects. It is generally believed that polyphenols such as theaflavins and thearubigins as well as catechins as major constituents of tea are mainly responsible for antioxidant actions. Studies showed that tea possessed diverse pharmacological properties, which include anti-oxidative, anti-inflammatory, anti-mutagenic, anti-carcinogenic, anti-angiogenic, apoptotic, anti-obesity, hypocholesterolemic, anti-arteriosclerotic, anti-diabetic, anti-bacterial, anti-viral, anti-aging effects. However, these responses cannot always be reflected in human studies. This may be due to the limited bioavailability of tea components and the use of physiologically unachievable tea concentrations in some of the animal and in-vitro experiments. Caffeine in beverages such as tea and coffee is known to be toxic at high concentrations. Epidemiologic data and laboratory approaches indicate that the amount of polyphenols in four cups of tea or less (about 600 mL of a 1.5% solution) is insufficient to provide significant preventive effects in chronic diseases. Intake of 6-10 cups (approximately 960-1600 mL) of tea per day was shown to constitute a useful dietary habit to assist in lowering the risk of a number of chronic diseases. Total fluid intake in adults should be about 2.5 l; tea should account for 0.9-1.4 l of this amount. Copyright © 2006 by Türkiye Klinikleri.Öğe The usage of low-dose lidocaine fentanyl in intravenous regional anesthesia(2013) Guzel A.; Çelik F.; Uludag O.; Dogan E.; Alemdar C.; Yildirim B.We aimed to present our IVRA practices by adding low-dose lidocaine fentanyl for the patients who have undergone forearm and hand surgery. After approval Ethics Committee and the permission of patients, 36 patients which were undergone elective, forearm or hand surgery, aged 18-60 years, were included in the study. The intravenous route was opened with 20 G cannula from the hand back (dorsum) which will operated and double-cuffed pneumatic tourniquet was inserted into the arm proximal. The arm was uplift for ten minutes and had veins drained by firmly wrapping the arm from finger tips towards shoulder to distal arm with the Esmarch bandage. First, the proximal cuff was inflated so as to be 150 mmHg more than systolic pressure. The distal cuff was lowered and the Esmarch bandage was removed. The 100 mg lidocaine+100 ?g fentanyl from the IV cannula on the hand back which will be operated, was given in 40 ml and the distal cuff was inflated after 5 min then proximal cuff was put out. The sensory block was assessed and sensory block initial time and motor block initial time was recorded. The regression times of sensory and motor block were recorded. Also the complications during and after the operation were recorded. Duration of surgery was determined as 30.3±10.1 min and the duration of tourniquet was 41.3±9.1 min. Sensory block initial time was recorded as 8.1±2.6 min, and the time for sensory block regression was recorded as 6.2±3.1 min. The motor block initial time was recorded as 13.4±5.2 min and motor regression time was recorded as 5.6±2.8 min. The clinical diagnoses of the patients were shown in Table 2. According to the VAS scores, it was observed that adequate level of anesthesia and analgesia was maintained for all patients. The addition of low-dose lidocaine to fentanyl in IVRA may provide both sufficient and effective anesthesia and decrease the complications related with local anesthetic toxicity.
