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    A Case of Pneumothorax after Phrenic Nerve Block with Guidance of a Nerve Stimulator
    (Korean Pain Soc, 2011) Beyaz, Serbulent Gokhan; Tufek, Adnan; Tokgoz, Orhan; Karaman, Haktan
    Hiccups have more than 100 etiologies. The most common etiology has gastrointestinal origins, related mainly to gastric distention and gastroesophageal reflux disease. Intractable hiccups are rare but may present as a severe symptom of various diseases. Hiccups are mostly treated with non-invasive or pharmacological therapies. If these therapies fail, invasive methods should be used. Here, we present a patient on whom we performed a blockage of the phrenic nerve with the guidance of a nerve stimulator. The patient also had pneumothorax as a complication. Three hours after intervention, a tube thoracostomy was performed. One week later, the patient was cured and discharged from the hospital. In conclusion, a stimulator provides the benefit of localizing the phrenic nerve, which leads to diaphragmatic contractions. Patients with thin necks have more risk of pneumothorax during phrenic nerve location.
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    Caudal epidural block in children and infants: retrospective analysis of 2088 cases
    (K Faisal Spec Hosp Res Centre, 2011) Beyaz, Serbulent Gokhan; Tokgoz, Orhan; Tufek, Adnan
    BACKGROUND AND OBJECTIVES: Regional anesthesia is usually preferred as caudal block via the epidural space. However, the number of large-scale studies including pediatric caudal blocks is small. The objective of this study was to evaluate complications and side effects of local anesthetics and adjuvant drugs. DESIGN AND SETTING: Retrospective, descriptive study of cases occurring during the period December 2007 to October 2009. METHODS: Of 4815 medical records were screened, 2088 pediatric cases were identified and included in this study. RESULTS: As a local anesthetic, we preferred mostly levobupivacaine in 1669 (79.9%) patients and bupivacaine in 419 (20.1%) patients. As adjuvant drug, we preferred mostly morphine (41 patients), fentanyl (7 patients) and adrenaline (6 patients) in 54 (2.5%) patients. For general anesthesia induction, we preferred mostly propofol (1996 patients, 94.2%); for maintenance, sevoflurane (1773 patients, 84.9%). For airway control, we preferred mostly the ProSeal laryngeal mask (PLMA), in 1008 (48.2%) patients. One thousand six hundred five (76.9%) patients were from outpatient clinics and 483 (23.1%) patients were from inpatient clinics. No permanent complication was encountered after caudal blocks. CONCLUSION: We conclude that caudal epidural blocks are a safe and effective method for subumbilical day-case pediatric surgeries when performed by anesthetists.
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    Comparison of the efficacies of I-gel™ and LMA-ProSeal™ for airway management in pediatric patients
    (Tubitak Scientific & Technological Research Council Turkey, 2013) Tokgoz, Orhan; Tufek, Adnan; Beyaz, Serbulent Gokhan; Yuksel, Mustafa Ugur; Celik, Feyzi; Aycan, Ilker Onguc; Guzel, Abdulmenap
    Aim: The present study was performed to compare the performance of I-gel (TM) with LMA-ProSeal (TM) in children undergoing anesthesia. Materials and methods: A total of 185 patients who were scheduled for elective surgery in Dicle University's hospital were randomly divided into 2 groups: the I-gel (TM) group (Group-I, n = 95) and the p-LMA (TM) group (Group-P, n = 90). Airway leakage pressure, insertion time, fiberoptic laryngeal image scores, ease of insertion, and possible complications were compared between these groups. Results: The airway leakage pressure of Group-I was significantly higher than that of Group-P (means +/- SD: 28 +/- 5 vs. 20 +/- 4 cmH(2)O, P < 0.01). The duration of supraglottic airway device insertion was shorter in Group-I than Group-P (19 +/- 4 vs. 28 +/- 5 s, P < 0.01). The overall success rate was 95% for Group-I and 94% for Group-P (P = 0.10). The I-gel provided a better view of the glottis than the p-LMA (93% of cases in Group-I and 68% of cases in Group-P, P = 0.03). There were no significant differences with regard to ease of insertion (P = 0.97). Conclusion: This study suggested that I-gel is an effective and safe alternative supraglottic airway device for use in children.
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    Regional anaesthesia in paediatric surgery: results of 2200 children
    (Pakistan Medical Assoc, 2011) Beyaz, Serbulent Gokhan; Tokgoz, Orhan; Tufek, Adnan
    Objectives: To evaluate paediatric regional anaesthesia applications in 2200 children at Diyarbakir Children's Hosptial, Turkey. Methods: This is a cross-sectional study done from January 2005 and October 2009. Paediatric regional anaesthesia applications in 2200 children were retrospectively analysed and included in this study. Demographic data, operation type, choice of regional anaesthesia, local anaesthetics, adjuvant drugs, side effects and complications were recorded. Results: Mean age was 6 4 years and mean weight 21.1 +/- 10.7 kg. There were 317 (14.4%) girls, and 1883 (85.6%) boys. Of the 2200 cases studied, 2088 (94%) received caudal epidural block, 59 (3%) received spinal block, 34 (%2) had lumbar epidural block and 19 (1%) received dorsal penile nerve block Conclusion: In paediatric anaesthetic practice, caudal epidural block is used widely. However, paediatric regional anaesthesia should be supported and developed further by obtaining essential materials and devices. Variety of both neuraxial blocks and peripheral nerve blocks under sedation/general anaesthesia should also be increased.