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Öğe The comparison of neuroprotective effects of intrathecal dexmedetomidine and metilprednisolone in spinal cord injury(Elsevier Science Bv, 2013) Celik, Feyzi; Gocmez, Cuneyt; Kamasak, Kagan; Tufek, Adnan; Guzel, Abdulmenap; Tokgoz, Orhan; Firat, UgurBackground: The purpose of this study is the investigation of the effects of intrathecally injected dexmedetomidine and methylprednisolone and their dominancy over one another in rats with generated Spinal Cord Injury (SCI). Methods: 40, female, adult Wistar Albino rats weighing 220-260 g were included in the study. The rats were fixed with Intrathecal catheter (IT) and divided into four groups. All subjects were applied T7-10 laminectomy after catheter. Group S (n:10) was injected with IT 10 mu L isotonic saline; Group C (n: 10) with IT 10 mu L isotonic saline after SCI; Group D (n:10) with IT one doze 10 mu L of dexmedetomidine after SCI; Group M (n:10) IT one dose 10 mu L of methylprednisolone. The subjects were sacrificed 72 h after this operation. The damaged area was removed biochemically and histopathologically examined. Results: Antioxidant and inflammatory parameters searched for in all damages tissue were statistically different in all groups from group S. They were different in group M and group D than group C (p < 0.001). After the comparison of group D and group M, PON and IL6 values were higher in group D (p = 0.003, p = 0.035) while the other two biochemical parameters were similar in both groups (Table 1). After histopathologic trials, edemas, bleeding and necrosis were found less in group S while at the most in group C (p < 0.001). In group M and group D, however, they were higher than group S and lower than group C (p < 0.001). After the comparison of group D and group M, while there was no difference in terms of edema necrosis, the amount of bleeding was lower in group D (p < 0.001) (Table 2). Conclusions: It has been discovered that intrathecal use of dexmedetomidine caused neuroprotective effects similar to methylprednisolone. (C) 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.Öğe Comparison of the effectiveness of intrathecal bupivacaine and Levobupivacaine in hip surgery(Slovene Medical Soc, 2013) Celik, Feyzi; Karaman, Haktan; Tufek, Adnan; Kavak, Gonul Olmez; Yildirim, Zeynep Baysal; Tokgoz, Orhan; Guzel, AbdulmenapPurpose: We aimed to compare the anesthetic and hemodynamic effects of intrathecally administered levobupivacaine and bupivacaine in combination with fentanyl in hip surgery. Subjects and methods: Sixty patients categorized as class 1 or 2 according to the American Society of Anesthesiologists (ASA) Physical Status classification, aged between 18 and 65 years and scheduled for hip surgery were randomly assigned to two groups. Patients in Group I received spinal anesthesia with 0.5 % bupivacaine 12.5 mg + fentanyl 10 mu g (total 2.6 ml), and patients in Group II received 0.5 % levobupivacaine 12.5 mg + fentanyl 10 mu g (total 2.6 ml) intrathecally. The level of sensory block and motor block was evaluated, and hemodynamic data were recorded. Results: The onset of sensory block and the time to two-segment regression were similar between the two groups. In the levobupivacaine group, the time to motor block onset was longer and the motor block regression time was shorter than that of bupivacaine group. The groups were similar with respect to hemodynamic data. Conclusion: We consider that levobupivacaine may be a good alternative to bupivacaine, particularly in surgical procedures where less motor block development is desired.Öğe 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, AbdulmenapAim: 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.Öğe Dexmedetomidine and Magnesium Sulfate: A Good Combination Treatment for Acute Lung Injury?(Taylor & Francis Inc, 2019) Guzel, Abdulmenap; Dogan, Erdal; Turkcu, Gul; Kuyumcu, Mahir; Kaplan, Ibrahim; Celik, Feyzi; Yildirim, Zeynep BaysalObjectives: In this study, we aimed to investigate the therapeutic effects of magnesium sulfate (MgSO4) and dexmedetomidine (dex) in a model of acute lung injury (ALI). We determined whether concomitant administration decreased the inflammatory effects of hydrochloric acid (HCl)-induced ALI in a synergistic manner. Materials and Methods: In this study, 42 Sprague-Dawley rats were randomized into six groups: Group S (saline), Group SV (saline + mechanical ventilation), Group HCl (HCl), Group Dex (Dex), Group Mag (MgSO4), and Group DM (Dex + MgSO4). All groups except Group S were mechanically ventilated prior to HCl-induced ALI. Saline or HCl was administered via tracheostomy. Prior to treatment, HCl was administered to Group HCl, Group Dex, Group Mag, and Group DM to induce ALI. Dex and MgSO4 were administered intraperitoneally. The rats were monitored for 4 h after treatment to measure oxidative stress parameters in blood, and prolidase enzyme activity. Lung tissue damage were determined via histopathology. Results: A significant increase in heart rate and rapid desaturation was observed in HCl-administered groups. Treatment administration decreased the pulse values. Increased saturation values and decreased oxidative stress indices were observed in groups that were subsequently administered Dex and MgSO4. Serum prolidase activity increased significantly in Group HCl. Severe pathological findings were detected following HCl-induced ALI. Group Mag showed greater improvement in the pathology of HCl-induced ALI than did Group Dex. Administration of both Dex and MgSO4 did not improve the pathological scores. Conclusions: The antioxidant and anti-inflammatory effects of Dex and MgSO4 ameliorated the detrimental effects of HCI-induced ALI. However, adverse effects on hemodynamics and lung damage were observed when the two drugs were administered together.Öğe Echocardiographic diagnosis of double-chambered left ventricle(Springer Japan Kk, 2016) Bilici, Meki; Demir, Fikri; Akin, Alper; Guzel, Abdulmenap; Akdeniz, Osman; Tan, IlhanDouble-chambered left ventricle (DCLV) is a rare congenital abnormality in which the left ventricle is divided into two separate chambers by a septum or anomalous muscular structure. The chambers are observed mostly parallel to each other without stenosis, and less frequently in a superior-inferior arrangement. An asymptomatic girl is presented here who was diagnosed with DCLV on echocardiographic examination that was performed for the evaluation of cardiac murmur detected by a pediatrician. She has been followed up without treatment.Öğe Effects of Hyperbaric Oxygen Treatment on Renal System(Iranian Soc Nephrolgy, 2017) Tezcan, Orhan; Caliskan, Ahmet; Demirtas, Sinan; Yavuz, Celal; Kuyumcu, Mahir; Nergiz, Yusuf; Guzel, AbdulmenapIntroduction. Hyperbaric oxygen (HBO) treatment is steadily increasing as a therapeutic modality for various types of diseases. Although good clinical outcomes were reported with HBO treatment for various diseases, the multisystemic effects of this modality are still unclear. This study aimed to investigate the renal effects of HBO experimentally. Materials and Methods. Fourteen New Zealand White rabbits were divided into 2 groups randomly as the control group and the study group. The study group received HBO treatment for 28 days (100% oxygen at 2.5 atmospheres for 90 minutes daily) and the control group was used to obtain normal renal tissue of the animal genus. After the intervention period, venous blood samples were obtained, and renal tissue samples were harvested for comparisons. Results. Normal histological morphology was determined with Masson trichrome staining and periodic acid-Schiff staining in the control group. Atrophic glomerular structures, vacuolated tubule cells, and degeneration were detected in the renal samples of the study group with Masson trichrome staining. Additionally, flattening was observed on the brush borders of the proximal tubules, and tubular dilatation was visualized with periodic acid-Schiff staining. The histopathologic disruption of renal morphology was verified with detection of significantly elevated kidney function laboratory biomarkers in the study group. Conclusions. Our findings suggests that HBO has adverse effects on renal glomerulus and proximal tubules. However, the functional effects of this alteration should be investigated with further studies.Öğe An extremely rare complication associated with primary varicella zoster virus infection: Cardiac tamponade(Turkish Soc Cardiology, 2014) Bilici, Meki; Yilmazer, Murat Muhtar; Demir, Fikri; Caliskan, Ahmet; Bozkurt, Fatma; Guzel, Abdulmenap; Onan, Sertac Hanedan[Abstract Not Available]Öğe Foot drop following spinal anaesthesia(Elsevier Science Inc, 2015) Aycan, Ilker Onguc; Turgut, Huseyin; Guzel, Abdulmenap; Dogan, Erdal; Kavak, Gonul Olmez[Abstract Not Available]Öğe Inhalation Anesthesia with Sevoflurane during Intravitreal Bevacizumab Injection in Infants with Retinopathy of Prematurity(Hindawi Ltd, 2013) Tokgoz, Orhan; Sahin, Alparslan; Tufek, Adnan; Cinar, Yasin; Guzel, Abdulmenap; Ciftci, Taner; Celik, FeyziBacground. To investigate the anesthetic management in premature infants with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB) injections. Methods. A retrospective chart review was performed for the patients with ROP who had IVB injection. Clinical characteristics, demographic variables, anesthetic medications, operation techniques, time intervals, and complications were recorded. Results. Sixty-six eyes of 33 patients (23 males, 10 females) with type 1 ROP who were treated with IVB were included. A total of 66 anesthetic applications were performed. Mean gestational age at birth was 28.3 weeks (range 25-33). Mean birth weight was 1300 g (range 600-1850). Serious ocular and systemic complications were not observed in any infant. Conclusion. Inhalation anesthesia with sevoflurane during IVB treatment in premature infants with ROP may be appropriate for anesthetic management.Öğe Magnetic Resonance Imaging in Children under Anesthesia: The Relationship between the Degree of Information Provided to Parents and Parents' Anxiety Scores(Hindawi Ltd, 2014) Guzel, Abdulmenap; Atli, Abdullah; Dogan, Erdal; Celik, Feyzi; Tufek, Adnan; Dusak, Abdurrahim; Sen, VelatBackground. We aimed to investigate the correlation between the anxiety scores of parents whose children are administered anesthesia for magnetic resonance imaging (MRI) and the level of information provided to them before the MRI. The study included 146 children and their parents. The demographic information of the children and their parents was recorded. The parents were divided into two groups. In Group I, the patient's medical history and physical exam findings were recorded on a standard consultation form by an anesthesiologist. In Group II, the parents were additionally provided with more detailed information on how the anesthesia would be administered and the drugs to be used and their side effects and complications. The anxiety scores of the parents were found to be lower in Group II. A higher level of education was associated with higher anxiety scores. Intergroup comparison detected lower anxiety scores for Group II parents whose education levels were up to high school. However, no change upon receiving detailed information was detected in the anxiety scores of parents with higher education levels. In conclusion, this may lower the anxiety scores in parents informed about details of anesthesia administration and may raise parents' sense of confidence in the doctor.Öğe A Miracle That Accelerates Operating Room Functionality: Sugammadex(Hindawi Ltd, 2014) Dogan, Erdal; Akdemir, Mehmet Salim; Guzel, Abdulmenap; Yildirim, Mehmet Besir; Yildirim, Zeynep Baysal; Kuyumcu, Mahir; Gumus, AbdurrahmanBackground. Sugammadex offers a good alternative to the conventional decurarisation process currently performed with cholinesterase inhibitors. Sugammadex, which was developed specifically for the aminosteroid-structured rocuronium and vecuronium neuromuscular blockers, is a modified cyclodextrin made up of 8 glucose monomers arranged in a cylindrical shape. Methods. In this study, the goal was to investigate the efficacy of sugammadex. Sugammadex was used when there was insufficient decurarisation following neostigmine. This study was performed on 14 patients who experienced insufficient decurarisation (TOF < 0.9) with neostigmine after general anaesthesia in the operating rooms of a university and a state hospital between June, 2012, and January, 2014. A dose of 2 mg/kg of sugammadex was administered. Results. Time elapsed until sugammadex administration following neostigmine 37 +/- 6 min, following sugammadex it took 2.1 +/- 0.9 min to reach TOF >= 0.9, and the extubation time was 3.2 +/- 1.4 min. No statistically significant differences were detected in the hemodynamic parameters before and after sugammadex application. From the time of administration of sugammadex to the second postoperative hour, no side effects or complications occurred. None of the patients experienced acute respiratory failure or residual block during this time period. Conclusion. Sugammadex was successfully used to reverse rocuronium-induced neuromuscular block in patients where neostigmine was insufficient.Öğe Oral ketamine administration for radiation therapy in children.(Scientific Publishers India, 2017) Dogan, Erdal; Guzel, Abdulmenap; Zincircioglu, Seyit Burhanedtin; Arslan, Mehmet Serif; Celik, Feyzi; Yildirim, Mehmet Besir; Yildirim, Zeynep BaysalBackground: 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.Öğe Preventive Effects of Dexmedetomidine on the Liver in a Rat Model of Acid-Induced Acute Lung Injury(Hindawi Ltd, 2014) Sen, Velat; Guzel, Abdulmenap; Sen, Hadice Selimoglu; Ece, Aydin; Uluca, Unal; Soker, Sevda; Dogan, ErdalThe aim of this study was to examine whether dexmedetomidine improves acute liver injury in a rat model. Twenty-eight male Wistar albino rats weighing 300-350 g were allocated randomly to four groups. In group 1, normal saline (NS) was injected into the lungs and rats were allowed to breathe spontaneously. In group 2, rats received standard ventilation (SV) in addition to NS. In group 3, hydrochloric acid was injected into the lungs and rats received SV. In group 4, rats received SV and 100 mu g/kg intraperitoneal dexmedetomidine before intratracheal HCl instillation. Blood samples and liver tissue specimens were examined by biochemical, histopathological, and immunohistochemical methods. Acute lung injury (ALI) was found to be associated with increased malondialdehyde (MDA), total oxidant activity (TOA), oxidative stress index (OSI), and decreased total antioxidant capacity (TAC). Significantly decreased MDA, TOA, and OSI levels and significantly increased TAC levels were found with dexmedetomidine injection in group 4 (P < 0.05). The highest histologic injury scores were detected in group 3. Enhanced hepatic vascular endothelial growth factor (VEGF) expression and reduced CD68 expression were found in dexmedetomidine group compared with the group 3. In conclusion, the presented data provide the first evidence that dexmedetomidine has a protective effect on experimental liver injury induced by ALI.Öğe The protective effects of dexmedetomidine on the liver and remote organs against hepatic ischemia reperfusion injury in rats(Elsevier Science Bv, 2013) Tufek, Adnan; Tokgoz, Orhan; Aliosmanoglu, Ibrahim; Alabalik, Ulas; Evliyaoglu, Osman; Ciftci, Taner; Guzel, AbdulmenapAim: To investigate the protective effects of dexmedetomidine against hepatic ischemia/reperfusion (IR) injury and hepatic IR induced remote organ injury. Methods: Forty Wistar albino rats were divided into the following four groups: sham, dexmedetomidine, IR, and IR + dexmedetomidine. Hepatic ischemia was created by the Pringle maneuver for 30 min followed by a 30 min reperfusion period in the IR and IR + dexmedetomidine groups. The dexmedetomidine and IR + dexmedetomidine groups were administered dexmedetomidine (100 mg/kg, single dose) intraperitoneally after the anesthesia insult. Blood samples and hepatic, renal, and lung tissue specimens were obtained to measure serum and tissue total oxidative activity (TOA), total antioxidant capacity (TAC), paraoxonase (PON-1), and oxidative stress index (OSI) after 60 min in all groups. Results: According to the biochemical analyses of the samples taken from the serum and the liver, lung, and kidney tissues, when comparing the sham group and the IR group, TOA and OSI values were higher in the IR group, while TAC and PON-1 values were lower (p < 0.05). It was observed that TOA and OSI values were significantly lower, while TAC and PON-1 values increased with dexmedetomidine treatment (p < 0.05). In addition, dexmedetomidine ameliorated hepatic histopathological changes inducing IR, but there were no significant histopathological changes in the remote organs. Conclusion: This study demonstrated that dexmedetomidine markedly reduced the oxidative stress in serum, liver, and remote organs induced by hepatic IR injury, and ameliorated the histopathological damage in the liver. (C) 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.Öğe Restrictive factors for detection of responsible agent in perioperative anaphylaxis: A case report(Bayrakol Medical Publisher, 2019) Gunes, Haci Yusuf; Guzel, AbdulmenapPerioperative anaphylaxis is a type I hypersensitivity reaction, which rapidly develops with severe and variable clinical findings and can be fatal even in previously healthy patients. Early diagnosis and appropriate treatment are required but identifying the responsible agent is difficult. After anaphylaxis developed in our case, we did not have a healthy and adequate knowledge about the following questions. When should we get the blood sample, how much blood and to which tubes? Which tests can we work for detection of the responsible agent, where and in which laboratories? When we were communicating with the centers and laboratories which are given as references, we could not reach to standard information. Therefore, when perioperative anaphylaxis develops, it would be beneficial to have a set of perioperative anaphylaxis management guideline, including contact information of a national center for feedback and a reference anesthetic allergy testing center that could identify the responsible agent.
