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Öğe Beneficial effects of single dose multimodal epidural analgesia on relief of postoperative microdiscectomy pain(2004) Kararmaz A.; Kaya S.; Karaman H.; Turhano?lu S.; Özyilmaz A.We aimed to assess the efficacy of multimodal epidural analgesia in decreasing postoperative pain after microdiscectomy. Fourty patients, ASA physical status I or II, undergoing microsurgical lumbar discectomy were enrolled in this prospective, randomised, controlled, double-blinded study. 10 ml study solution consisting of 2 mg of morphine, 15 mg of bupivacaine, 80 mg of methylprednisolone, and 0.05 mg of adrenaline was prepared for epidural administration. At the end of the procedure but prior to wound closure, the surgeon inserted an 18-gauge epidural catheter into the epidural space. After closure of incision, patients were assigned to receive either study solution (Group E) or saline (Group C). The epidural catheter was then removed. Patient controlled analgesia with morphine was used for postoperative analgesia. Visual Anologue Scale (VAS) pain scores and morphine consumptions were lower in Group E. Time to first ambulation was shorter in Group E. Patients in Group E were more satisfied with their analgesic regimen. Single dose multimodal epidural analgesia administered after wound closure provided better postoperative analgesia after lumbar microdiscectomy.Öğe A cardiac arrest associated with double lumen endobronchial tube: Case report(2011) Tufek A.; Celik F.; Tokgoz O.; Karaman H.; Ulku R.; Yildirim Z.B.; Kavak G.O.Double lumen tubes are used frequently in operations of Thorax Surgery Department. This case report presents a cardiac arrest towards the end of surgery in patient with placement of left bronchial double lumen tubes. Unexplained perioperative cardiac arrest may be due to obstruction of pulmonary artery flow associated with double lumen tube in thorax surgery.Öğe The Effects of the Type of Neuroaxial Block on Postoperative Pain after Total HIP Replacement Surgery: Spinal vs. Epidural Anaesthesia(2004) Kararmaz A.; Kaya S.; Karaman H.; Turhano?lu S.; Özyilmaz M.A.In this study, we aimed to investigate whether the type of anaesthesia affected postoperative pain, or not, when total hip replacement surgery was performed under spinal or epidural anaesthesia. The patients were randomly assigned to two groups. In Group E, surgery was performed under epidural anaesthesia, and in Group S under spinal anaesthesia. Patient controlled epidural analgesia with morphine and bupivacaine was used for postoperative analgesia. Visual analog scale was recorded at the rest and during movement. Postoperative analgesic consumption, patient satisfaction and complications were also recorded. Visual analog scale scores were significantly lower in Group S at the rest and during movement (p<0.05). Postoperative analgesic consumption was lower in Group S (p=0.001). There was no difference with regard to postoperative complications. The patients were more satisfied with their analgesic treatment in Group S (83%) than those of Group E (54%) (p=0.037). In conclusion, we observed that spinal anesthesia produced more satisfactory postoperative analgesia after total hip replacement surgery. We believe that this beneficial effect may be related to complete blockade of nociceptive afferent signals by the spinal anaesthesia.Öğe Immediate cardiac arrest after neostigmine administration(2012) Tüfek A.; Yildirim B.; Tokgöz O.; Karaman H.; Aycan l.O.Many drugs used in anaesthesia have some potential fatal consequences; for example complete heart block and QTc interval prolongation. Since the parasympathetic system in children is not fully developed, electrical transmission of the heart is not stable. Neostigmine is used in order to reverse neuromuscular block but it may also lead to prolongation of Q-Tc interval. We present a case of an 18-month-old male patient weighing 12kg subjected to a surgical operation because of congenital glaucoma. In order to reverse neuromuscular block at the end of operation, atropine and neostigmine were injected intravenously. However, cardiac arrest developed immediately after administration.Öğe Obstructive atelectasis after nasotracheal intubation (case report)(2004) Ölmez G.; Özyilmaz M.A.; Karaman H.; Atay Ç.Severe intraoperative hypoxemia occurred in a healthy 18-yr-old accident victim scheduled to undergo operation because of maxillofacial trauma. Almost complete atelectasia was noticed in X-ray in the left lung. Fiberoptic bronchoscopy revealed a blood clot in the left main bronchus. Hypoxia and atelectasia improved immediately after removal of the blood clot. Obstruction due to clotted blood in the bronchus causing atelectasia after nasotracheal intubation should be kept in mind as a cause of intraoperative hypoxemia.Öğe Opioids inhibit angiogenesis in a chorioallantoic membrane model(American Society of Interventional Pain Physicians, 2017) Karaman H.; Tufek A.; Karaman E.; Tokgoz O.Background: Angiogenesis is an important characteristic of cancer. Switching from the avascular phase to the vascular phase is a necessary process for tumor growth. Therefore, research in cancer treatment has focused on angiogenesis as a drug target. Despite the widespread use of opioids to treat pain in patients with cancer, little is known about the effect of these drugs on vascular endothelium and angiogenesis. Objectives: We aimed to investigate the efficacies of morphine, codeine, and tramadol in 3 different concentrations on angiogenesis in hens’ eggs. Study Design: This is a prospective, observational, controlled, in-vivo animal study. Setting: Single academic medical center. Methods: This study was conducted on the chorioallantoic membrane (CAM) of fertilized hens’ eggs. The efficacies of morphine, codeine, and tramadol in 3 different concentrations were evaluated on angiogenesis in a total of 165 hens’ eggs. Results: Statistically significant differences were found between drug-free agarose used as a negative control and concentrations of morphine of 10 ?M and 1 ?M, a concentration of tramadol of 10 ?M, and concentrations of codeine of 10 ?M and 1 ?M. Concentrations of morphine of 10 ?M and 1 ?M showed strong antiangiogenic effects. While codeine had strong antiangiogenic effects at high concentrations, at 0.1 ?M it was shown to have weak antiangiogenic effects. However, tramadol at a concentration of 10 ?M had only weak antiangiogenic effects. Limitations: This is just a CAM model study. Conclusion: In this study, we tested the effects of 3 different opioid drugs on angiogenesis in 3 different concentrations, and we observed that morphine was a good anti-angiogenic agent, but tramadol and codeine only had anti-angiogenic effects at high doses. © 2017, American Society of Interventional Pain Physicians. All rights reserved.Öğe Our applications of percutaneous vertebroplasty in vertebra plana type compression fractures associated with osteoporosis(2011) Karaman H.; Öztürkmen Akay H.; Aslanhan Taze H.A.; Kaya S.; Ölmez Kavak G.; Balkan B.The indication area of percutaneous vertebroplasty, which was first applied successfully for the management of aggressive vertebral hemangioma in 1987 in France, has grown in the years. One of these indications is osteoporotic vertebral compression fractures. Osteoporosis, common amongst elderly patients causes significant compression fractures. Most of the fractures that do not cause pressure on the spinal canal are successfully treated with percutaneous vertebroplasty. However most authors, claiming that in cases of severe vertebral compression fracture (vertebra plana) associated with osteoporosis, cement leakage developing due to technical difficulties may cause dangerous complications such as emboli, death and disability, asserted that the application of percutaneous vertebroplasty is contraindicated. This study, presenting successful ercutaneous vertebroplasty in two patients with the vertebra plana type compression fracture associated with osteoporosis, underlines that as long as it is performed meticulously, the complication risk in percutaneous vertebroplasty is very low.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
