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Öğe Comparison of epidural administration of bupivacaine-fentanyl, bupivacaine-morphine and bupivacaine-fentanyl morphine combinations(1994) Tok D.; Atasever J.; Bayhan N.; Turhanoglu S.; Ozyilmaz M.A.; Ozyurek L.Addition of fentanyl, morphine or fentanyl and morphine to bupivacaine administered for epidural anaesthesia was evaluated in eighty healthy patients. The patients were randomized into four equal groups to receive epidural anaesthesia in a double blind design, 20 ml of 0.5% bupivacaine (group 1), 20 ml of 0.5% bupivacaine with 75 ?g fentanyl (group 2), 20 ml of 0.5% bupivacaine with 30 ?g fentanyl and 1.5 mg morphine (group 3) and 20 ml of 0.5% bupivacaine with 3 mg morphine (group 4). The times for sensory block to develop bilaterally to T12, the time to achieve maximal sensory block, time to request postoperative analgesia and side effects were assessed. The onset time of sensory anaesthesia to T12 was significantly shorter in groups 2 and 3 (4.4 ± 1.2 and 4.1 ± 1 min. vs 6.8 ± 1.8 min. in group 1 and 6.25 ± 1.2 min, in group 4). There mere no significant differences in the, time to achieve maximal sensory block in any group. Duration of analgesia assessed during postoperative period was significantly longer in groups 3 and 4 (1209 ± 860 min. in group 3, 1224 ± 854 min. in group 4 vs 290.1 ± 60 min. in group 1 and 471.1 ± 96 min. in group 2). A decrease in mean arterial pressure of more than 30% of baseline values as observed 10-15% in each group.Öğe A comparison of propofol-nitrous oxide and propofol-alfentanil anaesthesia in children(1994) Tok D.; Ozyurek L.; Turhanoglu S.; Ali Ozyilmaz M.; Atasever J.The haemodynamic effects, recovery from anaesthesia and side effects of continuous propofol infusion supplemented with nitrous oxide were compared with total intravenous anaesthesia using propofol and alfentanil in sixtytwo healthy children. The patients were randomly allocated to two groups. In group A, anaesthesia was induced with propofol, then propofol was given by continuous infusion supplemented with nitrous oxide for maintenance of anaesthesia. In group B, the induction with propofol and alfentanil was followed by a three stage stepped infusion of propofol and alfentanil mixture. Serious side effects were not observed in both groups during and after anaesthesia. There were statistically significant changes in systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and heart rate (HR) between the two groups, but the haemodynamic alterations were not considered to be serious (The mean values of haemodynamic data were not altered more than ± 20% of the baseline cardiovascular measurements).Öğe The effect of diazepam and fentanyl premedication to intraocular pressure during general anesthesia induction(1994) Karakas N.; Mordeniz C.; Saltik A.; Unlu K.; Coskunseven E.; Ozyurek L.; Atasever J.Some agent used for general anesthesia induction can cause unwanted increase in intraocular pressure (IOP). But this increase can be controlled by using some other premedication agents. For this purpose, 90 patients have randomly been allocated into 3 subgroups and diazepam, fentanyl and a placebo (% 0.9 NaCl) were administered to each subgroup and IOP values were compared within and among groups at pre-medical on, pre-induction and post-intubation phases. In diazepam subgroup; the average IOP was raised from 16.0 mm Hg to 22.6 (40 %) between pre and post induction phases. This increase was 50 % in placebo subgroup from 16.6 to 24.5 mm Hg while only 4.3 mm Hg average increase (from 16.7 up to 21.0 and only 20 %) assessed in fentanyl group. The average IOP elevations in diazepam and placebo subgroups carry the patients to the upper normal/critical values but not in fentanyl subgroup. With these findings, fentanyl as a narcotic having dose-dependent IOP decreasing effect have been qualified significantly high performing premedication agent in suxamethonium induction when compared to diazepam and placebo.Öğe The efficacy of pre and post incisional bupivacaine infiltration on the postoperative pain for cholecystectomy(1994) Tok D.; Turhanoglu S.; Ozyilmaz M.A.; Ozyurek L.; Atasever J.The efficacy of preincisional and postincisional infiltration with 0.025 % bupivacaine (40 ml) on the postoperative pain was evaluated in 60 adult (ASA I-II) patients undergoing for elective cholecystectomy. The patients were allocated randomly to receive infiltration of the surgical area with bupivacaine either 15 min. before skin incision (preincisional group) or immediately before skin closure (postincisional group). Local anesthetic infiltration was not administered to control group. The difference in time to first request for analgesic drug was compared between 3 groups. This period was found 511.5 ± 136.81 minutes for preincisional group, 343.25 ± 101.65 minutes for postincisional group and 257.5 ± 85.15 minutes for control group. We concluded that preincisional bupivacaine infiltration delayed the first analgesic requirement in the postoperative period.
