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Öğe Bupivacaine for caudal analgesia in children(1996) Tok D.; Turhanoglu S.; Ozyilmaz M.A.; Bayhan N.Caudal epidural analgesia has gained wide acceptance in pediatric anesthesia as a technique for providing postoperative pain relief and reducing general anesthetic requirements for surgical procedures below the umbilicus. The aim of this study is to evaluate the efficacy of caudal block with 0.25 % bupivacaine for postoperative pain relief. It is demonstrated that caudal blocks performed with 0.8 mg/kg, 0.25 % bupivacaine produce effective postoperative analgesia in children undergoing either inguinal or penile procedures.Öğe Comparison of bupivacaine and bupivacaine with fentanyl in epidural analgesia during labour(1997) Tok D.; Ganidagli S.; Ozyilmaz M.A.; Turhanoglu S.; Yayla M.; Bayhan N.We have studied 50 healthy women who were in the first stage of labour and requesting epidural analgesia. They were allocated randomly in a double-blind fashion to receive either 15 cc 0.133% plain bupivacaine (group 1) 15 cc 0.133% plain bupivacaine + 100 ?g fentanyl (group 2) and when requested 15 cc 0.133% bupivacaine was given via the epidural route. Efficacy of analgesia was evaluated using linear visual analogue scoring (VAS) and verbal pain score (VPS). Maternal and fetal cardiovascular variables: maternal respiration rate (MRR) were measured continuously. The reduction in VAS and VPS was greater and the onset time of analgesia was shorter in group 2. Analgesia was associated with a reduction in arterial pressure in both groups but the haemodynamic alterations and the reduction in MRR were considered to be insignificant. Fetal heart rate didn't change side effects were insignificant and this study shows that epidural bupivacaine or bupivacaine + fentanyl combination provide effective analgesia and appeared to be safe for the mother and the child.Öğe Comparison of continious epidural infusion and patient-controlled epidural analgesia in labour(1999) Turhanoglu S.; Ozyilmaz M.A.; Olmez G.; Tok D.; Bayhan N.This study was performed with 42 pregnant women, planned to have vaginal delivery. The patients were allocated randomly to one of the two groups. After inserting epidural catheter, 0.5 % bupivacaine 4 ml and fentanly 2 ml were diluted to 15 ml with 0.9 % saline and administered to all patients with the epidural catheter when VAS scores were greater than 4. Bupivacaine 0.125 % concentration prepared with 0.9 % saline for PCA pump and 30 min after the first close, PCA pump was activated. To group I (n=21), 12 ml/h-1 bupivacaine was administered as continuous epidural infusion (CEI) and the patients in group II (n=21) were allowed to self-administer 3 ml of bupivacaine with a lockout interval of 10 min. VAS scores in group II were significantly lower then group I (p<0.05) and total bupivacaine consumption was also higher in group I (p<0.05). We concluded that PCEA could be used in labour analgesia as an alternative method.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 Comparison of general and spinal anaesthesia in pregnant women with pregnancy induced hypertension(1999) Turhanoglu S.; Tok D.; Ozyilmaz M.A.; Bayhan N.; Olmez G.; Kaya S.; Yayla M.The technique of anaesthesia may become important when caeseraen section will be necessary instead of vaginal delivery in pregnant women with pregnancy induced hypertension. In our study, we compared general versus spinal anaesthesia in hypertensive pregnant women who had the same clinical conditions. Sixty pregnant women had taken to the study and allocated randomly into two groups. In the first group (n=30) general anaesthesia, and in second group (n=30) spinal anaesthesia were administered to the patients. Heart rate (HR), systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) in the periods of pre, per (1., 3., 5. minutes and every 5 minute for thirty minutes) and postoperative (1., 30. and 60. minutes), APGAR scores at 1. and 5. minutes, uterine incision-cordon clamping time (Ui-Cc) and the time of first analgesic requirement in the postoperative period were recorded. The values of HR, SAP and DAP were significantly lower in the group of spinal anaesthesia (p<0.05). APGAR scores at the first minute were found significantly better in the group of spinal anaesthesia than the group of general anaesthesia (p<0.05). The times of first analgesic requirements were significantly shorter in the group of general anaesthesia (p<0.05). We concluded that spinal anaesthesia may be performed in preeclamptic women undergoing caeserean section with safe if the anaesthesiologist takes the necessary measures.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 A comparison of the effects of ondansetron with or without dimenhydrinate in the prevention of nausea and vomiting after major gynaecological surgery(1999) Turhanoğlu S.; Özyilmaz M.A.; Tok D.; Ölmez G.; Ş Çinar F.; Bayhan N.The aim of this study was to compare the efficacy and safety of ondansetron plus dimenhydrinate with ondansetron or dimenhydrinate alone and control groups in prevention of postoperative nausea and vomiting (PONV). We studied 100 ASA I-II females undergoing general anaesthesia for major gynaecological surgery. Patients were allocated randomly to one of four groups and administered ondansetron 4 mg i.v. to groups I and II immediately prior to the induction of anaesthesia and dimenhydrinate 50 mg i.m. to groups II and III about 30 minutes before operation. The patients of group IV were administered 0.9% saline as placebo and were accepted as a control group. A standardized anaesthetic tecnique and postoperative analgesia were used in all patients. The incidence of nausea in the ondasetron with dimenhydrinate group was lower than in the other groups (p < 0.05). The incidence of vomiting in the ondansetron with dimenhydrinate group was significantly lower at the first six hours of the postoperative period than in the control group (p < 0.05). Sedation was significantly greater with dimenhydrinate groups for the first hour of the postoperative period (p < 0.05). We conclude that prophylactic administration of combined ondansetron and dimenhydrinate is more effective in preventing PONV than ondansetron or dimenhydrinate alone and control groups in women undergoing major gynaecological surgery.Öğe The effects of intraarticular bupivacaine and bupivacaine-ketamine combination on postoperative pain and recovery(1995) Tok D.; Turhanoglu S.; Ozyilmaz M.A.; Necmioglu S.; Bayhan N.; Atasever J.The effects of intraarticular bupivacaine and bupivacaine-ketamine combination on postoperative pain and recovery were evaluated in 63 healthy patients undergoing knee arthroscopy under general anesthesia. The patients were divided into 3 groups. Group I was applied 20 ml of 0.5 % bupivacaine, Group II received 20 ml of 0.5 % bupivacaine + 50 mg ketamine and group III was injected 20 ml of 0.9 % NaCl intraarticularly. There was a statistically significant decrease in postoperative pain and first request period for analgesic drug in groups I and II compared to the group III. Also the periods from the end of anesthesia until sitting up on bed and tolerating oral fluids were significantly shorter in groups I and II than in group III. No seriously adverse reactions of this technique were noted during and after the operation.Öğe The effects of magnesium sulphate and alfentanil combination on haemodynamic control in general anaesthesia(1999) Turhanoglu S.; Ozyilmaz M.A.; Cinar F.S.; Tok D.; Olmez G.; Bayhan N.Sixty ASA class I or II patients were included to the study in which the effects of magnesium sulphate and alfentanil combination on the haemodynamic response to tracheal intubation and intraoperative haemodynamic control had been investigated. The patients were randomly allocated into three groups. At the induction of anaesthesia, the patients of group I (n=20) were received isotonic sodium chloride IV bolus and infusion, and 10 ?g/kg alfentanil, group II (n=20) were received IV magnesium sulphate 20 mg/kg bolus and 10 mg/kg/h infusion, and group III (n=20) were received IV magnesium sulphate 20 mg/kg bolus with 10 mg/kg/h infusion and 10 ?g/kg alfentanil. Anaesthesia induction and maintenance were performed respectively with thiopentone 5 mg/kg, isoflurane (% 1-1,5) in 50 % nitrous oxide and 50 % oxygen in all groups. Magnesium and alfentanil combination produced better control of arterial pressure and heart rate than magnesium and alfentanil alone (p<0.05). Furthermore, the consumption of alfentanil during the surgery were found significantly higher in group I than groups II and III (p<0.05). In conclusion we considered that the doses of magnesium sulphate and alfentanil combination in this study were adequate to attenuate the haemodynamic response to tracheal intubation and produce better control of arterial pressure and heart rate.Öğe The effects of prophylactic ondansetron administration time on postoperative nausea and vomiting at laparoscopic gynecologic procedures(1999) Turhanoglu S.; Ozyilmaz M.A.; Tok D.; Olmez G.; Bayhan N.The effects of ondansetron on postoperative nausea and vomiting (PONV) were investigated in laparoscopic gynecologic procedures and 120 patients were included to the study. Ondansetron 4 mg was administered via intravenous route to group I (n=30) immediately before induction, to group II (n=30) fifteen minutes before ending of surgery and also to group III (n=30) one hour before anaesthesia induction via oral route. Any drugs weren't given for preventing PONV to group IV (n=30) and was accepted as a control group. The patients were followed postoperatively in three periods as 0-2, 2-6 and 6-24 hours to assess PONV. Metoclopramide 10 mg was administered IV to the patients if necessary. Incidence of nausea were significantly lower in the patients of group I at the second and third periods (p<0.05). The incidence of vomiting were seen significantly low in the patients of groups I and II during the first period and vomiting were not present in the first group during the second and third periods (p<0.05). We concluded that the incidence of PONV could be decreased by using IV ondansetron 4 mg immediately before anesthesia induction or at the end of surgery in laparoscopic gynecologic procedures.Öğe The effects of unilateral spinal anaesthesia: 2 ml, 1.5 ml and 1 ml 0.5% hyperbaric bupivacaine for surgery on lower extremity(1997) Tok D.; Turhanoglu S.; Ozylmaz M.A.; Bayhan N.; Akca T.The quality of anaesthesia and the haemodynamic effects of unilateral spinal block was evaluated in fifty one healthy patients undergoing lower limb surgery. The patients were randomly divided into three groups to receive 2 mL (group I), 1.5 mL (group II) or 1 mL (group III) of 0.5% hyperbaric bupivacaine via the subarachnoid route in the lateral decubitus position. The sensory and motor block were assessed and compared between the upper and lower parts of the body in each group when patients were still in the lateral decubitus position. The sensory and motor block was more profound at the lower parts of the body in each group (p < 0.05) and motor block was found to be more intensive in the upper parts in group I were compared to groups II and III. Significant haemodynamic changes were not observed in any groups during the study (p > 0.05). We conclude that unilateral spinal anaesthesia with low dose 0.5% hyperbaric bupivacaine provides satisfactory anaesthesia and haemodynamic stability.Öğe Effects of whole blood, crystalloid and colloid resuscitation of hemorrhagic shock on lung perfusion in rats(1999) Turhanoglu S.; Özyilmaz M.A.; Tok D.; Çobaner A.; Kaya S.; Bayhan N.This study was undertaken to determine the effects of various resuscitation regimens on lung perfusion following resuscitation from hemorrhagic shock. We used Spraque Dawley rats and measured blood pressure, rectal temperature and lung perfusion using radioscintigraphy with a technetium colloid indicator. Compared to a control group, lung perfusion was decreased significantly in groups resuscitated with saline, Ringer's lactate and hetastarch while perfusion was restored with autologous blood and dextran 40.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.
