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    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, Abdurrahman
    Background. 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.
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    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 Baysal
    Background: 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.