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Öğe A randomized, placebo-controlled, double-blind study that evaluates efficacy of intravenous ibuprofen and acetaminophen for postoperative pain treatment following laparoscopic cholecystectomy surgery(Springer New York LLC, 2020) Ekinci, Mürsel; Çiftçi, Bahadır; Çelik, Erkan Cem; Köse, Emine Arzu; Karakaya, Muhammet Ahmet; Özdenkaya, YaşarBackground: Ibuprofen is a NSAID that has anti-inflammatory, antipyretic, and analgesic effects. The oral form of the drug has been used safely for a long time and is one of the most preferred NSAIDs. It has been shown that ibuprofen is effective in the treatment of postoperative pain; however, there have not been sufficient studies on ibuprofen. We evaluated and compared the influence of IV forms of ibuprofen and acetaminophen on pain management and opioid consumption on patients undergoing laparoscopic cholecystectomy surgery. Methods: Patients were stratified into three groups. Group I (group ibuprofen, n = 30) was administered 800 mg of IV ibuprofen; group A (group acetaminophen, n = 30) was administered 1000 mg of IV acetaminophen; and group C (control group, n = 30) was given 100 ml of saline solution. We evaluated opioid consumption and VAS scores postoperatively. Results: Pain scores in group I and group A at all time periods were lower than those in group C (p < 0.05). Group I had significantly lower VAS scores than those in group A at all time periods postoperatively (p < 0.05). Those in group C had significantly higher opioid consumption than the other groups (p < 0.05). Opioid consumption in group I at all time periods postoperatively was significantly lower than those in group A (p < 0.05). Group I had statistically lower rescue medication than the other groups at all time periods. Conclusion: Our study suggested that IV ibuprofen resulted in lower pain scores and reduced opioid use compared with acetaminophen postoperatively in the first 24 h in patients undergoing laparoscopic cholecystectomy surgery.Öğe Airway obstruction due to intraoperative endotracheal tube cuff herniation: Case report(Scientific Publishers of India, 2017) Karakaya, Muhammet Ahmet; Tukaç, İsmail Cem; Kutlu, Esra; Karaaslan, Pelin; Tercan, ElvanEndotracheal tube obstruction by blood, mucus material or kinking is not uncommon however endotracheal cuff herniation is an extremely rare condition. It could easily be overlooked and may cause airway obstruction. Bronchoscopy is the gold standard method of diagnosis. In this case report, we aimed to present an unusual case of intraoperative endotracheal tube cuff herniation in a 62 year-old patient scheduled for nephrectomy.Öğe Anesthesia management for ALS and WPW(Derman Medical Publishing, 2018) Çiftçi, Bahadır; Ekinci, Mürsel; Karakaya, Muhammet Ahmet; Uzunoğlu, Emine; Köse, Emine ArzuEpidural anesthesia can provide anesthesia and analgesia for unilateral or bilateral lower extremity surgery and is associated with a low complication rate. We present our epidural anaesthetic management of a patient with both Amyotrophic lateral sclerosis (ALS) and Wolff-Parkinson-White (WPW) syndrome after intertrochanteric femur fracture surgery. It should be kept in mind that the choice of correct anaesthetic method in such patients with complicated neurological, pulmonary, and cardiac symptoms will significantly reduce postoperative mortality and morbidity.Öğe Comparison of intravenous ibuprofen and paracetamol for postoperative pain management after laparoscopic sleeve gastrectomy. A randomized controlled study(Springer, 2019) Çiftçi, Bahadır; Ekinci, Mürsel; Çelik, Erkan Cem; Kaçıroğlu, Ahmet; Karakaya, Muhammet Ahmet; Demiraran, Yavuz; Özdenkaya, YaşarBackground Laparoscopic sleeve gastrectomy (LSG) is defined as the first-step bariatric surgery for the treatment of obesity. Opioid analgesics are often preferred for pain management because of their strong analgesic potentials. However, opioids have undesirable adverse effects. Objectives The objective of this study is to evaluate and compare the influence of IV forms of ibuprofen and paracetamol on pain management and opioid consumption on patients undergoing LSG surgery. Setting This study was conducted at Istanbul Medipol University Hospital. Methods Patients were stratified into three groups. Group I (group ibuprofen, n = 30) was administered 800 mg of IV ibuprofen, group P (group paracetamol, n = 30) was administered 1000 mg of IV paracetamol, and group C (control group, n = 30) was given 100 ml of saline solution. We evaluated opioid consumption and VAS scores postoperatively. Results This study included 90 patients who underwent LSG. The use of rescue medication in group I was statistically lower than the other groups. VAS scores in group I and group P at recovery and at 2, 4, 8, 12, and 24 h were lower than those in group C. In particular, the VAS scores in group I at the first 2 h postoperatively were significantly lower than those in group P (p <0.05). Opioid consumption in group C was significantly higher than the other groups (p <0.05). Conclusion Our study suggested that IV ibuprofen resulted in lower pain scores compared to paracetamol by reducing postoperative opioid use in the first 24 h in patients undergoing LSG surgery.Öğe Comparison of the Trendelenburg position versus upper-limb tourniquet on internal jugular vein diameter(King Faisal Specialist Hospital and Research Centre, 2017) Karaaslan, Pelin; Vural Gökay, Banu; Karakaya, Muhammet Ahmet; Darçın, Kamil; Karakaya, Afak Durur; Örmeci, Turgul; Köse, Emine ArzuBACKGROUND: Central venous cannulation is a necessary invasive procedure for fluid management, haemodynamic monitoring and vasoactive drug therapy. The right internal jugular vein (RIJV) is the preferred site. Enlargement of the jugular vein area facilitates catheterization and reduces complication rates. Common methods to enlarge the RIJV cross-sectional area are the Trendelenburg position and the Valsalva maneuver. OBJECTIVE: Compare the Trendelenburg position with upper-extremity venous return blockage using the tourniquet technique. DESIGN: Prospective clinical study. SETTING: University hospital. SUBJECTS AND METHODS: Healthy adult volunteers (American Society of Anesthesiologists class I) aged 18-45 years were included in the study. The first measurement was made when the volunteers were in the supine position. The RIJV diameter and cross-sectional area were measured from the apex of the triangle formed by the clavicle and the two ends of the sternocleidomastoid muscle, which is used for the conventional approach. The second measurement was performed in a 20° Trendelenburg position. After the drainage of the veins using an Esbach bandage both arms were cuffed. The third measurement was made when tourniquets were inflated. MAIN OUTCOME MEASURE(S): Hemodynamic measurements and RIJV dimensions. RESULTS: In 65 volunteers the diameter and cross-sectional area of the RIJV were significantly widened in both Trendelenburg and tourniquet measurements compared with the supine position (P<.001 for both measures). Measurements using the upper extremity tourniquet were significantly larger than Trendelenburg measurements (P=.002 and <.001 for cross-sectional area and diameter, respectively). CONCLUSION: Channelling of the upper-extremity venous return to the jugular vein was significantly superior when compared with the Trendelenburg position and the supine position. LIMITATIONS: No catheterization and study limited to healthy volunteers.Öğe Effects of varying entry points and trendelenburg positioning degrees in internal jugular vein area measurements of newborns(Medknow Publications & Media Pvt Ltd, 2018) Karaaslan, Pelin; Darçın, Kamil; Örmeci?, Tu?rul; Karakaya, Muhammet Ahmet; İnce, Ayşe; Aslan, Nesrin Ahu; Taştekin, AyhanBackground: Recent guidelines from the National Institute for Clinical Excellence recommend the use of ultrasonography in the central venous catheterization of children. In this study, we aimed to compare area measurements using ultrasonography and efficiency of varying Trendelenburg degrees on the area measurements, for two different entry points used as internal jugular vein (IJV) cannulation points in newborns. Methods: Fifty-eight healthy newborns, weighing between 3000 and 3500 g, were recruited for this prospective study. Right IJV (RIJV) consecutive measurements were performed in three different Trendelenburg positions at 0 degrees, 15 degrees, and 30 degrees, at two different entry points: The superior approach and an inferior approach. The landmark used in the superior approach was the top of the triangle formed by the two heads of the sternocleidomastoid muscle with the clavicle; while in the inferior approach, it was taken as the midpoint of the clavicle, as measured from the upper edge of the clavicle. Results: The cross-sectional area (CSA) of the RIJV was significantly increased when using the inferior approach, compared to that in the superior approach, in all Trendelenburg degrees, including the neutral position. Both 15 degrees and 30 degrees Trendelenburg positioning resulted in a significant increase in CSA, both in superior and inferior approaches, when compared to neutral positioning. Conclusion: The use of 15 degrees Trendelenburg positioning may have significant advantage for increasing the CSA when used with the inferior approach.Öğe Elektif ve acil sezaryen ameliyatlarında anestezi yönetimimiz: Son on yılın retrospektif değerlendirilmesi(Logos Medical Publishing, 2016) Özmen, Özgür; Arslan, Zakir; Ekinci, Mürsel; Tör, İbrahim; Kara, Duygu; Karakaya, Muhammet AhmetSezaryen ameliyatlarında kullanılan anestezi uygulaması seçi- mi; hastanın kliniği, anestezistin tecrübesi, cerrahinin aciliyeti ve hastanın isteğine göre belirlenir. Bu çalışmada, kadın doğum hastanemizde son 10 yılda yapılan sezaryen operasyonlarındaki anestezi uygulamaları değerlendirilmiştir. 2006-2015 yılları ara- sında hastanemiz bilgisayar sistem kayıtları ve dosya arşivleri tarandı. Elektif ve acil olarak yapılan sezaryen ameliyatlarında kullanılan anestezi yöntemleri kaydedildi. Bu yöntemlerin yılla- ra göre dağılımı analiz edildi. Hastanemizde 2006-2015 yılları arasında toplam 28986 sezaryen ameliyatı gerçekleştirilmiştir. Sezaryenlerin %84’ü acil, %16’sı elektifti. Dört bin sekiz yüz kırk sekiz (%17) hastada genel anestezi, 24138 (%83) hastada böl- gesel anestezi tercih edilmiş olup, hastaların %2’sinde kombine spinal-epidural, %1’inde ise epidural anestezi tercih edilmiştir. Kliniğimizde bölgesel anestezi yöntemlerinin kullanımı Avru- pa ülkelerine benzer şekilde yüksek bulunmuştur. Kliniğimizde bölgesel anestezi yontemi olarak en Çok spinal anestezi tercih edilirken, özellikle acil vakalarda hiç kombine spinal-epidural ve epidural anestezi uygulanmadığı görülmektedir. Elektif va- kalarda ise kombine spinal-epidural uygulamasının artırılması gerektiği düşüncesindeyiz.Öğe Evaluation of pain scoring and free cortisol levels of postoperative analgesic methods in cardiac surgery: A new perspective(Baycinar Medical Publishing, 2019) Özmen, Özgür; Özçelik, Fatih; Kaygın, Mehmet Ali; Yılmaz, Habip; Karakaya, Muhammet AhmetBackground: This study aims to evaluate the most appropriate analgesic method of minimizing postoperative pain to prevent complications in patients scheduled for cardiac surgery. Methods: Between January 2016 and June 2016, a total of 60 patients with the American Society of Anesthesiologists Physical Status Class III (27 males, 33 females; mean age 63 years; range, 49 to 77 years) with an ejection fraction of above 50% who underwent elective coronary artery bypass grafting were included. The patients were divided into two groups following admission to the intensive care unit. Group 1 (n=30) was administered intravenous fentanyl citrate with patient-controlled analgesia protocol, while Group 2 (n=30) was administered 0.1% bupivacaine hydrochloride analgesia protocol with catheter placed between the sternum and subcutaneous tissue. Results: In Group 1, pain intensity scores at two h and visual analog scale scores except at 24, 36, and 48 h were higher than Group 2 (p<0.05). The length of intensive care unit stay and urine cortisol levels were higher in Group 1 than Group 2 (78±12 h and 631±505 ?g at 24 h vs. 66±13 h and 401±297 ?g at 24 h, respectively p<0.05). Partial pressure of oxygen levels at 10 and 16 h during the postoperative intensive care unit stay were lower, while partial pressure of carbon dioxide levels at 24 h was higher in Group 1 than Group 2 (p<0.05). Conclusion: The bupivacaine protocol is a relatively more useful analgesic method which produces improved results in blood gas analysis by reducing the effects of pain and shortens the length of intensive care unit stay. Low levels of free cortisol also confirm this finding.Öğe Pediyatrik inguinal herni tamirinde ultrasonografi eşliğinde yapılan transversus abdominis plan bloğu ile yara yeri infiltrasyonunun karşılaştırılması: Randomize klinik çalışma(Dr. Behçet Uz Çocuk Hastalıkları ve Cerrahisi, 2017) Ahıskalıoğlu, Ali; Yayık, Ahmet Murat; Ekinci, Mürsel; Gölboyu, Birzat Emre; Ergüney, Özlem Dilara; Çelikkaya, Mehmet Emin; Oral Ahıskalıoğlu, Elif; Karakaya, Muhammet Ahmet; Fırıncı, Binali; Alıcı, Hacı AhmetAmaç: Transversus abdominis plan (TAP) blokun postoperatif analjezik etkinliği abdominal cerrahi geçirecek olan hastalarda tartışmalıdır. Bu çalışmanın amacı, inguinal herni tamiri yapılan pediyatrik hastalarda ultrasound eşliğinde yapılan TAP blok ile yara yeri infiltrasyonunun analjezik etkinliğini karşılaştırmaktır. Yöntem: Etik onam alındıktan sonra 3-8 yaş arası, tek taraflı inguinal herni onarımı yapılacak olan 60 hasta randomize olarak TAP blok (Grup TAP, n=30) veya yara yeri infiltrasyonu (Grup infiltrasyon, n=30) olarak iki gruba ayrıldı. TAPB grubuna ultrason eşliğinde 0,5 ml/kg olacak şekilde %0,25’lik bupivakain, Grup C’ye ise 0,5 ml/kg olacak şekilde 0,25’lik bupivakain cerrahi öncesi uygulandı. Ağrı skorları (Wong-Baker Yüz Skalası), aile memnuniyeti, blok komplikasyonları ve ek analjezik gereksinimi kaydedildi. Bulgular: İnfiltrasyon grubu ile karşılaştırıldığında, ilk 12 saatteki ağrı skorları TAPB grubunda istatistiksel olarak daha düşüktü (p<0,05). Ek analjezik gereksinimi TAPB grubunda, infiltrasyon grubuna göre istatistiksel olarak daha düşüktü (10/30 vs 18/30 sırasıyla, p=0,038). Aile memnuniyeti TAPB grubunda, Grup infiltrasyona göre istatistiksel olarak daha fazlaydı (p<0,001). Sonuç: TAP bloğun postoperatif analjezik etkinliği tartışmalı olmasına rağmen, pediyatrik inguinal herni tamirinde ultrason eşliğinde uygulanan TAP blok yara yeri infiltrasyonuna göre ağrı skorlarını anlamlı derecede azaltmaktadır.Öğe Prostat cerrahisi sonrasında görülen bilateral lumbosakral pleksopati: bir olgu sunumu(2016) İnce, İlker; Aksoy, Mehmet; Ahişkalıoğlu, Ali; Karakaya, Muhammet Ahmet; Alıcı, Hacı AhmetPostoperatif olarak gelişen nörolojik komplikasyonların sıklıkla anesteziye sekonder olarak geliştiği düşünülür. Rejyonel blok sonrası tespit edilen bilateral alt ekstremite paralizisinde ilk akla gelen neden anestezidir. Ancak, bilateral lumbosakral pleksopati gibi nadir görülen komplikasyonlar da mevcut klinik tabloya yol açabilir. Biz bu olguda açık prostat cerrahisi sonrasında acil olarak tekrar operasyona alınan ve bilateral lumbosakral pleksopati gelişen bir hastayı sunmayo ve pleksopatinin olası sebeplerini tartışmayı amaçladık.Öğe Taze donmuş plazma ile uygulanan plazmafereze yanıtsız "TTP-HÜS" olgusu: Donmamış taze plazma ile plazmaferezin etkinliği(Anestezi Dergisi, 2016) Çelik, Erkan Cem; Ekinci, Mürsel; Soykut, Cem; Ahişkalıoğlu, Ali; Karakaya, Muhammet Ahmet; Doğan, Nazım; Kürşad, HüsnüTrombotik Mikroanjiopatik Hastalıklar içerisinde değerlendirilen TTP ve HÜS fizyopatolojisi farklı olan yalnız benzer klinik ve tedavisi olan hastalıklardır. Ateş, kanlı ishal, şuurunda gerileme, idrar yapamama şikâyetleri ile yoğun bakım ünitemize yatırılan 39 yaşında bayan hastanın bakılan laboratuvar sonuçları ve klinik muayenesi sonrası TTP-HÜS tanıları ile takibine başlandı. Plazmaferez tedavisi düzenlenen hastanın taze donmuş plazma ile uygulanan plazmaferez tedavisine yanıt vermediği görüldü. Donmamış taze plazma ile uygulanan plazmaferez işlemiyle ise dramatik bir iyileşme izlendi. Taze donmuş plazmanın etkisiz olduğu vakalarda donmamış taze plazma kullanımının hastanın tedavisinde bafları oranını artırabileceği düşünüldü.Öğe The efficacy of different volumes on ultrasound-guided type-I pectoral nerve block for postoperative analgesia after subpectoral breast augmentation: a prospective, randomized, controlled study(Springer, 2019) Ekinci, Mürsel; Çiftçi, Bahadır; Çelik, Erkan Cem; Karakaya, Muhammet Ahmet; Demiraran, YavuzBackgroundPECS type-1 block, a US-guided superficial interfacial block, provides effective analgesia after breast surgery. Aesthetic breast augmentation is one of the most common surgical procedures in plastic surgery. Subpectoral prostheses cause severe pain. The aim of this study was to investigate the effect of different volumes of the solution on the efficacy of PECS type-I block for postoperative analgesia after breast augmentation surgery. MethodsNinety ASA status I-II female patients aged between 18 and 65years who scheduled breast augmentation surgery under general anesthesia were included in this study. The patients were randomly divided into three groups of 30 patients each (Group 20=20ml of anaesthetic solution, Group 30=30ml anaesthetic solution, and Group K=Control group). Postoperative assessment was performed using the VAS score. The VAS scores were recorded postoperatively at 1, 2, 4, 8, 16 and 24h.ResultsFentanyl consumption was statistically significantly lower in Group 20 and Group 30 compared to the Control group (p<0.05). There was no statistically significant difference in fentanyl consumption between Group 20 and Group 30. The right and left VAS scores were statistically significantly lower in Groups 20 and 30 than in the Control group (p<0.05). There was no statistical difference in terms of VAS scores between Group 20 and Group 30. The use of rescue analgesia was statistically lower in Groups 20 and 30.ConclusionsPECS type-1 block using 20ml of 0.25% bupivacaine can provide effective analgesia after breast augmentation surgery.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.Öğe The management of anesthesia for breast surgery in a progressive supranuclear palsy case(2017) Karakaya, Muhammet Ahmet; Darçın, Kamil; Heyik, Çiğdem; Kutlu, Esra; Karaaslan, PelinProgressive Supranuclear Palsy (PSP) is a rare adult-onset neurodegenerative disease presenting with parkinsonian disorders such as; ophtalmoplegia, pseudobulbar paralysis, bradykinesia, rigidity, and behavioral and cognitive findings. In this case report, a 61 years old female patient who has been followed up for PSP for 6 years and who had diffuse rhonchi and decrease in respiratory sounds in both lungs was presented. Chest x-ray revealed atelectasis in lower zones bilaterally. The patient was scheduled for lumpectomy due to breast cancer. By the combination of thoracic epidural anesthesia and pectoral nerves block 1 (PECS 1) sufficient perioperative anesthesia and postoperative analgesia and to prevent the risks of general anesthesia was aimed.Öğe Ultrasound-guided combined interscalene and superficial cervical plexus blocks for anesthesia management during clavicle fracture surgery(Springer, 2019) Kaçıroğlu, Ahmet; Karakaya, Muhammet Ahmet; Ahıskalıoğlu, Ali; Çiftçi, Bahadır; Ekinci, Mürsel; Yayık, Ahmet MuratTo the Editor, Fractures of the clavicle constitute 2.6–4% of all fractures in adult patients. The most frequent injury mechanism is a direct trauma on the shoulder. These fractures are mainly treated surgically (Kihlstrom et al. 2017). The cervical and brachial plexus innervate the clavicular region (Tran et al. 2013). Thus, interscalene brachial plexus block (IBPB) and superficial cervical plexus block (SCPB) may be used for pain management following clavicular surgery. Herein, we aimed to report our ultrasound (US)-guided IBPB and SCPB combination experiences for anesthetic management during clavicular surgery.
