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Öğe A practical approach in difficult intubation: use of gum elastic bougie on 10 cases(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2016) Altinisik, Ugur; Erbas, Mesut; Kiraz, Hasan Ali; Simsek, Tuncer; Altinisik, Hatice Betul; Turk, Fatos Ipek; Toman, HuseyinObjective: When faced with unexpected difficult intubation, despite all the technological advances, there is still a need of equipments that are easy to use and very reachable. In this study, we offer our experiences in use of gum elastic bougie in 10 cases with unexpected difficult intubation in our operation rooms. Material and Methods: In Canakkale 18 March University Medical Faculty's Operating Rooms and between the years 2013-2014, all the encountered unexpected difficult intubation cases are classified and the patients who has Mallampati score I-II and having any airway pathology evaluated for the use of Gum elastic bougie (GEB). Auxiliary equipments used in intubation, number of intubation attempts, number of anesthesiologists who tried for intubation, the number of trials with GEB and the complications due to the use of GEB were recorded. Results: A total of 10 cases with unexpected difficult intubation were included in the study. All of the cases were male and intubation was attempted with size 4 blades. Stylet in 6 cases, fast trach laryngeal mask in 1 case were used after unsuccessful intubation attempts. However the use of this equipments patients couldn't be intubated and after at least 3 three attempts GEB used this time for intubation. An experienced anesthesiologist with the help of GEB intubated all the patients at once. There were no complications related to the use of GEB. Conclusion: GEB is widely used in European countries for unexpected difficult intubation. In our patients, despite the absence of any complications, due to the blind insertion of bougie trauma cases have been reported. GEB when performed by an experienced anesthesiologist is a good alternative airway equipment in unexpected difficult airway management, because it's inexpensive, easy to use and portable.Öğe An experimental study of ascorbic acid effects in acute renal failure under general anesthesia(Acta Cirurgica Brasileira, 2017) Ozturk, Omur; Ustebay, Sefer; Eroglu, Huseyin Avni; Gunay, Murat; Adali, Yasemen; Donmez, Ilksen; Erbas, MesutPurpose: To evaluate the preventive effect of ascorbic acid on sevoflurane-induced acute renal failure in an experimental rat model. Methods: Twenty-four adult male Wistar rats were randomly distributed into three groups. Subjects were allocated into 3 groups: Group I received sevoflurane only, whereas Groups II and III had moderate (150 mg/kg) and high (300 mg/kg) doses of AA in addition to sevoflurane, respectively. Rhabdomyolysis and myohemoglobinuric ARF was formed by intramuscular administration of glycerol on the upper hind limb on the 15th minute of inhalation anesthesia. Biochemical parameters consisted of serum levels of blood urea nitrogen, creatinine, neutrophil gelatinase-associated lipocalin (NGAL), total antioxidant capacity (TAC), and protein carbonyl content. Histopathological variables were tubular necrosis, fibrin, and cast formation. Results: NGAL levels were significantly lower in Group III than Group II and Group I. On the other hand, TAC, PCO, urea and creatinine levels were notably higher in Group I compared with Groups II and III. There was a significant difference between 3 groups on frequencies of acute tubular necrosis (p=0.003), fibrin (p<0.001) and cast (p<0.001). Acute tubular necrosis and fibrin formation were more prominent in Group I. Casts were more common in Groups II and III. Conclusions: The ascorbic acid serve as a prophylactic agent against renal damage in patients receiving sevoflurane anesthesia and higher doses were associated with more apparent protective effects.Öğe Anaesthesiologist's Attitude and Behavior Toward Postoperative Pain Management in Turkey(Aves, 2022) Demir, Emin Tunc; Erbas, MesutObjective: This study aims to evaluate the approach of anaesthesiologist in Turkey and their applications toward postoperative pain treatment and in addition to raise awareness in this regard. Methods: The target audience of this descriptive survey study was physician members of the Turkish Society of Anaesthesiology and Reanimation, who were volunteering/accepting to participate in the study. The doctors were contacted via their e-mail addresses. Data were collected online, between October 10, 2016, and November 30, 2016, using a web-based (SurveyMonkey (R), https://tr.surveymonkey.com/) questionnaire form, and the data were analyzed by the Statistical Package for the Social Sciences (SPSS) version 20 software (IBM Corp.; Armonk, NY, USA). Descriptive data were presented with frequency, percentage, mean, standard deviation, median, minimum, and maximum values. Results: A total of 315 people were included in the study. Around 34.9% anaesthesiologists had 5-10 years of professional experience and 61.9% of the anaesthesiologists stated that they routinely check the patients' pain level in the postoperative period. Multimodal analgesia is mostly preferred (25.3%) after major surgical intervention. Around 71.9% of the participants stated that they cannot find the required time for postoperative analgesia in their institution, and they associated this matter with excessive workload and lack of staff time. Conclusion: In this study, we found that anaesthesiologists in Turkey are doing the follow-up of patients during the postoperative period pain-wise and that they use specific pain scales. Anaesthesiologists think that postoperative pain treatment is not done effectively and time required for the pain treatment is not enough. They also stated that a separate team should be formed for postoperative pain management in the hospital. We believe that this study will raise awareness on this issue and will contribute to the creation of algorithms for postoperative pain treatment, the establishment of pain teams, and the provision of more effective and safer health services.Öğe Anesthetic management for super-super morbidly obese patient(Anaesthesia Pain & Intensive Care, 2014) Erbas, Mesut; Toman, Huseyin; Kiraz, Hasan Ali; Simsek, Tuncer; Arik, M. Kasim; Uyan, Berna; Sahin, HasanObesity leads to several changes in both airway and drug metabolism. The problems are compounded in cases of super super morbid obesity. Gastric banding surgery for weight loss was planned for a 47 year old, super-super morbidly obese female patient (164 kg and 151 cm, BMI: 72 kg/m(2)). On pre-operative examination, patient had a short thick neck and grade 4 Mallampatti class. Induction of anesthesia was done in the sitting / semi-sitting position Maintenance was provided with 6% desflurane and O-2/air mixture. Remifentanil infusion of 0.05 mu g/kg was administered during surgery. Patient had an uneventful recovery. The use of short acting drugs and appropriate monitoring provided hemodynamic stability and a fast and smooth recoveryÖğe Blood gas analyzer utility in evaluating oxygen kinetics of the aqueous humor(Consel Brasil Oftalmologia, 2015) Ersan, Ismail; Arikan, Sedat; Toman, Huseyin; Kara, Selcuk; Gencer, Baran; Erbas, Mesut; Tufan, Hasan AliPurpose: To measure the partial pressure of oxygen (PO2) and carbon dioxide (PCO2) and the pH of aqueous humor (AH) and arterial blood samples from rabbits using a blood gas analyzer. Methods: Twenty New Zealand rabbits were anesthetized intramuscularly with ketamine and xylazine and were then allowed to breathe room air. Using a gas blood analyzer, arterial blood and AH samples were analyzed for PO2, PCO2, and pH. Results: The mean arterial blood pressure was 87.14 +/- 15.0 mmHg. The mean blood and AH PO2 were 95.18 +/- 11.76 mmHg and 88.83 +/- 9.92 mmHg, the mean blood and AH PCO2 were 25.86 +/- 5.46 mmHg and 29.50 +/- 5.36 mmHg, and the mean blood and AH pH were 7.38 +/- 0.06 and 7.33 +/- 0.09, respectively. Conclusions: The blood gas analyzer was easily employed to evaluate the aqueous humor in rabbits. When comparing the results of studies evaluating aqueous PO2, care should be taken to determine the methods used in these studies.Öğe Comparing the effect of two different induction regimens with thiopental on hemodynamics during laryngoscopy and tracheal intubation in hypertensive patients(Anaesthesia Pain & Intensive Care, 2018) Ural, Sedef Gulcin; Yazicioglu, Dilek; Simsek, Tuncer; Erbas, Mesut; Sahin, Hasan; Altinisik, Hatice BetulObjective: Inj thiopental is known to result in hypotension during induction, and the effect is more pronounced in hypertensive patients. This study aimed to compare the effect of two different anesthesia induction regimens with pentothal in managing the hemodynamic response to laryngoscopy and endotracheal intubation in known hypertensive patients. Methodology: The study was conducted in Van Educational Research Hospital in 2014 after approval from the ethics committee and informed consent from patients were obtained. The prospective, double-blind, randomized study included the American Society of Anesthesiologists (ASA) grade II-III 90 patients, aged 40-65 y, scheduled for elective abdominal surgery with general anesthesia. Thiopental (3-7 mg/kg) was given to the patients in Group 1 (n = 45) with single dose injection in 20 s. In Group 2 (n = 45), first 75% of the thiopental dose was given, and after the bispectral index- based scale (BIS) value was < 60 and after injecting neuromuscular blocking agent, the rest of the thiopental dose was added and injection duration was recorded. In both groups, midazolam 0.05-0.1 mg/kg was administered for premedication. Fentanyl and rocuronium were used in both groups to complete induction. During the first 25 min, systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, and heart rate of the patients were recorded. Also, BIS values after induction and total additional fentanyl requirement were recorded. Results: Heart rate, mean arterial pressure, and additional fentanyl requirement was significantly lower in Group 2. BIS values were also lower in Group 2. Induction duration was higher in Group 2, but hemodynamic control was more satisfying. Conclusion: The study indicated that injection of thiopental in divided doses is more comfortable and safe when considering hemodynamic instability during anesthesia induction in hypertensive patients.Öğe Comparison of effects of sugammadex and neostigmine on QTc prolongation in rabbits under general anesthesia(Acta Cirurgica Brasileira, 2014) Erbas, Mesut; Toman, Huseyin; Sahin, Hasan; Kiraz, Hasan Ali; Barutcu, Ahmet; Simsek, Tuncer; Yener, Ali UmitPURPOSE: To compare the effects of sugammadex and neostigmine, used to antagonize the effects of rocuronium, on the QT(c) interval. METHODS: This study used 10 adult New Zealand white rabbits of 2.5-3.5 kg randomly divided into two groups: sugammadex group (Group S, n: 5) and neostigmine group (Group N, n: 5). For general anesthesia administering 2 mg/kg iv propofol and 1 mcg/kg iv fentanyl, 0.6 mg/kg iv rocuronium was given. Later to provide reliable airway for all experimental animals V-Gel Rabbit was inserted. The rabbits were manually ventilated by the same anesthetist. After the V-Gel Rabbit was inserted at 2, 5, 10, 20, 25, 27, 30 and 40 minutes measurements were repeated and recorded. At 25 minutes after induction Group N rabbits were given 0.05 mg/kg iv neostigmine + 0.01 mg/kg iv atropine. Group S were administered 2 mg/kg iv sugammadex. RESULTS: Comparing the QT(c) interval in the rabbits in Group S and Group N, in the 25th, 27th and 30th minute after muscle relaxant antagonist was administered the QT(c) interval in the neostigmine group rabbits was significantly increased (p < 0.05). CONCLUSION: While sugammadex, administered to antagonize the effect of rocuronium, did not significantly affect the QTc interval, neostigmine+atropine proloned the QT(c) interval.Öğe Comparison of effects on the oxidant/antioxidant system of sevoflurane, desflurane and propofol infusion during general anesthesia(Elsevier Science Inc, 2015) Erbas, Mesut; Demiraran, Yavuz; Yildirim, Hayriye Ak; Sezen, Gulbin; Iskender, Abdulkadir; Karagoz, Ibrahim; Kandis, HayatiBackground and objectives: Desflurane and sevoflurane are frequently used for maintenance of anesthesia and studies have shown that these anesthetics cause a variety of changes to the oxidative stress and antioxidative defense mechanisms. This study aims to compare the effects of sevoflurane, desflurane and propofol infusion anesthesia on the oxidant and antioxidant systems of patients undergoing laparoscopic cholecystectomy. Methods: 45 patients between 18 and 50 years with planned laparoscopic cholecystectomy under general anesthetic were included in the study. Patients were divided into three groups on the way to surgery: propofol (group P n: 15), sevoflurane (group S n: 15) and desfiurane (group D n: 15). All groups were given hypnotic 2 mg/kg propofol IV, 1 mcg/kg fentanyl IV and 0.1 mg/kg vecuronium IV for induction. For maintenance of anesthesia group S were ventilated with 2% sevoflurane, group D cases were given 6% desflurane and group P were given propofol infusions of 12 mg/kg/h for the first 10 min, 9 rrig/kg/h for the second 10 min and 6 mg/kg/h after that. Before induction and after the operation venous blood samples were taken to evaluate the levels of glutation peroxidase, total oxidants and antioxidants. Results and conclusions: The 45 patients included in the study were 22 male and 23 female patients. The demographic characteristics of the groups were similar. In the postoperative period we observed that while sevoflurane and propofol increased antioxidants by a statistically significant level, desfiurane increased the total oxidants level by a significant amount compared to levels before the operation. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe Comparison of the effectivity of oral and intra-articular administration of tenoxicam in patients with knee osteoarthritis(Elsevier Science Inc, 2015) Erbas, Mesut; Simsek, Tuncer; Kiraz, Hasan Ali; Sahin, Hasan; Toman, HuseyinBackground and objectives: Tenoxicam is widely used in osteoarthritis treatment and we aimed to compare the effectivity of oral and intra-articular administration of tenoxicam in osteoarthritis treatment. Methods: This study was performed between 2011 and 2012 by retrospectively analyzing and comparing the findings of 60 patients who were clinically and radiologically diagnosed with knee degenerative osteoarthritis in Bunyan state hospital pain policlinic. 60 patients included in the study were divided into two groups. The first group (tenoxicam IA, n=30) included patient findings of those subjected to intra-articular injection of 20 mg tenoxicam to the knee once a week for three weeks and the second group (oral tenoxicam, n=30) included patients who were administered 20 mg oral tenoxicam once a day for three weeks. All patients were clinically evaluated pre-treatment and in the 1st week, 1st month and 3rd month post-treatment according to specified criteria. Results and conclusions: Twenty two of 60 patients included in the study were male and 38 were female. In both groups significant improvements were detected in all of the observed parameters: visual analog scale, Western Ontario McMaster Osteoarthritis Index (pain, physical activity, knee stiffness) and Lequesne index scores and in the evaluations performed in 1st week, 1st month and 3rd month with respect to pre-treatment values. Besides, a better compliance to treatment and gastrointestinal system tolerability in tenoxicam IA group was also observed. Intra-articular tenoxicam administration could be thought as an alternative treatment method in patients with knee osteoarthritis who cannot use oral tenoxicam especially due to systemic gastrointestinal system side effects and those who have difficulties in adapting to treatment. (c) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe Comparison of the effects of various airway devices on hemodynamic response and QTc interval in rabbits under general anesthesia(Springer Heidelberg, 2015) Toman, Huseyin; Erbas, Mesut; Sahin, Hasan; Kiraz, Hasan Ali; Uzun, Metehan; Ovali, Mehmet AkifIn this study, we aimed to compare the effects of various airway devices on QTc interval in rabbits under general anesthesia. The subjects were randomly separated into four groups: Group ETT, Group LMA, Group PLA, Group V-gel. Baseline values and hearth rate, mean arterial pressure and ECG was obtained at the 1st, 5th and 30th minutes after administration of anesthesia and placement of airway device and, QTc interval was evaluated. Difference was observed between ET group and V-gel group in the 5th minute mean arterial pressure values (p < 0.05). It was observed that QTc intervals at the 1st and 5th minute in the ET group significantly increased when compared with the other groups (p < 0.05). Again, it was observed that QTc interval of ET group at the 15th and 30th minute was longer when compared with PLA and V-gel groups (p < 0.05). It was also observed that QTc interval of LMA Group at the 5th minute after intubation significantly increased when compared with V-gel group (p < 0.05). It was observed that HR values of ETT group at the 1st, 5th and 15th minutes after intubation increased with regards to PLA and V-gel groups (p < 0.05). It was determined that the 30th minute hearth rate of ETT group was higher when compared to V-gel group (p < 0.05). Conclusion: In our study we observed that V-gel Rabbit affected both hemodynamic response and QT interval less than other airway devices.Öğe Correlation of ischemia-modified albumin levels and histopathologic findings in experimental ovarian torsion(Kare Publ, 2016) Yildirim, Ahmet; Yildirim, Sule; Topaloglu, Naci; Tekin, Mustafa; Kucuk, Adem; Erdem, Havva; Erbas, MesutObjectives: Ischemia modified albumin (IMA) levels significantly increased and may be used as a diagnostic marker in ovarian torsion. The aim of this study is to investigate whether there was any correlation between IMA levels and histopathologic changes in experimental ovarian torsion. Material and methods: Fourteen Sprague-Dawley rats, each weighing 220-250 g were divided randomly into 2 groups; in Group 1, the control group (n = 7), only laparotomy was performed and in Group 2, the experimental group (n = 7), ovarian torsion was performed. Ischemia was performed for 3 h; following the ischemia period, the torsion was relieved by detwisting the adnexa and then the ovarian I/R protocol was applied for 3 h. Blood samples were taken from all of the rats to measure the IMA levels and the ovaries were surgically removed for histologic examination. A blinded pathologist examined and scored the samples. Results: The median (minimum-maximum) IMA values were 921.00 (870.00-966.00) ABSUs in the ovarian torsion group and 853.00 (782.00-869.00) ABSUs in the control group. The difference was statistically significant. In the correlation analysis, a significant and strong correlationwas found between IMA levels and histopathologic changes (Spearman's rho = vertical bar 0.987, p < 0.001). Conclusion: Positive correlation was found between the IMA levels and the histopathologic severity of the disease. This finding is important for both diagnosis of the disease and patient follow-up. As a new marker in ovarian torsion, IMA may also indicate the severity of the ovarian histopathology. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.Öğe Effects of Prophylactic Ozone Therapy on General Anesthesia and Surgical Stress Response: Neutrophil/Lymphocyte Ratio and Ischemia-Modified Albumin(Int College Of Surgeons, 2019) Toman, Huseyin; Sahin, Hasan; Erbas, Mesut; Turkon, Hakan; Simsek, Tuncer; Kiraz, Hasan Ali; Ozkan, Muhammed Turgut AlperGeneral anesthesia and surgical stress cause an acute endocrine, metabolic, and immunologic inflammatory response in organisms and an increase in neutrophil lymphocyte ratio (NLR) and ischemia-modified albumin (IMA) levels. Ozone, other than inhalation administration, reduces the release of antioxidants and some proinflammatory cytokines and has been shown to have an anti-inflammatory effect. Our aim is to research how the NLR and IMA response is affected in rabbits undergoing surgical intervention with general anesthesia given prophylactic with ozone therapy. We divided 12 New Zealand rabbits into 2 groups: group O was given 70 lg/mL 10 mL ozone by the rectal route in 6 sessions on alternate days, and group C was given air by the rectal route. The rabbits underwent surgical intervention under general anesthesia. Blood samples were taken at basal, preoperation, 30 minutes postanesthesia, and 24 hours postoperation and were examined for hemogram and IMA. At 24 hours postoperation, an increase in NLR was observed in both groups, more clearly in group C (P < 0.05). In both groups, comparisons within the groups showed a significant increase in NLR only at 24 hours postoperation compared to other times (P < 0.05).When IMA values were compared, differences between the groups were observed between preoperative values and those at the 30 minutes postanesthesia and 24 hours postoperation (P < 0.05). When general anesthesia and surgical stress response were evaluated using inflammatory parameters of both NLR and IMA, there was significantly less of an increase in levels in rabbits given ozone compared to the control group.Öğe Effects of sugammadex on the prevention of postoperative peritoneal adhesions(Wiley, 2015) Sahin, Hasan; Toman, Huseyin; Kiraz, Hasan Ali; Simsek, Tuncer; Erbas, Mesut; Ozkul, Faruk; Arik, Muhammet KasimMany materials and techniques have been used to prevent and repair intra-abdominal adhesions, but an effective solution has not been found. The aim of this study is to research the effect of sugammadex on intra-abdominal adhesions in an experimentally induced intraabdominal adhesion model. Twenty-four female Wistar albino rats were included in the study. The experimental animals were randomly divided into three groups: the sugammadex group (Group SX, n=8), the control group (Group C, n=8), and the shamgroup (Group S, n=8). After starvation for 1 night, the rats were injected with a 50 mg/kg intramuscular dose of ketamine and a 5 mg/kg intramuscular dose of xylazine for anesthesia. The rats in the SX group were given 3 mL sugammadex into the peritoneal cavity, while rats in the control group were given 3 mL 0.9% sodium chloride. In the sham group, the peritoneal cavity was opened, but no chemicals were administered. All rats were sacrificed on the 10th postoperative day. The adhesions were staged as 0, 1, 2, and 3 according to Evans et al.'s model. Our evaluation of macroscopic adhesion intensity found statistically significant differences between the groups. The sugammadex group was observed to have fewer adhesions in a statistically significant manner compared with the control group (p < 0.05). In our experimental intra-abdominal adhesion model in rats, we observed that sugammadex prevented postoperative intra-abdominal adhesions. Copyright (C) 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.Öğe Evaluation of knowledge and attitudes among intensive care physicians during the COVID-19 pandemic: a cross-sectional survey(Associacao Paulista Medicina, 2020) Erbas, Mesut; Dost, BurhanBACKGROUND: The novel coronavirus (COVID-19) emerged in Wuhan, China, in December 2019. OBJECTIVES: To evaluate the knowledge of intensive care physicians in Turkey about COVID-19 and their attitudes towards the strategies and application methods to be used for COVID-19 cases that need to be followed up in an intensive care unit, and to raise awareness about this issue. DESIGN AND SETTING:The population for this descriptive study comprised clinicians working in a variety of healthcare organizations in Turkey who provide monitoring and treatment within the intensive care process for COVID-19 patients. METHODS: Data were collected online using a survey form on the SurveyMonkey website between April 20 and April 25, 2020. RESULTS: The mean age of the 248 intensive care clinicians participating in the study was 37.2 +/- 13.7 years and 49.19% were female. High rates of classical laryngoscope use were observed, especially among clinicians employed in state hospitals. Among all the participants, 54.8% stated that they were undecided about corticosteroid treatment for patients who had been intubated due to COVID-19. CONCLUSIONS: Many medications and methods are used for COVID-19 treatment. All national science committees are attempting to create standard treatment protocols. For intensive care treatment of COVID-19 patients, many factors require management, and clinicians experience is guiding future processes. We believe that this study will create awareness about this topic and contribute to the creation of standard treatment algorithms and the provision of better and safer healthcare services for this patient group.Öğe Evaluation of the relationship between the topographical anatomy in the axillary region of the brachial plexus and the body mass index(Springer Heidelberg, 2018) Ozturk, Omur; Tezcan, Aysu Hayriye; Bilge, Ali; Ates, Hakan; Yagmurdur, Hatice; Erbas, MesutTo investigate the topographic anatomy of the median, musculocutaneous, radial and ulnar nerves with respect to the axillary artery and to seek whether these configurations are associated with baseline descriptive data including age, gender, and body-mass index. This cross-sectional trial was carried out on 199 patients (85 women, 114 men; average age: 46.78 +/- 15.45 years) in the department of anaesthesiology and reanimation of a tertiary care center. Topographic anatomy of the median, musculocutaneous, radial and ulnar nerves was assessed with ultrasonography. Localization of these nerves with respect to the axillary artery was marked on the map demonstrating 16 zones around the axillary artery. Frequencies of localizations of every nerve in these zones were recorded, and the correlation of these locations with descriptive data including age, gender and BMI was investigated. There was no difference between women and men for the distribution of the median (p = 0.74), ulnar (p = 0.35) and radial (p = 0.64) nerves. However, the musculocutaneous nerve was more commonly located in Zone A13 in men compared to women (p = 0.02). The localization of the median (p = 0.85), ulnar (p = 0.27) and radial (p = 0.88) nerves did not differ remarkably between patients with BMI < 25 kg/m(2) and patients with BMI 25 kg/m(2). Notably, the musculocutaneous nerve was more often determined in Zone A10 in cases with BMI 25 kg/m(2) (p = 0.001). Our results imply that the alignment of the musculocutaneous nerve may vary in men and overweight people. This fact must be considered by the anaesthetist before planning the axillary block of brachial plexus. All these informations may enlighten the planning stages of the brachial plexus blockade.Öğe Experimental Esophagitis Model Preventing Tracheal Aspiration(Wroclaw Medical Univ, 2015) Kiraz, Hasan A.; Erbas, Mesut; Kucuk, Adem; Topaloglu, Naci; Erdem, Havva; Sahin, Hasan; Toman, HuseyinBackground. Corrosive esophagitis injuries are a serious clinical problem with many agents used for diagnosis and treatment. Experimental esophagus burn models use a method described mainly in studies by Gehanno and Guedon, and modified by Liu and Richardson. Objectives. The aim of this study was to describe a new esophagitis model that prevents tracheal aspiration. Material and Methods. In this study we used 16 Wistar albino rats weighing between 220-240 g. The experimental animals were randomly divided into two groups: the model group (group M, n: 8) and control group (group C, n: 8). The necessary anesthesia was administered. Passing through a median laparotomy incision, the abdomen was entered and in group M and C the esophagus was freed and held by a suture at the gastroesophageal junction. After this procedure, about 1 cm proximal to the gastroesophageal junction, the esophagus was suspended by a suture. The esophagus segment between the two sutures was exposed to 0.1 mL 10% NaOH in group M and 0.1 mL saline in group C for 20 s. Ten days later all experimental animals were sacrificed and their esophagus removed. After dying with hematoxylin and eosine trichrome, the histopathological evaluation results for the rats in all groups were investigated with a light microscope. Results. Histopathological examination indicated submucosal collagen increase, damage to muscularis mucosa and tunica muscularis and collagen deposition. In the model group, the rats had high neutrophils and tissue damage accompanied by necrosis. In the control group, the rats had minimal or no tissue damage and fibrosis was not observed. Conclusions. Our procedure is relatively less invasive and easy to apply with corrosive esophagitis only in the required region, and at the same time treatment medications can be easily administered.Öğe Investigation of proarrhythmic effect of high sugammadex doses: an experimental animal study(Springernature, 2022) Demir, Emin Tunc; Erbas, MesutBackgroundStudies on higher doses of sugammadex effect on QT interval and leading arrhythmia have been limited. In this study, we aimed to investigate possible proarrhythmic effect of higher doses of sugammadex in conditions that required urgent reversal of neuromuscular blockade during general anesthesia in an experimental animal model.MethodsIt was experimental animal study. Total of 15 male New Zealand rabbits were randomly divided into three groups for low (4 mg/kg, n = 5), moderate (16 mg/kg, n = 5), and high dose of sugammadex (32 mg/kg, n = 5). All rabbits were premedicated by intramuscular ketamine 10 mg/kg, and general anesthesia was inducted by intravenous injection of 2 mg/kg of a propofol, 1 mcg/kg fentanyl, and 0.6 mg/kg rocuronium injection. Airway was provided by V-gel rabbit and connected to anesthetic device and ventilated at about 40 cycle/min and 10 ml/kg; oxygen 50% plus air 50% mixture was used with 1 MAC isoflurane to maintain anesthesia. Electrocardiographic monitorization and arterial cannulation were provided to follow-up mean arterial pressure and for arterial blood gas analyses. Intravenous sugammadex in three different doses were injected at 25th min of induction. After observing adequate respiration of all rabbits, V-gel rabbit was removed. Parameters and ECG recordings were taken basal value before induction and at the 5th, 10th, 20th, 25th, 30th, and 40th min to measure corrected QT intervals and were stored on digital media. QT interval was calculated as the time from the beginning of the Q wave to the end of the T wave. Corrected QT interval was calculated according to the Bazett's formula. Possible adverse effects were observed and recorded.ResultsIn all three groups, there was no significant statistical difference in mean arterial blood gases parameters, arterial pressures, heart rates, and Bazett QTc values, and no serious arrhythmia was recorded.ConclusionWe found in animal study that low, moderate, and high doses of sugammadex did not significantly altered corrected QT intervals and did not cause any significant arrhythmia.Öğe Investigation of the effects of different doses of sugammadex on kidney histopathology in rabbits with acute renal failure(Anaesthesia Pain & Intensive Care, 2019) Ozturk, Omur; Erbas, MesutObjective: In our study, we hypothesised that using high doses, ie. 16 mg / kg sugammadex during general anesthesia after acute renal failure in rabbits would lead to a deteriorated renal histopathology due to the accumulation of rocuroniumsugammadex complex in the tubules. We aimed to investigate the effect of different doses of sugammadex (4 or 16 mg) on experimental kidney histopathology in rabbits with acute renal failure. Methodology: Eight New Zealand white adult male rabbits were used in the study. The rabbits were divided into 2 groups of four. The first group received low dose (4 mg) sugammadex and the second group received high dose (16 mg) sugammadex. Rabbits were administered 20 mg / kg of cisplatin intravenously 4 hours before general anesthesia and an acute renal failure model was established. After general anesthesia was applied, V-GEL (R) Rabbit was placed to all experimental animals to provide airway safety. All animals were manually ventilated using an anesthesia device. At the 25th min after induction, the rabbits in Group D received 4 mg / kg sugammadex iv, and the those in Group Y received 16 mg / kg sugammadex iv. At the end of the experiment, all experimental animals were sacrificed, and the kidneys were removed, and histopathologic examination was performed. Results: At the end of our study all experimental animals were sacrificed. There was no statistically significant difference between findings in the kidneys of animals of Group Y and Group D on histopathologic evaluation. Conclusion: The results of our study did not reveal any differences between the renal histopathological appearances of rabbits receiving 4 mg / kg or 16 mg / kg sugammadex IV.Öğe Percutaneous treatment of lumbar synovial cyst: A case report(Acta Medica Mediterranea, 2014) Erbas, Mesut; Ozdemir, Ugur; Toman, Huseyin; Sahin, Hasan; Savluk, Omer Faruk; Luleci, NurettinIntroduction and aims: Synovial cysts are benign cystic lesions that form when the joint capsule is worn during joint movement and synovial fluid leaks out. Intraspinal synovial cysts in the lumbar region are generally diagnosed when investigating patients who complaints of back pain or other symptoms which could be attributed to radiculopathy. The aim of this paper is to present the use of the percutaneous needle aspiration method with tomography guidance to treat an L4-L5 synovial cyst causing radicular symptoms. Case report: A 40-year old female, with a 5-year complaint of back pain, applied to our clinic with recent increase in existing complaints and the addition of left leg pain. Lumbar computed tomography and magnetic resonance imaging examinations showed at L4 vertebra corpus level in the spinal canal right posterolateral recess, neighboring the right L5 nerve root, a 9x7x4 mm T2 hyperintense, T1 hypointense nodular appearance. A percutaneous cyst aspiration was planned and after aseptic conditions were ensured, a 22 G spinal needle was used to aspire the fluid in the synovial cyst between L4-L5 guided by tomography images and 80 mg methyl prednisone with 6 ml 0.25% bupivacaine were injected into cyst and the procedure was completed. Discussion and conclusion: In symptomatic lumbar synovial cyst cases percutaneous cyst aspiration, steroid injection or surgical resection may be chosen. However as percutaneous cyst aspiration has a lower rate of complications such as infection, bleeding, nerve damage and dural puncture compared to surgical treatment, it should be first choice.Öğe PERCUTANEOUS TREATMENT OF LUMBAR SYNOVIAL CYST: A CASE REPORT(Carbone Editore, 2014) Erbas, Mesut; Ozdemir, Ugur; Toman, Huseyin; Sahin, Hasan; Savluk, Omer Faruk; Luleci, NurettinIntroduction and aims: Synovial cysts are benign cystic lesions that form when the joint capsule is worn during joint movement and synovial fluid leaks out. Intraspinal synovial cysts in the lumbar region are generally diagnosed when investigating patients who complaints of back pain or other symptoms which could be attributed to radiculopathy. The aim of this paper is to present the use of the percutaneous needle aspiration method with tomography guidance to treat an L4-L5 synovial cyst causing radicular symptoms. Case report: A 40-year old female, with a 5-year complaint of back pain, applied to our clinic with recent increase in existing complaints and the addition of left leg pain. Lumbar computed tomography and magnetic resonance imaging examinations showed at L4 vertebra corpus level in the spinal canal right posterolateral recess, neighboring the right L5 nerve root, a 9x7x4 mm T2 hyperintense, T1 hypointense nodular appearance. A percutaneous cyst aspiration was planned and after aseptic conditions were ensured, a 22 G spinal needle was used to aspire the fluid in the synovial cyst between L4-L5 guided by tomography images and 80 mg methyl prednisone with 6 ml 0.25% bupivacaine were injected into cyst and the procedure was completed. Discussion and conclusion: In symptomatic lumbar synovial cyst cases percutaneous cyst aspiration, steroid injection or surgical resection may be chosen. However as percutaneous cyst aspiration has a lower rate of complications such as infection, bleeding, nerve damage and dural puncture compared to surgical treatment, it should be first choice.