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Öğe Clinical Picture, Radiological Findings, and Physical Examination in Tracheobronchial Foreign Body Aspiration: Which One is More Important?(Aves, 2013) Gedik, Ismail Ertugrul; Alar, Timucin; Omur, Dilek; Akdur, OkhanTracheobronchial foreign body aspiration is more frequent in children between 6 months-3 years of age, whereas it is seen less often in adults. The diagnosis of TBFB aspiration can be delayed in the adult population due to the lack of clinical suspicion. A case of a 56-year-old male patient admitted to the emergency department with a history of aspiration of a piece of carrot 4 hours previously, a cough and stridorous breathing is presented. His physical examination revealed reduced respiratory sounds in the lower zone of the left lung. There was no radiological clue of a tracheobronchial foreign body. Thus, we performed rigid bronchoscopy and found that the left lower lobe basal segment bronchus was almost totally obstructed by a foreign body (carrot) of 1.5x1 cm, which was removed. This was based on the clinical suspicion derived from the history and the physical examination alone. We emphasise that history and physical examination are more important in the diagnosis of organic or non-opaque tracheobronchial foreign body aspiration.Öğe Detection of fetal keratin with high molecular weight cytokeratin immunostaining in lung biopsy material from a patient with amniotic fluid embolism(2013) Hacivelioglu, Servet; Oguzalp, Huseyin; Muratli, Asli; Asgun, Fatih; Kirilmaz, Bahadir; Omur, DilekAmniotic fluid embolism (AFE) is a rare and fatal disorder in which the diagnosis can be challenging for clinicians and pathologists. A healthy 36-year-old woman (gravida 4, para 2) was admitted for delivery in the 40th week of gestation. At the fifth minute following birth, during expulsion of the placenta, the patient suddenly collapsed with bradycardia, shallow respiration, and loss of consciousness. After evaluation, an emergent pulmonary embolectomy for acute thrombo-embolism was performed, however the patient could not be weaned from cardiopulmonary bypass, and died of severe right ventricular dysfunction following the operation. Microscopic examination of the biopsy material detected clearly visible fetal epithelial squames inside pulmonary vessels, both with routine hematoxylin-eosin (HE) staining and immunostaining for high molecular weight cytokeratin (HMW-CK). The diagnosis of amniotic fluid embolism (AFE) was made, which was confirmed as the cause of death. We show that HMW-CK staining can be a useful means of detecting amniotic fluid-derived fetal keratin within alveolar tissue. We suggest that this technique, used in addition to HE staining and in combination with sudden-onset clinical findings, may increase the accuracy of diagnosis in AFE.Öğe Effects of smoking on venous cannulation pain: a randomized prospective trial(Elsevier Science Inc, 2015) Hanci, Volkan; Kiraz, Hasan Ali; Omur, Dilek; Ekin, Serpil; Uyan, Berna; Yurtlu, Derya Arslan; Yurtlu, SerhanBackground and objectives: It has been demonstrated that smoking increases pain perception; however the effect of smoking on perception of pain during venous cannulation is not known. The purpose of this study is to determine whether or not smoking has an effect on pain perception due to peripheral venous cannulation. Methods: 220 patients scheduled to have elective surgery were enrolled in the study and were divided into two groups (Group S and C, n=110 for each) according to their smoking habits. Numerical rating scale was introduced to the patients and then peripheral venous cannulation at the dorsum of the hand was made with a 20 G intracath. Pain perception of the patients was scored by subsequent numerical rating scale questioning. Results: The demographic characteristics of the groups were identical. Numerical rating scale scores in Group S and C were 3.31 +/- 1.56 and 1.65 +/- 1.23, respectively (p < 0.001). Conclusion: Pain perception due to peripheral venous cannulation is higher in smokers. Future studies on pain treatment should consider the smoking habits of patients. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe Evaluation of Precipitation Characteristics of Commonly Used Non-Steroidal Anti-Inflammatory Analgesic Drugs(Colegio Farmaceuticos Provincia De Buenos Aires, 2015) Kiraz, Hasan Ali; Omur, Dilek; Ekin, Serpil; Toman, Huseyin; Uyan, Berna; Yurtlu, Bulent Serhan; Hanci, VolkanPostoperative pain is a major problem in clinical practice. Non-steroidal anti-inflammatory drugs have traditionally been used to relieve postoperative pain. Administration of intravenous products together can result incompatibility problems and this is clinically hazardous. Reference texts, published reports can provide information about drugs' incompatibility characteristics but there have been limited data for new drugs such as lornoxicam, tenoxicam and dexketoprofen, commonly used non-steroidal anti-inflammatory drugs. In this study, it was aimed to investigate whether there is precipitation between lornoxicam, tenoxicam and dexketoprofen with other commonly used drugs in anesthesiology practice.Öğe In vitro evaluation of antimicrobial features of sugammadex(Elsevier Science Inc, 2014) Hanci, Volkan; Vural, Ahmet; Hanci, Sevgi Yilmaz; Kiraz, Hasan Ali; Omur, Dilek; Unver, AhmetBackground: Drugs administered by intravenous routes may be contaminated during several stages of production or preparation. Sugammadex is a modified gamma cyclodextrin. While research into the antibacterial effects of varieties of cyclodextrin is available, there are no studies focusing on the antibacterial effects of sugammadex. This study investigates the in vitro antimicrobial activity of sugammadex. Materials and methods: The in vitro antimicrobial activity of sugammadex was investigated using the broth microdilution method. The pH of the test solution was determined using a pH meter. The test microorganisms included Staphylococcus aureus ATCC 29213, Enterococcus fecalis ATCC 29212, Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853. In the second phase of the study 100 mg/mL sugammadex (54 mu g) was contaminated with test microorganisms (50 mu g), including S. aureus ATCC 29213, E. fecalis ATCC 29212, E. cob ATCC 25922 and P aeruginosa ATCC 27853, Left to incubate for 24 h and then the bacterial production in sugammadex was evaluated. Results: The pH of the test solutions ranged between 7.25 and 6.97. Using the microdilution method, sugammadex had no antibacterial effect on S. aureus, E. fecalis, E. coli and P aeruginosa at any concentration. In the second phase of the study bacterial production was observed after 24h in 100 mg/mL sugammadex contaminated with the test microorganisms S. aureus, E. fecalis, E. coli and P. aeruginosa. Conclusions: Sugammadex had no antimicrobial effect on the test microorganisms, S. aureus, E. fecal's, E. coli and P aeruginosa. Care should be taken that sterile conditions are maintained in the preparation of sugammadex; that the same sugammadex preparation not be used for more than one patient; and that storage conditions are adhered to after sugammadex is put into the injector. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rightsÖğe Post operative effects: Anesthesia(2013) Haliloglu, Murat; Omur, Dilek; Yuksel, Tuba Can; Alan, Cabir; Hanci, VolkanAnesthesia result in a variety of metabolic and endocrine responses, but conventional wisdom maintains that anesthetic technique has little long-term effect on patient outcomes. There is accumulating evidence that, on contrary, anesthetic management may in fact exert a number of longer-term effects in postoperative outcome. Here, we review the most topical aspects of anaesthetic management which may potentially influence later postoperative outcomes. Overall, there is insufficient evidence to confirm the ability of postoperative outcomes. This is primarily due to typically insufficient subject numbers to detect differences in currently low incidences of postoperative complications. © 2012 Haliloglu M, et al.Öğe Precipitation in Gallipoli: Sugammadex/Amiodarone & Sugammadex/Dobutamine & Sugammadex/Protamine(Elsevier Science Inc, 2013) Hanci, Volkan; Kiraz, Hasan Ali; Omur, Dilek; Ekin, Serpil; Uyan, Berna; Yurtlu, Bulent Serhan[Anstract Not Available]Öğe The analgesic efficacy of ultrasound-guided transversus abdominis plane block on postoperative pain and morphine consumption in varicocelectomy(Saudi Med J, 2016) Omur, Dilek; Oguzalp, Huseyin; Kiraz, Hasan A.; Ekin, Serpil; Alan, Cabir; Ersay, Ahmet R.; Hanci, VolkanObjectives: To evaluate the analgesic effect of transversus abdominis plane (TAP) block administered before varicocele surgery. Methods: This study was completed at the Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey, between January 2011 and April 2013. In a prospective, double blind, randomized, placebo controlled clinical study, 40 male patients scheduled for elective varicocele operations were randomized to group T (treatment group) or group C (controls). After receiving general anesthesia, group T received a TAP block using 20 mL 0.25% bupivacaine on the operation side, whereas group C received a control block using 20 mL 0.9% Sodium chloride. During the first 24 hours after surgery, the patient pain was evaluated using the visual analogue scale (VAS) at rest and while coughing. Postoperative patient controlled analgesia morphine consumption, VAS scores, and side effects were recorded. Results: Of 34 patients, Group T (n=18) had significantly lower VAS pain scores than Group C (n=16) both at rest and while coughing. The total morphine consumed was lower (7.7 +/- 4.0) versus 21.6 +/- 12.4 mg, p<0.001) in the 24 hours after surgery. Conclusion: As part of a multimodal analgesic regime after varicocelectomy surgery, morphine consumption and VAS pain scores were significantly lower among those receiving 20 mL 0.25% bupivacaine administered for a TAP block than among controls.Öğe The effect of anaesthesia technique on maternal and cord blood ischaemia-modified albumin levels during caesarean section: A randomized controlled study(Sage Publications Ltd, 2013) Omur, Dilek; Hacivelioglu, Servet Ozden; Oguzalp, Huseyin; Uyan, Berna; Kiraz, Hasan Ali; Duman, Can; Tutunculer, Funda KirtayObjective: Ischaemia-modified albumin (IMA) is an early marker for various ischaemic events, including cardiac ischaemia. This study determined variations in IMA levels during caesarean section, performed under general anaesthesia or with combined spinal epidural anaesthesia. Methods: Full-term, healthy pregnant women were allocated to undergo caesarean section, using either general anaesthesia or combined spinal epidural anaesthesia. IMA and albumin levels were measured in maternal serum samples taken immediately prior to caesarean section and 30min into the procedure, as well as from serum taken from cord blood after double clamping. Results: At total of 51 healthy pregnant women underwent either general anaesthesia (n=28) or combined spinal epidural anaesthesia (n=23). Within-group analysis of the general anaesthesia group showed that both IMA levels and IMA/albumin ratios were significantly higher at 30min of surgery compared with the immediate preoperative period. Conclusions: Lower IMA levels in the combined spinal epidural anaesthesia group may have been due to improved balancing of oxidative stress during caesarean section. Further research on IMA levels during caesarean section should take into account the method of anaesthesia used.Öğe Use of Succinylcholine by Anaesthetists in Turkey: A National Survey(Aves, 2015) Omur, Dilek; Kiraz, Hasan Ali; Sahin, Hasan; Toman, Huseyin; Uyan, Berna; Ekin, Serpil; Hanci, VolkanObjective: Although succinylcholine (SCh) has side effects, it is among the most commonly used muscle relaxants for rapid induction because of the faster onset of its effects and short effect duration. However, there is no information regarding the frequency of use of SCh by anaesthetists in Turkey. This study aims to investigate the use of SCh by anaesthetists working in Turkey. Methods: A web-based survey form was sent by e-mail to anaesthetists working in Turkey. The form comprised a total of 24 questions. Results: E-mails were sent to a total of 1882 addresses at two separate times. E-mail replies were received from 433 (23%) anaesthetists. Based on those who responded to the survey, 54.27% anaesthetists routinely used SCh for adult elective cases, 29.33% for paediatric elective cases and 74.13% for emergency cases. In adult elective cases, SCh was most frequently chosen for caesarean section (20.5%), and in paediatric elective and emergency cases, SCh was chosen most frequently because difficult intubation was expected (31.3 and 21.4%, respectively). Conclusion: Our study reveals that SCh is still widely used by anaesthetists in Turkey. Majority of physicians who participated our survey were aware of the side effects; however, they reported using SCh in certain special situations. It is evident that creation of a standard care guide for departments is essential. The first stage of creating a standard care guide is to analyse and document the current application. With this aim, more wide-ranging advanced studies should be completed.
