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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 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 Are Fetuin-A levels beneficial for estimating timing of sepsis occurrence?(Saudi Med J, 2018) Altinisik, Hatice B.; Altinisik, Ugur; Uysal, Sema; Sacar, Suzan; Simsek, Tuncer; Demiraran, YavuzObjectives: To evaluated Fetuin-A levels of patients admitted in the intensive care unit with a diagnosis of sepsis. Methods: This study was conducted at the Faculty of Medicine, Canakkale Onsekiz Mart University Hospital, Canakkal, Turkey, between February 2015 and October 2015. Forty septic patients were included in the study. Subsequent to clinical suspicion of sepsis, serum levels of C-reactive protein (CRP) and procalcitonin; and white blood cell (WBC) counts were evaluated at 3 time-points: 0 (basal), 24, and 72 hours. Results: The mean Fetuin-A levels at the 3 time-points were 58.5 +/- 29.2 ng/mL, 40.9 +/- 23.6 ng/mL, and 47.8 +/- 25.7 ng/mL, respectively. Fetuin-A levels at 24 hours were significantly lower than the basal level (p<0.05), where as no significant difference was observed between the basal levels and those at 72 hours (p>0.05). Correlation between the temporal changes in Fetuin-A levels and the changes in other inflammatory markers (CRP, procalcitonin and WBC) was examined. Fetuin A was found to have only a negative correlation with serum procalcitonin level (p<0.05). Conclusion: In this study, serum Fetuin-A levels in septic patients decreased significantly in the first 24 hours, followed by an insignificant increase at 72 hours. These findings suggest that monitoring of Fetuin-A levels may help predict the time of occurrence of sepsis and prognosis of sepsis.Öğe Clinical Characteristics of Patients Diagnosed with Synthetic Cannabinoid (Bonsai) Intoxication in Intensive Care Unit(Galenos Yayincilik, 2015) Altinisik, Ugur; Altinisik, Hatice Betul; Simsek, Tuncer; Dogu, Tugba; Simsek, Esen; Aydin, HalideObjective: In recent years, synthetic cannabinoids (bonsai) poisoning is a widely seen case that needs to be treated in intensive care unit (ICU) in our country. In this study, it was aimed to discuss the clinical characteristics of patients diagnosed with synthetic cannabinoid intoxication followed in ICU. Material and Method: Patients followed in ICU of Canakkale Onsekiz Mart University and Canakkale State Hospital between 2014 and 2015 were studied retrospectively. Results: Twelve cases were included. In neurological system; confusions (n=4), drowsiness (n=7), restlessness/agitations (n=5), hallucinations (n=2), anxieties/panics (n=3), acute psychosis (n=1) and amnesias (n=11) were detected. One patient was intubated. In cardiovascular system; tachycardias (n=3), bradycardias (n=2), hypertensions (n=2), hypotension (n=1), and arrhythmias (n=2) were observed. In laboratory tests, leukocytosis (n=4), leukopenia (n=1), hypoglycemias (n=3), elevation in liver and renal function tests (n=1) were identified. The average recovery time was 19.3-hours and the average ICU stay was 3-days. Conclusion: In the synthetic cannabinoid intoxication cases; it should be kept in mind that seizure activities may occur in the first hours, myocardial infarction risk in the first 3-days. Liver-kidney functions should be monitored. Hypopotasemia is the most common electrolyte disorder. Cases without any complication are expected to recover in 24-hours. However, new types of synthetic cannabinoids are put on the market every day.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 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 Effects of Inadvertent Perioperative Hypothermia on Metabolic and Inflammatory Mediators(Aves, 2019) Aydin, Halide; Simsek, Tuncer; Demiraran, YavuzObjective: The aim of the present study was to investigate the effects of perioperative undesirable hypothermia on inflammatory (interleukin (IL)-8, IL-10, IL-18, IL-23 and pentraxin (PTX)-3) and metabolic responses (cortisol and insulin) and recovery time. Methods: A total of 60 patients between the ages of 18 and 65 years who were in the lumbar stabilisation operation were included in the study. In this prospective, randomised controlled study, two groups were constituted as with warmed (Group N) and not warmed (Group C) patients before and during the operation. Diuresis, blood loss, body temperature and side effects were recorded with IL-8, IL-10, IL-18, IL-23, PTX-3, cortisol and insulin levels. Results: Perioperative diuresis was significantly higher in Group C. Aldrete score was significantly higher in Group N with less shivering and vomiting in the postoperative period. IL-10, PTX-3 and cortisol levels were found to be significantly higher in Group C in the first postoperative hour. PTX-3 and cortisol were found to be significantly higher in Group C after 24 h of the operation. Insulin was significantly higher in Group N. In 72 h, IL-8 in Group N and cortisol level in Group C were significantly higher. Conclusion: Positive effects of heating the patients in the perioperative period on haemorrhage, diuresis, complications and recovery time were observed in our study. In addition, maintenance of normothermia appeared to modulate the biomarkers that indicate the inflammatory and metabolic responses.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 the Approaches of the Anaesthesiologists on Maintenance of Anaesthesia Machines(Aves, 2016) Altinisik, Ugur; Altinisik, Hatice Betul; Simsek, Tuncer; Kiraz, Hasan Ali; Dogu, Tugba; Toman, Huseyin; Sahin, HasanObjective: In this study, we aimed to discuss the level of knowledge and approach on 'maintenance, calibration and cleaning of anaesthesia devices' among anaesthesiologists in Turkey. Methods: A questionnaire was prepared with 21 questions based on the Google document system, and these questionnaires were sent to the anaesthesiologists via e-mail. Results: Overall, 226 anaesthesiologists answered our survey. With respect to the maintenance and calibration, anaesthesiologists had sufficient information about the vaporizer and the carbon dioxide canister devices; however, information about the vital components, such as disassembly of the anaesthesia machine, flow sensor, oxygen sensor, battery and exhaust system, was insufficient. The cleaning and sterilization procedures were performed when the devices became dirty, and the bacteria filter was used only for the protection of the anaesthesia system. There was a lack of knowledge about how and which part of the anaesthesia device should be disinfected. In total, 85% of the survey participants were thinking of the need of additional education on anaesthesia machine maintenance. Conclusion: It is observed that education about anaesthesia device maintenance, calibration and cleaning issues is obviously necessary for the anaesthesiology specialists in our country. We believe that it would be useful to highlight this issue to anaesthesia educational institutions and anaesthesia associations.Öğe Evaluation of the Hospitalized Coronavirus Disease 2019 Patients in First 3 Months of the Pandemic(Aves, 2022) Alkan, Sevil; Akca, Anil; Sener, Alper; Dogan, Ebru; Gonlugur, Ugur; Simsek, Tuncer; Ozer, SuleOBJECTIVE: Data about Turkish coronavirus disease 2019 patients are limited. We evaluated hospitalized coronavirus disease 2019 patients who were followed up in the first 3 months of the pandemic. MATERIAL AND METHODS: This retrospective, single-center, observational study included 415 confirmed hospitalized coronavirus disease 2019 patients. The patients were divided into groups, namely, mild, moderate, and critically ill patients. Symptoms at the time of admission, clinical, laboratory, and imaging findings were examined. RESULTS: In our study, 6.74% of coronavirus disease 2019 patients had severe disease, 59.5% were male, and the mortality rate was 11.3%. Diabetes mellitus and chronic obstructive pulmonary disease were more frequently seen in critically ill patient groups and hyper- tension in moderate patient groups. Anemia and aspartate aminotransferase levels were higher in non-survivors among mild coronavirus disease 2019 patients. In the moderate patients' group, aspartate aminotransferase, lactate dehydrogenase, international normalized ratio, ferritin, and D-dimer levels were higher and lymphocyte, hemoglobin levels were lower; in the critically ill patients' group, platelets were lower and uric acid levels were higher in non-survivor patients. CONCLUSION: In mild patients, anemia, lymphopenia, and increased aspartate aminotransferase levels; in moderate patients, leukopenia, anemia, and increased aspartate aminotransferase, lactate dehydrogenase, international normalized ratio, ferritin, and D-dimer levels; in the critically ill patient group, lower platelet and increased uric acid levels should he followed closely as they are mortality predictors.Öğe Prevention of intraocular pressure elevation with oleuropein rich diet in rabbits, during the general anaesthesia(Springer International Publishing Ag, 2016) Simsek, Tuncer; Altinisik, Ugur; Ersan, Ismail; Sahin, Hasan; Altinisik, Betul; Erbas, Mesut; Pala, CigdemBackground: Oleuropein is known to have anti-oxidant and anti-inflammatory effects. An important aim of anesthetic management in ocular surgery is to keep the intraocular pressure under control. Studies have researched a variety of prophylactic materials used to prevent increases in intraocular pressure. We aimed to research the effects of oleuropein on intraocular pressure (IOP) during general anaesthesia. Methods: Fourteen New Zealand rabbits were randomly divided into two groups of seven. The rabbits in Group O were given olive leaf extract (OLE) equivalent to a daily dose of 20 mg/kg oleuropein for 15 days. HPLC method used for oleuropein standardization. For anaesthesia induction 1 mg/kg rocuronium was given and after muscle relaxation all animals had a V-gel Rabbit inserted. Anesthetic maintenance was provided by 1 MAC isoflurane. Twenty minutes after rabbits were given 10 mg/kg ketamine, basal IOP values were measured. After the V-gel rabbit was inserted, in the 5th, 10th, 20th, 25th and 30th minutes measurements were repeated. Results: IOP data variation of OLE group was compared with control group and the measured levels were lower in Group O during the anaesthesia. IOP was 33.8 +/- 4 mmHg in Group C and 24.1 +/- 8 mmHg in Group O in 25th minute and the difference between the two groups was statistically significant at this time. Conclusion: We observed that consumption of prophylactic OLE had a reducing effect on IOP in the period before waking in anaesthesia. We believe it is necessary to investigate the effects of OLE on IOP in broad participation patient groups.Öğe Prevention of rocuronium induced mast cell activation with prophylactic oleuropein rich diet in anesthetized rabbits(Acta Cirurgica Brasileira, 2018) Simsek, Tuncer; Erbas, Mesut; Buyuk, Basak; Pala, Cigdem; Sahin, Hasan; Altinisik, BetulPurpose: The effect of a prophylactic oleuropein-rich diet before anesthesia accompanied by the widely-used steroid-based neuromuscular drug rocuronium on mast cell activation was investigated in the study. Methods: 14 rabbits used in the study. The rabbits in the oleuropein group were given oleuropein-rich extract added to the animals' water at doses of 20 mg/kg oleuropein for 15 days orally. After 15 days, all rabbits in the two groups were given general anesthesia with rocuronium of 1 mg/kg. After 1 day, animals were sacrificed and the liver tissue sections stained with H&E, toluidine blue and tryptase for immunohistochemical study. Results: There was no statistically significant difference between ALT, AST and albumin averages of the oleuropein and control groups (p>0.05). The tryptase average of the control group was higher than the tryptase average of the oleuropein group and this difference was statistically significant (p=0.003). The T. blue average in the oleuropein group was higher than the control group. However, there was no statistically significant difference between groups (p=0.482). Conclusions: Rocuronium adverse effects, like hypersensitivity and anaphylaxis, may limit routine use of this substance. The use of oleuropein reduced the number of inflammatory cells and prevented degranulation.Öğe Protective Effect of Possible Olive Oil, Olive Leaves and Olive Seeds on Ethanol Induced Experimental Ulcer Model in Rats(Wiley-Blackwell, 2015) Vural, Zehra; Kahraman, Mustafa; Sehitoglu, Hilal; Vural, Ahmet; Arik, Kasim; Simsek, Tuncer; Cetiner, Sule[Anstract Not Available]Öğe The ameliorative effect of ozone therapy on spinal cord ischemia in rabbits(Bayrakol Medical Publisher, 2020) Akman, Tarik; Aras, Adem Bozkurt; Simsek, Tuncer; Sehitoglu, Muserref Hilal; Yukser, Yasemin; Aslan, Esra; Akman, CananAim: Research in applications of O3 treatment for spinal cord ischemia is a rich area of study. The effects of O3 treatment on spinal cord ischemia have not been studied much to date. The aim of this study is to investigate the role of prophylactic administration of O3 on the recovery of ischemic changes in terms of oxidative stress markers in lysosomal and mitochondrial enzymatic activities in the spinal cord of male rabbits. Material and Method: Twenty-four New Zealand White (NZW) adult male rabbits (weight: 2.5-3 kg) were obtained from Saki Yenilli Experimental Animals Center (Ankara, Turkey). The rabbits were housed in plastic cages at a temperature of 21 +/- 2 degrees C, with 12 hours light/12 hours dark cyclus, fed with standard rabbit diet (Bil-Yem Ltd. Co., Ankara, Turkey) and water ad libitum for the duration of the experiment. Rabbits were randomly divided into 4 groups of 6 rabbits. The first group was accepted as control and the second group was treated with 50 mu g/mL (20 mL) ozone by rectal insufflation 5 times per day. On the 10th day, animals were sacrificed. The third sham group had infrarenal abdominal aorta cross- clamping (IAACC) performed and were sacrificed 24 hours later. The fourth group was treated with 50 mu g/mL ozone (20 mL) by rectal insufflation 5 times per day and on the 10th day, IAACC was performed. Twenty-four hours later the animals were sacrficed. Results: When data obtained from the biochemical analysis were investigated (Table 1) in the groups with induced ischemia, the expected reduction in SOD, CAT, and GPX enzyme activities was observed and an increase in MPO activity was observed. The statistical difference between ozone administered groups and the control group was significant (p < 0.05). When the ischemia+ozone group is compared with the ischemia group, the results are significant and a statistical difference is observed (p < 0.05). When GPX values in the group with ischemia-induced were investigated, the enzyme activity values were very low. A serious increase was observed in the ozone administered treatment group (p < 0.05). Discussion: Ozone (O3) is a molecule carrying three oxygen atoms forming as a result of exposure of oxygen to high energy electric currents and ultraviolet (UV) light in nature. It is found as a gas at room temperature. It is colorless, and has a characteristic smell. As ozone has a high degree of oxidation strength, it is called active oxygen in medicine. Due to its ability to increase blood circulation, it is used for treatment, not just of disorders related to circulation, but as an aid to the renewal of organic functions disrupted by many diseases.Öğe The comparison of analgesic effects of various administration methods of diclofenac sodium, transdermal, oral and intramuscular, in early postoperative period in laparoscopic cholecystectomy operations(Professional Medical Publications, 2014) Ural, Sedef Gulcin; Yener, Ozlem; Sahin, Hasan; Simsek, Tuncer; Aydinli, Bahar; Ozgok, AysegulObjective: The aim of this study was to compare the efficacy of oral, intra muscular and transdermal diclofenac sodium for pain treatment in patients undergoing laparoscopic cholecystectomy, and their effect on postoperative opioid consumption. Methods: Following informed consent, 90 ASA I-II patients scheduled for laparoscopic cholecystectomy were randomized into three groups. Group PO got oral diclofenac sodium 1 hour before the operation, Group IM 75 mg diclofenac sodium intra muscular and Group TD diclofenac sodium patch 6 hours before the operation. Patients were not premedicated. Routine anaesthesia induction was used. After the operation in post anaesthesia care unit tramadol HCl infusion was delivered by intravenous patient controlled analgesia (iv PCA). Ramsey Sedation Score (RSS), Modified Aldrete's Score System(MASS) and Visual Analog Scale Pain Score (VAS) was used for postoperative evaluation. Postoperative opioid consumption was recorded. Results: Demographic characteristics, intraoperative and postoperative hemodynamics of the patients were similar between groups. Postoperative VAS were lower at all time points in Group IM and Group TD than in Group PO. Lowest Postoperative RSS were in Group IM and the highest were in Group PO, and the difference between groups was significant. There was no significant difference in Postoperative MASS between groups. Postoperative tramadol consumption was statistically different between groups. Tramadol consumption in Group IM and Group TD was lower than Group PO. Postoperative nausea and vomiting was not observed. Local complications related to transdermal and intra muscular applications was not reported. Conclusion: In patients undergoing ambulatory laparoscopic cholecystectomy, a noninvasive application transdermal diclofenac sodium is as effective as intramuscular diclofenac sodium and can be preferred in postoperative pain treatment.Öğe The effect of general and spinal anesthesia on neutrophil to lymphocyte ratio in patients undergoing cesarian section(Anaesthesia Pain & Intensive Care, 2015) Erbas, Mesut; Toman, Huseyin; Gencer, Meryem; Sahin, Hasan; Kiraz, Hasan Ali; Simsek, Tuncer; Saylan, HaticeObjective: Neutrophil to lymphocyte ratio (NLR) has become popular recently so that many studies have been done to find out the predictive value of NLR in many different aspects of clinical practice. The aim of this retrospective study was to evaluate the relationship between blood NLR and anesthetic techniques in patients undergoing cesarian section. Methodology: In this study, eighty patients (American Society of Anesthesiologists physical status I similar to II) undergoing elective cesarian section using spinal (Group S: 40) or general anesthesia (Group G: 40) were retrospectively analyzed for neutrophil to lymphocyte ratio. Results: The demographic characteristics of the groups, amount of bleeding, before the operation hemoglobin values, platelet counts, and NLR values were similar in both the spinal and general anesthesia groups. However, significant differences were observed with regard to NLR values in the postoperative period. Conclusion: Postoperative neutrophil to lymphocyte ratio in patients undergoing cesarian section under spinal anesthesia was found to be significantly lower as compared to general anesthesia.Öğe Turkish Anaesthesiologist's Experiences of Anaesthetic Management of Patients with Obstructive Sleep Apnea (OSA)(Aves, 2015) Erbas, Mesut; Kiraz, Hasan Ali; Simsek, Tuncer; Sahin, Hasan; Toman, Huseyin; Hanci, VolkanObjective: Obstructive sleep apnea (OSA) is an important health problem that is increasing with the increase in the incidence of obesity. For patients with OSA, it is reported that preoperative OSA diagnosis is made in only 10%-20% of the patients. Therefore, it gains importance that these patients are diagnosed in the preoperative period. The aim of this study is to analyze with a survey the experiences of anaesthesia experts working in Turkey about the diagnosis of patients with OSA, anaesthetic methods and postoperative care. Methods: The study was completed with an online survey form distributed via email. Survey participants were sent an email, and those experts who wished to participate clicked on the link, answered the questions and returned the survey via email. Results: A total of 134 anaesthesia experts participated in this study. While 97% of the participating anaesthetists considered diagnosis of patients with OSA to be important, only 53% trusted themselves to recognize this patient group. Of the total number of participants. 43% did not know the STOP-BANG test used in the preoperative period to diagnose patients with OSA. The percentage who thought that patients with OSA would increase the incidence of difficult intubation was 84%. In the intraoperative period, the percentage who chose inhalation anaesthetics was 35%, whereas the rate of those who chose total intravenous anesthesia (TIVA) was 48%. Conclusion: This study indicates that the medical knowledge of Turkish anaesthetists on the topic of OSA requires updating. In addition, we believe a practical guide to standardize the diagnosis and preoperative/perioperative management of patients with OSA should be prepared for Turkish anaesthetists.
