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    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 Betul
    Objective: 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.
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    Effects of preoperative smoking cessation on HAM-A sedation scores and intraoperative consumption of anesthetics and fentanyl
    (Anaesthesia Pain & Intensive Care, 2017) Ural, Sedef Gulcin; Yazicioglu, Dilek; Sahin, Hasan; Altinisik, Ugur; Dogu, Tugba; Altinisik, Hatice Betul; Ozmen, Mustafa
    Objective: Patients undergoing surgery, experience acute physiological distress in the preoperative period. Smoking addiction is a complex behavior in which environment and genetic effects play a part. In this study our aim was to compare the impact of cigarette smoking cessation verses continued smoking on preoperative HAM-A scores and anesthetic requirement Methodology: After approval by the Ethic Committee, informed consent was obtained from patients, 1865 years old, American Society of Anesthesiologists (ASA) physical status I-II, 120 patients scheduled for elective laparoscopic cholecystectomy were included in this prospective randomized, double-blind study. Groups were defined as Group N (n:60, patients who continued smoking in the preoperative period) and Group NS (n:60, who stopped smoking 48 hours before the operation). Only the first patient on the list were included... All patients received intravenous midazolam 0.05-0.1 mg/kg as premedication. In the preoperative period HAM-A scores were recorded while the preoperative examination was performed in the outpatient clinic and after premedication. In addition, we monitored patients with Bispectral Index Monitor (BIS) and anesthetic requirements were recorded during surgical procedure. Results: HAM-A scores in the outpatient clinic and after receiving premedication were statistically significantly higher in Group N. Additional fentanyl requirement was also significantly higher in Group N. Conclusion: We conclude that to stop smoking 48 hours before surgery reduced anxiety as measured by HAM-A scores and anesthetic requirement and increased patient comfort.
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    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, Aysegul
    Objective: 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.