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    Effects of Intravenous Small Dose Ketamine and Midazolam on Postoperative Pain Following Knee Arthroscopy
    (Wiley, 2009) Akkurt, Buket Cagla Ozbakis; Inanoglu, Kerem; Kalacı, Aydıner; Turhanoglu, Selim; Asfuroglu, Zeynel; Tumkaya, Feray
    Background: The aim of this randomized, double blind, controlled study was to assess the effect of intravenous coadministration of small dose midazolam with ketamine on postoperative pain and spinal block level. Methods: Sixty patients undergoing arthroscopic knee surgery under spinal anesthesia were randomized into three groups: Group I (saline control); group II (ketamine 0.15 mg/kg i.v.); and group III (ketamine 0.15 mg/kg + midazolam 0.01 mg/kg i.v.). Sedation scores, visual analogue scores, time to first postoperative analgesic, total meperidine consumption, patient satisfaction, sensory and motor block levels, and two segments regression times were assessed. Results: Sedation scores were significantly lower in group I when compared with groups II and III at 1, 3, 5, and 10 minutes after administration of the spinal anesthetic (P = 0.001). Sensory block was significantly higher in group III (P = 0.001) in comparison with group II. Two segment regression time was significantly longer in group II than group I, whereas no difference was found between groups II and III. Total meperidine consumption was significantly higher in group I (P = 0,001). Patient satisfaction was significantly higher in group III compared with group I (P = 0.001), but no difference was found between groups II and III (P = 0.3). Conclusion: Ketamine improved the postoperative pain patient satisfaction, increased the maximal sensory level, and was associated with lower sedation scores in the first 15 minutes after administration. Group I was also associated with decreased total meperidine consumption and delayed the time to first recue analgesic administration. Coadministration of ketamine and midazolam did not provide any further benefit over ketamine alone.
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    THE RELATIONSHIP BETWEEN DISEASE SEVERITY AND PREDICTORS OF DIFFICULT INTUBATION IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME
    (Carbone Editore, 2015) Akkurt, Buket Cagla Ozbakis; Dogru, Sibel; Koyuncu, Onur; Davarci, Isil; Genc, Sebahat
    Objectives: The objective of our study was to identify clinical and polysomnographic predictors of difficult intubation, through the correlation between commonly used measurements to predict difficult intubation. Methods: Consecutive patients diagnosed with moderate or severe obstructive sleep apnea syndrome (OSAS) using polysomnography (PSG), and sex and age matched normal controls were included in the study. The patient group was divided into two subgroups as mild/moderate and severe desease groups. Body mass index (BMI), neck circumference (NC), abdominal circumference (AC), Epworth Sleepiness Scale (ESS) score, Apnea/Hypopnea Index (AHI), Arousal Index (AI) were recorded. Predictive tests for difficult intubation were recorded for each subject. Records were compared between all groups. Results: Forty OSAS patients and 39 control subjects were enrolled in the study. Class III-IV Modified Mallampati Test (MMT) score was found in 37 (%92.5) OSAS patients, while in 10 (25.6 %) of the control subjects. There was statistically significant difference between two groups in terms of NC, AC, interincissor distance (IID). There was a significant inverse correlation between sternomental distance (SMD) and AHI in patients with OSAS. Conclusion: AHI is a reliable predictor of difficult intubation in patients with OSAS and is correlated with the sternomental distance.
  • [ N/A ]
    Öğe
    The relationship between disease severity and predictors of difficult intubation in patients with obstructive sleep apnea syndrome
    (Acta Medica Mediterranea, 2015) Akkurt, Buket Cagla Ozbakis; Dogru, Sibel; Koyuncu, Onur; Davarci, Isil; Genc, Sebahat
    Objectives: The objective of our study was to identify clinical and polysomnographic predictors of difficult intubation, through the correlation between commonly used measurements to predict difficult intubation. Methods: Consecutive patients diagnosed with moderate or severe obstructive sleep apnea syndrome (OSAS) using polysomnography (PSG), and sex and age matched normal controls were included in the study. The patient group was divided into two subgroups as mild/moderate and severe desease groups. Body mass index (BMI), neck circumference (NC), abdominal circumference (AC), Epworth Sleepiness Scale (ESS) score, Apnea/Hypopnea Index (AHI), Arousal Index (AI) were recorded. Predictive tests for difficult intubation were recorded for each subject. Records were compared between all groups. Results: Forty OSAS patients and 39 control subjects were enrolled in the study. Class III-IV Modified Mallampati Test (MMT) score was found in 37 (%92,5) OSAS patients, while in 10 (25.6 %) of the control subjects. There was statistically significant difference between two groups in terms of NC, AC, interincissor distance (IID). There was a significant inverse correlation between sternomental distance (SMD) and AHI in patients with OSAS. Conclusion: AHI is a reliable predictor of difficult intubation in patients with OSAS and is correlated with the sternomental distance.