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Öğe The analgesic efficacy of preoperative versus postoperative lornoxicam in varicocele repair(Elsevier Science Inc, 2007) Inanoglu, Kerem; Gorur, Sadik; Akkurt, Cagla Ozbakis; Guven, Oguz E.; Kararmaz, AlperStudy Objective: To determine whether intravenous injection of lornoxicam 30 minutes before skin incision provides better pain relief after varicocelectomy than postoperative administration of lornoxicam. Design: Prospective, double-blind, randomized clinical investigation. Setting: Operating room and postoperative recovery area. Patients: 44 ASA physical status I and 11 adult male patients undergoing varicocelectomy. Interventions: Patients were randomized either to receive 8 mg lornoxicam infusion 30 minutes before skin incision, followed by saline infusion immediately after skin closure (group 1), or to receive the identical injections but in reverse order (group 2). All patients received local anesthesia with bupivacame. Measurements: Postoperative pain scores were evaluated hourly for the first 8 hours after surgery, then at 12, 16, 20, and 24 hours after surgery, using a 10-cm visual analog scale. Time to first analgesic request and patient's global assessments also were recorded. Main Results: Patients in group 1 reported significantly lower pain scores (P < 0.05) at all time intervals except at 24 hours and better global assessment (P = 0.001) than did group 2. There were significantly fewer patients in the preemptive group than group 2 who required rescue analgesic within the first 24 hours (0% vs 22.7%; P = 0.024). Mean time to first analgesic request was also significantly longer in the preemptive group (P = 0.001). Conclusion: Intravenous lornoxicam administered before surgery has a better analgesic effect for varicocelectomy than when administered postoperatively. (c) 2007 Elsevier Inc. All rights reserved.Öğe Comparison between ultrasound-guided sciatic-femoral nerve block and unilateral spinal anaesthesia for outpatient knee arthroscopy(Sage Publications Ltd, 2013) Davarci, Isil; Tuzcu, Kasim; Karcioglu, Murat; Hakimoglu, Sedat; Ozden, Raif; Yengil, Erhan; Akkurt, Cagla OzbakisObjective To compare unilateral spinal anaesthesia (USA) and ultrasound-guided combined sciatic-femoral nerve block (USFB) in ambulatory arthroscopic knee surgeries in terms of haemodynamic stability, nerve block quality, bladder function, adverse events and time-to-readiness for discharge (TRD). Methods Patients undergoing ambulatory arthroscopic knee surgery were randomly assigned to one of two groups. The USA group received 2ml (10mg) of 0.5% levobupivacaine and the USFB group received a 25ml mixture consisting of 10ml of 2.0% lidocaine, 10ml of 0.5% levobupivacaine and 5ml of saline (15ml for the femoral and 10ml for the sciatic nerve block). Preparation time (PT), surgical anaesthesia time (SAT), operation time, total anaesthesia time, time-to-first spontaneous urination, time-to-first analgesia, TRD, adverse events and patient satisfaction were recorded. Results A total of 40 patients were enrolled in the study (n=20 per group). PT, SAT, total anaesthesia time and time-to-first analgesia were significantly shorter in the USA group than the USFB group; time-to-first spontaneous urination and TRD were significantly longer in the USA group than the USFB group. Conclusions USFB provided sufficient duration of sensory blockade and it reduced the TRD and the rate of adverse events.Öğe Comparison of sugammadex and conventional reversal on postoperative nausea and vomiting: a randomized, blinded trial(Elsevier Science Inc, 2015) Koyuncu, Onur; Turhanoglu, Selim; Akkurt, Cagla Ozbakis; Karcioglu, Murat; Ozkan, Mustafa; Ozer, Cahit; Sessler, Daniel I.Study Objective: To determine whether the new selective binding agent sugammadex causes less postoperative nausea and vomiting (PONY) than the cholinesterase inhibitor neostigmine. Design: Prospective, randomized, double-blinded study. Setting: University-affiliated hospital. Patients: One hundred American Society of Anesthesiologists physical status 1 and 2 patients scheduled for extremity surgery. Interventions: Patients were randomly assigned to neostigmine (70 mu g/kg) and atropine (0.4 mg per mg neostigmine) or sugammadex 2 mg/kg for neuromuscular antagonism at the end of anesthesia, when 4 twitches in response to train-of-four stimulation were visible with fade. Measurements: We recorded PONY, recovery parameters, antiemetic consumption, and side effects. Main Results: Nausea and vomiting scores were lower in the sugammadex patients upon arrival in the postanesthesia care unit (med: 0 [min-max, 0-3] vs med: 0 [min-max, 0-3]; P <.05), but thereafter low and comparable. Postoperative antiemetic and analgesic consumption were similar in each group. Extubation (median [interquartile range], 3 [1-3.25] vs 4 [1-3.25]; P <.001) first eye opening (4 [3-7.25] vs 7 [5-11]; P <.001), and head lift (4 [2-7.25] vs 8 [11-25]; P <.001) in minutes were shorter in patients given sugammadex. Postoperative heart rates were significantly lower in all measured times patients given neostigmine. Conclusions: Nondepolarizing neuromuscular blocking antagonism with sugammadex speeds recovery of neuromuscular strength but only slightly and transiently reduces PONY compared with neostigmine and atropine. (C) 2014 Elsevier Inc. All rights reserved.Öğe The effect of anesthetic agents on perioperative bleeding during tonsillectomy: Propofol-based versus desflurane-based anesthesia(Mosby-Elsevier, 2008) Okuyucu, Semsettin; Inanoglu, Kerem; Akkurt, Cagla Ozbakis; Akoglu, Ertap; Dagli, SafakOBJECTIVE: Hemorrhage during tonsillectomy is related to the surgical technique, management of bleeding, and choice of anesthetic agent. This study evaluated the effects of anesthetic agents on hemorrhage during tonsillectomy with standardized surgical techniques and management of bleeding. STUDY DESIGN: Double-blind, randomized controlled trial. SUBJECTS AND METHODS: Sixty patients, aged 3 to 12 years, who were scheduled for elective tonsillectomy were enrolled in the study. Propofol-based anesthesia was administered to the first group; desflurane-based anesthesia, to the second. The amount of blood loss due to hemorrhage was measured. RESULTS: Propofol-based anesthesia significantly decreased bleeding during tonsillectomy. CONCLUSION: Propofol-based anesthesia is a reliable method for use in children who undergo tonsillectomy. (C) 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.Öğe Evaluation of nosocomial infections and risk factors in critically ill patients(Int Scientific Information, Inc, 2011) Ozer, Burcin; Akkurt, Cagla Ozbakis; Duran, Nizami; Onlen, Yusuf; Savas, Lutfu; Turhanoglu, SelimBackground: Nosocomial infections are one of the most serious complications in intensive care unit patients because they lead to high morbidity, mortality, length of stay and cost. The aim of this study was to determine the nosocomial infections, risk factors, pathogens and the antimicrobial susceptibilities of them in intensive care unit of a university hospital. Material/Methods: The patients were observed prospectively by the unit-directed active surveillance method based on patient and the laboratory. Results: 20.1% of the patients developed a total of 40 intensive care unit-acquired infections for a total of 988 patient-days. The infection sites were the lower respiratory tract, urinary tract, bloodstream, wound, and the central nervous system. The respiratory deficiency, diabetes mellitus, usage of steroid and antibiotics were found as the risk factors. The most common pathogens were Enterobacteriaceae, Staphylococcus aureus, Candida species. No vancomycin resistance was determined in Gram positive bacteria. Imipenem and meropenem were found to be the most effective antibiotics to Enterobacteriaceae. Conclusions: Hospital infection rate in intensive care unit is not very high. The diabetes mellitus, length of stay, usage of steroids, urinary catheter and central venous catheter were determined as the risk factors by the final logistic regression analysis. These data, which were collected from a newly established intensive care unit of a university hospital, are important in order to predict the infections and the antimicrobial resistance profile that will develop in the future.Öğe Spinal anesthesia in a patient with cerebral manifestations of Wilson's Disease: case report(Int Scientific Literature, Inc, 2008) Inanoglu, Kerem; Akkurt, Cagla Ozbakis; Kalacı, Aydıner; Asfuroglu, Zeynel; Turhanoglu, SelimBackground: Wilson's disease is a rare autosomal recessive genetic disorder of copper metabolism and patients with Wilson's or other severe liver diseases are at risk when undergoing anesthesia and surgery. Case Report: We report the case of a neurologically impaired (lack of motor coordination, spasticity and dystonia of all four limbs, and drooling) 18-year-old male who was diagnosed with Wilson's disease 5 years earlier. He underwent intramedullary nailing for femoral fracture with spinal anesthesia and no complication was observed. Conclusions: In patients with cerebral manifestations of Wilson's disease, in appropriate surgical procedures spinal anesthesia may be used as the anesthesia method.
