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Öğe Comparação de tramadol e lornoxicam em anestesia regional por via intravenosa, um estudo randomizado e controlado(Elsevier Editora Ltda, 2016) Çelik, Hande; Abdullayev, Ruslan; Akçaboy, Erkan Y.; Baydar, Mustafa; Göğüş, NerminJustificativa e objetivos A dor relacionada ao torniquete é um dos maiores obstáculos para a anestesia regional intravenosa (ARIV). Nosso objetivo foi comparar tramadol e lornoxicam usados em ARIV em relação aos seus efeitos sobre a qualidade da anestesia, dor relacionada ao torniquete e dor no pós?operatório Métodos Após a aprovação do Comitê de Ética, 51 pacientes com estado físico ASA I?II entre 18?65 anos foram inscritos. Os pacientes foram divididos em três grupos. Grupo P (n = 17) recebeu 3 mg/kg de prilocaína a 0,5%; Grupo PT (n = 17) 3 mg/kg de prilocaína a 0,5% + 2 mL (100 mg) de tramadol e Grupo PL (n = 17) de 3 mg/kg de prilocaína a 0,5% + 2 mL (8 mg) de lornoxicam para ARIV. O início do bloqueio sensorial e motor e os tempos de recuperação foram registrados, bem como a dor relacionada ao torniquete e o consumo de analgésico no pós?operatório. Resultados Os tempos de início do bloqueio sensorial foram mais curtos nos grupos PT e PL, enquanto que os tempos de recuperação correspondentes foram mais longos do que os do Grupo P. Os tempos de início do bloqueio motor nos grupos PT e PL foram menores do que no Grupo P, enquanto que o tempo de recuperação do grupo PL foi maior do que os dos grupos P e PT. O tempo para início da dor relacionada ao torniquete foi menor no Grupo P e maior no Grupo PL. Não houve diferença em relação à dor relacionada ao torniquete entre os grupos. O Grupo PL apresentou o menor consumo de analgésicos no pós?operatório. Conclusão A adição de tramadol e lornoxicam à prilocaína para ARIV produz efeitos favoráveis sobre o bloqueio sensorial e motor. O consumo de analgésicos no pós?operatório pode ser reduzido com a adição de tramadol e lornoxicam à prilocaína em ARIV.Öğe Sağlık profesyonellerinin bitkisel ilaç kullanan hastalara yaklaşımı(Anesteziyoloji ve Reanimasyon Uzmanları Derneği (ARUD), 2014) Taşpınar, Vildan; Gökbulut Özaslan, Nihal; Özkaya, Güven; Karakelle, Nursel; Türkaslan, Derya; Yavuz, Nurcan; Dikmen, Beyazıt; Göğüş, NerminObjective: PatienObjective: Patients commonly take a combination of prescription drugs and herbal medicines. Often these alternative products have known pharmacological effects which may interact with drugs given perioperatively, resulting in adverse effects (1, 2). These herbal mixtures, which are known as natural herbal products, have been reported in cases as increasing morbidity and mortality. These herbal products must have effect on anesthetic and surgical method since they have that much side effects in daily usage. The purpose of this study is to raise awareness of medical specialists of herbal product usage in preoperative stage. Method: The study was performed on voluntary residents and specialists practicing in the Ankara Numune Education and Research Hospital following the approval received from the Ethics Committee. Apart from personal information such as age, gender, department and academic status, it was also investigated whether they use herbal medicine and recommend herbal medicines to their patients. The perioperative management strategies of patients who use herbal medicine were examined. The data obtained were analyzed using SPSS for Windows, version 20.0. The level of significance was set as p<0.05. Results: 150 medical doctors aged 24-60 participated in the study on voluntary basis. The maximum herbal medicine was observed in 40-49 age group attendants. The ratio of recommending herbal medicine was higher among attendants over 50, and among doctors who used herbal medicine. 4% of the participants stated that they had protocols for herbal medicines, 57% of the participants claimed that usage of herbal medicine should be avoided in preoperative stage but only 8.6% of doctors managed to answer the question regarding the period of stopping the use of medicine accurately. Conclusion: Anesthesiologists should obtain a history of herbal medicine use from patients and work out the adverse perioperative herb-drug interactions before the actual operation.Öğe The effect of intraarticular levobupivacaine and bupivacaine injection on the postoperative pain management in total knee artroplastic surgery(Professional Medical Publications, 2014) Yavuz, Nurcan; Taşpınar, Vildan; Karasu, Derya; Tezcan, Aysu; Dikmen, Beyazıt; Göğüş, NerminObjective: Total knee arthroplasty (TKA) is associated with considerable postoperative pain. We compared the effects of intraoperative intraarticular levobupivacaine and bupivacaine on postoperative analgesia and analgesic consumption after total knee arthroplasty. Methods: Sixty ASA (American Society of Anesthesiologists) physical status II-III, 18-75 years old patients scheduled for unilateral TKA were included in this study. For the operative procedure combined spinal epidural anesthesia was given by injecting 15mg levobupivacaine in subarachnoid space at L3-4/L4-5 in sitting position for all patients. In Group L 20ml levobupivacaine(0.5%), in Group B 20ml bupivacaine(0.5%) was injected intraarticularly 10 minutes before opening of the tourniquet at the end of the surgery. For all patients postoperative analgesia was provided with PCEA (levobupivacaine+fentanyl) and oral 1gr paracetamol four times a day. Patients’ intraoperative-postoperative hemodynamical data, postoperative sensorial-motor block characteristics, side effects, PCEA demand ratios and bolus volumes, total analgesic consumption, VAS values, first mobilization time, hospitalization time were recorded. Statistical analysis was performed with SPSS version 13.00 software. Results: There was no intergroup difference in demographic data, hemodynamical data, PCEA demand ratios, total analgesic consumption, first mobilization time, hospitalization time and VAS values at 0,2,72 hour. Postoperative lower VAS values were determined at 4,8,12,24 hours in Group B and at 48th hour in Group L (p<0.05). Conclusions: Intraarticular local anesthetic administration in addition to PCEA for post operative pain relief provides good analgesia after TKA surgery.Öğe Tourniquet-inducedischaemia-reperfusioninjury: the comparison of antioxidative effects of small-dose propofoland ketamine(Elsevier Editora Ltda, 2017) Karaca, Ömer; Göğüş, Nermin; Ahıskalıoğlu, Ali; Aksoy, Mehmet; Ünal, Doğuş; Kumaş Solak, Sezen; Kalafat, HakanObjectives The aim of the present study was to investigate the preventive effects of propofol and ketamine as small dose sedation during spinal anesthesia on tourniquet?induced ischemia?reperfusion injury. Methods 30 patients were randomly assigned into two groups of 15 patients. In the propofol group, sedation was performed with propofol 0.2 mg.kg?1 followed by infusion at a rate of 2 mg.kg?1.h?1. In the ketamine group, a continuous infusion of ketamine 0.5 mg.kg?1.h?1 was used until the end of surgery. Intravenous administration of midazolam was not used in any patients. Ramsay sedation scale was used for assessing the sedation level. Venous blood samples were obtained before propofol and ketamine infusion (T1), at 30 minutes (min) of tourniquet ischemia (T2), and 5 min after tourniquet deflation (T3) for malondialdehyde (MDA) measurements. Results No differences were noted between the groups in hemodynamic (p > 0.05) and demographic data (p > 0.05). There was no statistically significant difference between the two groups in terms of T1, T2 and T3 periods (p > 0.05). There was a statistically increase observed in MDA values respectively both in Group P and Group K between the reperfusion period (1.95 ± 0.59, 2.31 ± 0.48) and pre?ischemia (1.41 ± 0.38, 1.54 ± 0.45), and ischemia (1.76 ± 0.70, 1.71 ± 0.38) (?moL?1) periods (p < 0.05). Conclusions Small?dose propofol and ketamine has similar potential to reduce the oxidative stress caused by tourniquet?induced ischemia?reperfusion injury in patients undergoing arthroscopic knee surgery under spinal anesthesia.
