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    Effect of bispectral index monitoring on sevoflurane consumption
    (Greenwich Medical Media Ltd, 2003) Başar, H.; Özcan, S.; Büyükkocak, Ü.; Akpinar, S.; Apan, A.
    Background and objective: The bispectral index, a parameter derived from the electroencephalograph, has been shown to correlate with the toss of consciousness and sedation. This study was designed to assess the effects of bispectral index monitoring on sevoflurane and its recovery profiles. Methods: Sixty ASA I and II patients undergoing open abdominal surgery were randomized into two groups: one monitored using the bispectral index (Group BIS) and the other without its use (controls). After a standardized induction, anaesthesia was maintained with sevoflurane in both groups. In Group BIS, sevoflurane was titrated to maintain the bispectral index in the range 40-60. In the control group, the administered sevoflurane concentration was adjusted according to the signs of anaesthesia. The end-tidal sevoflurane concentration, bispectral index and routine haemodynamic variables were noted every 5 min during surgery. The consumption of sevoflurane was computed. At the conclusion of surgery operations, the time to open eyes on verbal command', 'motor response to verbal command' and Aldrete's score were recorded by a blinded anaesthesiologist. Results: The difference in the consumption of sevoflurane was not significant between the groups. Bispectral index monitoring was associated with a reduction of 4.73% in sevoflurane usage and 2.19 mL h(-1) was saved. Conclusions: Bispectral index monitoring during anaesthesia provides only a small advantage related to the need to monitor the depth of anaesthesia.
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    An intraoperative unexpected respiratory problem in a patient with Apert syndrome
    (Edizioni Minerva Medica, 2007) Başar, Hülya; Büyükkoçak, Ünase; Kaymak, Çetin; Akpinar, S.; Sert, O.; Vargel, İbrahim
    We present a case of a 5-year-old child who underwent four operations (three for syndactyly of the hands and one for craniofacial corrections). At the third hour of his craniofacial operation, his EtCO, started to increase and airway resistance was encountered during manual ventilation. The position of the head and neck was checked. An increase in secretion with oral and endotracheal aspiration and a decrease in saturation were observed. When breath sounds disappeared, the patient was reintubated orally. The nasal tube was obstructed with a mucolytic plug. There was no problem during the other operations. This case is presented since anaesthesiologists should be aware of the high incidence of respiratory complications in Apert syndrome.