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Öğe The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters(Elsevier Science Inc, 2008) Basar, Hülya; Akpinar, Serpil; Doganci, Nur; Buyukkocak, Unase; Kaymak, Cetin; Sert, Ozgur; Apan, AlpaslanStudy Objectives: To investigate the hemodynamic, cardiovascular, and recovery effects of dexmedetomidine used as a single preanesthetic dose. Design: Randomized, prospective, double-blind study. Setting: University Hospital of Kirikkale, Kirikkale, Turkey. Patients: 40 ASA physical status I and II patients, aged 20 to 60 years, who were scheduled for elective cholecystectomy. Interventions: Patients were randomly divided into two groups to receive 0.5 mu g kg(-1) dexmedetomidine (group D, n = 20) or saline solution (group C, n = 20). Anesthesia was induced with thiopental sodium and vecuronium, and anesthesia was maintained with 4% to 6% desflurane. Measurements: Mean arterial pressure (MAP), heart rate (HR), (ejection fraction (EF), end-diastolic index (EDI), cardiac index (CI), and stroke volume index (SVI) were recorded at 10-minute intervals. The times for patients to "open eyes on verbal command" and postoperative Aldrete recovery scores were also recorded. Main Results: In group C, an increase in HR and MAP occurred after endotracheal intubation. In group D, HR significantly decreased after dexmedetomidine was given. The EDI, Cl, SVI, and EF values were similar in groups D and C. The modified Aldrete recovery scores of patients in the recovery room were similar in groups C and D at the 15th minute. Conclusions: A single dose of dexmedetomidine given before induction of anesthesia decreased thiopental requirements without serious hemodynamic effects or any effect on recovery time. Crown Copyright (C) 2008 Published by Elsevier Inc. All rights reserved.Öğe High-Dose Ropivacaine versus Bupivacaine for Posttonsillectomy Pain Relief in Adults(Bmc, 2008) Arikan, Osman Kursat; Şahin, Saziye; Kazkayasi, Mustafa; Muluk, Nuray Bayar; Akpinar, Serpil; Kilic, RahmiObjective: To compare the efficacy and safety of preincisional high-dose ropivacaine with bupivacaine in relieving posttonsillectomy pain. Design: A prospective, randomized, double blind, placebo-controlled clinical trial. Setting: University hospital. Patients: Before the incision, 58 subjects were randomly assigned to receive 10 mL of 10 mg/mL ropivacaine hydrochloride with epinephrine (n = 19, group 1), 10 mL of 2.5 mg/mL bupivacaine with epinephrine (n = 20, group 2), or saline with epinephrine (n = 19, group 3) as a placebo. Main Outcomes Measures: Postoperative pain, additional analgesic drug consumption, otalgia, operating time, amount of intraoperative blood loss, and possible complications were assessed. The intensity of pain was scored on a visual analogue scale. The patients were followed up for 10 days after surgery. Results: There were no statistically significant differences between the demographic and operational characteristics of the patient groups. Statistically significant differences were determined between in the mean intensity of constant and swallowing pain values of group 1 and group 2 or 3, at 4, 8, and 12 hours, and on days 1, 2, 3, and 4, postoperatively. However, no statistical differences were determined between the groups on days 5, 7, and 10. A lower amount of additional analgesic drug was consumed by the ropivacaine group than by the bupivacaine group, and by the bupivacaine group than by the control group, and the differences were statistically significant. Conclusion: Preincisional infiltration of the tonsils with high-dose ropivacaine markedly decreased the intensity of pain after tonsillectomy when compared with bupivacaine or placebo, especially until postoperative day 4 in adults.Öğe Local anesthesia in transrectal ultrasound-guided prostate biopsy: EMLA cream as a new alternative technique(Informa Healthcare, 2005) Basar, Hülya; Basar, M. Murad; Özcan, Şaziye; Akpinar, Serpil; Basar, Halil; Batislam, ErtanObjectives. The aims of the present study were to evaluate the efficacy of eutectic mixture of local anesthetics ( EMLA) cream in transrectal-guided prostate biopsy and to compare its effect with that of other injectable anesthetic procedures. Material and methods. Eighty male patients with prostate-specific antigen (PSA) levels >4 ng/ml or who had prostate nodules on digital rectal examination were randomly divided into four groups. In Group 1 ( controls), prostate biopsy was performed after application of a placebo cream. In Group 2, local surface anesthesia with EMLA cream was performed 15 min before biopsy. Periprosthetic nerve blockade was performed with 1% prilocaine and 1% lidocaine in Groups 3 and 4, respectively. Pain was evaluated using a visual analog scale (VAS) after each core biopsy. In addition, blood pressure, heart rate and oxygen saturations were recorded after each biopsy and then at 5-min intervals for 15 min. Results. Average VAS scores in Groups 1-4 were 5.5, 2.9, 2.4 and 2.2, respectively. There was a statistically significant difference in VAS scores between the treatment groups and the placebo group (p=0.000). There were no statistically significant differences in VAS scores between the three treatment groups (p(2-3) = 0.126, p(2-4) = 0.303, p(3-4) = 0.537). We detected no statistically significant differences between the groups based on the hemodynamic data (p(MAP) = 0.899). Moreover, these measurements did not show statistically significant changes with time in any of the groups (p > 0. 05). Conclusion. Intrarectal application of EMLA cream provides equal anesthesia to periprostatic nerve blockade with prilocaine and lidocaine.Öğe Preincisional infiltration of tonsils with ropivacaine in post-tonsillectomy pain relief: double-blind, randomized, placebo-controlled intraindividual study(B C Decker Inc, 2006) Arıkan, Osman Kürşat; Özcan, Şaziye; Kazkayasi, Mustafa; Akpinar, Serpil; Koç, CanObjective: To determine whether pre-emptive ropivacaine has an influence on postoperative pain in adult patients undergoing tonsillectomy. Design: A prospective, randomized, double-blind, placebo-controlled clinical trial. Setting: University hospital. Patients: The study included 20 adult patients undergoing elective tonsillectomy. Anesthetic induction and maintenance, dissection tonsillectomy, hemostasis techniques, and postoperative analgesic treatment were standardized for all patients. Before the onset of incision, one tonsillar fossa was administered 5 mL of 2% ropivacaine hydrochloride with epinephrine, whereas the other side received 5 mL of 0.9% saline with epinephrine and was designated as the control side. Main Outcomes Measures: For each side, postoperative pain, otalgia, operating time, amount of intraoperative blood loss, and postoperative hemorrhage were assessed. The intensity of postoperative pain was measured at rest and when the patient was drinking and was scored on a visual analogue scale. The patients were followed up for 10 days after surgery. Results: There was no statistically significant difference in the amount of intraoperative hemorrhage and operation time between sides (p >.05). The constant postoperative pain in the ropivacaine side at rest was significantly less than in the placebo side on days 1, 2, 5, and 6 (p <.05). The post-tonsillectomy pain experienced in the ropivacaine side when swallowing was significantly less than that in the placebo side throughout the study period except on day 10 (p <.05). Conclusion: Based on the present findings, preincisional infiltration of ropivacaine 2% appears to be effective against both early and late postoperative pain, especially on swallowing, following tonsillectomy in adults.
