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Öğe Plasma levels of interleukin-10 and nitric oxide in response to two different desflurane anesthesia flow rates(Elsevier Science Inc, 2014) Kalayci, Dilek; Dikmen, Bayazit; Kacmaz, Murat; Taspinar, Vildan; Ornek, Dilsen; Turan, OzlemObjective: This study investigated interleukin-10 and nitric oxide plasma levels following surgery to determine whether there is a correlation between these two variables and if different desflurane anesthesia flow rates influence nitric oxide and interleukin-10 concentrations in circulation. Materials and methods: Forty patients between 18 and 70 years and ASA I-II physical status who were scheduled to undergo thyroidectomy were enrolled in the study. Interventions: Patients were allocated into two groups to receive two different desflurane anesthesia flow rates: high flow (Group HF) and low flow (Group LF). Measurements: Blood samples were drawn at the beginning (t(0)) and end (t(1)) of the operation and after 24h (t(2)). Plasma interleukin-10 and nitric oxide levels were measured using an enzyme-linked-immunosorbent assay and a Griess reagents kit, respectively. Hemodynamic and respiratory parameters were assessed. Results: There was no statistically significant difference between the two groups with regard to interleukin-10 levels at the times of measurement. Interleukin-10 levels were increased equally in both groups at times t(1) and t(2) compared with preoperative concentrations. For both groups, nitric oxide circulating concentrations were significantly reduced at times t(1) and t(2) compared with preoperative concentrations. However, the nitric oxide value was lower for Group HF compared to Group LF at t(2). No correlation was found between the IL-10 and nitric oxide levels. Conclusion: Clinical usage of two different flow anesthesia forms with desflurane may increase interleukin-10 levels both in Group HF and Group LF; nitric oxide levels circulating concentrations were significantly reduced at times t(1) and t(2) compared with preoperative concentrations; however, at 24h postoperatively they were higher in Group LF compared to Group HF. No correlation was detected between interleukin-10 and nitric oxide levels. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe The effects of bispectral index monitoring on end-tidal desflurane concentration and desflurane consumption(2008) Kaymak, Çetin; Takmaz, Suna Akin; Özcan, Ayşe Ongun; Gülhan, Yusuf; Dikmen, BayazitAim: The aim of the study is to assess whether the concentration of end-tidal desflurane decreases or not with the use of bispectral index (BIS) monitoring to standard anesthetic practice. Materials and Methods: In all patients anesthesia was induced with thiopental sodium 5 mg kg-1 and fentanyl 1 ?g kg-1. The trachea was intubated using vecuronium 0.1mg kg-1. Anesthesia was maintained with desflurane, in a mixture of nitrous oxide 1 L min-1 and oxygen 1 L min-1. Desflurane with 4-6 % concentration was administered to patients for 5 min after tracheal intubation. Additional fentanyl 1 ?g kg-1 was given before skin insicion and no more was given. The desflurane concentration was then changed as follows: In Group I; if the patients displayed clinical signs consistent with inadequate anesthesia, the inspired desflurane concentration was increased or decreased by 1 %. In Group II, the anesthesiologist adjusted the concentration of desflurane to achieve a target BIS in the range of 50±5. Results: The mean BIS value was 35.98±2.3 and 45.68±5.3 in Group I and II, respectively. BIS levels in Group I were significantly lower during surgery (p=0.001). The end tidal desflurane concentrations in Group I were significantly higher than Group II (Group I: 4.61±0.48, Group II: 3.92±0.61) (p=0.007). The desflurane consumption was total 917.84±14.08 mL and 838.02±11.73 mL in Group I and II, respectively. Conclusion: These findings indicate that the use of BIS, as it decreases the end-tidal concentration of desflurane and desflurane consumption, has become a technique which determines the depth of anesthesia safely.Öğe The preoperative analgesic effect of 3-in-1 block on postoperative pain and tramadol consumption in total hip arthroplasty(Kare Publ, 2008) Koroglu, Suleyman; Takmaz, Suna Akin; Kaymak, Cetin; Narli, Altug; Karalezli, Kubilay; Dikmen, BayazitWe studied the effect of preoperative 3-in-1 block for total hip replacement surgery on postoperative pain and tramadol consumption during patient-controlled analgesia. Thirty ASA I-II patients undergoing elective total hip arthroplasty (THA) were included in the study. Patients were randomly divided into 2 groups; Group I: Patients who received 3-in-1 block with 40 ml of 0.25% bupivacaine 30-minutes before surgery and later received general anesthesia, Group II: Patients who received only a simple needle puncture at the operation site 30-minutes before surgery and later received general anesthesia. All patients received intravenous tramadol at the end of surgery via a PCA device. Pain was evaluated at 0,1/2,1,4,8,12,24 and 48h at rest and on movement of the hip, using a 10cm VAS. The average intraoperative fentanyl consumption was lower in Group I than in Group II. VAS scores were significantly lower in group I, both at rest and during movement at all timepoints over in the first postoperative 12h and also during movement 24h postoperatively. However differences in VAS scores weren't clinically significant after 4 hours. In the recovery room, Group I VAS scores were only a third of Group II, both at rest and movement (p=0.0001). Total tramadol consumption was lower in GroupI (633.0 +/- 119.3 mg) than in GroupII (991.1 +/- 41.0 mg). Patient satisfaction scores were higher in GroupI than in GroupII. We concluded that preoperative 3-in-1 block with 40 ml-0,25% bupivacaine provides effective postoperative pain relief for elective THA, reducing intra-and postoperative analgesic consumption without increase in side effects.
