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Öğe Anesthesia management of a newborn with Pena-Shokeir Syndrome(Elsevier Science Inc, 2018) Aydin, Gulcin; Gencay, Isin; Colak, Selim…Öğe Anesthetic Risks Associated With Antley-Bixler Syndrome(Lippincott Williams & Wilkins, 2013) Gencay, Isin; Vargel, Ibrahim; Buyukkocak, Unase; Yazici, Ilker; Apan, AlpaslanAntley-Bixler syndrome is an autosomal recessive disorder characterized by multiple bone and cartilaginous abnormalities. The main features of this syndrome include brachycephaly, midface hypoplasia, dysplasia of ears and nose, radiohumeral synostosis, choanal stenosis, or atresia. Distinctive features are based on craniofacial deformity and humeroradial synostosis. In this report, we describe the anesthesia management of a 20-year-old Antley-Bixler syndrome patient who underwent maxillary advancement via Le Fort I osteotomy. During surgical management of craniofacial syndrome patients, particularly Antley-Bixler syndrome, the whole surgical team should be aware of possible deformities involving the airway, which may be underestimated or nondetected prior to surgery. These deformities including choanal atresia/stenosis may lead to failure of nasotracheal intubation and mask ventilation, therefore jeopardizing the surgical procedure and/or patient safety. Accurate preoperative preparation and being aware of the components of this syndrome is vital to eliminate respiratory complications and enable uneventful anesthetic and surgical management.Öğe Apert Syndrome: Intraoperative and Postoperative Hyponatremia(Lippincott Williams & Wilkins, 2019) Gencay, IsinApert syndrome is one of the acrocephalosyndactilia syndromes that is characterized with calvarial an extremity deformities. Anesthesia management of this syndrome is commonly related with difficult airway. However, hyponatremia is another insistent complication that can occur during craniosynostosis surgeries. Hyponatremia is a common complication during calvarial remodeling surgeries and it can result in serious neurologic damage. Development of mild hyponatremia in a patient with Apert syndrome that went under craniosynostosis surgery was presented in this study.Öğe Dexmedetomidine as an Alternative Anesthetic Agent for Flap Surgery: An Intravital Evaluation in the Cremaster Muscle Flap(Lippincott Williams & Wilkins, 2019) Gencay, Isin; Boybeyi, Ozlem; Unlu, Gulhan; Yazici, Ilker; Aydin, Gulcin; Buyukkocak, UnaseIntroduction: Flap surgery is one of the most commonly used techniques of reconstructive surgery for effective repair of damaged tissue. Optimal anesthetic technique and anesthetic agent plays an important role in flap perfusion. This study aimed to evaluate the effects of dexmedetomidine infusion on the microcirculation in the cremaster muscle flap by direct in vivo monitoring. Materials and Methods: We randomly divided 9 Wistar albino rats into 3 groups. The rats in the control group underwent the surgical procedure (isolation of the cremaster muscle) alone; the rats in the experimental groups 1 and 2 received an infusion of dexmedetomidine (10 and 30 min) after the surgical procedure. Results: The means of vessel diameters, number of functional capillaries, and movements of leukocytes in all groups were evaluated using intravital microscopic examination. The diameters of the arterioles and venules of the cremaster muscle significantly increased in the dexmedetomidine groups. The number of functional capillaries was higher in the dexmedetomidine groups than in the control group. No difference was observed in the movements of leukocytes between the control and experimental groups. Dexmedetomidine significantly increased the diameters of the arterioles and venules of the cremaster flap and the number of functional capillaries. Conclusion: On the basis of the effects of dexmedetomidine on microcirculation, we suggest that dexmedetomidine continue to be used as an anesthetic agent, and may be considered also for reconstructive procedures, particularly flap surgery.Öğe Effect of delivery mode and anaesthesia methods on cardiac troponin T(ELSEVIER MASSON, CORP OFF, 2020) Bakirci, Sukru; Tulmac, Murat; Dag, Zeynep Ozcan; Sayan, Cemile Dayangan; Isik, Yuksel; Gencay, Isin; Boyunaga, Hakan[Özet Yok]Öğe The effect of insulin resistance on mortality in critically ill patients in the intensive care unit(INDIAN ANAESTHETISTS FORUM, 2020) Bakkal, Ayse Gulcan; Buyuksekerci, Murat; Gencay, Isin; Aydin, Gulcin; Caglayan, Osman; Buyukkocak, UnaseBackground and Aims: Insulin resistance can be described as a subnormal biological response to a specific insulin concentration or deterioration of an accepted response to insulin in glucose homeostasis and deficiency of insulin response. The aim of this study is to evaluate the effect of insulin resistance on mortality in critically ill patients. Methods: Over 18-year-old and nondiabetic 150 patients that had been hospitalized in an intensive care unit (ICU) between September 2013 and October 2014 were enrolled in this study. The Acute Physiology and Chronic Health Enquiry II (APACHE II), Glasgow Coma Scale, and Richmond Agitation and Sedation Scale were calculated on the day of admission to the ICU, and following 4th day and 1st, 2nd, 3rd, and 4th weeks. Insulin resistance was calculated using the HOMA formula. Infection and other complications during ICU stay, the requirement of mechanical ventilation (MV), nutritional status (parenteral and/or enteral), vasopressor, steroid, and insulin treatment were also recorded. Patients followed in the ICU were recorded as survivors and nonsurvivors. Results: Glucose levels were found to be higher in nonsurvivor group at the 1st week and there was a significant positive relationship between APACHE II score and insulin resistance at the 3rd week. There was a significant relationship between mortality and requirement of MV, vasopressor medication, complications, and infection. Conclusion: We conclude that the effect of insulin resistance seems to affect the mortality in critically ill patients after at least a 3 weeks long follow-up time.Öğe The effect of preemptive retrolaminar block on lumbar spinal decompression surgery(Springer, 2024) Peker, Kevser; Aydin, Guelcin; Gencay, Isin; Saracoglu, Ayse Gizem; Sahin, Ahmet Tugrul; Ogden, Mustafa; Peker, Seydi AliPurpose Spinal decompression surgery causes severe pain. Retrolaminar block (RLB) is block, which is done by infiltration of local anesthetic to block spinal nerves between the lamina and superior costotransversospinalis muscle. The primary aim of this study is to evaluate the effectiveness of RLB on postoperative analgesia in patients undergoing spinal surgery. Secondary aims are effects on additional anesthetic and analgesic consumption. Methods The sixty (60) patients who underwent lumbar spinal surgery between May 2020 and May 2021 under general anesthesia with or without applied preemptive RLB for postoperative analgesia were included in this prospective observational study. Group I received ultrasound-guided preemptive RLB. In Group II, no intervention was performed. Postoperative VAS scores were compared in groups as primary outcome, perioperative additional anesthetic and analgesic needs were compared as secondary outcome. Results There was a significant difference between the groups in favor of the RLB group in terms of postoperative VAS scores at rest [1.33 (0.33-3.509)] and movement [2.40 (1.20-4.00)] (p < 0.001). Perioperative sevoflurane consumption was significantly low in block group (p < 0.001). Postoperative tramadol consumption was lower in Group I compared with Group II [Group 1: 200 (100-300); Group 2: 37.5 (0-200); p < 0.001]. Conclusion Preemptive RLB may be used to reduce patients' pain in lumbar decompression surgery as well as to be part of a multimodal analgesia and anesthesia regimen to reduce anesthetic and analgesic drug consumption. Trial registration numberClinicalTrials.gov (No. NCT04209907). Conclusion Preemptive RLB may be used to reduce patients' pain in lumbar decompression surgery as well as to be part of a multimodal analgesia and anesthesia regimen to reduce anesthetic and analgesic drug consumption. Trial registration numberClinicalTrials.gov (No. NCT04209907).Öğe The Efficacy of Gabapentin plus Dexamethasone for Postoperative Analgesia Following Septoplasty: A Prospective Randomized Placebo-Controlled Trial(Sage Publications Inc, 2023) Kandemir, Suheyla; Pamuk, A. Erim; Ozel, Gokce; Gencay, Isin; Kilic, RahmiAims: This study aimed to compare the efficacy of gabapentin, dexamethasone, and gabapentin + dexamethasone for pain control after septoplasty. Materials and Methods: This prospective randomized trial included 120 patients that underwent septoplasty and were randomly divided into 4 groups: group G (preoperative gabapentin 600 mg p.o.); group D (intraoperative dexamethasone 8 mg i.v.); group GD (preoperative gabapentin 600 mg p.o. + intraoperative dexamethasone 8 mg i.v.); group C (placebo control). Results: The median VAS score was significantly lower in groups G and GD at 1, 2, 4, 6, 12, and 24 hours postsurgery than in group C (P < .008 for all). The median VAS score was significantly lower in group D than in group C at 1, 2, and 4 hours postsurgery (P < .008 for all). There weren't any significant differences in the VAS score between groups D, G, and GD at any time point. Groups G, D, and GD had a significantly lower frequency of rescue analgesic use than group C; however, there were no differences between groups G, GD, and C (P < .001 and P = .108, respectively). Conclusion: Gabapentin, dexamethasone, and gabapentin + dexamethasone are equally more effective analgesics during the first 4 hours postsurgery than placebo. The addition of dexamethasone to gabapentin does not provide extra analgesia. Both gabapentin and gabapentin + dexamethasone have a more prolonged analgesic effect than dexamethasone alone.