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Öğe Comparison of Effects of Dexmedetomidine-ketamine and Dexmedetomidine-midazolam Combinations in Transurethral Procedures(Elsevier Science Inc, 2012) Köse, Emine Arzu; Honca, Mehtap; Yılmaz, Erdal; Batislam, Ertan; Apan, AlpaslanOBJECTIVE To compare the effects of dexmedetomidine-ketamine and dexmedetomidine-midazolam combinations on the recovery time, hemodynamic and respiratory variables, and side effects in patients undergoing transurethral procedures. METHODS Sixty patients scheduled for elective outpatient transurethral procedure were randomized into 2 groups. In the group K, a ketamine-dexmedetomidine combination was administered, and in the group M, midazolam-dexmedetomidine was administered, to provide sedation/analgesia. Pain and sedation levels were assessed using visual analog score (VAS) and Ramsey Sedation Scale, respectively. The recovery time was assessed with the scale of Aldrete. Time was measured and recorded to the moment at which patient responses brought the Aldrete score to 10 points. Time to eye opening and length of stay in the recovery room were recorded. RESULTS Group M showed significantly lower mean arterial pressure (MAP) values at 5 and 10 minutes during the procedure when compared with group K (P = .02 and P = .01, respectively). Visual analogue scale scores were greater in group M than in group K at 5 and 10 minutes for the transurethral procedure (P = .039 and P = .028, respectively). Sedation scores were similar between groups during the procedure. Time to eye opening and length of recovery room stay were shorter (P < .001 and P < .001, respectively), and Aldrete scores were greater in group K than group M. CONCLUSION Both combinations provided satisfactory sedation levels, but the dexmedetomidine-ketamine combination provided better analgesia and hemodynamic stability, with less nausea and vomiting and shorter recovery time, than the dexmedetomidine-midazolam combination. UROLOGY 79: 1214-1219, 2012. (c) 2012 Elsevier Inc.Öğe Effects of the menstrual cycle on injection pain due to rocuronium(Elsevier Science Inc, 2013) Honca, Mehtap; Purtuloglu, Tarik; Honca, Tevfik; Sizlan, Ali; Deniz, Suleyman; Kose, Arzu; Horasanli, EyupStudy Objective: To investigate the effect of the menstrual cycle on rocuronium injection pain. Design: Prospective, randomized, double-blinded study. Setting: Academic medical center. Patients: 80 ASA physical status 1 and 2 women scheduled for elective surgery with general anesthesia. Measurements: Patients were divided into two groups according to their time in the menstrual cycle. Forty patients at days 8 to 12 of the menstrual cycle were considered to be at the follicular phase (Group F), and 40 patients at days 20 to 24 of the menstrual cycle were considered to be at the luteal phase (Group L).Withdrawal movements were recorded. Main Results: Overall frequency of withdrawal movements was significantly higher in Group L than Group F (P < 0.001). The mean withdrawal movement score was 1.77 +/- 0.76 in Group L and 0.52 +/- 0.67 in Group F. Conclusion: Menstrual cycle phases affect the severity of rocuronium injection pain. Women exhibit greater pain sensitivity from rocuronium injection in the luteal phase than the follicular phase. (c) 2013 Elsevier Inc. All rights reserved.Öğe In Vitro Effect of Dexmedetomidine on Platelet Aggregation(Elsevier Science Inc, 2013) Kose, Emine Arzu; Nevruz, Oral; Honca, Mehtap; Yildirim, VedatBackground and objectives: Dexmedetomidine is a selective alpha(2)-agonist. There are 250-300 alpha(2)-agonist-adrenoceptor on the surface of each human platelet and ephedrine induces platelet aggregation by binding these receptors. This study was designed to study platelet function after incubation with therapeutic concentrations of dexmedetomidine. Methods: The study was carried out on 18 healthy, non-smoking males, ages ranging 25 to 35 years old. Because of the recommended therapeutic concentration range of dexmedetomidine obtained by intravenous infusion is 0.4-1.2 ng.mL(-1), dexmedetomidine solutions were prepared in three different concentrations. The calculated value of dexmedetomidine solution and diluent without dexmedetomidine as control were added to the blood sample. Thus, we obtained 0, 0.4, 0.8 and 1.2 ng.mL(-1) dexmedetomidine concentrations of plasma. Each concentration of dexmedetomidine was incubated with whole blood at 37 degrees C during 15 minutes. Then blood samples were centrifugated to prepare platelet-rich plasma and platelet-poor plasma. The platelet-rich plasma was diluted with the platelet-poor plasma to yield test platelet-rich plasma with a final platelet count of 250 +/- 50 X 10(9).L-1. Results: The platelet aggregation amplitudes and slopes were statistically similar among all groups by the aggregation test, which were performed with ADP, collagen or epinephrine. Conclusion: Therapeutic concentrations of dexmedetomidine had no effect on the platelet functions in healthy individuals in vitro. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.Öğe Preeklamptik ve sağlıklı gebelerde spinal anestezi altında gerçekleştirilen sezaryen operasyonunun hemodinamik etkilerinin karşılaştırılması(2014) Honca, Mehtap; Külah, B. Berna; Köse, E.Arzu; Türker, Türker; Horasanlı, EyüpAmaç: Preeklamptik ve sağlıklı gebelerde spinal bupivakain ve fentanil uygulanarak gerçekleştirilen nöroaksiyel anestezinin hemodinamik parametreler üzerine etkilerini retrospektif olarak karşılaştırmaktır. Metod: Ocak-Aralık 2012 arası, preeklampsi tanısı alan ve sağlıklı ASA I kadınlarda spinal anestezi altında sezaryen operasyonu geçirenlerin dahil edildiği retrospektif randomize bir çalışma planlanmıştır. Hastaların yaşı, vücut ağırlığı, gebelik haftası, operasyon süresi, anestezi süresi, intraoperatif dönemdeki hemodinamik parametreleri ( non invazif kan basıncı, kalp hızı, periferik oksijen satürasyonu), intraoperatif volüm tedavisi (kristaloid, kolloid), efedrin ihtiyacı, neonatal vücut ağırlıkları ve APGAR skorları kaydedilmiştir. Bulgular: Spinal anestezi altında sezaryen operasyonu yapılan, 223 preeklamptik hasta ve 221 sağlıklı gebeden oluşan toplam 444 olgu çalışmaya dahil edilmiştir. Preeklamptik hasta grubunda daha az hipotansiyon gözlenmiştir ve efedrin ihtiyacı daha az olmuştur. Preeklamptik hasta grubunda neonatal vücut ağırlıkları ve APGAR skorları daha düşük olarak bulunmuştur. Sonuç: Preeklamptik hastalarda spinal anestezi esnasında hipotansiyon ve efedrin ihtiyacı daha az olarak bulunmuş ve güvenli bir yöntem olduğu sonucuna varılmıştır.
