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Öğe Antibacterial activity of remifentanil and mixtures of remifentanil and propofol(Elsevier Science Inc, 2007) Apan, Teornan Zafer; Apan, Alpaslan; Sahin, Saziye; Cakirca, MehmetStudy Objective: To investigate the antibacterial activity of glycine, which is contained in remifentanil, when combined with propofol. Design: Prospective study. Setting: Departments of anesthesiology and microbiology of a university hospital. Measurements: Growth of the microorganisms Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans in propofol 1%; saline dilutions of remifentanil at one-, 10-, and 100-,mu g/mL concentrations; and 1:1 mixtures of propofol with remifentanil solutions was determined. Main Results: Remifentanil inhibits bacterial growth in a concentration-dependent manner. The antibacterial effects were more pronounced with Staphylococcus aureus and Pseudomonas aeruginosa at cultures obtained at the fifth hour. The inhibition of bacterial growth was less influenced with Escherichia coli and Candida albicans. Conclusions: Propofol and remifentanil mixtures decreased bacterial growth, and combinations may reduce the infectious complications from accidentally contaminated propofol. Crown Copyright (c) 2007 Published by Elsevier Inc. All rights reserved.Öğe Comparison of tramadol, tramadol-metamizol and tramadol-lornoxicam administered by intravenous PCA in management of postoperative pain(Kare Publ, 2007) Kemal, Sibel Ozcakir; Sahin, Saziye; Apan, AlparslanComparison of tramadol, tramadol-metamizol and tramadol-lornoxicam administered by intravenous PCA in management of postoperative pain. The aim of the present study was to compare of the postoperative analgesic effects of tramadol, combinations of tramadol-metamizol and tramadol-lornoxicam administered by intravenous Patient Control Analgesia (PCA) in lower abdominal surgery. Sixty adult, female patients who undergoing lower abdominal surgery, were included in this study. Patients were randomized to three groups. The solutions were prepared containing 500 mg tramadol in 50 ml saline (10 mg/ml tramadol) for Group I, 250 mg tramadol+3000 mg metamizol in 50 ml saline (5 mg/ml tramadol+60 mg/ml metamizol) for Group II and 250 mg tramadol+20 mg lornoxicam in 50 ml saline (5mg/ml tramadol + 0.4mg/ml lornoxicam) for Group III. Loading dose 10 ml was administrated within 30 min 30 to 40 min before the end of the surgery. PCA was started at the first complaint of pain. Pain was evaluated by VAS in every 15 minute intervals at the first hour and later at 2nd, 4th, 8th, 12th, 18th and 24th hours postoperatively. Vital parameters, side-effects, sedation scores and total analgesic consumptions were also recorded concurrently. Total tramadol and anti-emetic consumption, the incidence of postoperative nausea and vomiting (PONV) were significantly higher in group I than the other groups (p<0.05). In conclusion; Tramadolmetamizol and tramadol-lornoxicam combinations administered by intravenous PCA provide efficient postoperative analgesia with less side effects.Öğe A novel approach for brachial plexus block(Tubitak Scientific & Technical Research Council Turkey, 2009) Apan, Alpaslan; Basar, Huelya; Sahin, Saziye; Buyukkocak, UnaseAim: The line from the midpoint of the sternocleidomastoid muscle to the midpoint of the clavicle was considered the surface projection of the brachial plexus in the supraclavicular region in a previous report using radiological and anatomic techniques. The needle insertion site was the point between the clavicular one-third and cervical two-thirds of this line. The aim of the present study was to determine the clinical efficacy of these suggested landmarks. Materials and methods: Brachial plexus block was performed in 60 healthy adult patients undergoing elective Surgery on an upper extremity using the above-mentioned new surface landmarks. Results: The characteristics of the block resemble those in the interscalene technique. Brachial plexus block was performed with a high success rate (98.5%) and minor complications including phrenic nerve palsy (45%), Horner syndrome (15%), and recurrent nerve block (1.6%). No major complication such as pneumothorax or accidental intravascular insertion was observed. Conclusion: The new landmarks were not dependent on patients' physical features or deeper anatomic structures. The surface landmarks based on bony prominences were defined easily. Brachial plexus block was performed with a high success rate and is considered a safe alternative to the classically described techniques.Öğe The Postoperative Analgesic Effects of Magnesium Infusion on Brachial Plexus Block(Kare Publ, 2007) Anbarci, Ozlem; Apan, Alparslan; Sahin, SaziyeMagnesium sulphate infusion decreases analgesic requirements after general anesthesia. Aim of this study was to assess the effects of postoperative magnesium infusion for 24 hours on duration of the block, sedation and postoperative analgesic consumption after brachial plexus block. After obtaining approval from local ethic committee, 70 ASA class I and II patients were included to the randomised double blind study. Brachial plexus block was performed using axillary approach with lignocaine 1.25 % adrenaline 1/200 000 40 ml. Groups received 5 mg/kg bolus and 500 mg/h magnesium sulphate infusion or saline controls at the same volume during 24 hour. Analgesia and sedation were assessed while determining time to first pain and rescue analgesic, time to regain motor capability, visual analogue scale and sedation scores for every 4 hour during postoperative 24 h. period. While time to first pain and rescue analgesic was increased, total analgesic consumption was reduced significantly on magnesium infusion group (Meperidine: C: 36.3 +/- 42.6 mg, Mg: 11.7 +/- 12.2 mg, p: 0.001). Visual analogue scales were also observed to be lower in all periods. Time to motor block resolution, and sedation scores were similar. Magnesium sulphate infusion is thought as a safe and suitable adjunct for reducing analgesic consumption and possible complications without interfering daily activity in patients undergoing brachial plexus block.
