Açık kalp cerrahisinde yüksek doz opioid ve nörolept anestezisinin karşılaştırmalı olarak değerlendirilmesi

TEZ957Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1991.Kaynakça (s. 41-46) var.46 s. ; 30 cm.

Patient-controlled intravenous analgesia with remifentanil in nulliparous subjects in labor

WOS: 000251666100001PubMed: 18035955Objective: in this study we controlled the efficiency and safety of using remifentanil combined with two different supplementary background infusions for labor analgesia in nulliparous patients. Research design and methods: 60 subjects were allocated to two groups. After programming the patient-controlled analgesia device to deliver a fixed load and demand doses of intravenous remifentanil for all subjects, group r (n = 30) received a background infusion of remifentanil 0.1 mu g/kg/min and group R (n = 30) received a supplementary infusion of remifentanil 0.15 mu g/kg/min. Visual analogue scale for analgesia, hemodynamic parameters, sedation scales and fetal heart rates were recorded at the 5th, 10th, 20th and 30th min of the study and measurements continued every 15 min during 90 min of labor and delivery. Side effects, Apgar and satisfaction scores were obtained for every subject. Results: visual analogue scale scores of group R were significantly lower than those of group r throughout labor and delivery (p 0.05). Most subjects were awake and only nausea was obtained (p > 0.05). The increase in the Apgar and satisfaction scores was not statistically significant (p > 0.05). Conclusion: it was determined that remifentanil with a 15-mu g demand dose and 0.15 mu g/kg/min supplementary continuous infusion is an effective choice for patient-controlled analgesia during labor in nulliparous subjects

Comparison of the analgesic effect of morphine, tramadol, bupivacaine and various combination of these drugs in patient-controlled epidural analgesia

Çalışmamızda ürolojik açık cerrahi hastalarının postoperatif ağrı tedavisinde "Epidural Hasta Kontrollü Analjezi (EHKA)" yöntemi ile morfin, tramadol, bupivakain ve kombinasyonlarının etkilerini karşılaştırmalı olarak değerlendirilmesi planlanlandı. Çalışmaya 65 erişkin hasta (ASA I-II) dahil edildi. Rasgele 13'er kişilik 5 gruba ayrılan hastaların postoperatif ağrı tedavisinde morfin (I. grup), tramadol (II. grup), bupivakain (III. grup), bupivakain+tramadol (IV. grup), bupivakain+morfin (V. grup) kombinasyonları hazırlanan protokole göre EHKA yöntemi kullanılarak uygulandı. Tüm gruplarda; kalp atım hızı, noninvaziv kan basıncı, solunum sayısı, periferik oksijen satürasyonu, ağrı (VAS skoru) ve sedasyon skorları ekstübasyonu takiben 5, 15, 30. dk'larda ve 1, 2, 4, 8, 12, 24. st'lerde değerlendirildi. Gruplar arasında kalp atım hızı, solunum sayısı ve periferik oksijen saturasyonu açısından fark saptanmadı (p>0.05). Kan basıncı, ilk 1 saatlik takiplerde bupivakain ve kombinasyonlarının olduğu gruplarda, morfin ve tramadol gruplarına göre düşük bulundu (p0.05). Bupivakain+tramadol grubunda diğer gruplara göre ek doz ihtiyacı daha az bulundu (p0.05). Systolic and diastolic blood pressures were significantly lower during the first hour of bupivacain administration in groups III, IV and V compared to morphine and tramadol groups (<0.05). The mean VAS scores at 5, 15, 30. minutes and at first hour were lower in bupivacaine+tramadol group compared to tramadol, bupivacane and morphine groups (<0.05). Similarly at 5, 15, 30. minutes VAS scores were lower in bupivacaine+morphine group compared to morphine and tramadol groups (<0.05). The VAS score was not different in bupivacaine+tramadol and bupivacaine+morphine groups. Additional doses needed less frequently in bupivacaine+tramadol group compared to other groups. In conclusion; bupivacaine, morphine, tramadol and various combinations of these drugs can be used in the management of postoperative pain after open urologic surgery by patient controlled epidural analgesia technique. Bupivacaine in combination with morphine or tramadol may improve the quality of analgesia and decrease the frequency of additional doses

Anesthetic management in Friedreich's ataxia (case report)

Bu makalede, ürolojik operasyon geçiren Friedreich ataksili bir hastada anestezik yaklaşım sunuldu.In this article anesthetic management of a patient with Friedreich ataxia undergoing urological operation was presented

The effects of three neurosurgical anaesthetic methods on HLA-Dr expression

Expression of human leukocyte antigen-DR (HLA-DR) is considered a meaningful indicator of immune response because of the important role that HLA-DR plays in presenting antigen to T-lymphocytes. The aim of this study was to evaluate the effects of three anaesthetic methods (intravenous anaesthesia with propofol-fentanyl and balanced anaesthesia with isoflurane-fentanyl or sevoflurane-fentanyl) on monocytic HLA-DR expression in neurosurgical patients who underwent craniotomy. Thirty patients were divided into 3 groups of 10, and each group was the subject of one of the anaesthetic regimes noted above during craniotomy procedures. Blood samples were collected and HLA-DR expression was measured by flow cytometry at 15 minutes before induction, 1 hour into surgery, 3 hours after surgery, and on postoperative day 3. Comparing the levels of expression at each given stage between and within groups, there were no significant differences found at any time point except on the third postoperative day. For all groups, HLA-DR expression on postoperative day 3 was significantly higher than that measured in the first three stages (<0.05). The results indicate that neither intravenous anaesthesia nor balanced anaesthesia has any significant effect on monocytic HLA-DR expression in neurosurgical patients.Expression of human leukocyte antigen-DR (HLA-DR) is considered a meaningful indicator of immune response because of the important role that HLA-DR plays in presenting antigen to T-lymphocytes. The aim of this study was to evaluate the effects of three anaesthetic methods (intravenous anaesthesia with propofol-fentanyl and balanced anaesthesia with isoflurane-fentanyl or sevoflurane-fentanyl) on monocytic HLA-DR expression in neurosurgical patients who underwent craniotomy. Thirty patients were divided into 3 groups of 10, and each group was the subject of one of the anaesthetic regimes noted above during craniotomy procedures. Blood samples were collected and HLA-DR expression was measured by flow cytometry at 15 minutes before induction, 1 hour into surgery, 3 hours after surgery, and on postoperative day 3. Comparing the levels of expression at each given stage between and within groups, there were no significant differences found at any time point except on the third postoperative day. For all groups, HLA-DR expression on postoperative day 3 was significantly higher than that measured in the first three stages (<0.05). The results indicate that neither intravenous anaesthesia nor balanced anaesthesia has any significant effect on monocytic HLA-DR expression in neurosurgical patients