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Dilek Karaaslan

Publications and source records attributed to Dilek Karaaslan.

4 recordsLinked to original sources
PubMed2006

Microbiological surveillance in the intensive care unit: a tertiary hospital experience.

BACKGROUND: Hospital infections are important because of increased risk of mortality and morbidity and their economic burden and are most commonly seen in intensive care units (ICUs). We aimed to document the characteristics of patients at an ICU, obtain bacteriologic samples, and determine the distribution of the isolated microorganisms. MATERIAL/METHODS: The study was conducted in the ICU of an anesthesiology department with 16 beds. The characteristics of 154 patients treated there over a one-year period were documented. The distribution of bacteriologic samples and isolated microorganisms and susceptibilities were investigated. The emerging hospital infections were determined using surveillance methods that were based on clinical and laboratory data. RESULTS: Intoxication was the most common cause of hospitalization, followed by respiratory insufficiency due to severe pneumonia and/or chronic obstructive respiratory disease, then trauma, postoperative conditions, and cerebrovascular problems. The mean number of culture studies per patient was 5.36+/-3.27. Cultures were most commonly obtained from patients with respiratory insufficiency and trauma. According to clinical specimens, the most commonly isolated microorganisms were E. Coli (37.2%) in urine, S. Aureus (50.0%) in blood, P. aeruginosa (25.7%) in tracheal aspirates, and Acinetobacter spp. (37.5%) in wounds. Considering all specimens, MRSA (22.0%) was the most common microorganism. CONCLUSIONS: Hospital infections pose an serious problem in an ICU setting. Surveillance studies comprise the basis for treatment of ICU infections. A multidisciplinary approach is required for a better quality of care and the achievement of therapy.

Acinetobacter↗
PubMed2006

Comparison of buccal and intramuscular dexmedetomidine premedication for arthroscopic knee surgery.

STUDY OBJECTIVE: To compare the sedative, anxiolytic, analgesic, hemodynamic, and respiratory effects of buccal dexmedetomidine with intramuscular (IM) dexmedetomidine for premedication in patients undergoing arthroscopic knee surgery during spinal anesthesia. DESIGN: Randomized, placebo-controlled trial. SETTING: University medical center. PATIENTS: 75 ASA physical status I and II patients undergoing arthroscopic knee surgery with spinal anesthesia. INTERVENTIONS: Patients were randomized to one of three groups for premedication: group B, buccal dexmedetomidine 2.5 microg kg(-1); group IM, IM dexmedetomidine 2.5 microg kg(-1); and group P, buccal 0.9% and NaCl 2 mL. MEASUREMENTS: Noninvasive blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation were recorded. Sedation and anxiety levels were consecutively assessed with Ramsay sedation scores and Visual Analog Scale (VAS) scores of anxiety before premedication, before spinal anesthesia, during surgery, and at the end of surgery. Two, 4, and 8 hours after surgery, sedation levels, postoperative VAS pain scores, and consumption of analgesics (diclofenac sodium) were recorded. MAIN RESULTS: Before spinal anesthesia, during surgery, and at the end of surgery, sedation and anxiety scores of the patients receiving buccal or IM dexmedetomidine were, respectively, higher and lower than in group P. Patients receiving buccal dexmedetomidine (group B) had lower requirement of diclofenac sodium than group P and lower pain scores than groups P and IM. Mild hypotension and bradycardia were observed in the buccal and IM dexmedetomidine patients. CONCLUSIONS: Buccal dexmedetomidine for premedication in arthroscopic knee surgery provided equal levels of sedation and anxiolysis, and more evident analgesia compared with IM dexmedetomidine.

Administration, Buccal↗
PubMed2006

Preemptive analgesia in laparoscopic cholecystectomy: a randomized controlled study.

In pain control after laparoscopic cholecystectomy, subhepatic administration of bupivacaine immediately after the creation of pneumoperitoneum has been shown to be more effective than administration before the withdrawal of the trocars. We aimed to investigate the effect of intraperitoneal bupivacaine administration to the subhepatic area before the creation of the pneumoperitoneum. Eighty patients undergoing elective laparoscopic cholecystectomy under general anesthesia were included in a prospective, randomized study. Patients received 20 mL of 0.5% bupivacaine in the subhepatic area just after intubation, before pneumoperitoneum (group 1), immediately after the creation of the pneumoperitoneum (group 2), just before the removal of the trocars (group 3), or received no local anesthetic (group 4). The degree of the postoperative pain was assessed at 0, 4, 8, 12, and 24 hours after the surgery. The consumption of analgesics (diclofenac sodium) was also recorded. The pain scores and analgesic consumption did not differ among groups 1, 3, and 4. The pain scores of group 2 were lower at each time point compared to the other groups (P < 0.001). Postoperative analgesic consumption in group 2 was reduced compared to the other groups (23.4 +/- 35.9 mg vs. 80.0 +/- 66.3 mg, P = 0.005 [group 1], 69.6 +/- 62.2 mg, P = 0.026 [group 3], and 70.0 +/- 59.9 mg, P = 0.022 [group 4]). The subhepatic infiltration of 20 mL of 0.5% bupivacaine offers good postoperative analgesia when applied just after the creation of the pneumoperitoneum, not before the pneumoperitoneum or after the termination of the pneumoperitoneum.

Adult↗