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M E Güzeldemir

Publications and source records attributed to M E Güzeldemir.

5 recordsLinked to original sources
PubMed1996

Esmolol for hypotensive anesthesia in middle ear surgery.

This study was performed to investigate the efficacy of esmolol, an agent used in hypotensive anesthesia for middle ear surgery. We compared 20 ASA I-II patients to 20 controls in whom we administered routine anesthesia. All patients were premedicated with intramuscular 0.05 mg/kg atropine, 1 mg/kg pethidine and 25 mg promethazine. Anesthesia was induced with 0.004 mg/kg fentanyl and 5 mg/kg thiopental sodium. Succinylcholine 1.5 mg/kg was administered to facilitate intubation. Isoflurane, nitrous oxide, oxygen, 0.08 mg/kg vecuronium bromide and controlled ventilation were used for anesthetic maintenance. Before the controlled hypotensive period, nitrous oxide was discontinued and an esmolol infusion started. We registered hemodynamic values (via noninvasive and invasive radial artery cannulation), central venous pressure, electrocardiography, body temperature, end-tidal carbon dioxide levels, periferal oxygen saturation, and arterial blood gas analysis. Mean infusion rate of esmolol was 330 +/- 10 micrograms/kg/min. We found significant decreases in systolic blood pressure (28.7%), mean blood pressure (26.5%) and diastolic blood pressure (33.4%). The operative field was virtually bloodless. Hemodynamic values recovered to normal or to within -12.45% of normal at the end of intravenous esmolol infusion. During the postoperative period, no side effects were observed. In conclusion, esmolol is an appropriate hypotensive agent for patients undergoing middle ear surgery under hypotensive anesthesia because it yields no side effects, it is easy to control administration and it provides the desired degree of hypotension without complications.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

The effects and side effects of interscalene brachial plexus block by posterior approach.

BACKGROUND AND OBJECTIVES: To investigate the use of interscalene block by posterior approach in upper extremity surgery and its effects on routine pulmonary function tests. METHODS: Interscalene block by posterior approach was performed with a peripheral nerve stimulator localization in 29 ASA Physical Status I and II patients undergoing upper extremity surgery. All patients were given 20 mL of 1% lidocaine and 20 mL of 0.5% bupivacaine. Modified Bromage Scale for motor block and pinprick test for sensory anesthesia was used. Pulmonary function, measurements [forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and VC (vital capacity)] were done in all patients just before and 2, 5, 10, 15, and 30 minutes after the block. RESULTS: Surgery location was the arm in four cases, and the forearm in 25 cases. General anesthesia was added in nine patients. Intravenous analgesics or sedatives were needed in four cases. Ulnar nerve was missed in 13 patients. FEV1 decreased 11.5% in 2 minutes (P > .05), 19.7% in 5 minutes (P = .0525), and FVC decreased 16.6% in 2 minutes (P > .05), 24.5% in 5 minutes after block (P < .05). CONCLUSIONS: Interscalene block by posterior approach did not provide a satisfactory anesthesia for forearm and hand surgery. This method also caused hemidiaphragmetic paresis and a reduction in pulmonary function tests as in the lateral approach of Winnie. We believe limitations and relative contraindications for interscalene block by lateral approach are the same for posterior approach.

Adult↗