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Oguzhan Dagtekin

Publications and source records attributed to Oguzhan Dagtekin.

4 recordsLinked to original sources
PubMed2007

Manually controlled total intravenous anesthesia augmented by electrophysiologic monitoring for complex stereotactic neurosurgical procedures.

Stereotactically guided procedures are performed for an ever extending range of conditions. They present a unique anesthetic challenge. In our institution, a standardized anesthetic protocol for total intravenous anesthesia (TIVA) augmented by electrophysiologic monitoring with BIS or AEP monitors was introduced. We conducted a retrospective study of 21 patients (ASA status 2-3) presenting for stereotactically guided procedures who were anesthetized according to the protocol. Median duration of anesthesia was 260 minutes (222 to 325 min); on average 3.0 (1.0 to 4.2) adjustments to the TIVA-protocol were made per patient. Highest and lowest mean arterial blood pressures in relation to baselines were 100% (87.5% to 109.8%) and 68.7% (64.0% to 72.6%), respectively. Likewise highest and lowest heart rates recorded were 106.7% (98.5% to 119.0%) and 75.0% (68.2% to 83.3%). After discontinuation of TIVA, spontaneous breathing returned after 5.0 minutes (4.0 to 8.0 min), extubation was possible after 6.0 minutes (5.0 to 10.0 min) and patients were ready for discharge to the ward after 15.0 minutes (12.0 to 18.0 min). There were no cases of postoperative nausea or vomiting. We found that manually controlled TIVA, augmented by electrophysiologic monitoring, facilitated maintenance of an appropriate depth of anesthesia with stable hemodynamics and excellent recovery times.

Adult↗
PubMed2006

Clinical equivalence of IV paracetamol compared to IV dipyrone for postoperative analgesia after surgery for breast cancer.

OBJECTIVE: To assess clinical efficacy of IV paracetamol 1 g and IV dipyrone 1 g on a 24-h dosing schedule in this randomised, double-blinded study of 40 ASA I-III (American Society of Anesthesiologists classification of physical status) patients undergoing surgery for breast cancer. RESEARCH DESIGN AND METHODS: General anaesthesia using remifentanil and propofol was performed for surgery. The patients were randomly allocated to two groups, receiving infusions of paracetamol 1 g/100 mL (Para Group) or of dipyrone 1 g/100 mL (Dipy Group) 30 min before arrival in the recovery area and every 6 h up to 24 h postoperatively. All patients had unrestricted access to opioid rescue medication via an IV patient-controlled analgesia (PCA) device. MAIN OUTCOME MEASURES: The primary variables for clinical equivalence were the differences between the mean values for pain scores at rest and pain scores on coughing over 30 h postoperatively. The equivalence margin was determined as +/-10 mm on the visual analogue scale (VAS). RESULTS: Regarding pain scores at rest, the 90% CI of the mean differences between the treatment groups over 30 h postoperatively was found to be within the predefined equivalence margin [+7.5/-6.2], and the CI values for pain scores on coughing [+7.3/-9.0] were similar. The two groups did not differ in cumulative opioid rescue consumption (Dipy-Group 14.8 +/- 17.7 mg vs. Para Group 12.1 +/- 8.8 mg, p = 0.54) nor in piritramide loading dose (Dipy Group 0.95 +/- 2.8 mg vs. Para Group 1.3 +/- 2.8 mg, p = 0.545). Five patients in the Dipy Group experienced hypotension in contrast to none in the Para Group (p = 0.047). There were no significant between-treatment differences for other adverse events, patient satisfaction scores (p = 0.4) or quality of recovery scores (p = 0.3). CONCLUSION: IV paracetamol 1 g is clinically equivalent to IV dipyrone 1 g for postoperative analgesia after surgery for breast cancer.

Acetaminophen↗
PubMed2004

Regional anesthesia and anticoagulation.

PURPOSE OF REVIEW: Patients receiving perioperative anticoagulation are a challenge for anesthesiologists when regional anesthesia would be a beneficial component of the anesthetic plan. Newly approved antithrombotic drugs maintain the need for updated review articles and recommendations. RECENT FINDINGS: Due to the very low incidence of bleeding complications, guidelines are solely based on retrospective analyses of case reports and pharmacological considerations. Hence, they should not be taken as evidence-based 'cook books'. Recommendations of well established anticoagulants like heparin and non-steroidal antiinflammatory drugs may have a solid basis. However, the lack of data on new antithrombotic drugs including GII/GIIIA antagonists, factor X and thrombin-inhibitors requires a more conservative approach when regional anesthesia is considered. Current literature emphasizes postoperative monitoring; clear recommendations of its performance, however, are missing. SUMMARY: Decisions to perform regional anesthesia in patients under anticoagulation should always be made on an individual risk-benefit assessment. A vigilant preoperative evaluation of the patient's medication and physical findings are as important as awareness of postoperative plans for anticoagulation.

Journal Article↗