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Biomedical subjects

S B Akinci

Publications and source records attributed to S B Akinci.

9 recordsLinked to original sources
PubMed2005

Efficacy of prophylactic ketamine in preventing postoperative shivering.

BACKGROUND: Treatment with ketamine and pethidine is effective in postoperative shivering. The aim of this study was to compare the efficacy of low-dose prophylactic ketamine with that of pethidine or placebo in preventing postoperative shivering. METHODS: A prospective randomized double-blind study involved 90 ASA I and II patients undergoing general anaesthesia. Patients were randomly allocated to receive normal saline (Group S, n=30), pethidine 20 mg (Group P, n=30) or ketamine 0.5 mg kg(-1) (Group K, n=30) intravenously 20 min before completion of surgery. The anaesthesia was induced with propofol 2 mg kg(-1), fentanyl 1 microg kg(-1) and vecuronium 0.1 mg kg(-1). It was maintained with sevoflurane 2-4% and nitrous oxide 60% in oxygen. Tympanic temperature was measured immediately after induction of anaesthesia, 30 min after induction and before administration of the study drug. An investigator, blinded to the treatment group, graded postoperative shivering using a four-point scale and postoperative pain using a visual analogue scale (VAS) ranging between 0 and 10. RESULTS: The three groups did not differ significantly regarding patient characteristics. The number of patients shivering on arrival in the recovery room, and at 10 and 20 min after operation were significantly less in Groups P and K than in Group S. The time to first analgesic requirement in Group S was shorter than in either Group K or Group P (P<0.005). There was no difference between the three groups regarding VAS pain scores. CONCLUSION: Prophylactic low-dose ketamine was found to be effective in preventing postoperative shivering.

Adolescent↗
PubMed2004

Outcome at second-look laparotomy: anaesthesia related risk factors.

PURPOSE OF INVESTIGATION: To identify anaesthesia related risk factors associated with positive second-look laparotomy (SLL) findings in patients with epithelial ovarian carcinoma who had previous optimal cytoreduction surgery under general anaesthesia. METHODS: A retrospective review of the anaesthesia and medical records of patients with epithelial ovarian cancer who underwent SLL at our institution and analysis of patient related (age, haemoglobin, albumin), anaesthesia related (duration of anaesthesia, anaesthetics and dosages, transfusion of blood products), tumour related (stage, grade, presence of ascites, adhesion, histological type, capsule penetration and CA-125) data and outcome of SLL was undertaken. RESULTS: The patients had SLL 305 +/- 215 days after the first operation. Of the 83 patients 28 (33.7%) were SLL (+). SLL (+) patients were significantly more likely to have a mucinous histological subtype, required intraoperative packed red blood cell (PRBC) transfusion and longer anaesthesia duration (p < 0.05). Type of induction agent, whether narcotics were used or not, type of volatile agent used, dosages of induction agents and dosages of narcotic and muscle relaxants did not vary significantly between the patients with and without cancer recurrence (p > 0.05). Duration of anaesthesia (OR, 1.03; CI, 1-1.05, p = 0.031) and histological subtype (OR, 16.1; CI, 1.8-141.7, p = 0.012), were the independent variables predicting cancer recurrence in the multivariate logistic regression. CONCLUSION: We emphasize that duration of anaesthesia and histological subtype are risk factors for cancer recurrence in early stage ovarian carcinoma. From our data it seems that interventions to shorten the duration of general anaesthesia or reversing immunosuppression induced by anaesthesia and surgery must be carefully considered.

Anesthesia, General↗
PubMed2003

Serum sIL-2r, IL-6, IL-10 and TNF-alpha level in familial Mediterranean fever patients.

In this study we investigated cytokine levels in patients with familial Mediterranean fever (FMF). Twenty patients and 20 healthy controls were included. Ten patients had acute attacks of FMF, whereas the other 10 were in the silent period. Patients with the acute exacerbation of FMF had higher soluble interleukin-2 receptor (sIL-2r), interleukin-6 (IL-6), tumour necrosis factor-alpha, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and fibrinogen levels than those in the silent period ( P<0.001) and controls ( P<0.001). In patients with acute attacks of FMF, interleukin-10 (IL-10) levels were not significantly different from those in the other patients or the controls ( P>0.05). In FMF patients IL-6, TNF-alpha, sIL-2r, ESR, CRP and fibrinogen levels increased with the acute-phase reaction, especially in the attack period. On the other hand, anti-inflammatory cytokine IL-10 levels did not increase as much as did the inflammatory cytokines. The balance between the cytokines may help us to understand the pathophysiology of FMF and to develop therapies. We conclude that the levels of the acute-phase reactants and the cytokines could be useful for diagnosis of acute exacerbations, follow-up and treatment. However, the cost of cytokine measurement analyses seems disadvantageous at present.

Acute-Phase Proteins↗
PubMed2001

Liver transplantation in patients with severe portopulmonary hypertension treated with preoperative chronic intravenous epoprostenol.

Portopulmonary hypertension (PPHTN) is no longer an absolute contraindication to orthotopic liver transplantation (OLT). The pre-OLT management of patients with PPHTN requires early diagnosis and chronic therapy with intravenous epoprostenol to decrease pulmonary vascular resistance (PVR). Close follow-up is necessary to reassess pulmonary artery pressures (PAPs) and evaluate right ventricular (RV) function. This assists in the optimal timing of OLT. Successful management also necessitates reassessment of pulmonary artery hemodynamics just before OLT, with clearly defined parameters used to determine whether to proceed. Even with the intraoperative and postoperative availability of potent pulmonary vasodilators, clinical management may be suboptimal in reducing PAP. Adequate reduction in PVR and improvement in RV function in response to chronic epoprostenol therapy may facilitate successful OLT. We present a case report and review the limited experience with this treatment.

Adult↗