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Yavuz Gürkan

Publications and source records attributed to Yavuz Gürkan.

9 recordsLinked to original sources
PubMed2006

A comparison of midazolam and midazolam with remifentanil for patient-controlled sedation during operations on third molars.

Our aim was to compare patients' satisfaction and cooperation, and clinical efficacy, of midazolam alone, and midazolam and remifentanil for patient-controlled sedation during removal of third molars. Forty patients, American Society of Anesthesiologists grades I and II, admitted for extraction of impacted mandibular third molars were included in this randomised, prospective study. They were given an intravenous bolus of midazolam 0.03 mg/kg and then allowed to use patient-controlled sedation. In the midazolam group, 2 ml of 0.5 mg/ml midazolam was given automatically. In the midazolam-remifentanil group, 2 ml of 0.5 mg/ml midazolam and 12.5 microg/ml remifentanil were given in the same manner. The lockout period was 5 min. Vital signs and oxygen saturation were recorded. Patients' and surgeons' satisfaction, and the patients' degree of amnesia about the local anaesthetic, drilling, removal of the tooth, and pain during extraction were also assessed. There were no significant differences between systolic and diastolic blood pressures during sedation, but heart rate after 30 min in the combined group was significantly lower than in the midazolam group (p<0.05). Surgeons described the midazolam group as excellent in 9 and good in 11. In the combined group, satisfaction was excellent in 11, good in 7, and satisfactory or unacceptable in 1 of each. Immediately postoperatively, 19 patients in each group ranked their satisfaction as excellent and 1 as good. Twenty-four hours later it was unchanged in the midazolam group, while 15 patients in the other group thought it was excellent, 3 good, and 2 poor. Patient-controlled analgesia with midazolam or midazolam and remifentanil is safe and reliable during extraction of third molars.

Adolescent↗
PubMed2006

[Lateral sagittal infraclavicular block: a case report of three patients].

Magnetic resonance imaging (MRI) analysis performed on healthy volunteers assessed the effectiveness of brachial plexus block via the lateral sagittal infraclavicular approach to be easy-performed and relatively safe. In this case report, we presented three cases to whom we performed infraclavicular block via the lateral sagittal approach. One of our cases was a high risk patient with osteomyelitis of the elbow joint and the other was a patient who had required surgery for Dupuytren's contracture. The third one was a patient admitted to emergency room who had got open metacarps fractures. Lateral sagittal infraclavicular block was planned in all of the patients. Twenty minutes after local anesthetic (LA) injection, sufficient surgical anesthesia was achieved. Non of the patients developed vascular puncture, LA toxicity and pneumothorax. In conclusion, LSIB appears to be an easy, a safe and a more acceptable approach for the patient, therefore a good alternative.

Adult↗
PubMed2005

[Comparison of bupivacaine-fentanyl versus bupivacaine-morphine for patient controlled epidural analgesia].

Analgesic efficacy and possible side effects of bupivacaine-fentanyl (BF) and bupivacaine-morphine (BM) combinations for patient controlled epidural analgesia (PCEA) have been compared. Sixty ASA I-II patients who had PCEA following lower abdominal surgery were admitted to the study. Epidural catheter was inserted at the level of L3-4 or L4-5 following induction of general anesthesia. In Group BF epidural drug solution was prepared as bupivacaine 0.1 % and fentanyl 2 microg/ml. In Group BM, solution was prepared as bupivacaine 0.1 % and morphine 0.2 microg/ml. In both groups PCEA was set as; bolus dose: 4 ml, lock - out period: 20 minutes, 4 hour limit: 30 ml. VAS was measured at postoperative 1, 2, 3, 6, 9, 12 and 24th hours. In both groups adequate postoperative analgesia was provided. VAS score was higher in Group BF than Group BM at postoperative 12th hour (p<0.05). One patient in Group BF had unilateral motor block, one patient in Group BM had respiratory depression responding to i.v. naloxon administration. The incidence of pruritus was higher in Group BM than Group BF (p<0.05). Both treatment modalities provided adequate postoperative analgesia, but the risk of respiratory depression with opioid use should be considered.

Abdomen↗
PubMed2003

Effects of halothane and sevoflurane on QT dispersion in paediatric patients.

BACKGROUND: The QT dispersion (QTd) of the ECG is an indirect measure of heterogeneity of ventricular repolarization which may contribute to complex ventricular arrhythmias. We compared the effects of halothane and sevoflurane on QTd, and heart-rate corrected QT dispersion (QTcd). METHODS: Fifty ASA physical status I patients, aged 5-15 years, undergoing general anaesthesia were studied. A control ECG recording was printed before induction of anaesthesia. In the halothane group, anaesthesia was induced with halothane 4% in 2 : 1 ratio of air : O2 mixture and in the sevoflurane group with sevoflurane 8% in 2 : 1 ratio of air : O2 mixture. The ECG was recorded 1 and 3 min after induction of anaesthesia, 1 and 3 min after the administration of vecuronium 0.08 m.kg(-1) intravenous and 1 and 3 min after the tracheal intubation. All ECGs were analysed by two cardiologists blinded to the anaesthetic. RESULTS: Although QTd increased in both groups following intubation, this difference was not statistically significant when compared with control values. Following intubation five patients in the halothane group had ventricular arrhythmias of short duration, whereas no arrhythmias were recorded in the sevoflurane group (P = 0.052). Following intubation, QTd (45 +/- 15 ms vs 40 +/- 14 ms) and QTcd (60 +/- 17 ms vs 55 +/- 16 ms) values in the halothane group were significantly greater than the sevoflurane group (P < 0.05). CONCLUSION: Neither sevoflurane nor halothane caused a significant increase in QTd compared with control values before induction. Only QTd following intubation was significantly greater in the halothane group than the sevoflurane group.

Adolescent↗
PubMed2002

Prophylactic ondansetron reduces the incidence of intrathecal fentanyl-induced pruritus.

UNLABELLED: We investigated the effectiveness of prophylactic IV ondansetron in preventing intrathecal fentanyl-induced pruritus. One-hundred-fifty ASA status I-II patients undergoing spinal anesthesia with 7-10 mg of hyperbaric bupivacaine and 25 micro g of fentanyl were randomized to receive ondansetron 8 mg IV or normal saline IV before the commencement of spinal anesthesia. Evaluations were performed every 15 min in the first hour after the injection of study drugs and at 1, 2, 3, 4, 5, and 6 h after the administration of the study drug. Statistical analysis was performed by using chi(2) tests and Student's t-test, as appropriate. The incidence of pruritus was significantly more frequent in the placebo group compared with the ondansetron group (68% versus 39%) (P = 0.001). Time to pruritus was similar in both groups (placebo group, 55 +/- 32 min versus ondansetron group, 50 +/- 31 min). Duration of pruritus was also similar in both groups (placebo group, 98 +/- 60 min versus ondansetron group, 103 +/- 58 min). Ondansetron prophylaxis significantly reduced the incidence of intrathecal fentanyl-induced pruritus in patients undergoing surgery under bupivacaine spinal anesthesia. IMPLICATIONS: Pruritus is a commonly reported side effect after intrathecal fentanyl administration during spinal anesthesia. This study was performed in a prospective, randomized, double-blinded, placebo-controlled manner to investigate the efficacy of prophylactic IV ondansetron in the prevention of pruritus after intrathecal fentanyl administration during spinal anesthesia. The incidence of pruritus was significantly more frequent in the placebo group compared with the ondansetron group (68% versus 39%) (P = 0.001).

Adult↗
PubMedDate not supplied

Probing for nasolacrimal duct obstruction using intranasal midazolam sedation as an alternative to general anesthesia.

OBJECTIVE: To investigate the effectiveness of topical anesthesia with sedation using intranasal midazolam in patients with symptomatic congenital nasolacrimal duct obstruction undergoing probing. PATIENTS AND METHODS: In this prospective study, probing was performed with general anesthesia (30 cases) and with topical anesthesia using intranasal midazolam (0.3 mg/kg; 44 cases) in 74 patients who were divided into two groups, those 6 to 36 months old and those older than 36 months. The groups were compared after 12 to 48 months (mean, 18.2 months). RESULTS: For the patients 6 to 36 months old, the success rate was 80% in the group who received general anesthesia and 88.9% in the group who received topical anesthesia with intranasal midazolam; the difference between the two groups was not statistically significant (P > .05). For the patients older than 36 months, the success rate was 20% in the group who received general anesthesia and 25% in the group who received topical anesthesia with intranasal midazolam; there was no statistically significant difference between the two groups (P > .05). CONCLUSIONS: Probing with topical anesthesia in the office setting is usually recommended for patients younger than 8 months. Our results show that this is suitable for children until 4 years of age with the support of intranasal midazolam sedation. Probing under topical anesthesia with intranasal midazolam is cost-effective, safe, and comparable in efficacy to probing under general anesthesia but with less risk.

Administration, Intranasal↗