Papers by ceyda özhan çaparlar
Turkish Journal of Anesthesia and Reanimation, 2013
Journal of Anesthesiology and Reanimation Specialists’ Society
Turkiye Klinikleri Journal of Anesthesiology Reanimation
Brazilian Journal of Anesthesiology (English Edition)
Turkiye Klinikleri Journal of Anesthesiology Reanimation
Genel anestezi altındaki hastalar endotrakeal tüp (ETT) ile entübe edilirken havayolu güvenliği s... more Genel anestezi altındaki hastalar endotrakeal tüp (ETT) ile entübe edilirken havayolu güvenliği sağlanmalıdır. Havayolu güvenliğini sağlamak için ETT kafı, belirli bir aralıkta basınçla şişirilmelidir. Kafın fazla veya az basınçla şişirilmesi, hasta güvenliğini tehlikeye atar. Kaf basıncı çeşitli yöntemlerle ölçülür. Bunlardan, kafın manometre ile ölçümü en güvenli yöntemdir. Endotrakeal kaf basıncının normal değeri: 20-30 cmH 2 O'dur. 1,2 Endotrakeal kafın normal değerinden az şişirilmesi (20 cmH 2 O'nun altında), gaz kaçağına neden olabilir. Mide içeriğinin aspirasyonu, mekanik ventilasyon ilişkili pnömoni (VIP) riskini artırır. Endotrakeal kafın normal aralığından fazla şişirilmesi de mukozal kan akımını bozar. Erken dönemde boğaz ağrısı, ses kısıklığı ve öksürüğe ileri dönemde trakeal stenoz, özofageal fistül ve trakeal rüptüre neden olur. 3,4
The European Research Journal
Objectives: This study was intended to discuss the process of brain death diagnosis of patients u... more Objectives: This study was intended to discuss the process of brain death diagnosis of patients undergoing extracorporeal membrane oxygenation (ECMO) and our approach regarding the existing literature. Methods: Demographics data (age, gender, admission diagnosis) were noted. ECMO type applied (venovenous or veno-arterial), time of diagnosing brain death (the time from admission time till diagnosis), being a donor or not, apnea testing application, supplementary tests applied at diagnosis stage (cerebral angiography, computerized tomography angiography, electroencephalography, transcranial doppler ultrasonography), and time of cardiac death (the time elapsing from the moment of brain death diagnosis till cardiac arrest) were noted. Results: Forty-two patients data were exaimed and ECMO was applied to 8 patients, 4 of whom are female and the others are male. The average age of the patients is 61.8 ± 9.8 years. The average time elapsing from the hospitalization till brain death diagnosis was 2.5 ± 0.5 days. Apart from that, only 2 (25%) of the patients were donors. Conclusions: The use of modified apnea testing on patients undergoing ECMO could be proliferated if such tests are standardized and reliable guidelines are set. For this reason, we think that cerebral angiography should be kept in mind in addition to apnea test especially on ECMO-treated patients.
Haydarpasa Numune Training and Research Hospital Medical Journal
The European Research Journal
Objective: The aim of the current study was to compare intraocular pressure (IOP), hemodynamic pa... more Objective: The aim of the current study was to compare intraocular pressure (IOP), hemodynamic parameters and throat pain in the use of C-MAC videolaryngoscope and the Macintosh laryngoscope under general anesthesia requiring endotracheal intubation. Methods: Seventy-eight patients aged 18-65 years, ASA (American Society of Anesthesiologists physical status). I-II, who underwent elective surgery under general anesthesia were scheduled in the study. The groups were allocated as Group M (Macintosh laryngoscope) and Group VL (videolaryngoscope). Standard anesthesia technique was used in both groups. To assess the depth of anesthesia which was kept between 40 and 60, a Bispectral Index Monitor Model 2000 (Aspect Medical Systems, Inc, Newton, MA) was used throughout the study. We recorded hemodynamic variables, oxygen saturation before induction, at the 3rd and at the 10th minutes after intubation. The duration of intubation was recorded as the time from the laryngoscope entering the mouth to removal with end-tidal carbon dioxide on the monitor. IOP was measured before induction, and at the 3rd and 10th minutes after intubation. Inhalation agent was given after intubation. 78 patients were included in the study. We recorded cough after extubation, and postoperative sore throat was evaluated by an anesthesiologist who was blinded to the group allocations at 10 minutes and at 24 hours postoperatively. Results: There was no significant difference between the groups regarding age (p > 0.05), mean body mass index (p = 0.157), mean ASA (p = 0.475), mean bispectral index values (p = 0.084) and mean operating time (p = 0.068). The mean duration of intubation was determined to be statistically significantly longer in Group M than in Group VL (p = 0.0001). There was no statistically significant difference between the groups regarding Modified Mallampati Score (p = 0.571) and Cormack Lehane Score (p = 0.819). The mean IOP at 3rd minute after intubation was determined to be statistically significantly higher in Group M (p = 0.0001). There was no statistically significant difference between the groups in regarding cough after extubation (p = 0.549), throat pain at 10 minutes (p = 0.662) and at 24 hours postoperatively. Conclusions: C-MAC videolaryngoscope can be recommended as the first choice in patients with high IOP requiring general anesthesia with endotracheal intubation.
Cumhuriyet Medical Journal
The aim of this study is to discuss the necessity of surgery by analysing the long term results a... more The aim of this study is to discuss the necessity of surgery by analysing the long term results and satisfaction of the symptomatic and asymptomatic patients who had parathyroidectomy for primary hyperparathyroidism. Method: Patients who had parathyroidectomy because of primary parathyroid pathology or during thyroid surgery as concomittant parathyroid pathology between June 1999 and September 2010 were enrolled to the present, retrospective study. A total of seventy one patient were included to the study. The Pasieka Symptom Scoring System and SF-36 questionnaire are applied to the patients. The patients were divided into two groups as symptomatic and asympyomatic. The answers to the Pasieka Symptom Scoring System's last 5 questions examining general health, surgical satisfaction and quality of life were evaluated between symptomatic and asymptomatic patients. Results: Number of the symptomatic patients were 38 (53.5%) whereas 33 patients (46.5%) were asymptomatic. Average length of follow up was 60 months. Among the operated 71 patients; 67 (94.4%) were cured, 4 (5.6%) had persistent hyperparathyroidism and 2 of these patients were operated again, the other two patients were out of follow up. Conclusions: Asymptomatic patients with primary hyperparathyroidism may have masked neurocognitive and psychiatric complaints and these patients' quality of life can be improved with surgery.
Journal of Clinical Anesthesia, 2017
The use of short-acting anesthetics has introduced a "fast-track anesthesia&... more The use of short-acting anesthetics has introduced a "fast-track anesthesia" concept in outpatient surgery which provides discharge of the patients from operation room directly to the phase II recovery area without entering into postanesthesia care unit. The aim of this prospective and randomized study was to compare general anesthesia using sevoflurane with propofol-remifentanil-based total intravenous anesthesia (TIVA) for fast-track eligibility in patients undergoing outpatient laparoscopic cholecystectomy. The secondary aim was to compare 2 discharge scoring systems: White's Fast-Tracking Scoring System (WFTSS) and Modified Aldrete Scoring Systems (MASS) with regard to postanesthesia care unit bypass rate and postoperative problems. After obtaining ethical approval and written informed patient consent, 80 patients were randomly assigned into 2 groups: group sevoflurane (n=40) and group TIVA (n=40). Anesthesia was induced with propofol, fentanyl, and rocuronium in both groups and maintained with sevoflurane in group sevoflurane and with remifentanil-propofol in group TIVA. Fast-track eligibility was evaluated using both WFTSS and MASS while patients were discharged from operation room according to WFTSS. Recovery times, number of fast-track eligible patients, factors related to fast-track ineligibility, and perioperative complications were evaluated. The ratio of fast-track eligible patients was higher and times to fast-track eligibility were shorter in group TIVA compared with group sevoflurane (82.1% vs 57.5% and 8 minutes vs 12 minutes; P<.05). The primary factors that have inhibited fast-tracking were desaturation, hemodynamic instability, pain, and postoperative nausea and vomiting, respectively. Postoperative nausea and vomiting presented a major difference in the rate of fast-track ineligibility between groups (4 patients in group sevoflurane, whereas none in group TIVA; P<.05). The fast-track ratio was lower with the WFTSS compared with MASS in group sevoflurane (57.5% vs 77.5%, P<.05), but similar in group TIVA.
Turkish Journal of Anesthesia and Reanimation, 2016
Journal of Anesthesia, 2013
Rocuronium is a non-depolarizing neuromuscular blocking agent which is associated with injection ... more Rocuronium is a non-depolarizing neuromuscular blocking agent which is associated with injection pain and induces withdrawal movement of the injected hand or arm or generalized movements of the body after intravenous injection. The aim of this randomized study was to compare the efficacy of pretreatment with oral dexketoprofen trometamol (Arvelles(®); Group A) with placebo (Group P) without tourniquet to prevent the withdrawal response caused by rocuronium injection. The study cohort comprised 150 American Society of Anaesthesiologists class I-III patients aged 18-75 years who were scheduled to undergo elective surgery with general anesthesia. The patients response to rocuronium was graded using a 4-point scale [0 = no response; 1 = movement/withdrawal at the wrist only, 2 = movement/withdrawal involving the arm only (elbow/shoulder); 3 = generalized response]. The overall incidence of withdrawal movement after rocuronium injection was significantly lower in Group A (30.1 %) than in Group P (64.6 %) (p < 0.001). The incidence of score 0 withdrawal movements was higher in Group A (69.9 %) than in Group P (35.4 %), that of score 1 withdrawal movements was similar between groups (Group A 21.9 %; Group B 26.1 %) (p = 0.560) and that of score 2 withdrawal movements was lower in Group A (8.2 %) than in Group P (38.5 %) (p < 0.001). There were no score 3 withdrawal movements in either group (p > 0.05). These results demonstrate that the preemptive administration of dexketoprofen trometamol can attenuate the degree of withdrawal movements caused by the pain of the rocuronium injection.
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Papers by ceyda özhan çaparlar