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In this study, we aimed to investigate the effects of topical tramadol administration on corneal wound healing, and examine ophthalmic structures and intraocular pressure 7 days after tramadol administration. The experiments were... more
In this study, we aimed to investigate the effects of topical tramadol administration on corneal wound healing, and examine ophthalmic structures and intraocular pressure 7 days after tramadol administration. The experiments were conducted on eight male Wistar rats (250-300 g). After ophthalmic examination, epithelial cell layers in the central cornea were wounded. Rats received 30 μL of tramadol hydrochloride in one eye (Group Tramadol) and the same volume of vehicle in the other (Group Control) every 12 h for 7 days. Both eyes were stained with fluorescein dye, photographed, and wound area was calculated every 8 h until complete healing was observed. Eye blink frequency and corneal reflex tests were measured before and after drug administrations. After 7 days, slit lamp biomicroscopy, fundoscopy, Goldmann applanation tonometry, and histological evaluation were performed. There was no difference in the corneal wound healing rates between the tramadol and control groups. Reduction in wound area over time was also similar; group-time interaction was insignificant (F = 738.911; p = 0.225). Tramadol application resulted in blinking and blepharospasm for 30 s, but vehicle did not. Corneal reflex was intact and eye blink frequency test results were similar in all measurement times in both groups. Slit lamp biomicroscopy, fundoscopy, and intraocular pressures were within normal range. Corneal cells appeared unaffected by the repeated doses of tramadol for 7 days. Topical tramadol application on the cornea did not cause any side effect, except for initial temporary blinking and blepharospasm. Corneal wound healing was not affected, either.
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Hidosefali, sakral agenezi ve spina bifida anomalileri olan femur fraktürlü hastamızda, başarılı üçü bir yerde femoral sinir bloğu uygulamasını sunmayı amaçladık. Üç yaşında kız hastamızda travmatik sağ femur fraktürü mevcuttu. Klinik... more
Hidosefali, sakral agenezi ve spina bifida anomalileri olan femur fraktürlü hastamızda, başarılı üçü bir yerde femoral sinir bloğu uygulamasını sunmayı amaçladık. Üç yaşında kız hastamızda travmatik sağ femur fraktürü mevcuttu. Klinik muayenesinde zor havayolu bulguları olan mikrognati ve makroglossi saptandı. Birlikte saptanan ileri derecede hidrosefali, alt etkstremitelerde motor paralizi, spina bifida ve sakral agenezi genel anestezi veya nöroaksiyal blok uygulamalarını güçleştirmişti. Hastamıza hafif sedasyon altında üçü bir yerde femoral blok uygulamaya karar verdik. Damar yolu bulunduktan sonra 0,05 mg kg1 intravenöz midazolam uygulandı. Femoral sinir bloğu sinir stimülasyonu tekniği ile 7,5 ml % 0,5 levobupivakain serum fizyolojik 10 ml'ye tamamlanarak uygulandı. Eksternal fiksasyon ek analjezik gereksinimi olmaksızın başarılı bir şekilde uygulandı. Hastanın vital bulguları operasyon süresi ve erken postoperatif dönemde stabil seyretti. Hasta postoperatif dönemde altı saa...
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Copyright © 2015 Ahmet Eroglu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is... more
Copyright © 2015 Ahmet Eroglu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A great number of anesthetic techniques (general, regional, spinal, epidural, caudal, hypotensive, total intravenous, regional intravenous, inhalation, and nerve blocks) can be used formultiple surgical procedures [1–3].The effect of anes-thetic technique on perioperative outcomes is controversial. Central neuraxial blocks including spinal, epidural, and caudal anesthesia are regional anesthesia techniques. Regional anesthesia techniques provide important advan-tages compared with general anesthesia in some surgical procedures [1, 3]. Regional anesthesia is not only performed for adequate anesthesia in the surgical procedures. There are other advantages for the use of regional anesthesia techniques including excellent pain control, red...
Schwannoma, neurilemmoma, is well capsulated, slowly growing tumor originating from benign neoplastic Schwann cells of the peripheral nerve sheath. Due to its rarity and complex anatomical location they can pose the misdiagnosis at... more
Schwannoma, neurilemmoma, is well capsulated, slowly growing tumor originating from benign neoplastic Schwann cells of the peripheral nerve sheath. Due to its rarity and complex anatomical location they can pose the misdiagnosis at clinical evaluation. A total surgical excision with a safety margin was performed for 63 year-old male with the complaints of painless lump at the axillary region for 4 months and the diagnosis of axillary Schwannoma confirmed by the histopathological examination and immunohistochemistry. Although its rarity, Schwannoma should be kept in mind for the differential diagnosis of axillary masses. Its complete resection represents the cure for indicated cases. KEY WORDS: Axilla, Immunohistochemistry, Peripheral Nerve Sheath, Schwannoma.
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Copyright © 2014 Ahmet Eroglu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is... more
Copyright © 2014 Ahmet Eroglu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pain is an outstanding problem after surgical trauma. Pain following surgery may initiate variety of mechanisms including inflammatory, visceral, or somatic in origin and may persist to be chronic pain if improperly treated. The incidence of postoperative pain has been reported to be as higher as 60%, and, despite intensive effort, it is not able to resolve completely [1]. Most of the surgeries become less invasive and are increasingly being outpatient-based in time dependent man-ner. Besides technical developments on surgery, this tendency is mainly dependent on effective pain control and reduction of the side effects related to the treatments. Opioids and nonsteroidal anti-inflammatory drugs are the other main
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OZET Bu cal›flmada, alt abdominal cerrahide intravenoz HKA yontemi ile kullan›lan tramadol, tramadol-metamizol ve tramadol-lornoksikam kombinasyonlar›n›n postoperatif analjezik etkilerinin karfl›laflt›r›lmas› amacland›. Alt abdominal... more
OZET Bu cal›flmada, alt abdominal cerrahide intravenoz HKA yontemi ile kullan›lan tramadol, tramadol-metamizol ve tramadol-lornoksikam kombinasyonlar›n›n postoperatif analjezik etkilerinin karfl›laflt›r›lmas› amacland›. Alt abdominal cerrahi giriflim uygulanacak 60 eriflkin kad›n hasta cal›flmaya dahil edildi. Hastalar randomize olarak uc gruba ayr›ld›lar. Grup I (tramadol) icin, 50 ml izotonik NaCl icinde 500 mg tramadol (10 mg/ml tramadol); Grup II (tramadol- metamizol) icin, 50 ml izotonik NaCl icinde 250 mg tramadol + 3000 mg metamizol (5 mg/ml tramadol + 60 mg/ml metamizol) ve Grup III (tramadol- lornoksikam) icin ise, 50 ml izotonik NaCl icinde 250 mg tramadol + 20 mg lornoksikam (5 mg/ml tramadol + 0,4 mg/ml lornoksikam ) iceren solusyonlar haz›rland›. Her uc grupta da operasyon bitiminden 30-40 dakika once bafllanarak, 10 ml, 30 dakikada gidecek flekilde yukleme dozu uyguland›. Hasta ar›dan ilk yak›nd›¤› zaman HKA uygulamas› bafllat›ld›. Ar› VAS ile ilk 1 saatte 15 dak. ara ...
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In this study, we aimed to investigate the effects of topical tramadol administration on corneal wound healing, and examine ophthalmic structures and intraocular pressure 7 days after tramadol administration. The experiments were... more
In this study, we aimed to investigate the effects of topical tramadol administration on corneal wound healing, and examine ophthalmic structures and intraocular pressure 7 days after tramadol administration. The experiments were conducted on eight male Wistar rats (250-300 g). After ophthalmic examination, epithelial cell layers in the central cornea were wounded. Rats received 30 μL of tramadol hydrochloride in one eye (Group Tramadol) and the same volume of vehicle in the other (Group Control) every 12 h for 7 days. Both eyes were stained with fluorescein dye, photographed, and wound area was calculated every 8 h until complete healing was observed. Eye blink frequency and corneal reflex tests were measured before and after drug administrations. After 7 days, slit lamp biomicroscopy, fundoscopy, Goldmann applanation tonometry, and histological evaluation were performed. There was no difference in the corneal wound healing rates between the tramadol and control groups. Reduction in wound area over time was also similar; group-time interaction was insignificant (F = 738.911; p = 0.225). Tramadol application resulted in blinking and blepharospasm for 30 s, but vehicle did not. Corneal reflex was intact and eye blink frequency test results were similar in all measurement times in both groups. Slit lamp biomicroscopy, fundoscopy, and intraocular pressures were within normal range. Corneal cells appeared unaffected by the repeated doses of tramadol for 7 days. Topical tramadol application on the cornea did not cause any side effect, except for initial temporary blinking and blepharospasm. Corneal wound healing was not affected, either.
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The aim was to investigate whether tramadol had toxic effect on cerebral neurons and/or spinal cord neurons when it was administered into the cerebrospinal fluid. Due to lipid peroxidation (LPO) and myeloperoxidation (MPO) levels are not... more
The aim was to investigate whether tramadol had toxic effect on cerebral neurons and/or spinal cord neurons when it was administered into the cerebrospinal fluid. Due to lipid peroxidation (LPO) and myeloperoxidation (MPO) levels are not specific predictors of neuronal damage, these biochemical markers of tissue damage were evaluated together with the histopathological findings of apoptosis. Forty eight Wistar rats were anesthetized and the right femoral artery was cannulated. Mean arterial pressures, and heart rates, arterial carbon dioxide tension, arterial oxygen tension, blood pH were recorded. When the free cerebrospinal fluid flow was seen; 0.04 mL normal saline (Group Sham) or diluted tramadol in 0.04 mL volume (Group T1, T2, T0.5 and T0.1) was administered within 30 seconds from the posterior craniocervical junction of rats. For the Control Group, the free cerebrospinal fluid flow was seen but nothing was injected in it. After 7 days, following the sacrification of the rats,...
Research Interests: Medicine, Cerebrospinal Fluid, Pubmed, Spinal Cord, Anesthesia, and 4 moreTramadol, Rats, Saline, and lumbar
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ABSTRACT The optimal volume of epidural saline administration on spinal anesthesia is not clear. The aim of this study was therefore to evaluate the block characteristics of 5, 10, 15, and 20 mL epidural saline after spinal anesthesia.... more
ABSTRACT The optimal volume of epidural saline administration on spinal anesthesia is not clear. The aim of this study was therefore to evaluate the block characteristics of 5, 10, 15, and 20 mL epidural saline after spinal anesthesia. This prospective, randomized double-blind study was conducted in the operation room setting of a university hospital. Seventy-five healthy adult patients electively undergoing limb surgery under regional anesthesia were investigated. Spinal anesthesia was performed, and plain bupivacaine (10 mg) was administered within one minute using combined spinal and epidural anesthesia. Epidural catheters were introduced, and patients were allocated to one of five groups to receive 0, 5, 10, 15 or 20 mL saline through the catheter (N=15 in each group). The patient was assessed every minute for motor and sensory block levels until a maximum level was reached. In addition, the patient was assessed thereafter in five-minute intervals using Bromage's scale for motor block and pinprick/cold sensation for sensory block. The maximum level of spinal analgesia was significantly lower in the control group compared to the saline treatment groups, but there was no significant difference between the epidural saline groups. The periods for motor block resolution were the same. The duration of analgesia was significantly longer in patients receiving 15 mL saline compared to other groups. The time to regression to the L1 level was significantly longer with 15- and 20-mL treatment groups compared to the 5- and 10-mL groups. The present results indicate that a ceiling effect was observed on the duration of spinal analgesia using plain bupivacaine with epidural saline loading (maximum--15 mL).
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Background: We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. The efficacy of the program was evaluated by comparing the performances of experts and novices. Methods: The training procedure... more
Background: We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. The efficacy of the program was evaluated by comparing the performances of experts and novices. Methods: The training procedure was divided into two sessions: a theoretical session on difficult airways, the fiber optic bronchoscope (FOB), remifentanil, topical anesthesia and patient interactions; and a session involving simulations of the FOI technique on dummies. For in vivo FOI, we enrolled patients requiring orotracheal intubation for elective surgery. Electrocardiograms, mean arterial pressure was railroaded over the fiberscope, and tracheal intubati6 and 7) FOIs, respectively, joined the study. To reach ±23 bpm, P=0.02), and RR was decreased (from 16±3 to 12±4 bpm, P<0.05). No differences were recorded between the experts and less-experienced anesthesiologists. The average duration of FOI was 3.3±2.0 min for experts and 4.2±2.4 min for novices (P=0.03). Procedures were successful in both groups, with patients in each group being equally satisfied with the procedures. Conclusion: This study highlights the importance of a structured FOI training program, demonstrating that it is possible to learn to perform FOI proficiently by practicing on dummies.
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Continuous peripheral nerve blocks refer to a local anesthetic solution administered via perineurally placed catheters in an effort to extend the benefits of a single-shot peripheral nerve block. They offer several advantages in the... more
Continuous peripheral nerve blocks refer to a local anesthetic solution administered via perineurally placed catheters in an effort to extend the benefits of a single-shot peripheral nerve block. They offer several advantages in the postoperative period including excellent analgesia, reduced opioid consumption and associated side effects, enhanced rehabilitation and improved patient satisfaction. The current trend towards less invasive, one-day surgery and enhanced recovery programs may decrease the requirement of catheter use. Prolonged motor block in particular is associated with undesirable outcomes. Should we routinely use continuous peripheral nerve blocks in our daily practice? This PRO-CON debate aims at answering the question from the experts' perspectives. Fascial compartment and wound catheters are outside the scope of this debate.
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Continuous peripheral nerve blocks refer to a local anesthetic solution administered via perineurally placed catheters in an effort to extend the benefits of a single-shot peripheral nerve block. They offer several advantages in the... more
Continuous peripheral nerve blocks refer to a local anesthetic solution administered via perineurally placed catheters in an effort to extend the benefits of a single-shot peripheral nerve block. They offer several advantages in the postoperative period including excellent analgesia, reduced opioid consumption and associated side effects, enhanced rehabilitation and improved patient satisfaction. The current trend towards less invasive, one-day surgery and enhanced recovery programs may decrease the requirement of catheter use. Prolonged motor block in particular is associated with undesirable outcomes. Should we routinely use continuous peripheral nerve blocks in our daily practice? This PRO-CON debate aims at answering the question from the experts' perspectives. Fascial compartment and wound catheters are outside the scope of this debate.
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The aim of this study is to investigate the potential hazardous effects of 1800 MHz Global System for Mobile Communications-like (GSM-like) Radiofrequency (RF) exposure on the cochlear functions of female infant and adult rabbits by... more
The aim of this study is to investigate the potential hazardous effects of 1800 MHz Global System for Mobile Communications-like (GSM-like) Radiofrequency (RF) exposure on the cochlear functions of female infant and adult rabbits by measuring Distortion Product Otoacoustic Emission (DPOAE) response amplitudes. Eighteen each one-month-old New Zealand White female rabbits and eighteen each 13-month-old adult rabbits were included into the study. They were randomly divided into four groups. Nine infant rabbits (Group 1) were not exposed to 1800 MHz GSM-like RF (Infant Control, C-In). Nine infant rabbits (Group 2) were exposed to 1800 MHz GSM-like RF, 15 min daily for 7 days after they reached one-month of age (Infant RF, RF-In). Nine adult rabbits were not exposed to 1800 MHz GSM-like RF, 15 min daily for 7 (Adult Control, C-Ad). Nine adult rabbits were exposed to 1800 MHz GSM-like RF, 15 min daily for 7 days (Adult RF, RF-Ad). Cochlear functions were assessed by DPOAEs at 1.0-8.0 kHz....
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PubMed: 25650560Postoperative nausea and vomiting (PONV) is still “the little big problem” for the anesthesiologists.1 Kolanek et al. have assessed the efficacy of a multimodal antiemetic strategy, which was associated with a continuous... more
PubMed: 25650560Postoperative nausea and vomiting (PONV) is still “the little big problem” for the anesthesiologists.1 Kolanek et al. have assessed the efficacy of a multimodal antiemetic strategy, which was associated with a continuous quality improvement program, in maintaining a low PONV incidence in the PACU. The authors performed a two phased study and they have shown that a multimodal approach associated with continuous quality improvement program was able to reduce the incidence of PONV from 9.4% to 3.9% during Phase I and Phase II respectively in patients without risk factors and from 16.6% to 4.2% during Phase I and Phase II respectively in high risk patients
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OZET Genel anesteziden sonra bafllanan magnezyum sulfat infuzyonu analjezik gereksinimini azaltmaktad›r. Bu cal›flmada, brakiyal pleksus blokaj›ndan sonra postoperatif ilk 24 saat uygulanan magnezyum sulfat infuzyonunun blok suresi,... more
OZET Genel anesteziden sonra bafllanan magnezyum sulfat infuzyonu analjezik gereksinimini azaltmaktad›r. Bu cal›flmada, brakiyal pleksus blokaj›ndan sonra postoperatif ilk 24 saat uygulanan magnezyum sulfat infuzyonunun blok suresi, sedasyon ve postoperatif analjezik tuketimine etkilerinin araflt›r›lmas› amacland›. Yerel Etik Kurul onay› al›narak ASA I ve II s›n›f› 70 hasta cift kor, randomize cal›flmaya al›nd›. Brakiyal pleksus blokaj› aksiller yaklafl›mla lidokainin 40 ml %1 .25 1/200000 adrenalinli solusyonu kullan›larak gerceklefltirildi. Hastalara 24 saat surede eflit volumde 5 mg/kg bolus ve 500 mg/saat magnezyum sulfat veya serum uyguland›. ‹lk 24 saatlik surede gruplar›n ilk ar› duyumu, motor bloun kalkma suresi ve analjezik gereksinimi yan›nda 4 saatte bir al›nan sedasyon ve vizuel analog skorlar› deerlendirildi. ‹lk ar› duyumu ve ilk analjezik kullan›m› belirgin oranda artmakla birlikte magnezyum infuzyon grubunda toplam analjezik tuketiminde belirgin duzeyde azalma saptan...
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Backgrounds: Erector spinae plane block (ESPB) has become very popular for post-operative and chronic pain management. ESPB applications sacral area procedures have been named 'sacral ESPB’. This study is aimed to conduct a cadaveric... more
Backgrounds: Erector spinae plane block (ESPB) has become very popular for post-operative and chronic pain management. ESPB applications sacral area procedures have been named 'sacral ESPB’. This study is aimed to conduct a cadaveric study to determine how local anesthesia was distributed at median and intermediate approaches of the sacral region ESPB procedures. Materials and Methods: Four cadavers were grouped into two groups; median and intermediate approaches. An ultrasound-guided ESPB was performed with a mixture of radiocontrast and dye. After the distribution of the solution was observed by computed tomography, cadavers were dissected in order to observe the dye spread in the groups. Results: CT Images of the median group demonstrated subcutaneous pooling of contrast agents between S1 and S5 horizontal planes. Contrast agent passing from the sacral foramina to the anterior of the sacrum via spinal nerves was also observed between S2-S5. In the intermediate group contrast ...
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BACKGROUND: In this prospective controlled study, the aim was to examine the effects of vitamin C, mannitol and verapamil on adnexial ischaemia-reperfusion injury in the rat ovary. METHODS: Thirty-six female Wistar rats were used. In the... more
BACKGROUND: In this prospective controlled study, the aim was to examine the effects of vitamin C, mannitol and verapamil on adnexial ischaemia-reperfusion injury in the rat ovary. METHODS: Thirty-six female Wistar rats were used. In the controls (group 1), only laparotomy was performed. In group 2, ovarian ischaemia was produced and the bilateral ovaries were surgically removed 4 h later.
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The choice of anesthetic technique based on its advantages and disadvantages in elderly patients will inevitably be influenced by the patient's comorbidities, such as cardiovascular disease, diabetes mellitus, stroke, renal... more
The choice of anesthetic technique based on its advantages and disadvantages in elderly patients will inevitably be influenced by the patient's comorbidities, such as cardiovascular disease, diabetes mellitus, stroke, renal insufficiency, and pulmonary disease. The patient's underlying cardiac conditions, although apparently stable at present, may become manifest during perioperative stresses. Caudal epidural block should be taken into consideration as a safe and effective anesthetic technique for the elderly patients who have limited cardiac reserve and comorbidities. Six patients with low ejection fraction and poor functional status due to ischemic cardiac disease scheduled for surgery under caudal epidural block are presented.