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    Comparison of Maintenance and Recovery Characteristics of Desflurane and Sevoflurane in Children [çocuklarda Desfluran-sevofluran Anestezisinin İdame Ve Derlenme Üzerine Olan Etkilerinin Karşilaştirilmasi]
    (2003) Uzun, S.; Tuncer, S.; Tavlan, Aybars; Reisli, Ruhiye; Sarkilar, Gamze; Ökesli S.
    In this study, the characteristics of desflurane and sevoflurane were compared for maintenance of anaesthesia in short-term surgery of children. Fifty children, 4-12 years old were studied. Thirty minutes prior to the induction of anaesthesia, all patients received 0.5 mg kg-1 midazolam orally. They were randomly assigned to receive 6-7 % desfurane (group I) and 2-2.5 % sevoflurane (group II) with 60 % nitrous oxide in oxygen for maintenance of anaesthesia. For anaesthesia induction all patients were given 2-2.5 mg kg -1 propofol, 10 ?g kg-1 alfentanil and 0.1 mg kg -1 cisatracurium and after two minutes all patients were intubated. Before surgery, patients received 20 mg kg-1 paracetamol rectally for postoperative analgesia. Dexamethasone 150 ?g kg-1 was given to reduce the incidence of postoperative nausea and vomiting. Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure and heat rate were measured: before induction, after induction and during intubation, 5, 10, 20 minutes after surgery and at the end of anaesthesia. At the end of the operation extubation and recovery times were determined. Agitation was evaluated by using the three -point score. Hemodynamic parameters were satisfactorily maintained within ± 30 % of baseline values in both groups. Recovery time was significantly shorter in the desflurane group than sevoflurane group (p<0.05). Extubation time and incidence of agitation were similar for both groups. Differences in the incidence of postoperative vomiting were not statistically significant between the groups. As a result, we concluded that both sevoflurane and desflurane can be used safely for the maintenance of anaesthesia after induction of propofol in children.
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    The Maternal and Neonatal Effects of Intrathecal Sufentanil and Fentanyl Added to Hyperbaric Bupivacaine for Cesarean Section [Sezaryenlerde Bupivakaine Eklenen Sufentanil ve Fentanilin Maternal ve Neonatal Etkileri]
    (2003) Reisli, Ruhiye; Tuncer, Sema; Çelik, J.; Yosunkaya, Alper; Uzun, S.; Sarkılar, Gamze; Ökesli, S.
    We aimed to evaluate the maternal and neonatal effects of intrathecal sufentanil, fentanyl and plasebo added to hyperbaric bupivacaine for cesarean section. After etthical committee approval, 45 healty, full-term parturients allocated into three groups. Group K (control group) received 10 mg bupivacaine heavy and 2 cc % 0.9 NaCl, Group F received 10 mg bupivacaine heavy and 25 ?g fentanyl and Group S received 10 mg bupivacaine heavy and 10 pg sufentanil intrathecally, Total volume of 4 mL was used in both groups. Haemodynamic values, sensory and motor blocs, the first requirement time for analgesia and Intrapostoperative side effects were recorded. Blood samples were collected from the umblical artery for blood gas analyses. Apgar score at 1 and 5 min. and Neurologic and Adaptive Capacity Score (NACS) of newborns at 2 evaluated. There were no significant differences in patients characteristics, time to reach L1-2, T10 and maximal sensory level, degree and resolution of motor block, blood gas analyses, Apgar and NACS scores. Nausea was more in group K than in group S and F (p<0.05). Pruritus was a frequent side effect both in group S and F (p<0.05), but it was more remarkable in group S (p<0.05). Complete analgesia was prolong in group F and S than in group K. The first requirement time for analgesia was longer in group S compared to group F (p<0.05). In summary, intrathecal fentanyl 25 pg or sufentanil 10 ?g added to hyperbaric bupivacaine for cesarean section reduced nausea and increased the duration of analgesia in the early postoperative period. Because this combinations had no adverse effects oil neonatals we concluded that they can be used safely in cesarean sections.