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Yayın The antimicrobial activity of ephedrine and admixture of ephedrine and propofol: an in vitro study [A atividade antimicrobiana de efedrina e da combinação de efedrina e propofol: um estudo in vitro](Elsevier Editora Ltda, 2018) Tulgar S.; Alasehir E.A.; Selvi O.Introduction Propofol and Ephedrine are commonly used during anesthesia maintenance, the former as a hypnotic agent and the later as a vasopressor. The addition of propofol to ephedrine or administration of ephedrine before propofol injection is useful for decreasing or preventing propofol related hemodynamic changes and vascular pain. This in vitro study evaluated the antibacterial effect on common hospital-acquired infection pathogens of ephedrine alone or combined with propofol. Material and method The study was performed in two stages. In the first, the Minimum Inhibitory Concentration of propofol and ephedrine alone and combined was calculated for Escherichia coli, Enterococcus faecium, Staphylococcus aureus, Pseudomonas aeruginosa, and a clinical isolate of Acinetobacter spp. at 0, 6, 12 and 24 h, using the microdilution method. In the second stage, the same drugs and combination were used to determine their effect on bacterial growth. Bacterial solutions were prepared at 0.5 MacFarland in sterile 0.9% physiological saline and diluted at 1/100 concentration. Colony numbers were measured as colony forming units.mL-1 at 0, 2, 4, 6, 8, 10 and 12th hours. Results Ephedrine either alone or combined with propofol did not have an antimicrobial effect on Escherichia coli, Enterococcus faecium or Pseudomonas aeruginosa and this was similar to propofol. However, ephedrine alone and combined with propofol was found to have an antimicrobial effect on Staphylococcus aureus and Acinetobacter species at 512 mcg.mL-1 concentration and significantly decreased bacterial growth rate. Conclusion Ephedrine has an antimicrobial activity on Staphylococcus aureus and Acinetobacter species which were frequently encountered pathogens as a cause of nosocomial infections. © 2017 Sociedade Brasileira de AnestesiologiaYayın Can unilateral erector spinae plane block result in bilateral sensory blockade?(Springer New York LLC, 2019) Tulgar S.; Selvi O.; Ahiskalioglu A.; Ozer Z.…Yayın Does Flumazenil effect the anesthetic agents other than benzodiazepines?: Case report [Flumazenil benzodiazepinler dişindaki anestezik ajanlari da etkiler mi?: Olgu sunumu](Anestezi Dergisi, 2015) Şentürk Ö.; Selvi O.; Özer Z.Flumazenil is an imidazobenzodiazepine which is used to reverse sedative and hypnotic effects of benzodiazepines. Although reversing effect of Flumazenil on other anesthetic drugs has been published in the recent studies the mechanism is still unknown. In this case report we present our experience in two patients who unexpectedly recovered from anesthesia following Flumazenil administration. Two male patients respectively at the age of 18 and 19 evaluated as ASA I in preoperative examination, were operated for tonsillectomy, adenoidectomy and septorhinoplasty. One of them was given Midazolam (1 mg iv) as premedication 30 minutes before the operation. Both patients received the same anesthesia induction method (Propofol, Fentanyl) and agents used for maintanence of anesthesia (Sevoflurane, Remifentanil) were identically same. At the end of the operation Atropine and Neostigmine were aplied to the patients to reverse neuromuscular blockers. Signs of recovery from anesthesia were not observed even after more than half an hour period. Flumazenil (0,5 mg iv) were used since there were no any possible reasons to explain this clinical manifestation. In both patients spontaneous eye opening and recovery of respiration were recorded after about a few minutes following Flumazenil administration. Our experience related to these two patients puts forward Flumazenil administration as an unignorable option in delayed recovery from anesthesia and the mechanism behind this phenomenon is worth to proceed further studies.Yayın Evaluation of ultrasound-guided transversalis fascia plane block for postoperative analgesia in cesarean section: A prospective, randomized, controlled clinical trial(Elsevier Inc., 2020) Serifsoy T.E.; Tulgar S.; Selvi O.; Senturk O.; Ilter E.; Peker B.H.; Ozer Z.Study objective: Cesarean Delivery (CD) is a commonly performed obstetric procedure. Adding a regional anesthesia technique to multimodal analgesia in CD, may improve the quality of postoperative analgesia. In this study we evaluated the efficacy of Transversalis Fascia Plane Block (TFPB) for postoperative analgesia management in CD. Design: Blinded, prospective, randomized study. Setting: Postoperative recovery room & ward, tertiary university hospital, Istanbul, Turkey, Patients: Seventy-five patients (ASA II-III) scheduled to undergo Cesarean delivery were recruited. Following exclusion, 70 patients were randomized into two equal groups (block and control group). Interventions: Standard multimodal analgesia (routine paracetamol and tramadol PCA in addition to diclophenac sodium as rescue analgesia) was performed in Group C while TFPB block was also performed in the intervention (TFPB) group. Measurements: The primary outcome was tramadol consumption within the first 24 h. The secondary outcome was Numeric Rating Scale (NRS) scores during rest and movement/coughing. Main results: Tramadol consumption in the first 24 h was 175 ± 72.32 mg in the control and 101.42 ± 51.45 mg in the TFPB group (p < 0.05). NRS was lower in Group TFPB during the first 3 h and at the 12th hour. There was no difference in NRS scores at other hours. Conclusion: Bilateral ultrasound guided TFPB leads to effective analgesia and a decrease in analgesia requirement in first 24 h in patients undergoing CD. © 2019 Elsevier Inc.Yayın Similarities between external oblique fascial plane block and blockage of thoracoabdominal nerves through perichondral approach (TAPA)(Elsevier Inc., 2019) Tulgar S.; Ahiskalioglu A.; Selvi O.; Thomas D.T.; Ozer Z.…Yayın Use of quips survey for the assessment of quality in postoperative pain management [Postoperatif agri yönetn kaütesinin degerlendirilmesinde quips anketi yönteminin kullanimi](Anestezi Dergisi, 2016) Ozütemiz M.; Selvi O.; Tulgar S.; Özer Z.Objective: Although there are guidelines and advanced pain management techniques, quality of postoperative pain management can not still be measured with a standard method considering safety issues. Many factors like nausea, vomiting, functional disability and immobility have an effect on the achivement of postoperative pain therapy. QUIPS is a survey which takes all these factors into account. In this study we tried to evaluate the quality of postoperative pain management by using QUIPS. Method: This study was conducted on 400 volunteers who were planned for surgical operation between 07.2014 - 01.2015 at Maltepe University Medical Faculty Hospital. QUIPS was applied to these patients the day after the surgery Results: Fifty-four percent (n:216) of the patients were women and 46% (n:184) of them were men. These patients were asked about their pain level in questions 3 and 4. The highest scores for pain were recorded in neurosurgery and orthopedics. In the fifth question patients were asked to answer whether they had immobility problems due to pain and the highest scores were in neurosurgery patients (p<0.01). The most satisfied patients with their pain theraphy were in ENT group. Conclusion: The fact that focusing on only pain revealing therapies are not adequate while approaching towards postoperative pain was the main motivation in preaparation of QUIPS. Beacuse of this fact QUIPS can be used as a useful tool to evaluate pain, pain related symptoms and quality of postoperative pain management.
