Search PubMed⌕ Search

Biomedical subjects

Unase Buyukkocak

Publications and source records attributed to Unase Buyukkocak.

6 recordsLinked to original sources

Similar effects of general and spinal anaesthesia on perioperative stress response in patients undergoing haemorrhoidectomy.

Surgery induces release of neuroendocrine hormones (cortisol), cytokines (interleukin-6: IL-6, tumour necrosis factor-alpha: TNF-alpha), acute phase proteins (C-reactive protein: CRP, leptin). We studied the effects of general and spinal anaesthesia on stress response to haemorrhoidectomy. Patients were assigned to general and spinal anaesthesia groups (n = 7). Blood samples were drawn before induction and 24 hours after surgery. Perioperative levels of IL-6, TNF-alpha, CRP, cortisol, and leptin were comparable among the groups. Twenty four hours after surgery, TNF-alpha and cortisol did not change; IL-6 and CRP increased significantly in all patients. Significant increase in leptin levels was found in patients undergoing spinal anaesthesia. Except for the increase in leptin levels, there was no significant difference related to the effects of general and spinal anaesthesia.

Adult↗

The decrease in erythrocyte sedimentation rate related to general anesthesia.

The aim of this study was to investigate whether general anesthetic agents change erythrocyte sedimentation rate (ESR) affecting erythrocytes' shape and membrane structure in routine clinical dose manner. Forty patients (23 female and 17 male) undergoing elective surgery were included to the study. Blood samples were obtained just before induction of the anesthesia and 10 minutes after endotracheal intubation. The ESR was measured using Test-1 ESR analyzer. ESR values of the second blood samples were significantly lower than the first values (p<0.001). At the beginning, the ESR was 18.1+/-11.5 mm/h, and then it decreased to 13.1+/-9.3 at 10th minutes. Our results indicated that anesthetic agents affected the ESR. No increase was observed in the second ESR values which were equal to, or less than the first values. General anesthesia may lead to this decrease changing electrolyte balance of erythrocyte, affecting ligands of agglomerins in membrane directly and indirectly, or changing discoid shape of erythrocyte.

Adult↗

Effects of different anesthetic techniques on serum leptin, C-reactive protein, and cortisol concentrations in anorectal surgery.

AIM: To compare the effects of intratracheal general anesthesia (ITGA) and regional (saddle block) anesthesia on leptin, C-reactive protein (CRP), and cortisol blood concentrations during anorectal surgery. METHODS: Fifty-eight patients suffering from hemorrhoidal disease, pilonidal sinus, anal fissure, or anal fistula were included the study. Patients were randomly assigned into one of the two groups (n=29). Patients in one group received ITGA. After thiopental and fentanyl induction, vecuronium was used as a muscle relaxant. Anesthesia was maintained with sevoflurane. In the other group we applied saddle block, injecting hyperbaric bupivacaine into the subarachnoid space, through the L3-L4 intervertebral space, in the sitting position. Blood samples were collected for leptin, CRP, and cortisol analysis before the induction of anesthesia at 3 and 24 hours postoperatively. RESULTS: Preoperative leptin, CRP, and cortisol concentrations were comparable between the groups. There was no significant difference in postoperative levels of leptin and CRP in both groups. Although not significant, leptin and CRP concentrations were lower in the saddle block group at three hours postoperatively (mean-/+SD, 6.95-/+8.59 and 6.02-/+12.25, respectively) than in the ITGA group (mean-/+SD, 9.04-/+9.89 and 8.40-/+15.75, respectively). During early postoperative period, cortisol increased slightly in the ITGA group and remained at similar level in the saddle block group, but later decreased in both groups. Cortisol levels in the saddle block group were significantly lower than in the ITGA group at 3 hours postoperatively (343.7-/+329.6 vs 611.4-/+569.8; P=0.034). CONCLUSION: Saddle block, a regional anesthetic technique, may attenuate stress response in patients undergoing anorectal surgery, by blocking afferent neural input during early postoperative period.

Adult↗

Anaesthesia and the acute phase protein response in children undergoing circumcision.

Concentrations of acute phase proteins (CRP: C-reactive protein, albumin) change during surgery. We investigated the acute phase response to circumcision and the effects of anaesthesia on this response. The children were divided into four groups; group 1 (intratracheal general anaesthesia, n=40), group 2 (general anaesthesia with mask, n=20), group 3 (ketamine, n=20), group 4 (local anaesthesia, n=35). Blood samples were obtained, 24 hours before circumcision, after premedication, and 24 hours after circumcision. CRP and albumin before circumcision were comparable for all groups. There was no increase in CRP, and albumin remained steady throughout the study. No difference was observed among the groups, and related to anaesthesia. No responsiveness may be explained with the size of injured tissue or anatomical and histological type of preputium.

Acute-Phase Proteins↗

The effects of anesthetic techniques on acute phase response at delivery (anesthesia and acute phase response).

OBJECTIVES: To investigate the effects of anesthetic techniques and delivery types on stress response during uncomplicated delivery. DESIGN AND METHODS: Forty pregnant women at term were divided into four groups. Group-I, cesarean section with general anesthesia; Group-II, section with spinal anesthesia; Group-III, section with epidural anesthesia; and Group-IV, vaginal delivery with epidural analgesia. C-reactive protein and albumin were measured on hospital admission, immediately after delivery and 24 h later. RESULTS: Albumin and CRP levels decreased significantly in Group-II and Group-III, just after delivery. CRP increased significantly in all groups at the 24(th) hour of delivery. The effect of hemodilution on CRP and Albumin, due to volume loading, during spinal and epidural anesthesia disappeared after 24 h. CONCLUSION: We found no influence of anesthetic techniques on acute phase response except hemodilution effect. In the view of delivery types, vaginal delivery caused less stress response than section.

Acute-Phase Reaction↗

Four analgesic techniques for shockwave lithotripsy: eutectic mixture local anesthetic is a good alternative.

BACKGROUND AND PURPOSE: Various sedative and analgesic medication has been used for shockwave lithotripsy (SWL). The aim of this study was to evaluate the efficacy of different anesthesia modalities in these patients. PATIENTS AND METHODS: One hundred patients were randomly divided into four groups. The first (Group F) received fentanyl 1 microg/kg intravenously (IV), the second (Group D) received diclofenac sodium 1 mg/kg intramuscularly (IM), the third (Group T) received tramadol 1.5 mg/kg IM, and the fourth (Group E) was given 15 g of eutectic mixture local anesthetic (EMLA) cream containing lidocaine and prilocaine. After routine preoperative evaluation, all patients received midazolam 2 mg IV 5 minutes before lithotripsy for sedative premedication. In all groups, a supplemental 25-microg bolus of fentanyl was administered IV when patients complained of pain, moved, or grimaced in response to the shockwaves. Pain intensity was evaluated on a 0- to 100-mm visual analog scale (VAS). The level of sedation was determined using the Observer's Assessment of Alertness/Sedation (OAS/S). Side effects such as bradypnea, oxygen desaturation, bradycardia, pruritus, and nausea and vomiting were recorded. RESULTS: There were no statistically significant differences among the four groups with regard to VAS, OAS/S scores, or side effects. In Group F, the mean arterial pressure was decreased significantly at 10 and 20 minutes. The patients in this group also manifested a decrease of oxygen saturation at the first, tenth, and twentieth minutes and the end of SWL. CONCLUSION: Application of EMLA cream was as safe and effective as fentanyl, diclofenac, and tramadol, and reduction of the fentanyl dose during SWL was possible.

Adult↗