Objective: During functional endoscopic sinus surgery (FESS), sufficient control of bleeding is essential in order to increase the visibility in the operative field and reduce the risk of injury to the optic nerve or internal carotid artery. However, choosing the ideal agent is still a controversial topic. The aim of this study is to compare the effects and possible side effects of remifentanil and dexmedetomidine for controlled hypotension in FESS.Methods: Fifty ASA I-II patients, aged between 18-60 years, undergoing elective FESS, were included. Patients were randomly assigned into two groups (n=25) as Group R (remifentanil infusion, 0.25 mcg kg -1 h -1 ) and Group D (dexmedetomidine infusion, 0.2-0.7 mcg kg -1 min -1 ). The duration of anesthesia, surgery and controlled hypotension, total drug doses, dryness of the surgical area, recovery time, side effects, liver and kidney function analyses were recorded. Results:There was no statistically significant difference between the groups in operation time, duration of anesthesia and controlled hypotension time. Group R and D were similar in average SpO 2 , dryness, arterial blood pressure, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN) and creatinine at all measurement times. Heart rate was lower in Group D than Group R at the time of extubation and 5, 10, 15, 20, 30. min after extubation (p<0.05). Mean recovery time of Group D was longer than Group R (p<0.001).Conclusion: Based on the side effect scores, visualisation results of surgical area, liver or renal functions; both dexmedetomidine and remifentanil provided adequate, safe, controlled hypotensive anesthesia. However, dexmedetomidine was associated with significantly longer recovery time period compared with remifentanil.Amaç: Fonksiyonel endoskopik sinüs cerrahisi (FESS) sırasında kanamanın kontrol altına alınması; cerrahi alandaki görüşün artması ile birlikte, optik sinir veya internal karotis arteri gibi önemli yapıların yaralanması riskini de azaltmaktadır. Ancak, bu amaç için ideal ajan seçimi tartışmalı bir konu olmaya devam etmektedir. Bu çalışmada, FESS için kontrollü hipotansiyon uygulamalarında remifentanil ile deksmedetomidinin etkinlikleri ile gelişebilecek yan etkilerinin karşılaştırılmaası amaçlanmıştır.Yöntemler: Çalışmaya, elektif FESS cerrahisi geçirecek, ASA I-II, 18-60 yaş arasında 50 hasta dahil edildi. Hastalar randomize olarak, Grup R (remifentanil infüzyonu, 0,25 mcg kg -1 s -1 , n=25) ve Grup D (deksmedetomidin infüzyonu, 0,2-0,7 mcg kg -1 dk -1 ) olarak iki gruba ayrıldı. İlaç enjeksiyonundan, hedeflenen kan basıncının oluşmasına kadar geçen süre, anestezi ve cerrahi süreleri, verilen toplam ilaç miktarı, cerrahi sahanın kuruluğu, derlenme süresi, yan etkiler ile karaciğer ve böbrek işlevlerine ait değerler kaydedildi. Bulgular: Gruplar arasında anestezi, cerrahi işlem süresi ve kontrollü hipotansiyon süresi bakımından istatistiksel olarak anlamlı fark yoktu. Ortalama periferik oksijen satürasyonu, cerrahi sahanın kuruluğu, kan basınçları,...
This article analyses the first 20 years of the journal Philosophyof Management to provide insight into how the journal has developed and delineated the field of philosophy of management. Our content analysis uses an inductively developed combination of thematic and frequency analysis. We present our findings in a descriptive tone, inviting scholars to reflect upon how the journal has shaped the field over the past two decades, and to trigger a discussion on a more deliberately inclusive future shaping of the field.
Çalışmamızın amacı spinal anestezi altında sezaryen ameliyatı geçirecek olgularda 10 mg levobupivakaine 10 mcg fentanil, 0.01 mg morfin veya salin eklenmesinin etkilerini karşılaştırmaktır.
OZET Konjenital agn duyarsizligi sendromunda anestezi uyguiamasi: Oigu sunumuKonjenital agn duyarsizligi sendromu, erken çocukiuk döneminde görülen, oldukça nadir, agn duyarsizligi ile karakterize otozomal resesif bir otonom nöropatidir. Olgulann tümünde dogumdan itibaren agn duyusu yoktur. Sistemik anhidroz ve zeka geriligi sendromun tipik bulgulanndandir. Konjenital agn duyarsizligi olan pediatrik olgular, siklikia birden çok defa ortopedik cerrahi uygulamalar nedeniyle genel anesteziye gerek duyarlar. Agn duyusu olmamasina ragmen, olgular cerrahi ijlem sirasinda rahatsiziik verici olan dokunsal hiperesteziye sahiptirler. Konjenital agn duyarsizligi sendromu olan, 12 yajindaki erkek olgudaki sag diz artodezi uygulamasi sirasindaki anestezi yönetimimizi sunduk.Anahtar kelimeler: Anestezi, genel, konjenital agn duyarsizligi sendromu, bispektral indeks ABSTRACT Anesthesia management in congenitai pain insensitivity syndrome.-a case reportCongenital pain insensitivity syndronne (CPIS) is a very rare autosomal recessive neuropathy, characterized by insensitivity to pain which is seen in early childhood. In all patients the pain sensation is absent from bimh. Systemic anhydrosis and mental retardation are also characteristic findings of this syndrome. Pédiatrie patients with CPIS frequently present for multiple orthopaedic surgeries requiring general anesthesia. Although there is insensitivity to pain, patients have taaile hyperesthesia that can cause unpleasant feelings during surgical procedures. We repon; our anaesthetic management of a 12 years old male patient with CPIS undergoing right knee amhrodesis undergoing general anaesthesia.
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