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Comparison of propofol-dexmedetomidine, tiopental-dexmedetomidine and etomidate-dexmedetomidine combinations' effects on the tracheal intubation conditions without using muscle relaxants

Bollucuoglu K. | Hanci V. | Yurtlu S. | Okyay D. | Ayoglu H. | Turan I.O.

Article | 2013 | Bratislava Medical Journal114 ( 9 ) , pp.514 - 518

Background: In our study, we aimed to compare the endotracheal intubation conditions without muscle relaxants during induction with the combinations of dexmedotimidine-propofol, dexmedotimidine-thiopenthal and dexmedetomidine-etomidate. Method: Seventy-six patients, in ASA risk group I-II, between ages 20-60 years, with Mallampati Class 1 were included in the study. All patients were premedicated with midazolam. The patients were randomly divided into three groups as Group P (n=30, dexmedetomidine-propofol), Group T (n=30, dexmedetomidine-thiopenthal), Group E (n=16, dexmedetomidine-etomidate). All patients received dexmedetomidine . . .1 µg.kg-1 in 10 min. Then, the patients were administered 2.5 mg.kg-1 propofol for Group P, 5 mg.kg-1 thiopental for Group T and 0.3 mg.kg-1 etomidate for Group E during induction. Hemodynamic data of the patients were recorded before induction, after dexmedetomidine administration, immediately after intubation and 3, 5 and 10 minutes after intubation. Results: There was no difference between the groups according to hemodynamic data. Sixteen patients in Group P and 10 patients in Group T had acceptable intubation conditions. Muscle relaxant was needed in 14, 20 and 16 patients in Groups P, T and E, respectively ( Daha fazlası Daha az

Does dexmedetomidine reduce the injection pain due to propofol and rocuronium?

Ayoglu H. | Altunkaya H. | Özer Y. | Yapakçi O. | Çukdar G. | Özkoçak I.

Article | 2007 | European Journal of Anaesthesiology24 ( 6 ) , pp.541 - 545

Background and objectives: This prospective, double-blind, randomized, placebo-controlled study was designed to determine the efficacy of dexmedetomidine compared with lidocaine in reducing the pain of propofol and rocuronium injection pain. Methods: One hundred and fifty patients, scheduled for elective surgery with general anaesthesia, were divided into five groups: saline (Group 1), dexmedetomidine 0.25 µg kg-1 (Group 2), lidocaine 0.5 mg kg-1 (Group 3), dexmedetomidine 0.25 µg kg -1 plus lidocaine 0.25 mg kg-1 (Group 4) or dexmedetomidine 0.25 µg kg-1 plus lidocaine 0.5 mg kg-1 (Group 5) were administered at a rate of 0.5 mL s-1 . . . after tourniquet application. The occlusion was released after 1 min and 5 mL of propofol was injected over 20 s. Pain was evaluated by use of a 10-point verbal analogue scale. Then, the rest of the induction dose of propofol, 3 mL of saline bolus and 0.6 mg kg-1 of rocuronium, was injected. The response to injection of rocuronium was assessed with a four-point scale (0-3). Results: Groups 1 and 2 were found to have higher propofol injection pain scores than Groups 3, 4 and 5 (P < 0.05). When the study groups were compared according to the overall incidence of withdrawal movements due to rocuronium (?1 response) in Groups 1, 2, 3, 4 and 5, they were different (86.7%, 60%, 36.7%, 50% and 40%, respectively) (P < 0.05). Except Group 1, there was no significant difference between the groups according to incidence of withdrawal movement after rocuronium injection (P = 0.325). Conclusions: Pretreatment with dexmedetomidine is not effective in reducing injection pain of propofol, but may attenuate the hand withdrawal associated to rocuronium, as lidocaine does. © 2007 European Society of Anaesthesiology Daha fazlası Daha az

Dexmedetomidine did not reduce the effects of tourniquet-induced ischemia-reperfusion injury during general anesthesia

Bostankolu E. | Ayoglu H. | Yurtlu S. | Okyay R.D. | Erdogan G. | Deniz Y. | Hanci V.

Article | 2013 | Kaohsiung Journal of Medical Sciences29 ( 2 ) , pp.75 - 81

Ischemia reperfusion injury causes the release of free oxygen radicals. Free oxygen radicals initiate the production of toxic metabolites, such as malondialdehyde (MDA), through the lipid peroxidation of cellular membranes. Following lipid peroxidation, the antioxidant enzyme system is activated against reactive oxygen species (ROS) and attempts to protect cells from oxidative damage. There is a balance between the scavenging capacity of antioxidant enzymes and ROS. Because of this balance, the total antioxidant capacity (TAC) measurement is a sensitive indicator of the overall protective effects of the antioxidants. Alpha2 receptor . . . agonists are effective in preventing hemodynamic reactions during extremity surgeries by preventing the release of catecholamines secondary to tourniquet application. They have also been shown to possess preventive effects in various ischemia-reperfusion injury models. In our study, we examined the effects of dexmedetomidine on tourniquet-induced ischemia-reperfusion injury in lower extremity surgeries performed under general anesthesia. The effects of dexmedetomidine were measured with serum MDA and TAC levels. We studied 60 adult American Society of Anesthesiologists (ASA) physical status I or II patients undergoing one-sided lower extremity surgery with tourniquet. The patients were randomly divided into two groups. Group D was administered a dexmedetomidine infusion at a rate of 0.1 µg/kg/minute -1 for 10 minutes prior to induction and then at 0.7 µg/kg/hour-1 until 10 minutes before the end of the operation. The control group (Group C) received a saline infusion of the same amount and for the same period of time. General anesthesia was induced with thiopental, fentanyl, and rocuronium and maintained with nitrous oxide and sevoflurane in both groups. Venous blood samples were obtained before the administration of the study drugs (basal) at 1 minute before tourniquet release and at 5 and 20 minutes after tourniquet release (ATR). In both groups, MDA levels decreased at 5 and 20 minutes ATR when compared with the basal values (p < 0.05). TAC levels decreased at 1 and 5 minutes ATR and then returned to basal values at 20 minutes ATR (p < 0.05). In reference to the prevention of lipid peroxidation in tourniquet-induced ischemia-reperfusion injury, the results from the two groups in our study showed that dexmedetomidine did not have an additional protective role during routine general anesthesia. Copyright © 2012, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved Daha fazlası Daha az

Effectiveness of dexmedetomidine in reducing bleeding during septoplasty and tympanoplasty operations

Ayoglu H. | Yapakci O. | Ugur M.B. | Uzun L. | Altunkaya H. | Ozer Y. | Uyanik R.

Article | 2008 | Journal of Clinical Anesthesia20 ( 6 ) , pp.437 - 441

Study Objective: To determine the effect of dexmedetomidine on intraoperative bleeding during septoplasty and tympanoplasty operations. Design: Randomized, placebo-controlled study. Setting: Univesity medical center. Patients: 80 ASA physical status I and II patients, aged 18 to 65 years, 40 of whom were scheduled for septoplasty and 40 to undergo tympanoplasty operations. Interventions: Patients undergoing septoplasty (S) and tympanoplasty (T) operations were randomly divided into 4 groups. Dexmedetomidine (D) was administered to Group SD and Group TD first as a bolus dose of one µg kg-1, then intraoperative maintenance was supplie . . .d with dexmedetomidine 0.7 µg kg-1 hour-1. Groups S and T (controls) were given identical amounts of saline. If systolic blood pressure measurements are greater than 20% preoperative values, then fentanyl one µg kg-1 was given. Measurements: Intraoperative blood loss was determined with suction volumes and gauze counting. Bleeding was rated according to a 6-point scale. Hemodynamic parameters and fentanyl administration were recorded. Main Results: Group SD had less bleeding and lower bleeding scores (P < 0.05). In addition, this group received less intraoperative fentanyl (P < 0.05). The only significant difference between Groups TD and T was the amount of intraoperative fentanyl given (35.4 ± 58.8 vs 110.0 ± 81.0 µg) (P < 0.05). Conclusion: Dexmedetomidine reduces bleeding, bleeding scores, and intraoperative fentanyl consumption during general anesthesia in septoplasty operations. © 2008 Elsevier Inc. All rights reserved Daha fazlası Daha az

Effect of dexmedetomidine on testicular torsion/detorsion damage in rats

Hanci V. | Erol B. | Bektaş S. | Mungan G. | Yurtlu S. | Tokgöz H. | Can M.

Article | 2010 | Urologia Internationalis84 ( 1 ) , pp.105 - 111

Background and Objective: We assessed the antioxidant activity of dexmedetomidine (DEX) during an ischemic period in a rat model of testicular torsion/detorsion (T/DT) by using biochemical and histopathological methods. Methods: Wistar Albino male rats weighing 250-300 g were divided into three groups: sham (group S, n = 7); torsion/detorsion (group T/DT, n = 7), and DEX treatment (group DEX, n = 7). In the T/DT group, right testes were rotated 720° for 1 h. Group S served for normal basal values. Rats in group T/DT were operated to make T/DT, this group served as a control group. Group DEX received intraperitoneal DEX 10 µg · kg-1 . . .after the 30-min torsion period. For measurement of total antioxidant enzyme activities and malondialdehyde (MDA) levels, testes of 7 animals in each group were excised after 4 h of reperfusion. Germ cell apoptosis was evaluated using the apoptosis protease-activating factor 1 (APAF-1) antibody in all groups and also on the expressions of endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) were assessed within the bilateral testes. Results: Mean MDA levels in group T/DT were significantly higher than in groups S and DEX (p < 0.05). There were also significant decreases in mean total antioxidant activities in group T/DT when compared to groups S and DEX (p < 0.05). These values were significantly higher in group DEX than group T/DT. Germ cell apoptosis, eNOS and iNOS levels were significantly higher in group T/DT when compared to groups S and DEX (p < 0.05). Conclusions: DEX treatment has potential biochemical and histopathological benefits by preventing ischemia/reperfusion-related cellular damage in an experimental testicular torsion model. Preference of DEX for anesthesia during the detorsion procedure may attenuate ischemia-reperfusion injury. © 2010 S. Karger AG, Basel Daha fazlası Daha az

The effects of dexmedetomidine on mesenteric arterial occlusion-associated gut ischemia and reperfusion-induced gut and kidney injury in rabbits

Kiliç K. | Hanci V. | Selek Ş. | Sözmen M. | Kiliç N. | Çitil M. | Yurtlu D.A.

Article | 2012 | Journal of Surgical Research178 ( 1 ) , pp.223 - 232

Objective: We assessed the antioxidant activity of dexmedetomidine (Dex) administered during the ischemic period in a rabbit model of mesenteric ischemia/reperfusion (I/R) injury using biochemical and histopathological methods. Methods: A total of 24 male New Zealand white rabbits weighing between 2.5 and 3.0 kg were randomly divided into three groups: the sham group (Group S, n = 8), the I/R group (Group I/R, n = 8), and the I/R plus Dex treatment group (Group Dex, n = 8). In the I/R group, ischemia was achieved with 60 min of mesenteric occlusion. The sham group provided normal basal values. The rabbits in Group I/R were operated . . .to achieve I/R. Group Dex received intravenous Dex 30 min after the commencement of reperfusion (10 µg/kg Dex was infused within 10 min, and then a maintenance dose of 10 µg/kg/h Dex was infused intravenously). For the measurement of tissue malondialdehyde, total antioxidant status, total oxidant status, lipid hydroperoxide levels, superoxide dismutase, catalase, and myeloperoxidase activity levels in the renal tissue samples of animals, the rabbits in each group were sacrificed 3 h after reperfusion. The histopathological examination scores were determined using the intestinal and renal tissues. Results: The mean malondialdehyde, total oxidant status, myeloperoxidase, and lipid hydroperoxide levels were significantly higher in Group I/R than in Groups S and Dex (P < 0.05). There also were significant decreases in the mean total antioxidant status, catalase, and superoxide dismutase activities in Group I/R compared with Groups S and Dex (P < 0.05). The histopathological examination scores of the intestinal and renal tissues were significantly higher in Group I/R compared with Groups S and Dex (P < 0.05). Conclusion: Dex treatment may have biochemical and histopathological benefits by preventing I/R-related cellular damage of intestinal and renal tissues as shown in an experimental mesenteric ischemia model. The preference to use Dex for anesthesia during the mesenteric ischemia procedure may attenuate I/R injury in intestinal and renal tissues. © 2012 Elsevier Inc. All rights reserved Daha fazlası Daha az

Effects of fentanyl-lidocaine-propofol and dexmedetomidine-lidocaine- propofol on tracheal intubation without use of muscle relaxants

Hanci V. | Erdogan G. | Okyay R.D. | Yurtlu B.S. | Ayoglu H. | Baydilek Y. | Turan I.O.

Article | 2010 | Kaohsiung Journal of Medical Sciences26 ( 5 ) , pp.244 - 250

The aim of this study was to compare the effects of fentanyl or dexmedetomidine when used in combination with propofol and lidocaine for tracheal intubation without using muscle relaxants. Sixty patients with American Society of Anesthesiologists stage I risk were randomized to receive 1 µg/kg dexmedetomidine (Group D, n = 30) or 2 µg/kg fentanyl (Group F, n = 30), both in combination with 1.5 mg/kg lidocaine and 3 mg/kg propofol. The requirement for intubation was determined based on mask ventilation capability, jaw motility, position of the vocal cords and the patient's response to intubation and inflation of the endotracheal tube . . . cuff. Systolic arterial pressure, mean arterial pressure, heart rate and peripheral oxygen saturation values were also recorded. Rate pressure products were calculated. Jaw relaxation, position of the vocal cords and patient's response to intubation and inflation of the endotracheal tube cuff were significantly better in Group D than in Group F (p < 0.05). The intubation conditions were significantly more satisfactory in Group D than in Group F (p = 0.01). Heart rate was significantly lower in Group D than in Group F after the administration of the study drugs and intubation (p < 0.05). Mean arterial pressure was significantly lower in Group F than in Group D after propofol injection and at 3 and 5 minutes after intubation (p < 0.05). After intubation, the rate pressure product values were significantly lower in Group D than in Group F (p < 0.05). We conclude that endotracheal intubation was better with the dexmedetomidine-lidocaine-propofol combination than with the fentanyl-lidocaine-propofol combination. However, side effects such as bradycardia should be considered when using dexmedetomidine. © 2010 Elsevier. All rights reserved Daha fazlası Daha az

Rectal dexmedetomidine in rats: Evaluation of sedative and mucosal effects [Dexmedetomidina retal em ratos: Avaliação dos efeitos sedativos e sobre a mucosa]

Hanci V. | Gülle K. | Karakaya K. | Yurtlu S. | Akpolat M. | Yüce M.F. | Yüce F.Z.

Article | 2015 | Revista Brasileira de Anestesiologia65 ( 1 ) , pp.1 - 6

Background and objectives: In this study, we investigated the anesthetic and mucosal effects of the rectal application of dexmedetomidine to rats. Methods: Male Wistar albino rats weighing 250-300g were divided into four groups: Group S (n=8) was a sham group that served as a baseline for the normal basal values; Group C (n=8) consisted of rats that received the rectal application of saline alone; Group IPDex (n=8) included rats that received the intraperitoneal application of dexmedetomidine (100 µg kg-1); and Group RecDex (n=8) included rats that received the rectal application of dexmedetomidine (100 µg kg-1). For the rectal drug . . . administration, we used 22G intravenous cannulas with the stylets removed. We administered the drugs by advancing the cannula 1cm into the rectum, and the rectal administration volume was 1mL for all the rats. The latency and anesthesia time (min) were measured. Two hours after rectal administration, 75 mg kg-1 ketamine was administered for intraperitoneal anesthesia in all the groups, followed by the removal of the rats' rectums to a distal distance of 3cm via an abdominoperineal surgical procedure. We histopathologically examined and scored the rectums. Results: Anesthesia was achieved in all the rats in the Group RecDex following the administration of dexmedetomidine. The onset of anesthesia in the Group RecDex was significantly later and of a shorter duration than in the Group IPDEx (p < 0.05). In the Group RecDex, the administration of dexmedetomidine induced mild-moderate losses of mucosal architecture in the colon and rectum, 2 h after rectal inoculation. Conclusion: Although 100µgkg-1 dexmedetomidine administered rectally to rats achieved a significantly longer duration of anesthesia compared with the rectal administration of saline, our histopathological evaluations showed that the rectal administration of 100µgkg-1 dexmedetomidine led to mild-moderate damage to the mucosal structure of the rectum. © 2013 Sociedade Brasileira de Anestesiologia Daha fazlası Daha az

Rectal dexmedetomidine in rats: evaluation of sedative and mucosal effects

Hanci, Volkan | Gulle, Kanat | Karakaya, Kemal | Yurtlu, Serhan | Akpolat, Meryem | Yuce, Mehmet Fatih | Yuce, Fatma Zehra

Article | 2015 | REVISTA BRASILEIRA DE ANESTESIOLOGIA65 ( 1 ) , pp.1 - 6

Background and objectives: In this study, we investigated the anesthetic and mucosal effects of the rectal application of dexmedetomidine to rats. Methods: Male Wistar albino rats weighing 250-300 g were divided into four groups: Group S (n=8) was a sham group that served as a baseline for the normal basal values; Group C (n=8) consisted of rats that received the rectal application of saline alone; Group IPDex (n=8) included rats that received the intraperitoneal application of dexmedetomidine (100 mu g kg(-1)); and Group RecDex (n=8) included rats that received the rectal application of dexmedetomidine (100 mu g kg(-1)). For the re . . .ctal drug administration, we used 22 G intravenous cannulas with the stylets removed. We administered the drugs by advancing the cannula 1 cm into the rectum, and the rectal administration volume was 1 mL for all the rats. The latency and anesthesia time (min) were measured. Two hours after rectal administration, 75 mg kg(-1) ketamine was administered for intraperitoneal anesthesia in all the groups, followed by the removal of the rats' rectums to a distal distance of 3 cm via an abdominoperineal surgical procedure. We histopathologically examined and scored the rectums. Results: Anesthesia was achieved in all the rats in the Group RecDex following the administration of dexmedetomidine. The onset of anesthesia in the Group RecDex was significantly later and of a shorter duration than in the Group IPDEx ( Daha fazlası Daha az

The effectiveness of dexmedetomidine in experimental spinal cord injury compared to methylprednisolone in rats

Gul S. | Hanci V. | Bahadir B. | Acikgoz S. | Bektas S. | Ankarali H. | Kalayci M.

Article | 2010 | Journal of Clinical Neuroscience17 ( 4 ) , pp.490 - 494

The present study aimed to investigate the neuroprotective efficacy of dexmedetomidine in a rat experimental spinal cord injury model. The rats (n = 40) were equally divided into four groups: G1, G2, G3, and G4. Rats in the G1 group underwent a laminectomy only. For the rats in the G2, G3, and G4 groups, spinal cord injury was induced by placing an aneurysm clip extradurally for 60 s at T10. The rats in G2 did not receive any post-injury treatment. Immediately after trauma was induced, rats in G3 were given methylprednisolone (30 mg/kg) and in G4, dexmedetomidine (10 µg/kg), both intraperitoneally. The rats were sacrificed under ane . . .sthesia 24 hours later and 1.5 cm lengths of injured spinal cord were obtained. Malonyldialdehyde values were significantly increased in G2 compared to G1, G3 and G4 (p < 0.05). The neuronal cell count in G1 was significantly higher than in G2 and G3 (p = 0.0001; p = 0.007). G4 had higher cell counts compared to G2 and G3 (p = 0.0001; p = 0.05). These findings indicated that dexmedetomidine might have neuroprotective effects in spinal cord injury. © 2009 Elsevier Ltd. All rights reserved Daha fazlası Daha az

Protective effect of dexmedetomidine in a rat model of alpha-naphthylthioureae-induced acute lung injury

Hanci, Volkan | Yurdakan, Gamze | Yurtlu, Serhan | Turan, Isil Ozkocak | Sipahi, Emine Yilmaz

Article | 2012 | JOURNAL OF SURGICAL RESEARCH178 ( 1 ) , pp.424 - 430

Background: We assessed the effects of dexmedetomidine in a rat model of alpha-naphthylthiourea (ANTU)-induced acute lung injury. Methods: Forty Wistar Albino male rats weighing 200-240 g were divided into 5 groups (n = 8 each), including a control group. Thus, there were one ANTU group and three dexmedetomidine groups (10-, 50-, and 100- mu g/kg treatment groups), plus a control group. The control group provided the normal base values. The rats in the ANTU group were given 10 mg/kg of ANTU intraperitoneally and the three treatment groups received 10, 50, or 100 mu g/kg of dexmedetomidine intraperitoneally 30 min before ANTU applica . . .tion. The rat body weight (BW), pleural effusion (PE), and lung weight (LW) of each group were measured 4 h after ANTU administration. The histopathologic changes were evaluated using hematoxylin-eosin staining. Results: The mean PE, LW, LW/BW, and PE/BW measurements in the ANTU group were significantly greater than in the control groups and all dexmedetomidine treatment groups (P < 0.05). There were also significant decreases in the mean PE, LW, LW/BW and PE/BW values in the dexmedetomidine 50-mu g/kg group compared with those in the ANTU group (P < 0.01). The inflammation, hemorrhage, and edema scores in the ANTU group were significantly greater than those in the control or dexmedetomidine 50-mu g/kg group (P < 0.01). Conclusion: Dexmedetomidine treatment has demonstrated a potential benefit by preventing ANTU-induced acute lung injury in an experimental rat model. Dexmedetomidine could have a potential protective effect on acute lung injury in intensive care patients. (C) 2012 Elsevier Inc. All rights reserved Daha fazlası Daha az

Protective effect of dexmedetomidine in a rat model of ?- naphthylthiourea-induced acute lung injury

Hanci V. | Yurdakan G. | Yurtlu S. | Turan I.Ö. | Sipahi E.Y.

Conference Object | 2012 | Journal of Surgical Research178 ( 1 ) , pp.424 - 430

Background: We assessed the effects of dexmedetomidine in a rat model of ?-naphthylthiourea (ANTU)-induced acute lung injury. Methods: Forty Wistar Albino male rats weighing 200-240 g were divided into 5 groups (n = 8 each), including a control group. Thus, there were one ANTU group and three dexmedetomidine groups (10-, 50-, and 100-µg/kg treatment groups), plus a control group. The control group provided the normal base values. The rats in the ANTU group were given 10 mg/kg of ANTU intraperitoneally and the three treatment groups received 10, 50, or 100 µg/kg of dexmedetomidine intraperitoneally 30 min before ANTU application. The . . . rat body weight (BW), pleural effusion (PE), and lung weight (LW) of each group were measured 4 h after ANTU administration. The histopathologic changes were evaluated using hematoxylin-eosin staining. Results: The mean PE, LW, LW/BW, and PE/BW measurements in the ANTU group were significantly greater than in the control groups and all dexmedetomidine treatment groups (P < 0.05). There were also significant decreases in the mean PE, LW, LW/BW and PE/BW values in the dexmedetomidine 50-µg/kg group compared with those in the ANTU group (P < 0.01). The inflammation, hemorrhage, and edema scores in the ANTU group were significantly greater than those in the control or dexmedetomidine 50-µg/kg group (P < 0.01). Conclusion: Dexmedetomidine treatment has demonstrated a potential benefit by preventing ANTU-induced acute lung injury in an experimental rat model. Dexmedetomidine could have a potential protective effect on acute lung injury in intensive care patients. © 2012 Elsevier Inc. All rights reserved Daha fazlası Daha az

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