Dr.Tolga Ergönenç

Question of the Day

Mon, 24 Dec 2007 10:26:20 GMT

Anesthesiology Question of the Day

A 52 year-old patient with CAD, with a history of an MI 2 years ago is now being prepared for a hip replacement and asks you if certain techniques are better for her heart than others. Of course you plan to provide a hemodynamically stable anesthetic.
Do regional versus general anesthetic techniques make a difference in patients with myocardial ischemia risk? Go to this Anesthesiology question at TheAnswerPage

SEAH Korucuk kampüsünde bugün

Wed, 19 Dec 2007 23:19:13 GMT

Bayramınızı en içten dileklerimle kutluyor,sağlık,mutluluk ve huzur dolu günler diliyorum.

SEAH Korucuk kampüsü ameliyathanesinden bugüne ait kareler...

TARK 2007 Poster Sunuları

Wed, 31 Oct 2007 17:25:40 GMT

Bupivakain Ve Levobupivakainin Spinal Anestezi Uygulamalarında Etki Başlangıç Süreleri Ve Hemodinamik Etkilerinin Karşılaştırılması
Uğur Uzun,Tolga Ergönenç , Jalan Şerbetçigil Ergönenç, Kadir İdin, Gülşen Bican, Ali Dirik, Gökhan Gedikli

Karaciğer Kist Hidatik Cerrahisi Esnasında Gelişen Anaflaktik Şok Reaksiyonu

Ece Altınay,Tolga Ergönenç,Engin Çelik,Hakan Demir

SEAH

Wed, 12 Sep 2007 08:43:20 GMT

Sakarya Eğitim Ve Araştırma Hastanesi Korucuk Kampüsü Hastanesi ameliyathaneleri faaliyete başladı. Ameliyathane toplam 6 operasyon odası, 3 adet küçük müdahale odası, pre-op ve post-op üniteleri ve 8 yataklı PACU ile hizmet vermektedir.
http://www.seah.gov.tr

TARK 2007

Tue, 04 Sep 2007 19:40:59 GMT


Erken Kayıt Bitiş Tarihi	03 Eylül 2007

Bildiri Özetlerinin elektronik ortamda Kongre sekreteryasına son gönderim tarihi	17 Eylül 2007

Sakarya Eğitim Ve Araştırma Hastanesi

Tue, 31 Jul 2007 11:41:58 GMT

Kongre

Tue, 31 Jul 2007 11:26:16 GMT

http://www.tark2007.org

Makale

Sat, 30 Jun 2007 10:11:46 GMT

Epidural Anesthesia and Analgesia Decrease the Postoperative Incidence of Insulin Resistance in Preoperative Insulin-Resistant Subjects Only

(Anesthesia & Analgesia 2007; 104(6): 1587-93)

TARK 2007

Fri, 25 May 2007 17:59:05 GMT

http://www.tark2007.org/

Brugada syndrome

Mon, 07 May 2007 16:33:48 GMT

1: Heart Rhythm. 2006 Sep;3(9):1074-8. Epub 2006 Jul 7.

Genetic and biophysical basis for bupivacaine-induced ST segment elevation and
VT/VF. Anesthesia unmasked Brugada syndrome.

Vernooy K, Sicouri S, Dumaine R, Hong K, Oliva A, Burashnikov E, Timmermans C,
Delhaas T, Crijns HJ, Antzelevitch C, Rodriguez LM, Brugada R.

Department of Cardiology, Academic Hospital Maastricht, Maastricht, the
Netherlands.

BACKGROUND: Brugada syndrome is an inherited disease associated with sudden
cardiac death. The electrocardiographic pattern associated with Brugada syndrome
has been linked to the use of sodium channel blockers, including
antiarrhythmics, trycyclics and anesthetics. OBJECTIVE: We report a case of
bupivacaine-induced Brugada syndrome, in which we investigated the genetic,
biophysical and path physiological mechanism involved. METHODS AND RESULTS: The
patient developed a Brugada-like electrocardiographic pattern twice under the
influence of bupivacaine. The first occurrence was accompanied by ventricular
tachycardia (VT) which subsided after withdrawal of the anesthetic. The VT was
also observed during co-administration of diltiazem and
isosorbide-5-mononitrate, agents thought to facilitate ST segment elevation in
the Brugada syndrome. Genetic analysis revealed a missense mutation in the alpha
subunit of the cardiac sodium channel, SCN5A. Biophysical analysis by whole-cell
patch-clamping revealed a reduction in sodium current as a result of the
mutation. The study of bupivacaine in the wedge model revealed use-dependent
changes in conduction, heterogeneous loss of the action potential dome in RV
epicardium and phase 2 re-entry when the preparations were pretreated with low
concentrations of the calcium channel blocker verapamil. CONCLUSION: Our
findings indicate that bupivacaine may induce the electrocardiographic and
arrhythmic manifestations of the Brugada syndrome in silent carriers of SCN5A
mutations. The data have important implications in the management of patients
who develop ST segment elevation when under the influence of anesthetics such as
bupivacaine.

PMID: 16945804 [PubMed - in process]

Anestezistanbul Toplantıları

Mon, 26 Mar 2007 19:40:20 GMT

06 Nisan 2007- Peri-operatif Sıvı Tedavisi, Prof.Dr.Tuğrul Denkel
TaksimHill Otel
İSTANBUL

Makale

Sat, 17 Mar 2007 19:50:04 GMT

1: Acta Anaesthesiol Scand. 2007 Jan;51(1):44- 9.

Makale

Sat, 17 Mar 2007 19:22:10 GMT

Post-dural puncture headache: pathogenesis, prevention and treatment (BJA, 2003, Vol. 91, No. 5 718-729)

Quality of tracheal intubation

Sat, 17 Mar 2007 19:13:19 GMT

Quality of tracheal intubation (Anesthesiology 2003;98(5))

Guidelines summary

Tue, 20 Feb 2007 20:23:28 GMT

The following is a summary of the 2002 ASRA guidelines adapted from Neal JM: Neural blockade and anticoagulation. In Regional Anesthesia.

Anestezistanbul Toplantıları

Sat, 10 Feb 2007 08:44:48 GMT

02 Mart 2007- Postoperatif analjezi - Doç.Dr.Mert Şentürk
TaksimHill Otel
İSTANBUL

Alzheimer

Sat, 10 Feb 2007 08:41:05 GMT

Reported February 7, 2007

Anesthesia and Alzheimer's Link

ORLANDO, Fla. -- A common anesthetic may induce biomarkers of Alzheimer's disease. Isoflurane (Forane), a general anesthetic inhalant, may cause cell death and generation of an Alzheimer's- associated protein, recent research reveals.

General anesthesia may increase risk for Alzheimer's disease. One biomarker of Alzheimer's disease is the presence of plaques in the brain. Amyloid-beta protein (A-beta) is toxic to brain cells and is a key component in these plaques. Apoptosis, or cell death, is another indicator of cognitive decline. Previous research revealed application of isoflurane to neural cells in a lab led to apoptosis and the generation of A-beta.

"Isoflurane can be one of the most commonly used anesthetics in operation. We use it every day," lead author Zhongcong Xie, M.D., Ph.D., of the MassGeneral Institute for Neurodegenerative Disease in Charlestown, Mass., told Ivanhoe.

Researchers at Massachusetts General Hospital in Boston applied isoflurane to cultured neural cells in a series of experiments. They reported activation of caspase, an enzyme that contributes to apoptosis. When researchers applied isoflurane to neural cells that express amyloid precursor protein (APP), which aids the formation of A-beta, isoflurane raised levels of A-beta-releasing enzymes.

Study results indicate isoflurane promotes apoptosis and the production of A-beta through specific molecular pathways. Isoflurane may also initiate a process by which A-beta generation and apoptosis interact and magnify one another.

Researchers only used cultured cells in their study. Dr. Xie said while these kinds of lab studies can give scientists a preliminary understanding of how medications affect disease, it's still too early to know if the same reactions would be seen in humans.

"This is alarming, but it's still premature to come to a conclusion," said Dr. Xie. "We need to work hard to have more data to support our hypothesis that isoflurane is toxic and facilitates dementia, or cognitive dysfunction, in humans."

SOURCE: Ivanhoe interview with Zhongcong Xie, M.D., Ph.D.; The Journal of Neuroscience, 2007;27:1247- 1254

Makale

Sun, 04 Feb 2007 06:49:27 GMT

Do patients profit from physostigmine in recovery from desflurane anaesthesia?

K. D. Röhm¹, J. Riechmann²² , J. Boldt¹ , T. Schöllhorn¹ , S. N. Piper¹

¹Department of Anaesthesiology and Intensive Care Medicine, Klinikum Ludwigshafen, Ludwigshafen and ²Department of Anaesthesiology, University Hospital of Johannes Gutenberg-University Mainz, Mainz, Germany

Kerstin D. Röhm
Department of Anaesthesiology and Intensive Care Medicine
Klinikum Ludwigshafen
Bremserstrasse 79
D-67063 Ludwigshafen
Germany
e-mail: k.d.roehm@web.de

Abstract

Background: Physostigmine is the drug of choice in the central anticholinergic syndrome, but has also been used in post-operative mental derangement secondary to sedatives and volatile anaesthetics. The aim of this double-blind, randomized, prospective study was to determine whether physostigmine alters recovery after desflurane anaesthesia.

Methods: One hundred patients undergoing urologic or surgical procedures were enrolled to receive either NaCl 0.9% (n = 50) or 2 mg of physostigmine (n = 50) at the end of general anaesthesia with propofol, fentanyl, cisatracurium and desflurane. Times to extubation, stating name, birthday and place of residence, and obeying commands such as eye opening and hand squeezing were noted. Haemodynamics, Aldrete and pain scores, the analgesic requirements, and any adverse side-effects were documented until the 1st post-operative day.

Results: Demographic, peri-operative data including duration of anaesthesia, surgery and postanaesthetic care unit (PACU) stay, and consumption of anaesthetics were comparable in both groups. No significant difference between the groups was found for extubation time or other emergence parameters. Patients undergoing anaesthesia >150 min showed after receiving physostigmine significantly (P < 0.05) faster spontaneous breathing (2.6 ± 3.1 vs. placebo 5.0 ± 4.2 min) and extubation time (6.2 ± 3.7 vs. placebo 8.8 ± 5.0 min). Women showed significantly shorter extubation times (5.5 ± 3.4 min) and eye opening (5.5 ± 2.6 min) with physostigmine than placebo (7.7 ± 4.5 and 7.8 ± 4.0 min). The incidence of post-operative nausea and vomiting (PONV) was significantly higher after physostigmine than placebo, whereas shivering occurred more often after placebo.

Conclusion: Physostigmine does not alter desflurane-based anaesthesia compared with placebo. An option is to use physostigmine in patients with a duration of anaesthesia >150 min who profit in earlier return to spontaneous breathing and shorter extubation time.

Makale

Sat, 27 Jan 2007 15:35:13 GMT

OR efficiency boosted by pre-op clinic visits

Anethesiology 2006; 105: 1254–1259

Pre-operative consultations can significantly increase efficiency in the operating room (OR) by allowing medical issues to be identified and resolved before surgery, according to the results of a retrospective study.

This is the view of surgeons at Brigham and Women’s Hospital in Boston, Massachusetts, USA, where all patients undergoing elective procedures are evaluated in a pre-operative clinic. To assess the economic impact of these visits, Darin Correll and colleagues retrospectively studied the charts of 5083 patients seen at the Hospital over a 3-month period.

Medical issues requiring further action were identified in 647 patients, Correll et al report in the journal Anesthesiology. The vast majority (87%) of issues were cardiac in origin, followed by pulmonary, anesthetic, and hematologic problems.

Many of the issues related to pre-existing problems and simply required the retrieval of information from other centers.

However, in 115 cases a new medical problem was identified at the pre-operative visit. The most common findings were electrocardiographic abnormalities or new cardiac symptoms that required an additional test or consultation.

Importantly, around one in 10 patients in whom new medical issues were identified had their operation delayed or canceled, a finding with implications for costs and resource use, say the authors.

“It is difficult to calculate the financial impact if the missing information results in a delay rather than a cancellation,” they write.

“However, should case delay result in the overall lengthening of the operating room day, resulting in increased overtime as well as shift differential payments, the variable costs of running the operating room would increase.”

Correll et al conclude that pre-operative clinic visits streamline assessment, allow implementation of protocols that may improve outcomes, and increase OR efficiency.

Makale

Sat, 27 Jan 2007 15:21:27 GMT

A New Video Laryngoscope - An Aid in Intubation and Teaching
(Department of Anesthesia, Cedars-Sinai Medical Center, Los Angeles)

Custom List: Medikal Linkler

Wed, 26 Dec 2007 18:22:50 GMT

Medikal Linkler

TARD
İstanbulanestezi
New York School of R.A.
RA Education
Çukurova Tıp Anestezi
Anaesthesiauk
ASRA
Gasnet
Simanest
ESA
Anaesthesia UK
Surviving Sepsis
Cleveland clinic
BJA
virtual anaesthesia textbook
Oyston associates
Cook county regional
Pakize Demirkalem
İtfanestezi
Metrohealthanesthesia
Anestezi güncesi
Korucuk kampüsü
Sakarya Eğitim Ve Araştırma Hastanesi Korucuk Kampüsü Hastanesi Anesteziyoloji Ve Reanimasyon

Custom List: Paramedikal Linkler

Wed, 03 Jan 2007 18:46:49 GMT

Paramedikal Linkler

Mac dünyası
Site klasifikasyonu
Doğru adresi bulur
Mac&Pc
Apple ürünleri ve Pc
Pdf dergi
Foto Kritik
Teknoseyir

Custom List: Bilimsel yayınlar

Tue, 01 Aug 2006 23:33:36 GMT

Bilimsel yayınlar

Yayınlar

Blog list: Blog list

Thu, 29 Jun 2006 20:55:54 GMT

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