The Effects of Intravenous Ephedrine During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial

Iclal Ozdemir Kol,Kenan Kaygusuz,Sinan Gursoy,Ali Cetin,Zeki Kahramanoglu,Fikret Ozkan,Caner Mimaroglu 대한의학회 2009 Journal of Korean medical science Vol.24 No.5

We designed a randomized, double-blinded study to determine the efficacy and safety of 0.5 ㎎/㎏ intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Patients were randomly allocated into two groups: ephedrine group (n=21) and control group (n=21). Intravenous preload of 15 mL/㎏ lactated Ringer’s solution was given. Shortly after the spinal injection, ephedrine 0.5 ㎎/㎏ or saline was injected intravenous for 60 sec. The mean of highest and lowest heart rate in the ephedrine group was higher than those of control group (P<0.05). There were significant lower incidences of hypotension and nausea and vomiting in the ephedrine group compared with the control group (8 [38.1%] vs. 18 [85.7%]); (4 [19%] vs. 12 [57.1%], respectively) (P<0.05). The first rescue ephedrine time in the ephedrine group was significantly longer (14.9±7.1 min vs. 7.9±5.4 min) than that of the control group (P<0.05). Neonatal outcome were similar between the study groups. These findings suggest, the prophylactic bolus dose of 0.5 ㎎/㎏ intravenous ephedrine given at the time of intrathecal block after a crystalloid fluid preload, plus rescue boluses reduce the incidence of hypotension.

Real-life ruxolitinib experience in intermediate-risk myelofibrosis

Fatma Arikan,Tayfur Toptas,Isik Kaygusuz Atagunduz,Tarik Ercan,Ozen Oruc,Fergun Yilmaz,Tulin Tuglular 대한혈액학회 2021 Blood Research Vol.56 No.4

Background In this retrospective cohort of patients with primary, post-polycythemia vera, or post-essential thrombocythemia myelofibrosis, 57 patients with MF who received ruxolitinib for MF-related symptoms or symptomatic splenomegaly were evaluated. Methods The median age of the patients in this cohort was approximately 58 years. Of these, there were 33 patients (57.9%) in INT-1, 23 patients (40.4%) in INT-2, and 1 patient (1.8%) at high risk. Overall, spleen size reduction of at least 35% (spleen response) was achieved in 56.6% and 63.3% of all cohort and INT-1 risk at any time, respectively. Results Symptom response and clinical improvement were observed in 21.7% and 60.7% of patients, respectively. Anemia and thrombocytopenia were prevalent, but manageable. About 73.7% of patients continued treatment during a median follow-up of 22 months. Two-year OS probability was approximately 84.5% (95% CI, 63.1‒94.0%) and 62.3% (95% CI, 37.5‒79.6%) for the intermediate-1 and -2 risk groups, respectively. Conclusion Real-life experience in a community-based hospital confirms the efficacy and safety profile of ruxolitinib in intermediate-risk myelofibrosis. Treatment discontinuation rates were lower than those in clinical trials.

Ineffective Doses of Dexmedetomidine Potentiates the Antinociception Induced by Morphine and Fentanyl in Acute Pain Model

Mumin Unal,Sinan Gursoy,Ahmet Altun,Cevdet Duger,Iclal Ozdemir Kol,Kenan Kaygusuz,Ihsan Bagcivan,Caner Mimaroglu 대한약리학회 2013 The Korean Journal of Physiology & Pharmacology Vol.17 No.5

The aim of this study was to evaluate the synergistic potentiation effect of ineffective doses of dexmedetomidine on antinociception induced by morphine and fentanyl in acute pain model in rats. Seventy albino Wistar rats were separated into 7 groups. Data for the control and sham groups were recorded. The ineffective dose of dexmedetomidine was investigated and found to be 3 μ g/kg. Each group was administered the following medications: 3 mg/kg morphine (intraperitoneal) to Group 3,5 μg/kg fentanyl (intraperitoneal) to Group 4, dexmedetomidine 3 μ g/kg (subcutaneously) to Group 5, dexmedetomidine 3 μg/kg (subcutaneous)+3 mg/kg morphine (intraperitoneal) to Group 6 and finally 3 μg/kg dexmedetomidine (subcutaneous)+5μg/kg fentanyl (intraperitoneal) to Group 7. Just before the application and 15, 30, 60, 90 and 120 min after the administration of medication, two measurements of tail flick (TF) and hot plate (HP) tests were performed. The averages of the measurements were recorded. TF and HP latencies were the main outcomes. The analgesic effect of the combinations with dexmedetomidine+morphine (Group 6) and dexmedetomidine+fentanyl (Group 7), compared to the analgesic effect of morphine alone and fentanyl alone was significantly higher at 15, 30, 60 and 90minutes after administration. In this study, dexmedetomidine in ineffective doses, when combined with morphine and fentanyl, potentiates the effects of both morphine and fentanyl.

Posterior-Only Approach with Pedicle Screws for the Correction of Scheuermann’s Kyphosis

Adem Cobden,Akif Albayrak,Yalkin Camurcu,Hakan Sofu,Temel Tacal,Mehmet Akif Kaygusuz 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.4

Study Design: Retrospective study (level of evidence: level 3). Purpose: The purpose of this study was to evaluate the clinical and radiological results of the posterior-only approach with pedicle screws for the treatment of Scheuermann’s kyphosis (SK). Overview of Literature: The correction of SK with instrumentation can be performed using posterior-only or combined anteriorposterior procedures. With the use of all-pedicle screw constructs in spine surgery, the posterior-only approach has become a popular option for the definitive treatment of SK. In a nationwide study involving 2,796 patients, a trend toward posterior-only fusion with lower complication rates was reported. Methods: We retrospectively reviewed the data of patients who underwent posterior-only correction for SK between January 2005 and May 2013. Patients with a definite diagnosis of SK who fulfilled the minimum follow-up criterion of 24 months were included. The thoracic kyphosis (T5–T12), lumbar lordosis (L1–S1), and thoracolumbar junction (T10–L2) angles were measured from preoperative, postoperative, and last control radiographs. Sagittal balance, thoracic length, thoracic diameter, Voutsinas index and the sacral slope, pelvic tilt, proximal junction kyphosis, and distal junction kyphosis angles were also measured. Results: Forty-five patients underwent surgery for the treatment of SK between 2005 and 2013. After applying the exclusion criteria, 20 patients (18 males and 2 females) with a mean age of 19 years were included. The mean thoracic kyphosis angle was 79.8 degrees preoperatively, 44.6 degrees postoperatively, and 44.9 degrees at the last control. There were statistically significant differences between preoperative and postoperative values in the thoracic kyphosis and lumbar lordosis angles, thoracic length, thoracic diameter, and Voutsinas index (p <0.05). Conclusions: The clinical and radiological results of the current study suggest that posterior-only fusion is an efficient technique for the treatment of SK.

Ineffective Doses of Dexmedetomidine Potentiates the Antinociception Induced by Morphine and Fentanyl in Acute Pain Model

Unal, Mumin,Gursoy, Sinan,Altun, Ahmet,Duger, Cevdet,Kol, Iclal Ozdemir,Kaygusuz, Kenan,Bagcivan, Ihsan,Mimaroglu, Caner The Korean Society of Pharmacology 2013 The Korean Journal of Physiology & Pharmacology Vol.17 No.5

The aim of this study was to evaluate the synergistic potentiation effect of ineffective doses of dexmedetomidine on antinociception induced by morphine and fentanyl in acute pain model in rats. Seventy albino Wistar rats were separated into 7 groups. Data for the control and sham groups were recorded. The ineffective dose of dexmedetomidine was investigated and found to be 3 ${\mu}g/kg$. Each group was administered the following medications: 3 mg/kg morphine (intraperitoneal) to Group 3, 5 ${\mu}g/kg$ fentanyl (intraperitoneal) to Group 4, dexmedetomidine 3 ${\mu}g/kg$ (subcutaneously) to Group 5, dexmedetomidine 3 ${\mu}g/kg$ (subcutaneous)+3 mg/kg morphine (intraperitoneal) to Group 6 and finally 3 ${\mu}g/kg$ dexmedetomidine (subcutaneous)+5 ${\mu}g/kg$ fentanyl (intraperitoneal) to Group 7. Just before the application and 15, 30, 60, 90 and 120 min after the administration of medication, two measurements of tail flick (TF) and hot plate (HP) tests were performed. The averages of the measurements were recorded. TF and HP latencies were the main outcomes. The analgesic effect of the combinations with dexmedetomidine+morphine (Group 6) and dexmedetomidine+fentanyl (Group 7), compared to the analgesic effect of morphine alone and fentanyl alone was significantly higher at 15, 30, 60 and 90 minutes after administration. In this study, dexmedetomidine in ineffective doses, when combined with morphine and fentanyl, potentiates the effects of both morphine and fentanyl.