Hayri Özbek

Comparison of caudal morphine and tramadol for postoperative pain control in children undergoing inguinal herniorrhaphy.

Objectives: We compared the quality and duration of analgesia, the effect on perioperative sevoflurane requirement after a single, presurgical caudal block with either tramadol or morphine in children undergoing inguinal herniorrhaphy. Our study was also designed to evaluate the preemptive analgesic efficacy of morphine administered caudally in children.

A comparison of single dose caudal tramadol, tramadol plus bupivacaine and bupivacaine administration for postoperative analgesia in children

Background: Our aim was to compare the effect of single dose caudal tramadol, tramadol plus bupivacaine and bupivacaine on the management of postoperative pain in children.

A Possible Central Antinociceptive Effect of Dipyrone in Mice

The antinociceptive effect of dipyrone, a nonsteroidal and inflammatory drug, was studied in a series of experiment employing tail-flick and hot-place models and the abdominal constrictor test. The drug was given via intracerebroventricular (i.c.v.), intrathecal (i.t.) or subcutaneous (s.c.) routes. Dipyrone exhibited no analgesic activity in the tail-flick and hotplate tests while it inhibited the number of stretches in a dose-dependent manner. The antinociceptive effect of dipyrone administered by the i.c.v. and i.t. routes was almost complete reversed by naloxone treatment. The same procedure attenuated but not completely inhibited the dipyrone action induced by s.c. administration. Histopathological examination revealed that i.t. dipyrone application produces no significant lesion in the spinal cord. The results suggest that dipyrone may exert a central antinociceptive action reversed by naloxone.

Comparison of caudal ketamine with lidocaine or tramadol administration for postoperative analgesia of hypospadias surgery in children.

Background:  This study was designed to investigate whether the addition of tramadol or lidocaine to ketamine would enhance the quality of intra‐ and postoperative analgesia for hypospadias surgery in children.

The comparison of caudal ketamine, alfentanil and ketamine plus alfentanil administration for postoperative analgesia in children

Background: Our aim was to compare the effect of single dose caudal ketamine, alfentanil or a mixture of both drugs in the treatment of pain after hypospadias repair surgery in children.

Dexmedetomidine-Remifentanil or Propofol-Remifentanil Anesthesia in Patients Undergoing Intracranial Surgery

Dexmedetomidine has been shown to provide good perioperative hemodynamic stability with decreased intraoperative opioid requirements. This study was conducted to compare the effect of dexmedetomidine-remifentanil (DR) anesthesia and propofol-remifentanil (PR) anesthesia on perioperative hemodynamics and postanesthesia recovery profiles in patients undergoing intracranial surgery. After receiving Ethics Committee approval and informed patient consent, 78 American Society of Anesthesiologists physical status I or II patients between the ages of 19 and 70 years with a Glasgow Coma Scale score 14 or 15 who were scheduled for elective intracranial surgery with general anesthesia were recruited. Anesthesia induction was provided by intravenous remifentanil (0.5 μg/kg) and propofol (1.5-2 mg/kg) in both groups and maintained with infusion of DR (0.6-1.2 mg/kg/h and 0.25 μg/kg/min)-nitrous oxide/oxygen (n2o/o2) in the DR group (n = 39) and infusion of PR (3-10 mg/kg/h and 0.25 μg/kg/min)-n2o/o2 in the PR group (n = 39). Hemodynamic variables were recorded before surgery, during the induction of anesthesia, after intubation, and during application of the headholder and skin incision; brain relaxation was also recorded. Times to extubation and awakening, eye opening, and response to commands as well as analgesic requirements were recorded after surgery. No significant difference was found in systolic blood pressure and mean arterial pressure throughout the study period except at the time of the dural incision (P < 0.05). These variables were significantly lower in the DR group (P < 0.05). Brain relaxation scores were similar between the 2 groups (P > 0.05). Time to extubation was significantly shorter in patients receiving PR anesthesia than in patients receiving DR anesthesia (3.6 minutes vs. 5.5 minutes). Analgesic requirements were significantly higher in the PR group than in the DR group (P = 0.013). No significant side effects were reported in the 2 groups (P > 0.05). In conclusion, dexmedetomidine (0.6-1.2 μg/kg−1/h−1) plus remifentanil (0.25 μg/kg−1 min−1) anesthesia offered lower analgesic requirements, a longer extubation time, and better hemodynamic stability compared with PR anesthesia for patients undergoing intracranial surgery.

The usage of remifentanil and alfentanil in alleviating pain and anxiety during bone marrow aspiration in pediatric patients

Abstract Aims: To investigate the efficacy and safety of remifentanil and alfentanil compared with local anesthesia in providing analgesia and sedation during bone marrow aspiration procedures. Methods: Seventy-four children who underwent a diagnostic bone marrow aspiration were included in this study. Patients were assigned to one of 3 treatment groups (remifentanil, alfentanil and local anesthesia). Vital signs, sedation, pain scores, and somatic responses were recorded during and after bone marrow aspiration procedure. Results: There were no statistical differences between pain scores of the remifentanil group and the alfentanil group. Pain scores were significantly higher in the local anesthesia group compared with the other groups. None of the patients in the study had deep sedation, hypotension, bradycardia, hypoxemia, or respiratory depression. Conclusions: Remifentanil and alfentanil are effective in children and can be used safely in bone marrow aspiration procedure.