Person: TÜRKER, YUNUS GÜRKAN
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TÜRKER
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YUNUS GÜRKAN
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Publication The effect of combined pulsed radiofrequency treatment to dorsal root ganglion with transforaminal epidural steroid injection on pain(Kare Publ, 2021-01-10) Çalışkan, Duygu Karaköse; Akesen, Selcan; Türker, Yunus Gürkan; Gurbet, Alp; AKESEN, SELCAN; TÜRKER, YUNUS GÜRKAN; GURBET, ALP; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; 0000-0002-3019-581X; 0000-0002-6503-8232; 0000-0002-9518-541X; AAI-6642-2021; A-7994-2018; ELR-9087-2022Objectives: We aimed to compare the treatment response with simultaneous application of transforaminal epidural steroid injection (TESI) and pulsed radiofrequency (PRF) to the lumbar dorsal root ganglion (DRG) with TESI in patients with chronic lumbar radicular pain.Methods: A total of 129 patients were enrolled. TESI was performed to 67 patients and TESI+DRG-PRF was performed to 62 patients. Demographic data, surgical records, and medications, side, and level of the procedure were recorded. Patients were evaluated on the pre-operative and post-operative 10th day, 1st and 3rd month follow-up visits, and visual analog scale (VAS, 0-10) scores, and patients' satisfaction assessment on the 3rd month follow-up were collected. A successful therapeutic response was defined as a 50% or more reduction in VAS scores.Results: In both groups, post-operative VAS scores were significantly lower than the pre-operative levels (p<0.001). VAS scores in the TESI+DRG-PRF group were significantly lower than the TESI group at all follow-up periods (p<0.001). Reduction ratios in VAS scores were significantly higher in the TESI+DRG-PRF group in all follow-up visits (p<-0.001). Satisfaction levels were significantly higher in the TESI+DRG-PRF group (p<0.01).Conclusion: According to our study, TESI provides short-moderate pain relief in patients with chronic lumbar radicular pain. A simultaneous application of PRF in the same session with TESI should be considered as an option to improve the treatment response.Publication Detecting coagulability status by thromboelastography in women with the history of preeclampsia and inherited thrombophilia(Canada Inc, 2015-01-01) Bülbül, Mehmet; Atalay, Mehmet Aral; Demir, Bilge Çetinkaya; Türker, Gürkan; Esmer, A.; Atalay, Mehmet Aral; ÇETİNKAYA DEMİR, BİLGE; TÜRKER, YUNUS GÜRKAN; Esmer, A.; Uludağ Üniversitesi/Tıp Fakültesi/Jinekoloji Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimat Bölümü; 0000-0002-9685-956X; 0000-0001-6845-9991; 0000-0002-3019-581X; AAI-6642-2021; AAH-9834-2021Objective: To assign tendency to thrombosis in patients with preeclampsia and inherited thrombophilia using thromboelastography (TEG), and therefore to evaluate possible relationship between thrombophilia and preeclampsia. Materials and Methods: Kinetics of clot formation was assessed with TEG analyzer in 49 patients with severe preeclampsia, 54 cases with previous diagnosis of inherited thrombophilia, and 31 controls. Results: 'r', 'k', TMA, coagulation index (CI) parameters were found statistically discrete between patients with inherited thrombophilia and controls. The difference between preeclampsia and control groups was not statistically significant. The difference in a angle was statistically significant between thrombophilics and preeclamptics (p = 0.01), and between thrombophilics and controls (p = 0.004). CI was found statistically lower in thrombophilia group than control group (p = 0.006). Particularly, clot lysis time (CLT) was measured to shorten in preeclampsia when compared with controls and patients with thrombophilia (p = 0.032, p = 0.028, respectively). Conclusions: Not only the inherited thrombophilia group but also preeclampsia group demonstrated elongated clot initiation patterns when compared to the controls. Moreover, apart from the patients with inherited thrombophilia, preeclamptics exposed shorter CLT values indicating a possible increment in clot turn over, which eventually results in increased depletion of coagulation substrates, and thus, increased frequencies of oxidative cycle injury.Publication Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy(Kare Publ, 2009-04-01) Arıcı, Semih; Gurbet, Alp; Türker, Gürkan; Yavaşcaoğlu, Belgin; Şahin, Şükran; Arıcı, Semih; GURBET, ALP; TÜRKER, YUNUS GÜRKAN; YAVAŞCAOĞLU, BELGİN; Şahin, Şükran; Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; 0000-0002-6503-8232; 0000-0002-3019-581X; 0000-0003-4820-2288; A-7994-2018; AAI-7914-2021; JZE-5924-2024; AAI-6642-2021; AAG-9356-2021Objectives: Paracetamol is primarily thought to be a cyclooxygenase inhibitor acting through the central nervous system. Indirect effects of paracetamol are through the serotoninergic system as a non-opioid analgesic. In this study, total abdominal hysterectomy patients were given intravenous (iv) paracetamol 1 g preoperatively or intraoperatively to assess its postoperative analgesic effects.Methods: 90 patients undergoing total abdominal hysterectomy were enrolled into the study. Patients were randomized into three groups: in Group I, iv paracetamol 1 g was given 30 minutes prior to induction. In Group II, iv paracetamol 1 g was given prior to skin closure. Group III served as the control group and received saline as placebo. Postoperatively, all patients received morphine via patient-controlled analgesia pump. Postoperatively, rest and activity pain scores, sedation scores, hemodynamic parameters, postoperative morphine consumption, side effects, patient satisfaction, and total hospital stay were recorded.Results: In the control group, at rest and movement pain scores and total morphine consumption via patient-controlled analgesia were higher than in Groups I and II. When Groups I and II were compared, total morphine consumption was much greater in Group II. Intravenous paracetamol intraoperatively and postoperatively did not result in any hemodynamic effects.Conclusion: In total abdominal hysterectomy, preemptive iv paracetamol 1 g provided good quality postoperative analgesia, with decreased consumption of morphine and minimal side effects.Publication Effect of operation timeline on frequency of surgical complication in deceased donor kidney transplantation(Frontiers Media SA, 2019-10-01) Ersoy, Alparslan; Düger, Hakan; Dizdar, Oğuzhan Sıtkı; Yıldız, Abdülmecit; Akgür, Suat; Kaygısız, Onur; Oruç, Ayşegul; Ünsal, Oktay; Coşkun, Burhan; Kordan, Yakup; Türker, Gürkan; Vuruşkan, Hakan; ERSOY, ALPARSLAN; Düger, Hakan; Dizdar, Oğuzhan Sıtkı; YILDIZ, ABDULMECİT; AKGÜR, SUAT; KAYGISIZ, ONUR; ORUÇ, AYŞEGÜL; Ünsal, Oktay; COŞKUN, BURHAN; Kordan, Yakup; TÜRKER, YUNUS GÜRKAN; VURUŞKAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Anabilim Dalı/Nefroloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; 0000-0001-5478-3192; 0000-0002-9790-7295; 0000-0002-0342-9692; 0000-0002-8242-9921; 0000-0002-9947-848X; 0000-0002-3019-581X; AAM-9726-2020; AAH-5054-2021; AAI-6642-2021; AAH-4002-2021; IZP-9361-2023; AAH-9704-2021; BBE-2157-2022; HIG-9032-2022; EJA-1761-2022; JJY-8484-2023; AAH-9704-2021; GAF-0095-2022; EFH-9523-2022Publication Comparison of blunt and sharp needles for transforaminal epidural steroid injections(Kare Publ, 2012-04-01) Özcan, Ulaş; Şahin, Şükran; Gurbet, Alp; GURBET, ALP; Çelebi, Sureyya; Türker, Gürkan; TÜRKER, YUNUS GÜRKAN; Özgür, Mustafa; YAYLI, MUSTAFA ÖZGÜR; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Algoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; 0000-0002-6503-8232; 0000-0002-3019-581X; AAI-6642-2021; A-7994-2018Objectives: The aim of this study was to compare the sharp and blunt needles in order to determine the incidence of complications during transforaminal anterior epidural steroid injections.Methods: In this retrospective study, 185 cases that undergo transforaminal epidural steroid injection with sharp or blunt needles were evaluated between June 2004 and December 2008. Patients age, sex, diagnosis, needle type (sharp or blunt), volume of local anesthetic and steroid injected, complications (paresthesia, dural puncture, bleeding, paralysis, intravascular penetration, headache, local back pain, temporary motor loss in lower extremities) was recorded.Results: 3 cases in blunt needle group and 8 cases in sharp needle group showed paresthesia during the procedure. The difference was not found to be significant among the groups. Vascular penetration was observed in 2 cases in blunt and 13 cases in sharp needle group and the difference between groups was statistically significant (p<0.001). Dural puncture and headache incidence were not significant when the two groups are compared. The local back pain at the injection site had a higher incidence in the blunt needle group.Conclusion: When using the blunt needles, vascular penetration and paresthesia were less during transforaminal epidural steroid injections. Therefore blunt needles seem to be more advantageous.Publication Conscious sedation for endoscopic retrograde cholangiopancreatography: Dexmedetomidine versus midazolam(Aves, 2011-04-01) Kılıç, Neslihan; Şahin, Şükran; Aksu, Hale; Yavaşcaoğlu, Belgin; Gurbet, Alp; Türker, Gürkan; Kadıoğlu, Aslı Güler; Kılıç, Neslihan; Şahin, Şükran; Aksu, Hale; YAVAŞCAOĞLU, BELGİN; GURBET, ALP; TÜRKER, YUNUS GÜRKAN; Kadıoğlu, Aslı Güler; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; 0000-0002-4887-1337; 0000-0003-4820-2288; 0000-0002-6503-8232; 0000-0002-3019-581X; A-7994-2018; AAG-9356-2021; AAI-7914-2021; AAI-6642-2021; FDK-6768-2022; DPH-3881-2022; AAO-7943-2020; ILV-9196-2023Objective: Midazolam and dexmedetomidine, which are used for sedation during endoscopic retrograde cholangiopancreatography, were compared to evaluate the differences in efficacy, hemodynamics, and side effects.Materials and Methods: Fifty patients aged between 18 and 80 were randomly assigned to two groups according to American Society of Anesthesiologists (ASA) classification: Group M received midazolam with an initial bolus infusion of 0.04 mg/kg intravenously (i.v.), followed by additional doses of 0.5 mg i.v. midazolam, titrated to achieve a Ramsay sedation scale score of 3-4. Group D received dexmedetomidine with an initial bolus infusion of 1 mcg/kg/hr i.v. over 10 minutes, followed by a continuous infusion of 0.2-0.7 mcg/kg/hr, titrated to achieve an RSS of 3-4. A Mini Mental Status Examination (MMSE) was performed prior to sedation and in the recovery room once the Modified Aldrete Score (MAS) reached 9-10. Patient heart rates, arterial pressure and pain were evaluated.Results: Patients in Group D had lower heart rates at 20, 25, 30, 35 and 40 minutes following the initiation of sedation (p<0.05). There was no statistical difference in arterial pressure, RSS, MMSE or respiratory rate between the two groups. Coughing, nausea and vomiting occurred in 3 patients in Group M (12%), whereas no patient in Group D experienced these symptoms. The procedure elicited a gag response in 7 patients in Group M (28%) and in 4 patients in Group D (16%), with no significant difference between groups (p>0.05). When patient and surgeon satisfaction was compared between the two groups, Group D showed higher surgeon satisfaction scores (p<0.05).Conclusion: The use of dexmedetomidine for conscious sedation during short, invasive procedures, such as endoscopic retrograde cholangiopancreatography, could be a superior alternative to the use of midazolam.Publication Comparison of two different doses of intrathecal levobupivacaine for transurethral endoscopic surgery(Aves, 2011-08-01) Dizman, Seçil; Türker, Gürkan; Gurbet, Alp; Moğol, Elif Başağan; Türkcan, Suat; Karakuzu, Ziyaatin; Dizman, Seçil; TÜRKER, YUNUS GÜRKAN; GURBET, ALP; MOĞOL, ELİF; Türkcan, Suat; Karakuzu, Ziyaatin; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji Anabilim Dalı.; 0000-0002-3019-581X; 0000-0002-6503-8232; EUA-4272-2022; AAI-6642-2021; A-7994-2018; DHL-3236-2022; ECV-0145-2022; FFT-4429-2022Objective: To evaluate the effects of two different spinal isobaric levobupivacaine doses on spinal anesthesia characteristics and to find the minimum effective dose for surgery in patients undergoing transurethral resection (TUR) surgery.Materials and Methods: Fifty male patients undergoing TUR surgery were included in the study and were randomized into two equal groups: Group LB10 (n=25): 10 mg 0.5% isobaric levobupivacaine (2 ml) and Group LB15 (n=25): 15 mg 0.75% isobaric levobupivacaine (2 ml). Spinal anesthesia was administered via a 25G Quincke spinal needle through the L3-4 intervertebral space. Sensorial block levels were evaluated using the 'pin-prick test', and motor block levels were evaluated using the 'Bromage scale'. The sensorial and motor block characteristics of patients during intraoperative and postoperative periods and recovery time from spinal anesthesia were evaluated.Results: In three cases in the Group LB10, sensorial block did not reach the T10 level. Complete motor block (Bromage=3) did not occur in eight cases in the Group LB10 and in five cases in the Group LB15. The highest sensorial dermatomal level detected was higher in Group LB15. In Group LB15, sensorial block initial time and the time of complete motor block occurrence were significantly shorter than Group LB10. Hypotension was observed in one case in Group LB15. No significant difference between groups was detected in two segments of regression times: the time to S2 regression and complete sensorial block regression time. Complete motor block regression time was significantly longer in Group LB15 than in Group LB10 (p<0.01).Conclusion: Our findings showed that the minimum effective spinal isobaric levobupivacaine dose was 10 mg for TUR surgery.