Browsing by Author "Çelik, H.K."

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    Pubmed
    High, Low, and Minimal Flow Anaesthesia Management: Effects on Oxygen Reserve Index and Arterial Partial Oxygen Pressure
    (2023) Dastan, R.; Çelik, H.K.; Doganay, Z.
    Objective: To determine the oxygen reserve index (ORI) as a supporting parameter to the arterial partial oxygen pressure (PaO2) in blood gases in hypoxia and hyperoxia monitoring with different fresh gas flows (FGF) in patients undergoing abdominal surgery. Study design: Randomised controlled trial. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Samsun Education and Research Hospital, Turkey, from January to September 2020. Methodology: The study population of ninety patients was divided into three groups. After the high-flow period, the inspired oxygen fraction (FiO2) and flow-guided ventilation (FGF) were set to be 4 L/m and 40% in Group H (high-flow), 1 L/m and 50% in Group L (low-flow), and 0.5 L/m and 68% in Group M (minimal-flow), respectively. Results: There was a very high statistically positive correlation between PaO2 and ORI in H, L, and M groups. When using a cut-off value of 0.005 for ORI for the detection of PaO2 >100 mmHg, the area under the curve (AUC) was 0.97 (p<0.001) with a sensitivity of 94.4% and specificity of 95.3%. The AUC was detected to be 0.95 in receiver operating characteristic (ROC) analysis when the hyperoxia cut-off value of ORI was used to determine PaO2 >150 mmHg in the estimation of hyperoxia. Conclusion: ORI can be used to complement SpO2 in low-flow anaesthesia in patients undergoing abdominal surgeries, provide guidance for PaO2, give information about tissue oxygen delivery, and contribute to the individualisation of oxygen therapy, and will therefore be included in the standard monitoring in the future.
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    Web of Science
    The Effects of Propofol and Ketofol on Hemodynamics, End-Tidal Carbon Dioxide, Integrated Pulmonary Index and Recovery in Patients Undergoing Endoscopy and Colonoscopy
    (2023.01.01) Askin, A.; Çelik, H.K.; Doganay, Z.
    BACKGROUND/AIMS: In this study, we aimed to compare the effects of propofol and ketofol on hemodynamics, end-tidal carbon dioxide (EtCO2), integrated pulmonary index (IPI), peripheral oxygen saturation (SpO(2)) and sedation quality during endoscopy and colonoscopy performed under anesthesia. MATERIALS AND METHODS: One hundred patients aged 18-79 years with American Society of Anesthesiology class I-III were randomly divided into two groups: the propofol group (1%) and the ketofol mixture group (group P and group K, respectively). Sedation was achieved with 0.15 mL/kg doses of both drugs, followed by additional 0.05 mL/kg doses based on the patients' Ramsey Sedation Scores. Before the procedure, the basal values of heart rate (HR), EtCO2, IPI, and SpO(2) were obtained, as well as instantaneous trend data. systolic blood pressure, diastolic blood pressure, and mean blood pressure values were recorded prior to the procedure (baseline values), at the 1st, 5th, 10th, 15th, 25th, 30th minutes, and at the conclusion of the procedure. The duration of anesthesia and the procedure, the amount of propofol administered, the rate of spontaneous eye opening, and recovery parameters were also recorded. RESULTS: The mean blood pressure values at the 1st, 5th, 10th, 15th, 20th minutes, at the end of the intervention, and at the 5th minute after the procedure were found to be higher in group K compared to group P. HR, SpO(2), EtCO2 and IPI values were higher in group K than in group P. Time to spontaneous eye opening was significantly lower in group K compared to group P. In addition, the recovery period during which the modified Aldrete score was >9 did not differ between groups. Additional doses and total propofol consumed during the procedure were significantly lower in group K than in group P. CONCLUSION: Ketofol appears superior to propofol in endoscopic procedures due to its superior hemodynamic and respiratory stability, without affecting recovery time. Incorporating non-invasive EtCO2 and IPI measurements into standard respiratory monitoring equipment improves monitoring quality and facilitates its execution.