Browsing by Author "Bilgi, Murat"
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Item Severe Pulmonary Edema due to Hyponatremia after Hysteroscopy; Rapid and Full Recovery.(2014-05) Akkaya, Akcan; Karatas, Ahmet; Demirhan, Abdullah; Ozlu, Tulay; Bilgi, Murat; Tekelioglu, Umit; Akkaya, KadirHysteroscopy is an important diagnostic and therapeutic procedure that can cause serious complications, including uterine perforation and dilutional hyponatremia. Hyponatremia itself may cause central pontine myelinolysis, and pulmonary edema, which could be dangerous. We report a patient who developed near fatal pulmonary edema, and hyponatremia during hysteroscopy. A total of 12 L irrigation fluid was given in 45 minutes and eight litres were collected. At the end of the procedure, the patient was suddenly being desaturated (Saturation O2 < %50) and huge amount of frothy fluid had come out of laryngeal mask airway, pulmonary edema was considered. The supportive treatment, mechanical ventilation and 3% hypertonic saline solution were used in the ICU. Initial sodium levels were below the value of 100mEq/L but after 12 hours it was reached 135mEq/L. At the 17th hour she was extubated and day after she healed completely. This case report emphasizes the importance of rapid correction of hyponatremia and pulmonary edema caused by excessive fluid overload during hysteroscopic surgery.Item Sugammadex associate persistant bradycardia.(2014-05) Bilgi, Murat; Demirhan, Abdullah; Akkaya, Akcan; Tekelioglu, Umit Yasar; Kocoglu, HasanSugammadex is a safe selective relaxant binding agent, composed of modified cyclodextrin molecules. It especially has a selectivity for neuromuscular blocking agents (NMBAs) of steroid composition, such as rocuronium and vecuronium. In this paper, we present a case where intravenous (iv) sugammadex has been applied and subsequently persistent bradycardia has developed. A 56-year-old male patient (weight 77 kg, height 163 cm) was scheduled for ureterorenoscopy because of a stone in the upper part of ureter. Preoperative examination showed possible difficult intubation (mallampati 3). There are no known heart diseases and no history of any drug use. The electrocardiography was in normal sinus rhythm, and the blood biochemistry was normal. (WBC: 8.47 K/mm3; Hb: 14.3 g/dL; Na: 135 mEq/L; K: 3.9 mEq/L; BUN: 41 mg/dL; Creatin: 0.69 mg/dL).When the operation ended, We monitored neuromuscular block level with a neuromuscular monitoring device (TOF- Watch S). At the end of the operation, 200 mg sugammadex (Bridion 200 mg/2 mL, MSD) was administered to the patient through iv injection. Approximately 2 minutes following the administration, the patient developed sinusoidal bradycardia (pulse 35 beats/min). We believe that cardiac side effects may be observed following sugammadex administration and that atropine-resistant bradycardia may also develop.