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Öğe A comparison of adductor canal block before and after thigh tourniquet during knee arthroscopy: A randomized, blinded study(Korean Society of Anesthesiologists, 2021) Ekinci, Mürsel; Çiftçi, Bahadır; Demiraran, Yavuz; Çelik, Erkan Cem; Yayık, Murat; Ömür, Burak; Kuyucu, Ersin; Atalay, Yunus OktayBackground: Adductor canal block (ACB) provides effective analgesia management after arthroscopic knee surgery. However, there is insufficient data about performing ACB before or after inflation of a thigh tourniquet. We aimed to investigate the efficacy of ACB when it is performed before and after thigh tourniquet and evaluate motor weakness. Methods: ACB was performed before the tourniquet inflation in the PreT group, it was performed after the inflation of the tourniquet in the PostT group. In the PO group, ACB was performed at the end of surgery after disinflation of the tourniquet. Results: There were no statistical differences between the groups in terms of demographic data. Opioid consumption showed no statistically significant differences (for total consumption; p = 0.5). The amount of rescue analgesia administered and patient satisfaction were also not significantly different between groups. There was no significant difference in terms of static and dynamic VAS scores between groups (for 24 hours; p = 0.3, p = 0.2 respectively). The incidence of motor block was higher in the PreT group (eight patients) than in the PostT group (no patients) and in the PO group (only one patient) (p = 0.005). Conclusions: Using a tourniquet before or after ACB may not result in any differences in terms of analgesia; however, applying a tourniquet immediately after ACB may lead to muscle weakness.Öğe A randomized trial to compare serratus anterior plane block and erector spinae plane block for pain management following thoracoscopic surgery(Oxford University Press, 2020) Ekinci, Mürsel; Çiftçi, Bahadır; Gölboyu, Birzat Emre; Demiraran, Yavuz; Bayrak, Yusuf; Tulgar, SerkanObjective. Comparison of ultrasound (US)-guided erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) in video-assisted thoracic surgery (VATS) patients. The primary outcome was to compare perioperative and postoperative (48 hours) opioid consumption. Methods. A total of 60 patients were randomized into two groups (N =30): an ESPB group and an SAPB group. All the patients received intravenous patient-controlled postoperative analgesia and ibuprofen 400 mg intravenously every eight hours. Visual analog scale (VAS) scores, opioid consumption, and adverse events were recorded. Results. Intraoperative and postoperative opioid consumption at 0-8, 8-16, and 16-24 hours and rescue analgesic use were significantly lower in the ESPB group (P< 0.05). Static/dynamic VAS scores were significantly lower in the ESPB group (P< 0.05). There was no significant difference between static VAS scores at the fourth hour. There were no differences between adverse effects. Block procedure time and one-time puncture success were similar between groups (P > 0.05 each). Conclusion. US-guided ESPB may provide better pain control than SAPB after VATS. Question. Even though there are studies about analgesia management after VATS, clinicians want to perform the technique that is both less invasive and more effective. Findings. This randomized trial showed that US-guided ESPB provides effective analgesia compared with SAPB. Meaning. Performing single-injection ESPB reduces VAS scores and opioid consumption compared with SAPB.Öğe Are Fetuin-A levels beneficial for estimating timing of sepsis occurrence?(Saudi Medical Journal, 2018) Altınışık, Hatice Betül; Altınışık, Uğur; Uysal, Sema; Saçar, Suzan; Şimsek, Tuncer; Demiraran, YavuzObjectives: To evaluated Fetuin-A levels of patients admitted in the intensive care unit with a diagnosis of sepsis. Methods: This study was conducted at the Faculty of Medicine, Canakkale Onsekiz Mart University Hospital, Canakkal, Turkey, between February 2015 and October 2015. Forty septic patients were included in the study. Subsequent to clinical suspicion of sepsis, serum levels of C-reactive protein (CRP) and procalcitonin; and white blood cell (WBC) counts were evaluated at 3 time-points: 0 (basal), 24, and 72 hours. Results: The mean Fetuin-A levels at the 3 time-points were 58.5 +/- 29.2 ng/mL, 40.9 +/- 23.6 ng/mL, and 47.8 +/- 25.7 ng/mL, respectively. Fetuin-A levels at 24 hours were significantly lower than the basal level (p<0.05), where as no significant difference was observed between the basal levels and those at 72 hours (p>0.05). Correlation between the temporal changes in Fetuin-A levels and the changes in other inflammatory markers (CRP, procalcitonin and WBC) was examined. Fetuin A was found to have only a negative correlation with serum procalcitonin level (p<0.05). Conclusion: In this study, serum Fetuin-A levels in septic patients decreased significantly in the first 24 hours, followed by an insignificant increase at 72 hours. These findings suggest that monitoring of Fetuin-A levels may help predict the time of occurrence of sepsis and prognosis of sepsis.Öğe Artroskopik omuz cerrahisi yapılan hastalarda postoperatif analjezi yönetiminde erektör spina plan bloğu ve interskalen brakiyal pleksus bloğu etkinliklerinin karşılaştırılması(İstanbul Medipol Üniversitesi Tıp Fakültesi, 2021) Kapukaya, Furkan; Demiraran, YavuzGiriş ve Amaç: Artroskopik omuz cerrahisi yapılan hastalarda postoperatif analjezi amacıyla kullanılan yöntemler arasında altın standart interskalen brakiyal pleksus bloğu (İSB)'dur. Ultrason (US) eşliğinde yapılan erektör spina plan bloğu (ESPB), Forero ve ark. tarafından 2016 yılında tanımlanmış bir interfasiyal plan bloğudur. ESPB yüksek torakal seviyeden (T2) uygulandığında, kronik omuz ağrısı ve akut postoperatif omuz ağrısında etkili olduğunu gösteren çalışmalar bulunmaktadır. Bu çalışmanın amacı, artroskopik omuz cerrahisi yapılan hastalarda postoperatif analjezi yönetiminde ESPB ile İSB etkinliklerini karşılaştırmaktır. Gereç ve Yöntem: İstanbul Medipol Üniversitesi Etik Kurulu'ndan onay (29.08.2019 tarihli 26 karar no.lu izin) ve hasta onamları alındıktan sonra, genel anestezi altında artroskopik omuz cerrahisi planlanan, ASA risk skoru I-II olan 60 hasta çalışmaya alındı. Kanama diyatezi hikayesi bulunan, antikoagülan tedavi alan, lokal anestezik ve opioid ilaçlara karşı alerjisi veya duyarlılığı olan, blok uygulanacak bölgede infeksiyonu olan, gebelik şüphesi ve/veya gebe olan, emziren anneler ve işlemi kabul etmeyen hastalar çalışma dışı bırakıldı. Hastalar bilgisayar randomizasyon programı yardımıyla iki gruba ayrıldı. Grup ESPB'de (n=30) ESPB, Grup İSB'de (n=30) İSB planlandı. Her iki gruba postoperatif dönemde iv fentanil ile hasta kontrollü analjezi (HKA) uygulandı. İntraoperatif ve postoperatif ilk 48 saatte her iki grubun opioid tüketimi, opioid kullanımına bağlı yan etkiler ve komplikasyonlar, postoperatif VAS skorları ve kurtarıcı analjezik kullanımı kaydedildi. Bulgular: ESPB grubunda İSB grubuna göre postoperatif ilk 4 saatte VAS skorları anlamlı olarak yüksek bulundu (p<0.05). Daha sonraki saatlerde her iki grup VAS skorları arasında anlamlı fark yoktu (p>0.05). ESPB grubunda, postoperatif dönemde HKA ile kullanılan toplam fentanil tüketimi ve kurtarıcı analjezik kullanımı İSB grubuna göre anlamlı olarak daha fazlaydı (p<0.05). Postoperatif dönemde yan etki olarak bulantı görülme sıklığı ESPB grubunda anlamlı olarak yüksekti (p<0.05). Diğer yan etkiler ve komplikasyonlar açısından her iki grup arasında anlamlı bir fark saptanmadı (p>0.05). Sonuç: Çalışmamızda, omuz cerrahisi yapılan hastalarda postoperatif analjezi açısından ESPB'nin etkin bir yöntem olduğu ancak İSB'nin analjezik etkinliğinin daha fazla olduğu görüldü. ESPB, başta hemidiyafragmatik paralizi gibi yan etkilerin olmaması, uygulamada kolaylık ve güvenlik gibi avantajları nedeniyle özellikle akciğer patolojisi bulunan hastalarda omuz artroskopisi sonrası analjezik yöntem olarak İSB'na iyi bir alternatif olabilir.Öğe Çocuklara anatomik tanımlama ve ultrasonografi eşliğinde perkütan santral venöz kateter takılması yöntemlerinin karşılaştırılması - Tek merkez deneyimi(Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği, 2019) Yıldız, Yahya; Ulukan, Mustafa Özer; Cantürk, Emir; Gül, Yaşar Gökhan; Erkanlı, Korhan; Demiraran, Yavuz; Uğurlucan, Murat; Türkoğlu, HalilAmaç: Pediyatrik kardiyak anestezist tarafından ultrasonun yaygın olarak kullanılması ile zaman ve malzeme tasarrufu ile birlikte başarılı girişim sayısı artmış, komplikasyonlarda da azalma olmuştur. Bu çalışmada, çocuklara 2 farklı yöntem olan anatomik tarif (AT) ve Ultrasonografi (US) eşliğinde perkutan santral venöz kateter (SVK) takılması yöntemlerini karşılaştırdık. Yöntem: On kilogramın altında, toplam 293 olgu, rastgele, retrospektif olarak; AT (n=151) ve US (n=142) eşliğinde kateterizasyon yapılanlar olarak 2 gruba ayrıldı. SVK sağ/sol internal juguler ven (İJ), sağ/sol femoral ven (FV) ve sağ/sol subklaviyen venden (SKV) takıldı. Karşılaştırılan parametreler: demografik veriler, kateterin takıldığı yer, girişim sayısı, işlemi bitirme süresi, cerrahi kateter takılma sayısı, komplikasyonlar idi. Bulgular: Grupların demografik verileri; yaş (1 gün- 4.5 yaş), ağırlık (560 g-10 kg), boy (23-103 cm) ve cinsiyetleri arasında fark yoktu (p>0,05). SVK takıldığı yerler sırası ile % olarak: sağ İJ/sol İJ/sağ FV/ sol FV/ sağ SKV / cerrahi femoral ven/sağ atriyum; AT de 82/6/6/2/2/2, US’de 89/9/1/0/0/0 (p<0.05). SVK girişim sayısı: AT grubunda 1-26 (6.7±17.7) kez ve US grubunda ise 1-4 (1.23±0,5) kez idi (p<0,05). SVK takma süresi: AT grubunda 16-231 (45.2±47,5) dk. ve US grubunda ise 11-82 (16.1±13.8) dakika idi (p<0.05). Komplikasyonlar: kanama, hematom, dolaşım bozukluğu, sinir hasarı, uzamış yatış, mortalite sırası ile % olarak, AT’de 11/9/7/3/4/1, US’de %1/2/0/0/0/0 idi (p<0,05). Sonuç: Pediatrik kardiyak anestezide kateterizasyonlar anatomik tarif veya ultrason eşliğinde yapılabilir. Ultrason eşliğinde yapılması; zaman ve başarılı girişim sağlarken, komplikasyonlarda da azalmaya neden olacağı kanısındayız.Öğe Comparison of intravenous ibuprofen and paracetamol for postoperative pain management after laparoscopic sleeve gastrectomy. A randomized controlled study(Springer, 2019) Çiftçi, Bahadır; Ekinci, Mürsel; Çelik, Erkan Cem; Kaçıroğlu, Ahmet; Karakaya, Muhammet Ahmet; Demiraran, Yavuz; Özdenkaya, YaşarBackground Laparoscopic sleeve gastrectomy (LSG) is defined as the first-step bariatric surgery for the treatment of obesity. Opioid analgesics are often preferred for pain management because of their strong analgesic potentials. However, opioids have undesirable adverse effects. Objectives The objective of this study is to evaluate and compare the influence of IV forms of ibuprofen and paracetamol on pain management and opioid consumption on patients undergoing LSG surgery. Setting This study was conducted at Istanbul Medipol University Hospital. Methods Patients were stratified into three groups. Group I (group ibuprofen, n = 30) was administered 800 mg of IV ibuprofen, group P (group paracetamol, n = 30) was administered 1000 mg of IV paracetamol, and group C (control group, n = 30) was given 100 ml of saline solution. We evaluated opioid consumption and VAS scores postoperatively. Results This study included 90 patients who underwent LSG. The use of rescue medication in group I was statistically lower than the other groups. VAS scores in group I and group P at recovery and at 2, 4, 8, 12, and 24 h were lower than those in group C. In particular, the VAS scores in group I at the first 2 h postoperatively were significantly lower than those in group P (p <0.05). Opioid consumption in group C was significantly higher than the other groups (p <0.05). Conclusion Our study suggested that IV ibuprofen resulted in lower pain scores compared to paracetamol by reducing postoperative opioid use in the first 24 h in patients undergoing LSG surgery.Öğe Comparison of the effects of clinical observation and protocol-based weaning on antioxidant stress factors(NLM (Medline), 2022) Erdoğan, Cem; Kızılaslan, Deniz; Tunay, Burcu; Karaaslan, Pelin; Ülfer, Gözde; Yiğitbaşı, Türkan; Demiraran, Yavuz; Öz, HüseyinBACKGROUND: We aimed to compare the effects of observation of the physician (POB) or by adhering to the protocol-based (PB) weaning methods on total antioxidant capacity (TAC) and total oxidative stress (TOS) levels and weaning success levels. METHODS: Our study was conducted on patients admitted from the emergency department between January 2015 and January 2018 in the intensive care unit of our hospital. During the spontaneous breathing trial (SBT), when one of the criteria specified in developed, SBT was terminated and the previous mechanical ventilator parameters were returned. The patient was planned to be taken to SBT again the next morning. If the SBT was successful, extubation was decided. The extubation decision based on physician observation was made according to the patient's state of consciousness and adequate chest expansion during the daily visit. RESULTS: The decrease in TAC average value before and after extubation was found to be significant in the POB group patients (p=0.001). The decrease in the average TAC value of the PB group patients before and after extubation was found to be significant (p=0.03). CONCLUSION: In our study, TAC values were found to be higher in the PB group than in the POB group, and in addition, the reintubation rate was found to be lower. We think that the management of weaning as a PB may contribute to maintaining the balance between TAC and TOS and reduce the rate of reintubation.Öğe Completion of septoplasty operation despite decreased oxygen saturation in a patient with rainier hemoglobinopathy with general anesthesia(Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği, 2019) Yıldız, Yahya; Özen Akay, Mine; Gül, Yaşar Gökhan; Demiraran, YavuzRainier hemoglobinopathy is an extremely rare hematologic disorder characterizedwith increased oxygen affinity of hemoglobin leading to decreased blood oxygensaturation. Up to date literature includes only 1 case who had been operated undergeneral anesthesia. In this report, we present a 27-year-old male patient with Rainierhemoglobinopathy who underwent nasal septoplasty under general anesthesia.Öğe Effect of different anesthetic agents management on electrocardiographic changes of patients operated under regional intravenous anesthesia(2020) Yorulmaz, İlknur; Akman Köse, Gökçe; Demiraran, Yavuz; Cangür, ŞengülObjective: We compared cardiac effects,electrocardiographic changes by intravenous regionalanesthesia (IVRA) with lidocaine and lidocaine +ketamine.Materials and Methods: Prospective, randomised,double blind study was performed in the operating roomof Du?zce University Hospital. Seventy patients between18-60 years, ASA I-II and who were undergo IVRA forarm and forearm operations. Patients were divided intotwo group s rando mly. Gro up 1 : 0.5 %Lidocaine+Ketamine 0.8 mg/kg; 40 ml. Group 2: 0.5%Lidocaine 40 ml. 20 minutes after injection the distal cuffwas inflated, and the proximal cuff deflated with a rate of50 mmHg in every 3 minutes. Time periods of therecordings were 0, 5, 10, 15, 30, 45, 60th minutes after thebeginning of deflation and 10 minutes after the deflation.Non-invasive blood pressure values, heart rate, pulseoximetry values were recorded. Electrocardiographicchanges on PR, RR intervals, QT, QTc were recorded.Results: QT basal value measured in GroupLidocaine+Ketamine is significantly lower than QT5thmin, QT10th min, QT15th min, QT30th min, QT45th min,QT60th min and QTtur10. QTcbasal values measured inGroup Lidocaine+Ketamine were significantly lower thanQTc tur10 values (p <0.001).Conclusions: In Group Lidocaine, no significantdifferences was observed. After the deflation of tourniquetwas completed, QT and QTc values and noninvasiveblood pressures were significantly higher in GroupLidocaine+Ketamine.Öğe Effect of PEEP, Zero PEEP and intraabdominal pressure levels on cerebral oxygenation in the morbidly obese undergoing sleeve gastrectomy(Mary Ann Liebert Inc., 2017) Yorulmaz, İlknur Suidiye; Demiraran, Yavuz; Salihoğlu, Ziya; Umutoğlu, Tarık; Özaydın, İsmet; Doğan, SamiThe study is designed to determine the effect of zero end expiratory pressure (ZEEP) and 5 mmHg positive end expiratory pressure (5PEEP) on cerebral oxymeter (CO) levels in morbidly obese (MO) patients. Study was performed on 60 morbidly obese patients between 18-60 years old, American Society of Anesthesiology 2-3 status, scheduled to undergo laparoscopic sleeve gastrectomy under general anesthesia. The patients were divided into two groups: those ventilated with no PEEP (group ZEEP, n = 30) and those ventilated with 5 cmH2O PEEP levels (group 5PEEP, n = 28). rSO2 values were measured. Data were recorded as basal, after the induction (A ind) of anesthesia, 5 min before insufflation (BI), 5 min after insufflation (AI), 15, 30, 45, and 60 min after induction, 5 min before desufflation, and 5 min after desufflation (AD). Invasive arterial pressures, CO values, peripheral oxygen saturation, end tidal carbondioxide, and intraabdominal pressure (IAP) were recorded in these time periods in all groups. Arterial blood samples were analyzed in terms of the 5BI, 5AI, and 5AD periods. There was a negative correlation between IAP and left CO on pneumoperitoneum time in group 5PEEP. Correlation was observed between bilateral CO values and ideal body weight (IBW), lean body weight (LBW), body surface area BSA, in group ZEEP. Correlation was observed between IBW, LBW, and right CO values in group 5PEEP. PEEP application may have a protective effect on cerebral oxygenation.Öğe Effect of perioperative terlipressin infusion on recipient's hepatic and renal functions in living donor liver transplantations(Wiley, 2017) Karaaslan, Pelin; Aktaş, Sema; Ayar, Işılay; Özgür, Selma; Hızarcı, Burcu; Köse, Emine Arzu; Sevmiş, Şinasi; Demiraran, Yavuz[Abstract Not Available]Öğe Effects of inadvertent perioperative mypothermia on metabolic and inflammatory mediators(AVES, 2019) Aydın, Halide; Şimşek, Tuncer; Demiraran, YavuzObjective: The aim of the present study was to investigate the effects of perioperative undesirable hypothermia on inflammatory (interleukin (IL)-8, IL-10, IL-18, IL-23 and pentraxin (PTX)-3) and metabolic responses (cortisol and insulin) and recovery time.Methods: A total of 60 patients between the ages of 18 and 65 years who were in the lumbar stabilisation operation were included in the study. In this prospective, randomised controlled study, two groups were constituted as with warmed (Group N) and not warmed (Group C) patients before and during the operation. Diuresis, blood loss, body temperature and side effects were recorded with IL-8, IL-10, IL-18, IL-23, PTX-3, cortisol and insulin levels.Results: Perioperative diuresis was significantly higher in Group C. Aldrete score was significantly higher in Group N with less shivering and vom-iting in the postoperative period. IL-10, PTX-3 and cortisol levels were found to be significantly higher in Group C in the first postoperative hour. PTX-3 and cortisol were found to be significantly higher in Group C after 24 h of the operation. Insulin was significantly higher in Group N. In 72 h, IL-8 in Group N and cortisol level in Group C were significantly higher.Conclusion: Positive effects of heating the patients in the perioperative period on haemorrhage, diuresis, complications and recovery time were observed in our study. In addition, maintenance of normothermia appeared to modulate the biomarkers that indicate the inflammatory and met-abolic responses.Öğe ERAS ve geriatrik hasta(Logos Yayıncılık Tic. A.Ş., 2018) Şahin, Ayça Sultan; Demiraran, YavuzGeriatrik hastalar genellikle perioperatif dönemde daha genç hastalara göre farklı bir bakım seviyesi gerektirir. Postoperatif komplikasyonlar, fonksiyonel düşüş, bağımsızlık kaybı ve diğer istenmeyen sonuçların gelişmesine eğilimlidirler. ERAS (Enhanced recovery after surgery) perioperatif yönetimi optimize etmeyi amaçlayan multimodal bir yaklaşımdır. ERAS, organ disfonksiyonunu ve cerrahi stres yanıtını azaltmak için preoperatif, intraoperatif ve postoperatif bakımdaki değişikliklerin bir bütünüdür ERAS protokollerinin uygulandığı geriatrik hastaların peroperatif ve postoperatif bakımlarının ve taburculuk sürelerinin uygulanmayanlara göre daha iyi olduğu gözardı edilmemelidir.Öğe Erector spinae plane block vs interscalene brachial plexus block for postoperative analgesia management in patients who underwent shoulder arthroscopy(BMC, 2022) Kapukaya, Furkan; Ekinci, Mürsel; Çiftçi, Bahadır; Atalay, Yunus Oktay; Gölboyu, Birzat Emre; Kuyucu, Ersin; Demiraran, YavuzBackground Interscalene brachial plexus block (ISB) is the gold standard method used for postoperative analgesia after arthroscopic shoulder surgery. Ultrasound guided erector spinae plane block (ESPB) is an interfascial plane block. The aim of this study is to compare the analgesic efficacy of ESPB and ISB after shoulder arthroscopy. The primary outcome is the comparison of the perioperative and postoperative opioid consumptions. Methods Sixty patients with ASA score I-II planned for arthroscopic shoulder surgery were included in the study. ESPB was planned in Group ESPB (n = 30), and ISB was planned in Group ISB (n = 30). Intravenous fentanyl patient-controlled analgesia was administered to both groups in the postoperative period. Intraoperative and postoperative opioid and analgesic consumption of both groups, side effects and complications related to opioid use, postoperative pain scores and rescue analgesic use were recorded in the first 48 h postoperatively. Results Pain scores were significantly higher in the ESPB group in the first 4 h postoperatively than in the ISB group (p < 0.05). The total fentanyl consumption and number of patients using rescue analgesics in the postoperative period were significantly higher in the ESPB group (p < 0.05). The incidence of nausea in the postoperative period was significantly higher in the ESPB group (p < 0.05). Conclusions In our study, it was seen that ISB provided more effective analgesia management compared to ESPB in patients underwent shoulder arthroscopy surgery.Öğe High thoracic erector spinae plane block for arthroscopic shoulder surgery: A randomized prospective double-blind study(Blackwell Science, Inc., 2021) Çiftçi, Bahadır; Ekinci, Mürsel; Gölboyu, Birzat Emre; Kapukaya, Furkan; Atalay, Yunus Oktay; Kuyucu, Ersin; Demiraran, YavuzObjective: Moderate to severe pain may occur following arthroscopic shoulder surgery. An erector spinae plane block (ESPB) may be used for painful conditions of the shoulder. The primary hypothesis of this trial is that ultrasound-guided ESPB would provide effective analgesia by reducing opioid consumption. The secondary hypothesis is that ESPB would result in low pain scores and reduce the use of rescue analgesia.Design: Randomized prospective double-blind study.Setting: Academic university hospital.Subjects: Sixty patients aged between 18 and 65 years designated as American Society of Anesthesiologists (ASA) class I or II who underwent unilateral arthroscopic shoulder surgery under general anesthesia were included in the study.Methods: Patients were equally divided into two groups-either the ESPB group (n=30) or the sham block group (n=30). ESPB was performed with 30 mL 0.25% bupivacaine at the T2 level in the ESPB group and sham block with 30 mL saline at the T2 level in the sham block group. Twenty minutes before the end of the operation, 100 mg tramadol was administered intravenously to the patients. Intravenous ibuprofen 400 mg 3 × 1 was ordered for the patients during the postoperative period. A patient control analgesia device including a dose of 10 µg/mL fentanyl was connected to the patients.Results: There were no statistical differences between groups in terms of demographical data. Postoperative fentanyl consumption was significantly lower in the ESPB group than in the sham block group (96.66 µg ±105.57 µg and 230 µg ±247.17 µg, respectively) (P=0.009). The need for rescue analgesia was significantly lower in the ESPB group than in the sham block group (26.66 mg ±35.43 mg and 48.5 mg ±35.45 mg, respectively) (P=0.020). Overall, the visual analog scale scores were significantly lower in the ESPB group than in the sham block group.Conclusions: ESPB may provide effective analgesia treatment following arthroscopic shoulder surgery.Öğe Predictors of perioperative morbidity and mortality in adult living donor liver transplantations: Report of results of a tertiary hospital(Springer, 2020) Hızarcı, Burcu; Karaaslan, Pelin; Ertuğrul, Gökhan; Yılmaz, Mesut; Demiraran, Yavuz; Öz, HüseyinBackground The aim of this study was to investigate the risk factors effective in perioperative morbidity and mortality in 161 living donor liver transplantations (LDLT). Results The most common indication for living donor transplantation was cryptogenic cirrhosis. The most common complication was biliary problems in 62.16% cases. Sepsis was the most common cause of in 52%. Patients in whom sepsis was observed, significantly prolonged stay under mechanical ventilation and prolonged ICU stay were detected. In patient group in whom mortality was observed, higher amounts of erythrocytes, fresh frozen plasma (FFP), and platelets were transfused, and patients remained longer under mechanical ventilation treatment, and in the ICU. Conclusion Perioperative morbidity and mortality was found to be significantly related with higher amounts of erythrocytes and FFP transfusions and longer operative and warm ischemia times. Sepsis was found to be the most common cause of mortality.Öğe SAPS III or apache IV: Which score to choose for acute trauma patients in intensive care unit?(Turkish Assoc Trauma Emergency Surgery, 2019) Korkmaz Toker, Melike; Gülleroğlu, Aykan; Karabay, Ayşe Gül; Biçer, İlhan Güney; Demiraran, YavuzBACKGROUND: The aim of the present study was to evaluate the effectiveness of the Simplified Acute Physiology Score (SAPS) III and the Acute Physiology and Chronic Health Evaluation (APACHE) IV in the prediction of in-hospital mortality in surviving multi-trauma patients. METHODS: This study was conducted in the 13-bed intensive care unit (ICU) of a tertiary hospital. A retrospective review of multi-trauma patients whose care was managed in the ICU was performed. Data collection included details of age, gender, ICU admission, and outcome. APACHE IV and SAPS III scores, as well as the predicted mortality rate (PMR), were calculated using web-based calculators. RESULTS: Of the 90 patients 20% (n= 18) were female and 80% (n= 72) were male. The overall mortality rate was 25.6%. The mean APACHE IV, Acute Physiology Score (APS) and SAPS III score was 69.27 +/- 34.51, 66.42 +/- 33.72, and 26.36 +/- 27.14, respectively. The mean PMR according to the APACHE IV and the SAPS III was 26.36 +/- 27.14 and 17.07 +/- 24.88, respectively. The area under the curve result of receiver operating characteristic curve analysis was 0.87 for the APACHE IV and 0.93 for the SAPS III. CONCLUSION: The performance of the SAPS III was more sensitive and discriminative than the APACHE IV scoring system for multi-trauma ICU patients.Öğe Sequential application of oxygen therapy via high-flow nasal cannula and non-invasive ventilation in COVID-19 patients with acute respiratory failure in the intensive care unit: A prospective, observational study(Galenos Publishing, 2023) Erdoğan, Cem; Çiftçi, Bahadır; Kızılaslan, Deniz; Ayar, Işılay; Topgül, Tamara Buruk; Alver, Selçuk; Demiraran, Yavuz; Çelik, Erkan CemObjective: Non-invasive mechanical ventilation (NIV) and high-flow nasal oxygen therapy (HFNO) are the most frequently used methods for treating hypoxemia in those diagnosed with coronavirus disease-2019 (COVID-19) in the intensive care unit (ICU). In this prospective study, we compared the effects of these two treatment modalities applied alternately in the same patient. Materials and Methods: Standard oxygen therapy (SOT) was administered for 1 hour to patients hospitalized in the ICU with a diagnosis of acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS) due to COVID-19. HFNO and NIV were applied alternately to patients who met the inclusion criteria, and we evaluated the effects of HFNO and NIV applied to the same patient. Results: Thirty of forty-five patients admitted to the ICU for COVID-19 ARDS met the inclusion criteria for the study. According to the first and second arterial blood gas (ABG) values, the PaO2/ FiO(2) (P/F) ratio was significantly higher during NIV compared to both baseline and HFNO. In addition, the ROX index was significantly higher during NIV than HFNO, and SpO(2) in NIV increased significantly compared with the baseline value. In both methods, patient satisfaction according to the visual analog scale was better than that of SOT. Eighty percent (24/30) of the patients were orotracheally intubated; 13 patients were transferred to the ward (43.3%), 2 patients were discharged home (6.7%), and 15 patients died (50%). Conclusion: Starting respiratory support with HFNO and/or NIV rather than SOT is more effective in improving oxygenation in patients with AHRF and ARDS due to COVID-19 and other causes. NIV is more effective than HFNO in increasing the SpO(2) and P/F ratio.Öğe Serratus anterior plane block versus erector spinae plane block for thoracoscopic surgery: Response to sun et al(Oxford University Press, 2022) Ekinci, Mürsel; Çiftçi, Bahadır; Gölboyu, Birzat Emre; Demiraran, Yavuz; Bayrak, Yusuf; Tulgar, SerkanDear Editor, We thank Sun et al. for their interest in our article, which compares the analgesic efficacy of erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) for thoracoscopic surgery [1]. Our study is a single-center, randomized, prospective study of two groups [2]. We compared T5-level ESPB and SAPB which was performed at the level of 4th–5th ribs in our study. According to our results, ESPB provided better pain control than SAPB in patients who underwent thoracoscopic surgery. However, there may be some considerations in our study, like the other clinical studies in the literature. Sun et al. reported that “The authors only statistically differentiated postoperative pain level, but the difference in baseline (before surgery) between the two groups was not?known” [1].Öğe The effect of vitamin D status on different neuromuscular blocker agents reverse time(Türkiye Klinikleri, 2020) Yorulmaz, İlknur Suidiye; Demiraran, Yavuz; Özlü, Onur; Dost, BurhanBackground/aim: This study is aimed to investigate the effects of vitamin D levels on sugammadex and neostigmine reversal times. Material and methods: Eighty patients between the ages of 18 and 65 years, with ASA I-III status who were undergoing surgery under general anesthesia were included in the study. A double blind fashion was used to randomly divide all the patients into two groups. At the end of the operation, sugammadex 2 mg/kg was administered to one group (Group sugammadex) and atropine and neostigmine was administered to the other group (Group neostigmine) intravenously. In the data analysis stage, the group was divided into two subgroups according to sugammadex and group neostigmine in itself, with vitamin D levels above and below 30 ng/mL. Statistical analysis was performed on these 4 groups (Group neostigmine and vitamin D < 30 ng/mL), (Group neostigmine and vitamin D ? 30 ng/mL), (Group sugammadex and vitamin D < 30 ng/mL), (Group sugammadex and vitamin D ? 30 ng/mL). When two responses to train of four (TOF) stimulation were taken, the following times were recorded until extubation phase. The time until TOF value 50%, 70%, 90%, and extubation were recorded. Results: There were statistically significant differences between Group sugammadex and vitamin D < 30 ng/mL and Group sugammadex and vitamin D ? 30 ng/mL (P = 0.007) for extubation times and 50% TOF reach times (P = 0.015). However, there was no difference observed between Group neostigmine and vitamin D < 30 ng/mL and Group neostigmine and vitamin D ? 30 ng/mL (P = 0.999). Conclusion: Vitamin D deficiency is important for anesthesiologists in terms of muscle strength and extubation time. Vitamin D deficiency seems to affect sugammadex reverse times but seems not to affect neostigmine reverse times. This conclusion needs further studies.
