Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Makale Koleksiyonu

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Is the dominant hemisphere effective in pain transmission?
(Anestezi Dergisi, 2025) Kütahya, Emine Çepni; Orhan, Rahime; Başaran, Betül; Bilge, Ayşegül
Objective: Propofol is one of the frequently used anesthetic agents. The most common side effect of it is injection pain. Hand dominance is one of the clinical factors that should be evaluated in pain sensitivity. The effect of hand dominance on many pain factors has been examined, but no clear conclusion has been reached. For this purpose, we aimed to evaluate the effect of this condition on propofol injection pain in patients with right- or lefthand dominance. Method: Our study included 163 patients aged 18-70 who would undergo general anesthesia with propofol for any surgical procedure in the operating room. Patients were randomly divided into 4 groups; group 1 (n=39) right-handed patients with vascular access on the back of the right hand, group 2 (n=45) right-handed patients with vascular access on the back of the left hand, group 3 (n=40) left-handed patients with vascular access on the back of the left hand, group 4 (n=39) were left-handed and had vascular access from the back of their right hand. It was evaluated with a 4-point verbal pain scale following propofol induction. Results: When dominant and non-dominant hand cannulation were compared in terms of pain score, no difference was found. No significant difference was found when the incidence of pain was evaluated according to the direction of the dominant hand and the cannulation side. Conclusion: In our study, no significant difference was found in propofol injection pain in terms of hand dominance and cannulation side.
The correlation between vitamin d levels and thyroid functions in early pregnancy
(Yüzüncü Yıl Üniversitesi Tıp Fakültesi, 2025) Dülger, Özlem; Oğul, Zeynep; Dinmez, Sinem
Vitamin D deficiency (serum vitamin D <10 ng/ml) and thyroid dysfunctions are prevalent issues globally, particularly during pregnancy. Evidence suggests a potential link between thyroid function and vitamin D levels. This study aims to investigate the correlation between serum vitamin D levels and thyroid functions in wome n during the first trimester of pregnancy. The study was conducted retrospectively at a University Education and Research Hospital’s pregnancy clinic, covering data from August 2023 to March 2024. The sample group consisted of first-trimester pregnant women who attended routine pregnancy check-ups and had complete vitamin D levels and thyroid function tests (n=185). The sociodemographic data form and blood serum level assessment forms were used as data collection tools. The data were analyzed using descriptive statistics and correlation analysis. The average age of the pregnant women participating i n our study was 27.6±4.9 years, and the Body Mass Index (BMI) was 25.4±4.8 (overweight). The mean number of pregnancies was 1.13±0.3, and the gestational week was 8.19±1.8. Of the participants, 35 had subclinical hypothyroidism, 37 had thyroiditis, and 113 had normal thyroid functions. The study identified 36 women with normal/adequate vitamin D levels (≥20 ng/ml), 113 with vitamin D insufficiency (10–20 ng/ml), and 36 with vitamin D deficiency (<10 ng/ml). The correlation analysis revealed no significant relationship between the thyroid function tests and vitamin D levels of the pregnant women. It was determined that vitamin D levels do not affect thyroid gland function in the first trimester. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Obesity May Present Challenges During Gastric Ultrasound
(London, Academic Press; New York, Grune & Stratton., 2025) Yarımoğlu, Rafet; Başaran, Betül; Osmanoğlu, Usame Ömer
No abstract available
The effect of weight-related self-stigma on sexual functioning in obese women with type 2 diabetes
(Benin City, Edo State, Nigeria : Women's Health and Action Research Centre, 2025) Şanlı, Ahmet; Çelik, Demet
This study aims to determine the relationship between weight-related self-stigma and sexual function in obese women with type 2 diabetes. This is a descriptive correlational study. The study reached 236 women through social media between December 2023 and April 2024. In data collection, a descriptive information form, the Weight Self-Stigma Questionnaire (WSSQ), and the Female Sexual Function Inventory (FSFI). The mean total score of the women on the Weight Self-Stigma Questionnaire was 32.78±10.00 and the mean total score on the Female Sexual Function Inventory was 22.38±4.08. Sexual dysfunction was identified in 70.8% of the women. We found that women with type 2 diabetes exhibited high levels of weight-related self-stigma and sexual dysfunction. Additionally, the findings indicated a negative correlation between self-devaluation and fear of enacted stigma and lubrication and sexual pain. However, self-stigma about weight and sexual dysfunction were not significantly related. It is recommended to determine the prevalence of weight bias and sexual dysfunctions among obese women with diabetes, and to provide adequate support by health professionals, in order to prevent negative effects on their mental health and sexual functions.
Evaluation of carbohydrate-containing fluid preloading in pregnant women using the obstetric quality of recovery scale after caesarean section
(Coll Physicians, 2025) Dülger, Özlem; Başaran, Betül
Objective: To test the short and long-term effects of consuming carbohydrate-rich beverages on patient-centred outcomes after caesarean delivery under spinal anaesthesia. Study Design: A prospective randomised controlled study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Karaman Training and Research Hospital, Karaman, Methodology: A total of one hundred parturients were randomly assigned to two groups. Fifty parturients were in the control group (Group C) and 50 in the oral carbohydrate preloading group (Group OCH). Group OCH were given carbohydrate-rich fluids, while those in Group C received distilled water before undergoing elective caesarean surgery. The primary outcome of this study was to evaluate the Obstetric Quality of Recovery-10 scores (ObsQoR-10) at the postoperative 24(th )hour. Secondary outcomes were ObsQoR-10 scores on the postoperative 3rd and 7(th ) day, postoperative pain scores, VAS scores, opioid consumption, and sensation of breast fullness. Welch's t-test and mixed-effect models were employed to analyse the outcomes. Results: The total recovery scores of both groups at the 24th hour, 3rd day, and 7(th ) day were similar (Group C: 80.08 +/- 15.58, Group OCH: 80.18 +/- 14.6; Group C: 93.98 +/- 7.45, Group OCH: 94.12 +/- 8.86; Group C: 97.2 +/- 5.16, and Group OCH: 98.16 +/- 3.18, respectively). The sensation of breast fullness was significantly higher in the Group OCH (p <0.05). No difference was recorded between the groups regarding postoperative tramadol consumption, VAS scores, and the presence of postdural puncture headache (p >0.05). Conclusion: Although carbohydrate-rich beverages did not affect the ObsQoR-10 score, they may have a notable influence on the increase of breast fullness and tenderness, which promotes breastfeeding among postoperative mothers.
Investigating the effects of metabolic and bariatric surgery on systemic immune-inflammation index and its relationship with smoking
(Wiley, 2025) Toprak, Hatice; Toprak, Şükrü Salih
PurposeThe contribution of obesity to inflammation may play a role in the progression of obesity-associated medical problems. The systemic immune inflammation index (SII) has recently been identified as a prognostic indicator for many adverse conditions. The primary purpose of the present study was to investigate the effects of metabolic and bariatric surgeries on white blood cell (WBC), platelet (PLT), lymphocyte (LYN), neutrophil (NEU), neutrophil/lymphocyte (NLR), platelet/neutrophil (PLR), and systemic immune inflammation index (SII). The secondary aim was to evaluate the effects of sleeve gastrectomy (SG) and gastric bypass (GB) surgeries, the most commonly performed metabolic and bariatric procedures, on individual inflammation parameters and their relationship with smoking status.MethodsThe blood inflammatory markers of the participants who underwent surgery were analyzed using the data evaluated during routine clinic follow-ups in the preoperative period and postoperative 1st, 3rd, 6th, and 12th months.ResultsThe primary result was a statistically significant decrease in WBC, NEU, NLR, and SII values in the 3rd postoperative month in those who underwent metabolic and bariatric surgery (MBS) (p values for each parameter: 0.000, 0.000, 0.028, and 0.006, respectively). A statistically significant decrease in WBC, NEU, and SII values in the 3rd postoperative month compared to preoperative values in nonsmoking individuals with obesity who underwent sleeve gastrectomy surgery was presented as our secondary result (p values for each parameter: 0.000, 0.000, and 0.015, respectively).ConclusionIn our study, MBS provided significant regression in inflammation parameters at 3 months after surgery in people smoking less than 10 cigarettes per day, although this effect did not seem to persist long term.Clinical Trial RegistrationACTRN12623000162617
Experiencing complications after metabolic and bariatric surgeries is a risk factor for postoperative emergency department admissions: a retrospective cohort study
(2025) Toprak, Şükrü Salih; Toprak, Hatice; Köse, Fulya
BackgroundEmergency department admissions significantly burden hospital staff and countries' health system. Studies are encouraged for effective and correct utilization of emergency departments. Rational management of obesity-related medical problems and postoperative complications may reduce emergency department visits. This study aimed to determine the rates, characteristics, and antecedents of emergency room admissions after metabolic and bariatric surgeries (MBSs) performed in our hospital. According to our hypothesis, experiencing postoperative complications is the most common reason for emergency department admissions.MethodsThe study was designed as a single-center, retrospective, cohort study. Metabolic and bariatric surgeries performed in our hospital between June 2021 and June 2023 were evaluated. Clavien Dindo Classification was used to classify complications. The reasons for emergency department admissions, re-hospitalization and surgical requirements, time relationships, and possible antecedents were examined in stages.ResultsA total of 153 patients were evaluated in the study. The average follow-up period was found to be 609.63 +/- 222.89. The emergency department admission rate following MBSs was found to be 31%, and the admission rate within the first month was 7.8%. The major complication rate following MBSs was 4.6%. Experiencing complications was the most important antecedent for admissions 1 month postoperatively.ConclusionsIn patients with complications after MBS, the discharge decision should be provided with stricter controls, and outpatient clinic controls should be planned more frequently. Providing training to patients on managing complications should be considered as a strategy that may reduce the number of emergency department visits.Clinical Trial RegistrationACTRN12624000810516
Effect of hypothalamic adrenal axis and thyroid function alterations on prognosis of critically Ill COVID-19 Patients
(Galenos Publ House, 2024) Korkusuz, Muhammet; Karaburgu, Sulbiye; Et ,Tayfun; Yarımoğlu, Rafet; Kumru, Nuh
Aim: The aim of this study was to evaluate the effect of changes in adrenal, and thyroid functions on the prognosis of Coronavirus disease-2019 (COVID-19) patients admitted to the intensive care unit (ICU). Materials and Methods: This was a retrospective evaluation that included COVID-19 patients requiring ICU admission. Serum cortisol, adrenocorticotrophic hormone (ACTH), thyroid-stimulating hormone (TSH), free thyroxine (fT4) and triiodothyronine (fT3) levels were measured on admission and two more times during the hospitalization. Routine biochemistry, hemogram, C-reactive protein, procalcitonin, fibrinogen and D-dimer levels were also measured, along with hormones. All-cause mortality during ICU stay, inotropic drug and mechanical ventilation needs, and duration of hospitalization were recorded for each patient. Euthyroid sick syndrome (ESS) and hypocortisolism rates were determined. Deceased and surviving patients were compared in terms of hormone values, and logistic regression to determine independent associates of mortality was performed. Results: Overall, 124 patients (58% male, mean age 70.7 +/- 11.3 years) were included. During the ICU stay, both fT3 and fT4, but not TSH, showed a statistically significant decrease compared to admission values. Serum cortisol and ACTH values increased compared to admission values, but this increase was not significant. ESS was present in 89.5% of the patients. Two-thirds of the patients died in ICU. Serum fT3 values were significantly lower among decedents compared to survivors. Hypocortisolism was detected in 20.1% of the patients. Only the fT3 level could independently and significantly predict all-cause mortality. Conclusion: ESS was almost universal among critically ill COVID-19 patients. Serum fT3, but not other thyroid or adrenal hormones, could significantly predict all-cause mortality.
Comparison of the effects of ring block and dorsal penile nerve block on parental satisfaction for circumcision operation in children: randomized controlled trial
(Springer Science and Business Media Deutschland GmbH, 2024) Toprak, Hatice; Kandemir, Emre
Purpose: In children, circumcision is a procedure associated with perioperative pain and parental satisfaction is an important parameter in the evaluation of anesthesia procedures. Inadequate dorsal penile nerve block (DPNB) for the ventral shaft of the penis might impact parental satisfaction negatively. To evaluate this hypothesis, we compared the effects of penile ring block (RB) and dorsal penile nerve block (DPNB) on parental satisfaction. Postoperative pain, need for additional analgesia, intraoperative hemodynamic data, recovery status, side effects, and postoperative complications were evaluated as secondary outcomes between the blocks. Methods: Parental satisfaction and anesthetic effectiveness of RB and DPNB for circumcision in children were compared. 86 patients were randomized 1:1 to Group RB and Group DPNB, which were administered the same dose of anesthesia. Parental satisfaction was evaluated with the Pediatric Anesthesia Parental Satisfaction Questionnaire (PAPS). Postoperative pain evaluations were made with the Face, Legs, Activity, Crying, Consolability Pain Scale (FLACC). Results: In terms of parent satisfaction, no differences were detected between the groups in the pre-anesthesia, pre-anesthesia and post-anesthesia, post-anesthesia, hospital team, and anesthesia team parameters (p > 0.05). The scores of Group DPNB patients were higher only in the “Q11” subparameter in the “anesthesia team” parameter, and this difference was significant (0.024). Conclusion: RB and DPNB were compared in circumcision, which is the most common surgical procedure for children. Parental satisfaction, anesthesia, and analgesic effects of both blocks were found to be similar. Clinical trials: ACTRN12622001211752.
Modified thoracoabdominal perichondrial approach (M-TAPA) injections with bupivacaine and dexamethasone on treatment of postherpetic neuralgia
(Edizioni Minerva Medica, 2024) Et, Tayfun; Korkusuz, Muhammet
Modified thoracoabdominal perichondrial approach (M-TAPA) injections with bupivacaine and dexamethasone on treatment of postherpetic neuralgia
Evaluation of patients admitted to intensive care unit with drug intoxication: retrospective analysis of 203 patients
(Yüzüncü Yıl Universitesi Tıp Fakultesi, 2024) Bilge, Ayşegül
The purpose of the present study was to retrospectively analyze the demographic and clinical characteristics of acute drug intoxication patients admitted to the emergency and Intensive Care Unit for follow-up and treatment. The records of the patients who were hospitalized in the Intensive Care Unit with the diagnosis of acute drug intoxication between 01.01.2018 and 01.01.2023 in the Karaman Training and Research Hospital were scanned from the hospital data system. A total of 203 patients (77 men and 126 women) were included in the study. The mean age was found to be 30.83±12.12. The number of patients who had suicidal intoxication was 183 (90%). It was determined that the most common agents of drug intoxication were analgesics (n=94, 46%), antidepressants (n=59, 29%), and antibiotic drugs (n=19, 9.4%). There was a history of depression in 113 (56%) of the patients. The median (IQR) GCS of the cases at the time of admission was 15 (0), and the mean APACHE II Score was 2.16±4.22. A significant relationship was detected between low GCS and increased APACHE II Scores and prolonged stays in the Intensive Care Unit. It was determined that acute drug intoxications occur to commit suicide with rapidly accessible drugs such as analgesics and antidepressants. It is considered that it would be more appropriate to follow-up patients who do not have an indication for Intensive Care Unit hospitalization in emergency departments or wards in terms of improving capacity management.
Comparative cross-sectional study on sexual function of couples during pregnancy: Assisted reproductive techniques versus spontaneous conceptions
(Women's Health and Action Research, 2024) Dülger, Özlem; Dinmez, Sinem; Torun, Sebahat D.; Osmanoğlu, Usame Ömer
This study aims to compare the sexual functions of couples undergoing assisted reproductive techniques (ART) with those conceiving spontaneously during pregnancy. A total of 102 couples participated in this cross-sectional study, with 68 couples in the spontaneous conception group and 34 couples in the ART group. Data collection was conducted face-to-face in the antenatal clinic using separate “Descriptive Information Form” for women and men, “Female Sexual Function Index (FSFI)” for women, and “Libido Scoring System (LSS)” for men. Descriptive statistical methods, Chi-square and Fisher exact tests, t-test, and Pearson correlation test were used for data analysis. It was observed that the mean FSFI total scores of women who conceived spontaneously and through ART during pregnancy were at a good level (≥30), while the mean LSS scores of their partners were at a moderate level (5-7). No statistically significant distinction existed among the groups. Further research is advisable by adjusting the sample selection criteria, such as gravida, duration of ART treatment, and gestational age.
Association Between the Success of Bariatric Surgery and Personality Traits
(2023) İmre, Okan; Toprak, Şükrü Salih
Objective: Acceptable preoperative psychosocial indicators of weight loss after obesity surgery in morbidly obese(MO) patients are still unknown. In this study, the association between personality traits, multidimensional perceived social support, and the percentage of excess weight loss (EWL) following obesity surgery was researched in MO patients. Methods: Participants in this prospective study were recruited from MO patients who applied to the hospital’s obesity unit between July 2021 and June 2022. The study comprised 84 MO individuals. The Temperament and Personality Inventory (TCI) was used to evaluate the personality traits of the MO. Perceived social support was measured using the multidimensional perceived social support scale. The percentage of weight loss after obesity surgery was compared with personality traits and perceived social support scores. Results: The mean age of the patients who were MO was 36.7 ±8.7 years. There were 22 men (25.3%) and 62 women (74.7%). The mean preoperative BMI was 46.2 ±63. The perceived social support score was 68.0±16.4. A univariate analysis found a positive relationship between 6 months and one year’s EWL and Self-Transcendence, a TCI subcategory (p=0.011,p=0.023). Conclusion: Obesity treatment is a complex situation that requires a multidisciplinary approach. Given the potential physiological and psychological consequences of obesity surgery, it is critical to uncover psychological predictive factors such as personality traits that boost the success of obesity surgery and are connected with weight loss. As a result, knowing the individuals who selftranscendence before obesity surgery may be useful in predicting the success of obesity surgery and planning treatment. This requires large-scale research.
Correlation between the severity of lung involvement and nasal mucociliary clearance time and acute phase biomarkers in patients with COVID-19
(2023) Yücedağ, Fatih; Sezgin, Arife; Gürel, Fatih; Kuzu, Selçuk; Kahraman, Şerif Şamil
Objectives: The aim of this research was to evaluate the correlation between the increased nasal mucociliary clearance time (NMCT) and chest computed tomography severity scores (CT-SS) and acute phase biomarkers in patients diagnosed with coronavirus disease 2019 (COVID-19) pneumonia. Patients and Methods: A total of 116 hospitalized patients were included in the prospective study between November 2021 and June 2022. For the measurement of the NMCT, all patients underwent the saccharin test. The patients were separated into two groups: Group 1, which included 53 patients (28 females, 25 males; mean age: 50.1±13.2 years; range, 19 to 75 years) with an NMCT of 7-13 min, and Group 2, comprising of 63 patients (32 females, 31 males; mean age: 52.3±12.1 years; range, 30 to 82 years) with an NMCT of 14-21 min. The CT-SS was adapted from a previous method including ground-glass opacity, interstitial opacity, and air entrapment and was used to express the severity and rate of involvement of COVID-19 pneumonia. Results: The mean CT-SS was 3.8±1.6 in Group 1 and significantly higher in Group 2 with 6.2±2.0 (p<0.001). In addition, a strong positive correlation was determined between the NMCT and CT-SS (r=0.711). The mean lung lobe involvement was 3.6±1.5 in Group 1 and 4.8±0.5 in Group 2, and the difference was statistically significant (p<0.001). The mean ferritin levels showed a statistically significant difference at 244.6±146.9 mg/L in Group 1 and 436.5±449.1 mg/L in Group 2 (p=0.038). Conclusion: The saccharin clearance test is not routinely used in clinical practice but with the lights of our study’s results increased NMCT results correlates with pneumonia severity scores in CT and it may be useful in the prediction of prognosis of pneumonia in COVID-19 patients.
Long-term results of tragal cartilage type 1 tympanoplasty
(2023) Yücedağ, Fatih; Sevil, Ergün; Çevik, İsmail
Aim: Tympanoplasty is one of the most frequently performed operations by ear, nose, and throat specialists. Surgical treatment of tympanoplasty aims to obtain a healthy ear membrane and minimise hearing loss. The purpose of this study was to evaluate the success of the graft and functional hearing outcomes of patients applied with tragal cartilage type 1 tympanoplasty operation in our clinic. Materials and Methods: This study included 43 patients who underwent tragal cartilage type 1 tympanoplasty operation between January 2016 and November 2020. A retrospective evaluation was made of the preoperative pure tone audiometry (PTA) values and the operative findings. In the follow-up examination, the graft status and PTA results were recorded. The graft success and improvements in hearing were evaluated in all the patients. Results: A total of 43 patients were evaluated, comprising 24 males and 19 females with a mean age of 31.2 years (range, 13-58 years). The operation was performed on the right ear of 22 patients and the left ear of 21. The tympanoplasty operation was performed with an endaural approach in 6 cases and a postauricular approach in 37. The mean follow-up period was 20.8 months (range, 12-39 months). The rate of graft success of all the patients was 88.4%. The mean air conduction threshold, air-bone gap, and bone conduction threshold values at 500, 1000, 2000, and 4000 Hz were determined to have statistically significantly decreased postoperatively in comparison with the preoperative values (p<0.05). Conclusion: In tragal cartilage type 1 tympanoplasty operations, high rates of graft success were obtained and a dramatic gain in hearing postoperatively.
Comparison of diaphragm thickness values ın cases of adenotonsillectomy before and after the operation
(2023) Toprak, Hatice; Aydoğan, Eyüp; Tire, Yasin
Aim: The ultrasonographic assessment in the operating room tends to increase daily, and ultrasonography is a method used to evaluate the thickness of the diaphragm. Measurement of the thickness of the diaphragm is a parameter that can be used to decide before separation from mechanical ventilation and extraction. In these cases where intubated and extubated at the end of the operation, it is planned to examine the ratio of the aperture muscle thickness to each other in the last inspirium and exprium before extubation. Determining the current ratio may be meaningful for determining the extubation time. Material and Method: In the study, 60 patients, who were in the physical state of ASA I and II, 3-12 age range, and who were scheduled for elective adenotonsillectomy operation were included. Age, gender, body mass index (BMI), and operation time data of patients were recorded. Before and after the procedure, inspiratory and exprituar diaphragm thicknesses were measured by ultrasonography. In addition, the ratio of the last inspirium and the diaphragm muscle thicknesses in the last expiration were also calculated. Results: There was no significant difference between the pre-operation values and the end of the operation in the diaphragm thickness measurements. The incidence of laryngospasm was 1.5 %. Conclusion: Diaphragm thickness measurements with ultrasound have many benefits but further studies are needed.
A rare cause of acute abdomen in childhood: coexistence of mesenteric cystic lymphangioma and acute appendicitis
(Cukurova Univ, Fac Medicine, 2023) Uysal, Mehmet; Bayram, Mehmet
Abdominal kistik lenfanjiyomlar, mezenterik ve retroperitoneal lenfatiklerin literatürde sık rastlanmayan benign konjenital anomalileridir. Tanı genellikle fizik muayene, ultrasonografi ve bilgisayarlı tomografi ile konulur. Komşu organların önemli bir kısmı feda edilmeyecekse, semptomatik abdominal kistik lenfanjiyomlar için kitlenin cerrahi olarak tamamen çıkarılması tedavi seçeneğidir. Bu çalışmada mezenterik kistik lenfanjiyom nedeniyle cerrahi tedavi uygulanan bir hasta sunulmaktadır. Aralıklı karın ağrısı ve karında kitle nedeniyle başvuran 17 yaşındaki kadın hastanın yapılan radyolojik incelemeleri sonucunda iyi sınırlı, septalı mezenterik kistik lenfanjiyom ve akut apandisit tespit edildi. Hastaya tanısal laparoskopik işlem uygulandıktan sonra açık cerrahi tedavi uygulandı ve Treitz ligamanının yaklaşık 100 cm distalinde jejunumu çevreleyen kitleye eksizyon ve rezeksiyon anastomozu uygulandı. Ameliyat sonrası herhangi bir sorun yaşanmayan hasta, ameliyat sonrası 5. günde şifa ile taburcu edildi. Aralıklı karın ağrısı ve karında kitle şikayeti olan hastalarda mezenterik kistik lenfanjiyomlar akılda tutulmalı ve nadiren ciddi komplikasyonlara yol açabileceğinden seçilmiş vakalarda cerrahi tedavi uygulanmalıdır.
The effects of dexamethasone added to ilioinguinal/iliohypogastric nerve (IIN/IHN) block on rebound pain in inguinal hernia surgery: a randomized controlled trial
(Springer, 2023) Korkusuz, Muhammet; Başaran, Betül; Et, Tayfun; Bilge, Ayşegül; Yarımoğlu, Rafet; Kuruçay, Yıldıray
Purpose: The purpose of the present study was to evaluate the effects of IV dexamethasone added to one single injection Ilioinguinal/Iliohypogastric Nerve (IIN/IHN) block on tramadol consumption and Modified Rebound Pain Score (MRPS) in the first postoperative 24 h in inguinal hernia surgery. Methods: Five mg IV dexamethasone as an analgesic adjunct in the multimodal analgesia was administered to the patients who were scheduled for Inguinal Hernia Surgery and randomized to Group Dex and normal saline was administered to the patients who were randomized to the Control Group in addition to IIN/IHN Block. Postoperative tramadol consumption, Modified Rebound Pain Score (MRPS), the incidence of Rebound Pain, Rebound Pain time, postoperative 48-h opioid consumption, Numerical Rating Scale (NRS) scores, Quality of Recovery Score (QoR-15), Sleep Quality, and adverse events were evaluated in the patients. Results: The mean scores of MRPS were lower in Group Dex than in the Control Group, both at rest (p = 0.001) and with motion (p = 0.001). Tramadol consumption in the first postoperative 24 h was 45.17 ± 49.59 mg in Group Dex and 95 ± 59.23 mg in the Control Group. The difference between the groups was statistically significant (p < 0.001). Conclusions: In conclusion, adding IV dexamethasone as a part of multimodal analgesia to IIN/IHN block for inguinal hernia surgery resulted in lower MRPS and lower postoperative opioid (tramadol) consumption. For this reason, IV dexamethasone can be added to the IIN/IHN block after inguinal hernia surgery to reduce the incidence of rebound pain, rebound pain scores, and NRS scores for pain, decrease postoperative opioid consumption, and improve the quality of recovery.
Assessing the educational value and content of YouTube videos for ultrasound-guided subclavian vein catheterization
(SAGE Publications Ltd., 2023) Satilmis, Tülin; Başaran, Betül
Background: The European Society of Anaesthesiology (ESA) published a guideline regarding continuous ultrasound guidance for central venous catheters in 2020. YouTube has been a popular educational platform since its inception. The purpose of the present study was to evaluate the adequacy of videos on ultrasound-guided subclavian vein catheterization posted on YouTube based on this guideline. Method: YouTube was scanned using the keywords associated with ultrasound-guided subclavian vein catheterization and 46 of the 106 most-watched videos were included in the study. The videos were divided into three groups, as individual, manufacturer, and academic according to their sources, and were evaluated as poor, satisfactory, and good in terms of the overall content. The videos were then evaluated based on ESA’s six-title guide for more specific informational content. Results: A total of 46 videos were reviewed and 52.2% (n = 24) were found to be prepared by individuals. Among the videos, the rate of videos describing only venipuncture (poor) was 23.9% (n = 11), 73.9% (n = 34) of videos described the verification of the guidewire location with venipuncture, and 2.2% of videos described all the recommendations suggested by the guide (n = 1). At the end of the catheterization procedure, 4.3% (n = 2) stated that the catheter location should be confirmed by using ultrasound, 15.2% (n = 7) recommended chest-X-ray, and 80.4% (n = 37) did not suggest any. Conclusion: Manufacturer and academic videos can be watched due to their high-quality scores, but it may be practical to prepare training videos with guidelines both for educators and students to have global access to the renewed guideline information.
Efficacy of the erector spinae plane block for quality of recovery in bariatric surgery: A randomized controlled trial
(Springer, 2023) Toprak, Hatice; Başaran, Betül; Toprak, Şükrü S.; Et, Tayfun; Kumru, Nuh; Korkusuz, Muhammet; Bilge, Ayşegül; Yarımoğlu, Rafet
Background: Postoperative pain management after bariatric surgery is difficult due to different physiological properties and high sensitivity toward opioids in patients with obesity. It has been reported that erector spinae plane block (ESPB) contributes to postoperative analgesia when applied together with multimodal analgesia. Methods: Eighty patients were randomized either bilateral ESPB (group E) each side or no block (group C). Our primary aim was to evaluate the effects of ESPB on the quality of recovery 24 h postoperatively in bariatric surgery by using 40-item Quality of Recovery-40 (QoR-40) questionnaire. Postoperative pain assessed using a numerical rating scale (NRS), time of additional analgesic requirement, analgesic consumption, side effects, sedation, mobilization time, and postoperative complications were evaluated as secondary outcomes. Results: Postoperative mean QoR-40 scores were found to be higher in group E (175.02 ± 11.25) than in group C (167.78 ± 18.59) at the postoperative 24th hour (P < 0.05). Pain scores at rest and during movement were higher in group C than in group E. At the postoperative 24th hour, NRS mean SD scores at rest for group C and group E were 3.25 ± 1.32 and 2.40 ± 0.96, respectively. NRS mean SD scores during movement for groups C and E were 3.88 ± 1.49 and 3.12 ± 1.30, respectively. The total amount of tramadol consumed in the first 24 h in group C and group E were mean SD: 86.40 ± 69.60 and 40.00 ± 46.96, respectively; P < 0.05. Conclusions: ESPB improved postoperative quality of recovery, reduced NRS scores, and total analgesic consumption in patients with obesity undergoing bariatric surgery. Clinical Trial Registration: NCT05020379. Graphical Abstract: [Figure not available: see fulltext.].

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