Browsing by Publisher "Anestezi Dergisi"

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    Rett syndrome and anesthetic management; [Rett sendromu ve anestezi yönetimi]
    (Anestezi Dergisi, 2017) Çevikkalp E.; Gül Hayran G.; Tezcan Keleş G.
    Rett syndrome is a developmental and neurological disease characterized by defective X and is caused by mutations in the gene MECP2 coded chromosomes. It is a central involvement diesase that starts in the early developmental years, together along with EEG abnormalities, seizures, mental retardation. Orthopedic, respiratory and cardiac problems can also be seen. Prolonged QT, scoliosis, apnea, cachexia is common in children with this syndrome and requires significant anesthesia care and attention. In this case, we emphasized the anesthetic management of a Rett Syndrome child, its possible risks and problems.
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    Evaluation of in-hospital cardiac arrest patients; [Hastane Içi Kardiyak Arrest Olgularinin Deǧerlendirilmesi]
    (Anestezi Dergisi, 2019) Keles G.T.; Çevikkalp E.; Açikel A.; Topçu I.
    Objective: Cardiac arrest is a suddenly developed unexpected clinical condition characterized with cessation of cardiac functions or inability to palpate pulsations in major arteries; loss of respiratory functions and consciousness. The aim of this study was to evaluate prospectively inhospital cardiac arrest cases. Method: We aimed to evaluate the patients diagnosed with cardiac arrest developed in the hospital using cardiopulmonary resuscitation procedure (CPR). Demographic variables as age, gender, body mass index (BMI), disease groups, reversible causes of cardiac arrest, dosages of drugs used, time to return to spontaneous circulation, heart rhythm during cardiac arrest, and blood pressure values were recorded. All data were evaluated in SPSS 15.0 statistical program using appropriate tests and p<0.05 is accepted as the level of statistical significance. Results: We included 189 patients in the study with a mean age of 58.49±16.78 years. Seventyone patients were women (37.5%), 118 patients were men (62.5%). Mean BMIs of female (n=71), and male patients (n=118) were 27.04±5.78 kgm-2 and 23.60±4.37 kgm-2, respectively (p<0.05). Respective percentages of patients had experienced HT (n=66: 34.9%), DM (n=54: 28.5%), CAD (n=46: 24.3%), COPD (n=24: 12.6%), CRF (12.1%), SVD (n=27: 14.2%), CHF (n=27: 14.2%) and MI (n=13: %6.8). DM was seen in significantly higher number of women (p<0.05). NEA (18.5%), and asystole (77.2%) were arrest rhythms. The most frequently seen reversible causes that induced arrest were hypoxia (n=20: 10.6%) and hypo-hyperkalemi (n=16: 8.5%). Mean duration of CPR was 38.47±14.71 min. (n=189). In the 46 of the patients (24.3%), spontaneous circulations returned, and 143 of them (75.5%) exited. Mean duration of resuscitation applied for patients (n=46) whose spontaneous respiration was recovered was 14.80±9.07 min. SBP, and DBP were recorded as 74.35±32.63 mmHg, and 45.00±18.34 mmHg, respectively. Conclusion: In cardiac arrests of in-patiens most frequently non-shockable rhythms such as pulseless electrical activity and asystole are seen. The short duration of cardiac arrest is in favor for survival. Reversible causes of cardiac arrest should be pre-determined and in the evaluation of critical evaluation of patients emergency intervention team should be notified.before development of cardiac arrest. © Copyright Association of Anesthesiologists and Reanimation Specialists.
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    Efficacy of pleth variability index (PVI) to evaluate intraoperative fluid management during orthopedic spinal surgery: A randomized controlled trial; [Ortopedik spinal cerrahi olgularında İntraoperatif sıvı yönetimini değerlendirmede pleth değişkenlik İndeksinin etkinliği: Randomize kontrollü çalışma]
    (Anestezi Dergisi, 2020) Çevikkalp E.; Topçu I.; Açıkel A.; Sarılar S.; Keleş G.T.; Özyurt B.C.
    Objective: To prevent complications during major surgery, it is important to monitor blood and fluid treatment. The Pleth Variability İndex (PVI) allows noninvasive assessment of fluid management. It is based on respiratory changes in arterial pulse pressure. In our study, we aimed to compare the management in terms of variations in PVI in response to fluid loading in the monitorization of intraoperative fluid management in major surgery using classical calculation method and CVP Method: The patients were randomized into two equal (n=50) groups. In Group C, the required amount of fluid replacement was carried out with crystalloid solutions using the 4-2-1 rule and by calculating fasting, maintenance, and insensible losses. In the PVI group, 250 mL of crystalloid solution was administered in 5 minutes to patients with a PVI greater than 14%, patients with a PVI less than 14% were administered a fluid infusion with an initial dose of 4 mL kg-1 h-1. Results: In the comparison of intraoperative fluid management the amount of intraoperative fluid replacement was 3522±1098.1 mL in Group C and 1914±542.86 mL in Group PVI (p<0.05). The mean amount of intraoperative red blood cell transfusion was 0.42±0.57 unit in Group C and 0.08±0.27 unit in Group PVI (p<0.05). There were no significant differences between the groups in terms of postoperative red blood cell transfusion (p>0.05) or intraoperative hemoglobin levels (p>0.05). Conclusion: It has been thought that PVI assessment is more valuable than CVP monitoring because it is noninvasive and thus provides better cardiac stabilization with less fluid replacement. It can also provide more accurate results when evaluating intravascular volume status. © Copyright Anesthesiology and Reanimation Specialists’ Society. This journal published by Logos Medical Publishing. Licenced by Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0).
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    Comparison of Postoperative Analgesic Efficacy of Different Methods after Cesarean-Section; [Sezaryen Sonrası Farklı Yöntemlerin Arasında Postoperatif Analjezik Etkinliğin Karşılaştırılması]
    (Anestezi Dergisi, 2020) Ok G.; Çevikkalp E.; Ülkümen B.A.; Erbüyün K.; Hasdemir P.S.; Özyurt B.C.; Aydın D.
    Objective: In this research study,we compared postoperative analgesic effects of general anesthesia followed with transversus abdominis plane block (TAPB), epidural or spinal anesthesia and we aimed to figure out the efficacy of TAPB for the postoperative pain. Method: After approval of the ethics committee (date: 03.25.2015; decision no: 142) for the study was obtained, the study population scheduled for elective cesarean operations was divided in three subgroups as spinal, epidural and general anesthesia. Group T consisted of 30 cases that underwent general anesthesia and TAP; Group E consisted of 32 cases that underwent epidural anesthesia; and Group S consisted of 30 cases that underwent spinal anesthesia. All cases received 75 mg IM diclophenac sodium after the operation. Data about the postoperative pain (the onset time of the pain, and the severity of the pain evaluated with VAS (Visual Analog Scale) and the need for adjuvant analgesics) were recorded. In addition, heart rate, blood pressure, peripheric oxygen saturation, respiration rates at postoperative 0., 1., 4., 6. and 12. hours and side effects seen were recorded. If the patient needed any additional postoperative analgesics, 50 mg tramadol was injected intravenously. Results: There was no significant difference between the groups regarding postoperative analgesia need (Table II). The need for postoperative tramadol was minimum for patients in Group E and maximum for patients in Group S (p<0.05). VAS scores at postoperative 0., 1. and 6. hours were significantly lower for patients in Group E (p<0,05). Regarding the groups T and S, VAS scores at 6. hours were significantly lower in Group T when compared with Group S (p<0.05). Conclusion: We found that the efficacy of the epidural anesthesia was more prominent and the best method for decreasing postoperative consumption of tramadol. Epidural anesthesia increased the postoperative analgesic efficacy and decreased the tramadol consumption in patients undergoing TAP block. In order to increase the comfort of the mother and newborn, TAPB may be an option for patients who are not candidates for epidural anaesthesia. © Copyright Anesthesiology and Reanimation Specialists’ Society.
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    Cardiopulmonary resuscitation practices in adult patients with diagnosed or suspected COVID-19 disease; [COVID-19 tanısı veya şüphesi olan erişkin hastalarda kardiyopulmoner resüsitasyon uygulamaları]
    (Anestezi Dergisi, 2021) Akın Ş.; Birbiçer H.; Doruk N.; Keleş G.T.; Özbilgin Ş.
    Cardiopulmonary resuscitation (CPR) includes all treatment procedures during cardiac arrest. Resuscitation of patients with diagnosed or suspected COVID-19 disease is particularly important in terms of protection and reducing the risk of transmission. In this review, the basic and advanced life support recommendations of Turkish Resuscitation Council for adult patients with a definite or probable diagnosis of COVID-19 are explained within the algorithm framework. © Copyright Anesthesiology and Reanimation Specialists’ Society. This journal published by Logos Medical Publishing. Licenced by Creative Commons Attribution 4.0 International (CC)