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Öğe Comparison of postoperative analgesic efficacy of bupivacaine and levobupivacaine for dorsal penile block(Bayrakol Medical Publisher, 2024) Esen, Hayruenisa Kahraman; Esen, Osman; Yildiz, Turan; Ilce, ZekeriyaAim: In this study, we aimed to evaluate the postoperative analgesic efficacy and side effects of bupivacaine and levobupivacaine for dorsal penile blockage in circumcised patients. Material and Methods: A total of 84 circumcised patients (age range: 7-11 years) were enrolled in this study. The patients were divided into two groups according to the dorsal penile block method: bupivacaine utilized Group B, levobupivacaine utilized Group L. Blocks were administered preoperatively with 1mL kg -1 of 0.25% bupivacaine and levobupivacaine. Postoperative pain scores and sedation were evaluated. Pain assessment was performed using the WongBaker faces Pain Scale (WBPS). The number of patients without pain within the first 6 hours, analgesia duration, time of first analgesia, and total paracetamol consumption were recorded. Results: Mean scores of WBPS were found statistically higher at the first, second and third hours in group B than in group L (p<0,05). The results showed no statistically significant differences between groups according to the WBAS assessment at 4, 5 and 6 hours, rates of rescue analgesic requirement and also rescue paracetamol dose between the groups. Discussion: Administration of levobupivacaine for dorsal penile blockage was found to be more efficient to provide postoperative analgesia and also to reduce postoperative analgesia utilization than bupivacaine in circumcised children under general anesthesia.Öğe Comparison of tap block and epidural block in gynecologic oncology surgeries(BAYRAKOL MEDICAL PUBLISHER, 2022) Aydın, Nevin; Esen, Osman; Ateş, HaticeAim: Transversus abdominis plane (TAP) block and epidural analgesia may be helpful in relieving pain after surgical procedures in gynecological malignancies. In this retrospective cohort study, it was aimed to compare the analgesic efficacy of TAP block and epidural block in patients operated for gynecological malignancy. Material and Methods: Medical files of 74 patients who underwent surgery for gynecological malignancy were retrospectively reviewed. All patients underwent gynecologic surgeries. Group I (n=25) received epidural analgesia, Group II (n=25) TAP block, and Group III (n=24) received no additional analgesic procedures. Baseline descriptors, visual analog scale for pain, Ramsay sedation score, operation and ICU length of stay, need for additional medication, and gastrointestinal symptoms were compared between groups. Results: The level of pain relief, hemodynamic and respiratory parameters in the 3 operated groups were mostly similar. In patients <55 years of age, the Ramsay sedation scale was significantly higher 12 hours after surgery. In these patients (<55 years), additional drug use was needed more at the 12th hour. VAS scores at theist (p=0.024) and 2nd (p=0.004) hours were also higher in patients with a body mass index of >25. Discussion: Our results showed that TAP block and epidural analgesia provide safe and effective methods for postoperative analgesia in gynecological malignancies.Öğe Comparison of videolaryngoscopy (Glidescope®) and direct laryngoscopy for tracheal intubation for cesarean section(Bayrakol Medical Publisher, 2024) Aydin, Nevin; Esen, OsmanAim: The aim of this study was to retrospectively investigate the perioperative features and clinical outcomes in cesarean section (C/S) patients who underwent endotracheal intubation using direct laryngoscopy and Glidescope (R) videolaryngoscopy (GSVL). Material and Methods: This retrospective study was performed using data gathered from the medical files of 179 C/S patients who underwent C/S under general anesthesia. After the induction of anesthesia with intravenous injection of propofol 2 mg/kg, and vecuronium 0.1 mg/kg, orotracheal intubation was performed using either direct laryngoscopy or GSVL. The patients underwent C/S after endotracheal intubation using either direct laryngoscopy or GSVL. Group I (n=47) was intubated via direct laryngoscopy, while Glidescope (R) was used in Group II (n=132). Results: Baseline descriptives, craniofacial morphological measurements, duration of intubation and number of attempts for intubation, Cormack Lehane and Mallampati scores, as well as hemodynamic and respiratory parameters including blood pressure, heart rate, oxygen, and carbon dioxide levels were compared between two groups. The interincisal mouth opening (p=0.003) and CO2 levels (p=0.023) were increased in Group II. In Group I, the number of patients with protruding front teeth was higher than that in Group II (p=0.043). Discussion: Our results demonstrated that the GSVL could be a safe, effective, and practical device for endotracheal intubation in patients scheduled for C/S. Our data imply that GSVL can be incorporated into routine clinical practice in obstetric anesthetic practice for C/S since it allows improved visualization of the larynx in pregnants without bringing any significant burden.Öğe Effect of fluoroscopy in central vein catheterization in children(ANNALS OF CLINICAL AND ANALYTICAL MEDICINE, 2021) Aydın, Nevin; Esen, Osman; Yılmaz, GülserenAim: In this study, we aimed to evaluate the effect of fluoroscopy on the prevention of malposition during placement of central venous catheters (CVC) in children, complications that occur during the procedure and follow-up and associated risk factors. Material and Methods: A total of 87 central venous catheter placement procedures performed in 59 pediatric patients under fluoroscopy between 2014 and 2016 were included in the study. Demographic data, catheter insertion site, indication, number of attempts, catheter diameter, insertion time, complications during insertion and follow-up were recorded. Results: The mean age of the cases was 5 months (1-28 months), and the mean body weight was 4.64 kg (1-14). Catheter insertions were mostly performed through the jugular vein. The femoral location was used in emergency situations in 12 patients (13.7%); 36.8% of catheter placements were used to provide peripheral vascular access, 59.8% were used for parenteral nutrition. intravenous fluid and inotropic support, and 3.4% for chemotherapy. Complications occurred during catheter placement in 29 of the patients. The most common intervention complication was arterial puncture. Complications in the right jugular and subclavian regions were more common than in other regions (p=0.015). Malposition or kinking of the catheter was not observed during the placement. Arterial puncture and pneumothoraxlhemothorax were encountered more frequently as the number of attempts increased (p=0.001). Catheterrelated bloodstream infection was the most common complication and was observed in 11 (12.6%) catheters. Discussion: Various complications may be encountered during placement and monitoring in CVC applications in pediatric patients. Using fluoroscopy during placement reduces complications such as malposition and arrhythmia.Öğe Effects of adding midazolam to ketamine and fentanyl combination in a burn wound dressing in adults(BAYRAKOL MEDICAL PUBLISHER, 2021) Esen, Osman; Balcı, CananAim: It was aimed to investigate the effects and side effects of adding midazolam to ketamine and fentanyl combination on sedation, hemodynamic stability and recovery rate during burn debridement and dressing in adult patients. Material and Methods: ASA I-II group, adult patients aged between 18-70 years, who were going to undergo therapeutic procedures such as change of burn dressings and debridement, were included in the study. The cases were randomly divided into two groups. The ketamine/fentanyl group (Group KF) received 1 mg/kg ketamine i.v and 1 mcgr/kg fentanyl just before the dressing. In the ketamine+midazolam/fentanyl group (Group MKF), 0.03 mg/kg midazolam was additionally administered 10 minutes before the procedure. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), peripheral oxygen saturation (sPO2), respiratory rate (RR) were monitored and recorded every 5 minutes. The results were evaluated at the 95% confidence interval and the significance level was p<0.05. Results: Fifty-nine patients aged between 15-56 years (29.98 +/- 9.22 years) were included in the study. Six patients (10.2%) were female and 53 (89.8%) were male. There was no statistically significant difference between the KF-MKF groups in terms of age, weight and gender, burn rate, ASA distribution, dressing time, and additional dose requirement values (p>0.05). SBP0, SBP5, SBP10, SBP15 values, DBP0, DBP5 values and HR0, HR5 values of the subjects in the KF group were found to be statistically significantly higher than the values of subjects in the MKF group (p<0.05). Discussion: Combinations of midazolam-ketamine/fentanyl and ketamine/fentanyl provide effective sedation in burn debridement and dressing in adult patients. It was concluded that the addition of midazolam to the ketamine/fentanyl combination provides better hemodynamic stability.Öğe Impact of a supervised pulmonary rehabilitation program on postoperative dyspnea in patients undergoing cardiac surgery(BAYRAKOL MEDICAL PUBLISHER, 2022) Esen, Osman; Özcanoğlu, Hatice DilekAim: This prospective study aimed to analyze the impact of postoperative in-hospital pulmonary rehabilitation on pulmonary outcomes in patients who underwent cardiovascular surgery. Material and Methods: This study was carried out on subjects who underwent cardiovascular surgery and were scheduled for a supervised pulmonary rehabilitation program following the cardiac surgery in our institute. The BORG scale of perceived exertion, a 100 points VAS scale for the severity of perceived dyspnea, and Respiratory Distress Assessment Instrument (RDAI) score were applied before and after completion of pulmonary rehabilitation program. Dyspnea, orthopnea, tachypnea, anxiety, cough and presence of sputum were also recorded prior to and subsequent to pulmonary rehabilitation. Blood gas analysis was also carried out before and after pulmonary rehabilitation. Results: BORG scale score (1.89 +/- 0.07 vs. 1.21 +/- 0.05, p=0.001), VAS scale scores for dyspnea (5.7:0.4 vs. 8.5:0.8, p<0.001), and RDAI scores (4.2 +/- 0.5 vs. 7.8 +/- 1.2, p<0.001) improved significantly following pulmonary rehabilitation. The prevalence of dyspnea and tachypnea also reduced following pulmonary rehabilitation. No significant change was observed in blood gas analysis results. Discussion: Application of a supervised pulmonary rehabilitation program including removal of bronchial secretions, postural drainage, percussion, vibration and aspiration and patients positioning improves self-reported dyspnea in patients who underwent cardiac surgery.Öğe Impact of leg wrapping in combination with leg elevation on postspinal hypotension in subjects undergoing elective cesarean section under spinal anesthesia(BAYRAKOL MEDICAL PUBLISHER, 2021) Esen, Osman; Balcı, Canan; Sargın, Mehmet Akif; Erdivanlı, BaşarAim: This study aimed to compare the efficacy of lower extremity wrapping with elastic bandages in conjunction with leg elevation to leg elevation alone in terms of maternal systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, and SaO2 in term mothers undergoing elective cesarean section (CS) with spinal anesthesia. Material and Methods: A series of 62 term mothers aged between 20 and 45 years who were scheduled for elective CS under spinal anesthesia were enrolled in the study. Using sealed envelopes, participants were allocated to one of two study groups: the wrapping group (n=30) or the control group (n=32). All subjects received volume administration of lactated Ringer's solution of 10 mL/kg over the 15 min prior to the administration of the spinal block. Subjects allocated to the wrapping group received lower extremity wrapping with 10-cm Esmarch elastic bandages applied from the ankle to the mid-thigh immediately before the administration of the subarachnoid block. Following intrathecal injection, lower limbs were elevated 20 degrees in subjects allocated to the wrapping group by tilting the foot-end of the operating table. Systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, and SaO2 were monitored intraoperatively. Results: Systolic, diastolic, and mean blood pressures were significantly higher in the wrapping group compared to the control subjects beginning from the 2nd minute of the intrathecal injection to the 20th-30th minute of the intrathecal injection. The median ephedrine dose was significantly higher in the control group than the wrapping group [15 (0-40) mg vs. 5 (0-30) mg, p=0.007]. Vomiting was also more frequent in control subjects compared to those receiving lower extremity wrapping and leg elevation (18% vs. 0%, p=0.024). Discussion: Lower extremity wrapping in combination with leg elevation provides a better hemodynamic profile than volume administration alone in subjects undergoing elective CS under spinal anesthesia. Subjects receiving lower extremity wrapping and leg elevation require less vasopressors and experience less vomiting compared to subjects receiving only volume administration.Öğe Venous port catheter implantation for chemotherapy: Our experience in pediatric cases Port-catheter experiences in pediatric cases(BAYRAKOL MEDICAL PUBLISHER, 2021) Aydın, Nevin; Yılmaz, Gülseren; Esen, Osman; Esen, Hayrunisa KahramanAim: The use of central venous access devices and especially venous port catheters is increasing day by day due to frequent venous Interventions and long-term and painful treatment in chemotherapy treatment of cancer patients. In this study, we aimed to evaluate the applications of chemotherapy port-catheters in pediatric patients. Material and Methods: Between 2014 and 2017, 76 pediatric cancer patients who were inserted venous port catheters for chemotherapy treatment in our hospital were evaluated retrospectively. Demographic data, diagnoses, port implantation site, and complications observed during and after the procedure were examined. The ports were placed under general anesthesia. Fluoroscopy was used during port placement, but not ultrasound. Results: The mean age of the patients was 6.88 +/- 4.79 (1-16) years and consisted of 31 (40.8%) female and 45 (59.2%) male patients. A chemotherapy portcatheter was inserted through the right subclavian vein in 48 patients, the left subclavian vein in 27 patients, and the right internal jugular win in 1 patient Five French (n=46; 60.5%), 6Fr (n=18; 23.7%) and 7Fr (n-12; 15.8%) port catheters were used for the number of patients involved. Arterial puncture was seen in 17 patients. Infection developed in 12 patients who received antibiotic therapy. Resorbed pneumothorax developed in one (1.3%) patient. No malposition was observed during the procedure. Discussion: Despite some complications that may occur during chemotherapy port-catheter implantation in patients who will receive chemotherapy, it is a preferred method in terms of patient comfort. It is recommended to use imaging methods during and after the procedure to reduce complications.
