Turkish journal of anaesthesiology and reanimation最新文献

{"title":"Evaluation of ASA, SORT, and ACCI Scores in Predicting the Need for Postoperative Intensive Care Unit Admissions After Hip Surgery.","authors":"Neslihan Gezer, Lütfiye Pirbudak, Elzem Şen, Ayşe Mızrak","doi":"10.4274/TJAR.2025.241708","DOIUrl":"10.4274/TJAR.2025.241708","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the effectiveness of the American Society of Anesthesiologists (ASA), the Surgical Outcome Risk Tool (SORT), and age-adjusted Charlson Comorbidity Index (ACCI) scores in determining the requirement for intensive care unit (ICU) admissions in patients aged 65 years and older who underwent hip surgery.</p><p><strong>Methods: </strong>The study population consisted of 450 patients who underwent orthopedic hip surgery. The patients who were admitted to the ICU were either monitored in the postoperative ICU (Group 1) or transferred to the ward (Group 2). SORT and ACCI scores of all patients were recorded.</p><p><strong>Results: </strong>The patients of Group 1 were significantly older than those in Group 2. SORT scores of both groups were comparable. The diagnostic sensitivity and specificity of ACCI scores were determined as 42.1% and 70.8%, respectively.</p><p><strong>Conclusion: </strong>As a conclusion, ACCI scores can predict the need for ICU admissions in patients undergoing hip surgery. Besides, the traditionally used ASA scores are generally higher in this patient group. Determinative criteria for predicting the need for ICU admissions include older age of the patients, presence of comorbidities as hypertension and diabetes mellitus, as well as a long preoperative waiting period.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"157-162"},"PeriodicalIF":0.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic Brain Biopsy with Awake Craniotomy: Our Awake Craniotomy Experience on a Complicated Case and Mini Review.","authors":"Can Ozan Yazar, Atakan Sezgi, Musa Zengin, Caner Ünlüer, Seyyid Furkan Kına, Emine Arık, Elif Şule Özdemir Sezgi, Jülide Ergil","doi":"10.4274/TJAR.2025.241823","DOIUrl":"10.4274/TJAR.2025.241823","url":null,"abstract":"<p><p>Awake craniotomy (AC) is a surgical technique where the patient stays conscious and interacts with the surgical team throughout part or all of the brain operation. In this case report, a 71-year-old ASA-3 patient with multiple comorbidities scheduled for a stereotactic brain biopsy was treated using AC. Our experience with AC, combined with a scalp block, is described in this case. AC is a safe technique that can be applied in patients with partially impaired communication abilities and may be particularly beneficial for those with multiple chronic conditions.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"177-182"},"PeriodicalIF":0.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of EuroSCORE II and STS Risk Scoring Systems in Patients who Underwent Open-heart Surgery.","authors":"Erkam Saka, Esin Öztürk, Aslıhan Esra Yüksel, Nüzhet Seden Kocabaş","doi":"10.4274/TJAR.2025.241778","DOIUrl":"10.4274/TJAR.2025.241778","url":null,"abstract":"<p><strong>Objective: </strong>In the present study, European Cardiac Operative Risk Assessment System II (EuroSCORE II) and the Society of Thoracic Surgery (STS) risk scoring systems were used to predict mortality in patients who underwent various types of open-heart surgery, including coronary artery bypass grafting, aortic valve replacement, mitral valve replacement, and combined valve surgery with coronary artery bypass grafting, in the cardiovascular surgery operating room. The aim was to compare risk assessment systems regarding their clinical applicability.</p><p><strong>Methods: </strong>A total of 469 patients, 141 (30.1%) female and 328 (69.9%) male, were included in the study. All risk factors were retrospectively recorded according to the EuroSCORE II and STS risk assessment systems. Statistical analysis was performed using the receiver operating characteristic (ROC) curve. Predicted and actual mortality rates were compared for each risk-scoring system.</p><p><strong>Results: </strong>When the ability of the EuroSCORE and STS risk classifications to predict mortality was analyzed using the ROC curve, the area under the curve for the EuroSCORE II risk score was 78.3% (<i>P</i> < 0.001), while the area under the curve for the STS risk score was 82.3% (<i>P</i> < 0.001). In our study, the STS scoring system was found to have a greater predictive value than EuroSCORE II. When the patients' observed and expected mortality rates were examined according to the EuroSCORE II and STS risk scores, no statistically significant relationship was found between the expected and observed mortality rates for each risk group.</p><p><strong>Conclusion: </strong>In our study, the STS risk scoring system was found to be more accurate in predicting in-hospital mortality than the EuroSCORE. However, there was no statistically significant difference between the expected and observed mortality rates in either risk-scoring system. There is no consensus in the literature regarding which scoring system is more effective. More studies from different societies are needed.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"163-169"},"PeriodicalIF":0.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study on Minimal Flow Anaesthesia in Geriatric and Middle-aged Patients.","authors":"Sinan Ünsal, Gülay Erdoğan Kayhan, Meryem Onay, Mehmet Sacit Güleç","doi":"10.4274/TJAR.2025.241740","DOIUrl":"10.4274/TJAR.2025.241740","url":null,"abstract":"<p><strong>Objective: </strong>Minimal flow anaesthesia reduces costs and environmental pollution, and has a protective effect on the respiratory tract. This study aimed to compare the ease and tolerability of minimal flow anaesthesia in the geriatric and middle-aged patient populations.</p><p><strong>Methods: </strong>In this prospective study, we enrolled 40 patients between 18 and 50 years (Group Y) and 40 patients 65 years or older (Group E), scheduled for abdominal surgery under general anaesthesia. Following a period of high flow with desflurane in O₂/air, the fresh gas flow was reduced to 350 mL min^-1. Desflurane concentration was adjusted to maintain a bispectral index between 40 and 50. The oxygen concentration in fresh gas flow was titrated by ±10%. Throughout the surgery, gas concentrations, oxygenation parameters, hemodynamic data, and the depth of anaesthesia were monitored. The number of alterations in fresh gas oxygen and desflurane concentrations was recorded.</p><p><strong>Results: </strong>The depth of anaesthesia and oxygenation parameters were adequately sustained within safe limits among all patients, while the number of changes in the fresh gas flow oxygen levels was found to be significantly lower in geriatric patients. The increase in the number of oxygen level was 1.1±0.8 in Group E and 1.8±1.2 in Group Y (<i>P</i>=0.006). Total alteration in oxygen was 1.2±1 in Group E and 1.9±1.3 in Group Y (<i>P</i>=0.01). Oxygenation parameters consistently remained within clinically acceptable ranges in both groups, and the amount of change in desflurane concentration showed no intergroup difference.</p><p><strong>Conclusion: </strong>Administering minimal flow anaesthesia at a rate of 350 mL min^-1 in the geriatric population, compared to the younger population, can be performed requiring less manipulation, without inducing hypoxia or inadvertent awareness.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"147-156"},"PeriodicalIF":0.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution from Decompressive Craniectomy to Early Minimally Invasive Surgical Approach for Refractory Increased Intracranial Pressure Treatment: Merit or Social Problems?","authors":"Rudin Domi, Filadelfo Coniglione, Gentian Huti, Mario Dauri, Asead Abdyli, Krenar Lilaj, Federico Bilotta","doi":"10.4274/TJAR.2024.241696","DOIUrl":"https://doi.org/10.4274/TJAR.2024.241696","url":null,"abstract":"<p><p>In conclusion, treating increased intracranial pressure is a significant challenge for physicians in intensive care units and emergency departments. If not managed properly, elevated intracranial pressure can lead to brain edema, reduced oxygenation, and, ultimately, death. Intracranial hypertension can be caused by various conditions, including traumatic brain injury, massive intracranial bleeding, and large ischemic stroke, such as middle cerebral artery thrombosis. Treatment consists of both pharmacological and surgical. Surgical treatments include early surgical evacuation and decompressive craniectomy (DC). DC is a critical intervention for managing refractory intracranial hypertension when all conventional therapies fail. It is a decisive step that is intended to save lives and minimize long-term neurological deficits. The procedure must be carefully planned and executed based on the patient's specific clinical scenario and needs. The decision to proceed with DC should be based on a comprehensive assessment of the patient's condition, the effectiveness of other treatments, and the potential benefits and risks of the procedure. If all conventional pharmacological and non-pharmacological therapies fail and intracranial hypertension persists, regardless of the underlying cause, DC is indicated and can be considered a critical intervention. Currently, surgical treatment has gained popularity, and many papers have been published. This review summarizes the tendencies in the literature.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"53 4","pages":"142-146"},"PeriodicalIF":0.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Hidden Therapeutic Potential of Local Anaesthetics: Antioxidant and Antimicrobial Effects.","authors":"Berrin Günaydin","doi":"10.4274/TJAR.2025.241871","DOIUrl":"10.4274/TJAR.2025.241871","url":null,"abstract":"","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"183-184"},"PeriodicalIF":0.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should I Change Anticoagulane in Veno-Venous ECMO?","authors":"Rabia Yılmaz, Murat Arslan, Deniz Özel Bilgi, Zafer Çukurova","doi":"10.4274/TJAR.2025.241745","DOIUrl":"10.4274/TJAR.2025.241745","url":null,"abstract":"<p><strong>Objective: </strong>Due to a lack of high-quality data to guide anticoagulation therapy in extracorporeal membrane oxygenation (ECMO) patients, there is significant variation in practice among centers. We aimed to investigate the safety, anticoagulation efficacy, and cost-effectiveness of using bivaluridine as a primary anticoagulant without unfractionated heparin (UFH) in ECMO patients.</p><p><strong>Methods: </strong>The study population included patients undergoing Veno-Venous ECMO for acute respiratory distress syndrome. A total of 56 patients were evaluated, 25 were on UFH and 31 were on bivalirudin.</p><p><strong>Results: </strong>There was no significant difference between the time to reach the target activated partial thromboplastin time (aPTT) interval [6 (3.5-11) UFH, 9 (4-19) bivalirudin, P=0.287]. There was no significant difference between the percentage of time spent in the target aPTT interval (61.48±14.72 UFH, 62.65±11.99 bivaluridine, <i>P</i>=0.745). The median amount of erythrocyte suspension replacement (12.04±8.01; 7.9±4.71; <i>P</i>=0.028) and the median amount of fresh frozen plasma replacement [4 (2-6); 1 (0-4); <i>P</i>=0.001] were higher in the UFH group than in the bivaluridine group. The cost was lower in the UFH group compared to the bivalirudin group [$38.1 (13.5-48.7); $463.7 (194.3-819.8); <i>P</i> < 0.001].</p><p><strong>Conclusion: </strong>The use of bivaluridine as a primary anticoagulant does not lead to any decrease in anticoagulant efficacy.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"170-176"},"PeriodicalIF":0.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Evaluation of Videolaryngoscopy and Direct Laryngoscopy Performed in Paediatric Patients Undergoing Elective Surgery.","authors":"Tuncer Yavuz, Lütfiye Pirbudak, Elzem Şen, Ayşe Mızrak","doi":"10.4274/TJAR.2025.252017","DOIUrl":"https://doi.org/10.4274/TJAR.2025.252017","url":null,"abstract":"<p><strong>Objective: </strong>Paediatric airway management poses unique challenges due to anatomical and physiological differences compared to adults. Videolaryngoscopy (VL) has been proposed as a potential improvement over direct laryngoscopy (DL) for tracheal intubation. This study aimed to compare VL and DL in paediatric patients undergoing elective surgery.</p><p><strong>Methods: </strong>A prospective, randomized study was conducted with 100 paediatric patients aged under 18 years, weighing 10-40 kg, and classified as American Society of Anesthesiologists physical status I-III. Patients were randomized into Group 1 (n = 50) that included patients who underwent laryngoscopic examination using Macintosh laryngoscope or Endolarenx videolaryngoscope (Group 2: n = 50). Data on intubation time, glottic view (Cormack-Lehane grades), first-attempt success rate, need for anterior laryngeal pressure, and complications were collected.</p><p><strong>Results: </strong>VL was associated with longer intubation time than DL (29.1±5.7 s vs. 20.7±5.1 s, <i>P</i>=0.001). Glottic visualization was better in the VL group (Cormack-Lehane Grade 1: 78% vs. 66%), but first-attempt success rate was lower (74% vs. 98%, <i>P</i> < 0.001). The need for anterior laryngeal pressure was significantly reduced in VL (32% vs. 78%, <i>P</i>=0.01). No complications, such as trauma or hypoxaemia, were observed in either group.</p><p><strong>Conclusion: </strong>VL improves glottic visualization and reduces the need for airway maneuvers but is associated with longer intubation times and lower first-attempt success. While DL may be more efficient for routine intubation, VL remains valuable in anticipated or emergent difficult airway situations.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Jousting in Research Publications: A Call for Ethical Discourse.","authors":"Ashwin Mani, Sukriti Jha, Prakash Gyandev Gondode, Sakshi Duggal","doi":"10.4274/TJAR.2025.251893","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251893","url":null,"abstract":"","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Cisatracurium in Cardiac Surgery.","authors":"Vikas C Roy, Sakshi Mehta, Rajni Bala","doi":"10.4274/TJAR.2025.241876","DOIUrl":"https://doi.org/10.4274/TJAR.2025.241876","url":null,"abstract":"<p><p>The introduction of neuromuscular blockers (NMBs) has revolutionized the practice of general anaesthesia, ushering in a new era where anaesthesia is conceptualized as a triad comprising narcosis, analgesia, and muscle relaxation. NMBs play a vital role in surgeries by facilitating tracheal intubation, preventing the movement of body and diaphragm, control of ventilation at normal partial pressure of carbon dioxide and counteraction of narcotic-induced truncal rigidity. However, the absence of specific guidelines for the selection and utilization of particular NMBs in various surgical contexts has led to inconsistencies within the healthcare system. Thus, a deep and thorough understanding of pharmacological aspects of NMBs is required for the selection and usage of particular NMB in clinical setting. Ideal NMBs are characterized by rapid onset, non-cumulative effects, independence from renal or hepatic function for elimination, rapid reversibility, and minimal adverse side effects. Among several NMBs, cisatracurium, an isomer of atracurium is a non-depolarizing intermediate-acting with characteristic features of high potency, smaller dosage requirement, no histamine release, no cardiovascular effects and elimination via organ-independent Hofmann reaction. Innumerable clinical experiments and trials suggest cisatracurium as safe, cost-effective, and better molecule with predictable recovery and no postoperative residual paralysis in comparison to other NMBs such as rocuronium, vecuronium, and pancuronium. In this review, we aimed to provide critical insights on the properties of NMBs first and then focused on the use of cisatracurium in cardiac surgeries.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}