Turkish journal of anaesthesiology and reanimation最新文献

{"title":"Fluid-therapy for Brain Surgery: A Narrative Review.","authors":"Maria Paola Lauretta, Luca Marino, Başak Akça, Boaz G Samolsky Dekel, Federico Bilotta","doi":"10.4274/TJAR.2025.251489","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251489","url":null,"abstract":"<p><p>Brain surgery presents unique challenges to the anaesthesiology team in terms of complexity of patients and procedures. Managing fluid-therapy in this setting requires profound knowledge of different types of fluids and administration regimens. This review focuses on updated information about fluid therapy in elective and emergency brain surgery with specific insight on the clinical outcomes of patients.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207721","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":"Perioperative Diagnosis of Acute Pulmonary Embolism Following Laparoscopic Hysterectomy Under General Anaesthesia: A Rare Case Report.","authors":"Thang Phan, Lanh Tran Thi Thu, Trong Binh Le, Braydon Bak, Minh Nguyen Van","doi":"10.4274/TJAR.2025.252004","DOIUrl":"https://doi.org/10.4274/TJAR.2025.252004","url":null,"abstract":"<p><p>Perioperative pulmonary embolism (PE) is rare but potentially fatal and often difficult to diagnose under general anaesthesia. A fifty-one-year-old woman with hypertension and type II diabetes underwent laparoscopic hysterectomy. After pneumoperitoneum and Trendelenburg positioning, she developed hypoxemia, decreased EtCO₂, and hypotension. Hemodynamics improved after de-sufflation, but hypoxemia persisted post-extubation. Echocardiogram showed right heart strain, and computed tomography pulmonary angiography confirmed acute PE from lower extremity deep vein thrombosis. She was treated with anticoagulation therapy, vasopressor support, and inferior vena cava filter placement and discharged from intensive care unit on postoperative day 5. This case highlights the importance of early suspicion and prompt diagnostic evaluation of intraoperative PE. A multidisciplinary approach and timely anticoagulation with or without interventional therapy are critical to improve outcomes.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201311","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 the Effects of Target-Controlled Versus Conventional Infusion Sedation on Recovery in Geriatric Patients Undergoing Diagnostic Cystoscopy","authors":"Nesibe Sena Bayburt, Fatma Nur Duruk Erkent, Ayşegül Güven, Neslihan Alkış","doi":"10.4274/TJAR.2025.252107","DOIUrl":"10.4274/TJAR.2025.252107","url":null,"abstract":"<p><strong>Objective: </strong>Procedural sedation management in geriatric patients undergoing cystoscopy requires careful monitoring due to age-related physiological changes and increased sensitivity to anaesthetic agents. Although both target-controlled infusion (TCI) and conventional total intravenous anaesthesia (TIVA) techniques with propofol are commonly used methods for sedation, their comparative effectiveness and safety in this population remain subjects of ongoing investigation. This study aims to compare the effectiveness of the two techniques in terms of time to induction, recovery time, hemodynamic stability, airway intervention requirements, and propofol consumption.</p><p><strong>Methods: </strong>This prospective, randomized study enrolled 60 male patients aged 65 years and older who were scheduled to undergo elective cystoscopy. Participants were randomly assigned to either the TCI group (n = 30) or the TIVA group (n = 30). The two groups were compared in terms of induction time, recovery time, hemodynamic parameters, airway interventions, and total propofol consumption.</p><p><strong>Results: </strong>Compared with the TCI group, the TIVA group presented significantly shorter induction-to-surgery initiation and recovery times (<i>P</i>=0.009 and <i>P</i>=0.016, respectively). However, systolic blood pressure was more stable in the TCI group compared to the TIVA group (<i>P</i>=0.014). Propofol consumption per unit time was greater in the TIVA group (<i>P</i>=0.048), although total propofol usage did not differ significantly. Airway intervention was more common in the TIVA group, particularly in the early phase; however, this difference was not significant.</p><p><strong>Conclusion: </strong>Both TCI and TIVA are effective sedation techniques for geriatric cystoscopy. While TIVA provides faster induction and recovery, TCI offers better hemodynamic stability and may reduce propofol requirements. Further studies are recommended to confirm these findings in broader patient populations.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016294","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":"Lung Isolation in a Child with Kinsbourne Syndrome for Paraspinal Neuroblastoma Excision in the Prone Position.","authors":"Nishant Patel, Aritra Kundu, Subodh Kumar, Rakesh Kumar, Sachin Kumar, Vishesh Jain","doi":"10.4274/TJAR.2025.251960","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251960","url":null,"abstract":"<p><p>Kinsbourne syndrome, also known asor opsoclonus-myoclonus-ataxia syndrome, is a rare paediatric neurological disorder characterised by abnormal eye movements, myoclonus, and ataxia. Its anaesthetic management presents significant challenges, especially when one-lung ventilation (OLV) is required in the prone position. This case report describes the anaesthetic management of a two year-old child with Kinsbourne syndrome undergoing T9-T11 paravertebral neuroblastoma excision. Because of the patient's size and the need for lung isolation, a Fogarty embolectomy catheter was used for OLV. Anaesthesia was induced with intravenous fentanyl, propofol, and atracurium, followed by the insertion of a 4.0 mm cuffed endotracheal tube to facilitate Fogarty catheter insertion. The catheter was positioned in the right bronchus under fibre-optic guidance; after which, a 4.5 mm cuffed tube was inserted, and the patient was placed in the prone position. Continuous fibre-optic monitoring ensured proper catheter placement. Anaesthesia was maintained with oxygen, air, and isoflurane. The patient remained haemodynamically stable, was extubated postoperatively, was observed in the paediatric intensive care unit for 24 hours, and was subsequently transferred to the ward. This case highlights the challenges of OLV in paediatric patients and demonstrates the effectiveness of a Fogarty catheter for lung isolation when traditional devices are unsuitable, emphasising the importance of multidisciplinary collaboration and continuous monitoring.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132001","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":"Craniotomy in Semi-sitting Position: A 4-year Single Institution Experience.","authors":"Arunabha Karmakar, Muhammad Jaffar Khan, Ayten Saraçoğlu, Merve Ergenç, Mogahed Ismail Hassan Hussein, Mohammed Janish, Kemal Tolga Saraçoğlu, Kishore Kumar Gangineni, Pawel Ratajczyk, Neeraj Kumar","doi":"10.4274/TJAR.2025.251874","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251874","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to determine patient outcomes after craniotomies performed in semi-sitting position in our institution from 2019-2023. Primarily, we examined surgical and anaesthetic (clinical) outcomes. Secondarily, we evaluated any major complications that may have occurred.</p><p><strong>Methods: </strong>Hospital records from 2019-2023 were retrospectively reviewed for adult patients who underwent craniotomy in the sitting position. Individual charts were examined for intra- and postoperative events. The demographic and clinically important findings were tabulated using Excel spreadsheet. The dataset was descriptively analyzed, with quantitative data represented as mean ± standard deviation, and qualitative data as valid percentages from the total cohort. Parametric comparisons of sex vs. (length of intensive care unit and hospital stay) and anaesthesia duration (in minutes) were performed using Student's t-test. A 95% confidence level was used to determine statistical significance. Analyses were performed using IBM SPSS^® Edition 22.</p><p><strong>Results: </strong>From 2019-2023, 10 patients underwent craniotomy in a sitting position. General anaesthesia was induced and maintained using an intravenous target-controlled infusion of remifentanil and propofol. Nine patients developed pneumocephalus, with one developing increased intracranial pressure. One patient had a significant venous air embolism with severe manifestations, including massive pleural effusion. All patients except one were extubated at the end of the surgery.</p><p><strong>Conclusion: </strong>Of the 10 craniotomies performed in the sitting position from 2019-2023, 90% were managed without major long-term sequelae. Although the sitting position for craniotomies is not without challenges, a dedicated and experienced team can manage complications and improve patient outcomes.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131977","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":"Attitudes of Anaesthesiology Specialists and Residents Toward Hemodynamic Monitoring: A National Survey Study.","authors":"Gamze Talih, Aslıhan Aykut, Burhan Dost, Emre Sertaç Bingül, Başak Akça, Muhammed Enes Aydın, Z Aslı Demir, Ümit Karadeniz, Ali Fuat Erdem","doi":"10.4274/TJAR.2025.251940","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251940","url":null,"abstract":"<p><strong>Objective: </strong>This descriptive survey study aims to evaluate the knowledge, attitudes, and practices of anaesthesiology specialists and residents in Türkiye regarding advanced hemodynamic monitoring in high-risk surgical patients.</p><p><strong>Methods: </strong>The survey, comprising 25 questions, was distributed to 960 anaesthesia professionals, with 713 completing the questionnaire.</p><p><strong>Results: </strong>The study reveals that while invasive blood pressure monitoring is widely used (96.3%), the adoption of advanced hemodynamic monitoring techniques, such as cardiac output monitoring, remains limited (12.6%). For awake high-risk surgical patients under regional anaesthesia, a significant proportion of respondents (15.1% and 37.1%) considered non-invasive blood pressure monitoring to be insufficient. Additionally, 41.1% of participants believed that stroke volume variation, pulse pressure variation, and systolic pressure variation parameters could be used to assess fluid deficits in awake patients.</p><p><strong>Conclusion: </strong>High costs, technical complexity, and lack of training are identified as major barriers. The findings highlight the need for enhanced educational programs and practical training to improve the utilization of advanced hemodynamic monitoring, ultimately aiming to reduce perioperative morbidity and mortality. The study underscores the importance of integrating advanced hemodynamic monitoring into routine clinical practice and suggests the development of nationwide algorithms to standardize practices.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125977","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":"Imaging in chronic thromboembolic pulmonary hypertension: review of the current literature.","authors":"Koray Hekimoglu, Deepa Gopalan, Mehmet Ruhi Onur, Gökhan Kahraman, Tankut Akay","doi":"10.4274/dir.2025.253249","DOIUrl":"10.4274/dir.2025.253249","url":null,"abstract":"<p><p>Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe, life-threatening complication of pulmonary embolism with pulmonary hypertension (PH). The combination of insufficient resolution of thrombi following pulmonary emboli and accompanying microvascular disease results in PH. Advances in imaging can offer better insight into CTEPH diagnosis and management, but lack of disease awareness among radiologists has been shown to be a cause of CTEPH misdiagnosis or delayed diagnosis. This review highlights features pertinent to CTEPH diagnosis. The primary focus is on different modalities with their distinctive signs and newly developed technologies employing artificial intelligence systems.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125990","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":"Anaesthesia Management of a Case with Hereditary Angioedema for Whom Tracheal Dilatation was Planned.","authors":"Muharrem Uçar, Mukadder Şanlı, Sezai Aktürk, İlham Gülçek, Feray Akgül Erdil","doi":"10.4274/TJAR.2025.241584","DOIUrl":"https://doi.org/10.4274/TJAR.2025.241584","url":null,"abstract":"<p><p>Hereditary angioedema (HAE) causes recurrent angioedema attacks in the oropharynx, larynx, face, and other regions due to bradykinin overproduction as a result of C1 esterase inhibitor deficiency. Surgical interventions requiring general anaesthesia might trigger HAE attacks. Laryngeal angioedema is the most important cause of perioperative mortality. Tracheal dilatation was performed by rigid bronchoscopy in our patient with type 1 HAE, because of tracheal stenosis due to prolonged intubation, which occurred after the attack. The patient was administered 2x500 IU C1-esterase inhibitor approximately 24 hours before rigid bronchoscopy. No complication developed after the first procedure. Two months later, tracheal dilatation was repeated and 2x500 IU C1 esterase inhibitor was administered. While the patient was followed up in the intensive care unit, significant oedema developed in the facial area, especially the tongue and lips, approximately 10 hours after the procedure. Our patient also had stridor due to airway obstruction. The patient was treated with 1000 IU C1 esterase inhibitor and 3 units of fresh frozen plasma (FFP). After FFP, edema started to regress. The patient was discharged after symptoms improved. The patient should be monitored in the intensive care unit for a minimum of 48 hours to monitor for postoperative laryngeal oedema.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081912","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 10-Year Analysis of Surgical Interventions Applied to Migrants: A Border Hospital Experience During the Syrian Civil War.","authors":"Ergün Mendeş, Neşet Gümüşburun","doi":"10.4274/TJAR.2025.252054","DOIUrl":"https://doi.org/10.4274/TJAR.2025.252054","url":null,"abstract":"<p><strong>Objective: </strong>The Syrian civil war has resulted in one of the largest refugee movements globally, significantly impacting Türkiye due to its geographic proximity. Surgical care represents a critical yet often overlooked aspect of healthcare services required by displaced populations. This study aimed to evaluate the demographic characteristics and surgical procedures performed on migrant patients over a ten-year period at a secondary-level hospital located on Türkiye's southern border.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at Kilis State Hospital between March 2010 and January 2020. Surgical procedures were categorized by department, patient nationality, and type of surgery. Patients operated under the \"war code\" were analyzed separately to identify conflict-related injury patterns.</p><p><strong>Results: </strong>A total of 52,978 surgical procedures were performed, with 41.76% involving Syrian patients. The mean age was 31.28±20.33 years, and male patients predominated, especially among the war-injured subgroup (91.59%). The most active surgical departments were orthopedics and traumatology (20.63%), gynecology and obstetrics (17.51%), and general surgery (15.67%). Among war-related surgeries, orthopedics, neurosurgery, and plastic surgery departments played major roles.</p><p><strong>Conclusions: </strong>This study highlights the high surgical demand among migrant populations in border regions, especially in conflict settings. Strengthening healthcare infrastructure, maintaining accurate surgical records, and implementing multidisciplinary approaches are essential for meeting these needs. Our findings can inform future policies aimed at improving surgical care for displaced populations.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081863","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 Effect of Using Smart Glasses Integrated Ultrasonography in Radial Artery Catheterization: A Prospective Randomized Trial.","authors":"Merve Gözen, Bengi Şafak, Ayşegül Güven, Onat Bermede","doi":"10.4274/TJAR.2025.252052","DOIUrl":"https://doi.org/10.4274/TJAR.2025.252052","url":null,"abstract":"<p><strong>Objective: </strong>The use of ultrasonography (USG) in arterial catheterization, in which the comfort of the practitioners and hand-eye coordination are very important, is frequently needed by anesthesiologists in daily practice. We aimed to investigate whether radial artery catheterization with smart glasses-integrated USG would increase success and satisfaction.</p><p><strong>Methods: </strong>One hundred twenty patients who were >18 years old and would have undergone elective surgery with an indication for radial artery catheterization between August and December 2022 were included in this prospective randomized study. Patients who underwent catheterization in the last month and had contraindications were excluded. In the Standard USG Group, catheterizations were performed with standard USG, and in the Smart Glass Group, with smart glasses-integrated USG. Two anesthetists, a junior practitioner with experience with 20-50 catheterizations and a senior practitioner with experience with over 50 catheterizations, performed the catheterizations. The subcutaneous distance, radial artery depth, and diameter in short axis, catheterization time, and ergonomic satisfaction were recorded.</p><p><strong>Results: </strong>Sixty patients in standard USG group and 59 patients in Smart Glass Group, with similar demographics, were included in statistical analysis. The mean first catheterization time by junior practitioners, with smart glasses integrated USG, was shorter than standard USG (49.07±29.91 sec vs. 99.73±75.18 sec, <i>P</i> <0.001). The junior practitioner was more satisfied with smart glasses-integrated USG. There was no significant difference between groups in terms of interventions made by the senior practitioner.</p><p><strong>Conclusion: </strong>Radial artery catheterization with smart glasses integrated USG shortens catheterization time, and increases satisfaction by increasing the comfort of USG use for junior practitioners.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081893","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}