Turkish journal of anaesthesiology and reanimation最新文献

{"title":"From Publication to Scientific Communication: The Expanding Role of Social Media in the Future of TJAR.","authors":"Burhan Dost, Ceyda Özhan Çaparlar, Zekeriyya Alanoğlu","doi":"10.4274/TJAR.2026.262806","DOIUrl":"10.4274/TJAR.2026.262806","url":null,"abstract":"","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"54 4","pages":"233-235"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Therapeutic Plasma Exchange in Refractory Anti-MDA5-Positive Dermatomyositis and Rapidly Progressive-Interstitial Lung Disease: A Case Report.","authors":"Bedih Balkan, Ebru Kaya","doi":"10.4274/TJAR.2026.252250","DOIUrl":"10.4274/TJAR.2026.252250","url":null,"abstract":"<p><p>Anti-MDA5-positive clinically amyopathic dermatomyositis (CADM) is closely linked to rapidly progressive-interstitial lung disease (RP-ILD) and is associated with high mortality rates. This report discusses a 60-year-old female patient diagnosed with anti-MDA5-positive CADM who developed RP-ILD that was resistant to pulse steroid therapy, tacrolimus, and intravenous immunoglobulin. As her respiratory condition worsened alongside rising inflammatory markers, therapeutic plasma exchange (TPE) was initiated. Following four sessions of TPE administered on alternate days, significant clinical and laboratory improvements were observed. This case underscores the potential life-saving impact of early TPE for patients with anti-MDA5-positive CADM and RP-ILD who do not respond to traditional immunosuppressive treatments.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"54 4","pages":"335-337"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Multimodal Pre-emptive Analgesia with Pregabalin Versus Naproxen on Post-Thoracotomy Pain and Opioid Consumption: A Randomized Clinical Trial.","authors":"Prajjal Das, Rajni Gupta","doi":"10.4274/TJAR.2026.262403","DOIUrl":"10.4274/TJAR.2026.262403","url":null,"abstract":"<p><strong>Objective: </strong>Thoracotomy produces severe postoperative pain that limits deep breathing and coughing and may worsen recovery. Opioid-centred regimens can cause adverse effects; pre-emptive multimodal analgesia may reduce central sensitisation and opioid use.</p><p><strong>Methods: </strong>In this randomized, active-controlled, assessor-blinded trial (CTRI/2022/07/043800), adults aged 18-70 years (American Society of Anesthesiologists I-II) undergoing thoracotomy were randomized (39 per group) to receive oral pregabalin 2.5 mg kg^-1 or oral naproxen 7 mg kg^-1 (maximum 500 mg) 2 hours preoperatively. All patients received standardized general anaesthesia combined with thoracic epidural analgesia. Numerical rating scale (NRS) pain at rest and during deep breathing and coughing were assessed at 2, 6, 12, and 24 hours. A rescue opioid was administered when NRS exceeded 3. Time to first rescue, total 24-hour opioid consumption, number of rescue doses, sleep interference, and adverse events were recorded.</p><p><strong>Results: </strong>Baseline demographics and perioperative haemodynamics were comparable. Resting pain scores and sleep interference were similar between groups. Pregabalin reduced opioid requirement: fewer patients required rescue analgesia (46.2% vs. 69.2%; <i>P</i>=0.042), time to first rescue was longer (7.6±3.1 vs. 5.4±2.8 h; <i>P</i>=0.001), and 24-hour opioid consumption was lower (6.2±3.0 vs. 8.6±3.4 mg morphine equivalents; <i>P</i>=0.001). Dynamic pain during deep breathing and coughing was lower with pregabalin at early time points; sedation was slightly higher at 2 hours, without significant adverse neurocognitive events.</p><p><strong>Conclusion: </strong>Pre-emptive pregabalin improved functional analgesia and produced an opioid-sparing effect compared with naproxen after thoracotomy, with acceptable short-term safety, thereby supporting enhanced recovery pathways.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"54 4","pages":"323-330"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Ultrasound-Guided Rectointercostal and Transversalis Fascia Plane Blocks for Postoperative Analgesia in a Pediatric Renal Transplant Recipient.","authors":"Volkan Özen, Engin İhsan Turan, Bahadır Çiftçi, Selçuk Alver, Gökçen Şahin Şener, Ayça Sultan Şahin","doi":"10.4274/TJAR.2026.262447","DOIUrl":"10.4274/TJAR.2026.262447","url":null,"abstract":"","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"54 4","pages":"342-344"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Representation at Turkish Anaesthesiology and Reanimation Congresses: Trends in Speakers, Session Chairs, and Society Leadership from 2015 to 2024.","authors":"Sait Fatih Öner, Sevim Şenol Karataş","doi":"10.4274/TJAR.2026.262473","DOIUrl":"10.4274/TJAR.2026.262473","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated gender representation among speakers, session chairs, and society leadership roles at the Turkish Society of Anaesthesiology and Reanimation (TARK) Congresses between 2015 and 2024, focusing on temporal patterns and subspecialty-based variation.</p><p><strong>Methods: </strong>This retrospective observational analysis of conference sessions included all scientific sessions listed in official TARK congress programmes from 2015 to 2024. Names, roles, and session topics were extracted from publicly available documents. In the absence of self-identified gender data, participants were categorised as women or men using names, academic titles, congress documents, and publicly accessible institutional or professional information, when clarification was required. Gender proportions were compared using chi-square tests. Temporal patterns were evaluated using logistic regression analyses, and subspecialty-specific analyses were performed using intensive care as the reference category. The leadership composition of the society was evaluated descriptively.</p><p><strong>Results: </strong>A total of 2,627 congress roles were analysed, including 966 session chairs and 1,661 speakers. Women accounted for 50.3% of session chairs and 50.8% of speakers, with no statistically significant temporal change during the study period. Marked variation was observed across subspecialties. Women were least represented in intensive care sessions (30.9%) and most represented in obstetric and paediatric anaesthesia sessions (82.1%), reflecting a higher relative representation of women speakers in the latter than in intensive care. Leadership composition varied across terms, with no persistent predominance of either gender according to the descriptive assessment.</p><p><strong>Conclusion: </strong>Gender representation at TARK congresses remained numerically balanced over the ten-year study period; however, the absence of a significant temporal increase and the presence of persistent subspecialty clustering suggest a stable but uneven distribution across academic areas.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"54 4","pages":"282-290"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Interfascial Plane Blocks in the Analgesia Management of High-risk Patients in Intensive Care Unit: M-TAPA and Pecto-intercostal Fascial Block after Simultaneous Liver Transplant Recipient and Coronary Artery Bypass Grafting Surgery.","authors":"Ayşe Nurmen Akın, Cem Erdoğan, Deniz Kızılaslan, Işılay Ayar Geçginer, Ökkeş Başak, Bahadır Çiftçi","doi":"10.4274/TJAR.2025.252133","DOIUrl":"10.4274/TJAR.2025.252133","url":null,"abstract":"<p><p>Liver transplantation is the gold standard treatment for end-stage liver failure, and early extubation in the postoperative period is recommended to improve graft function. Coronary artery bypass grafting (CABG) is a surgical procedure to restore normal blood flow to an obstructed coronary artery. Patients undergoing cardiac surgery are often heparinized, which increases the risk of hematoma associated with regional anaesthesia, particularly central neuraxial techniques. Effective analgesic management plays a crucial role in achieving early extubation in both surgical procedures. Opioid agents are often preferred for analgesia management. However, the use of opioids in these patients increases the risk of complications; therefore, regional anaesthesia techniques are preferred. In the intensive care unit, we performed a combination of modified thoracoabdominal nerve block and pecto-intercostal fascial plane block as rescue analgesia in a patient who had undergone simultaneous liver transplantation and CABG.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"331-334"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Ultrasonically Assessed Diaphragmatic Weakness with the Need for Postoperative Mechanical Ventilation in Older Adult Patients after Major Abdominal Surgeries: An Observational Study.","authors":"Jyoti Suthar, Deepak Singla, Bhavna Gupta, Sanjay Agrawal, Mridul Dhar, Ranjeeta Kumari","doi":"10.4274/TJAR.2026.262608","DOIUrl":"10.4274/TJAR.2026.262608","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the association between preoperative diaphragmatic weakness in older adult patients and the need for postoperative mechanical ventilation after major surgery. We hypothesized that preoperative diaphragmatic weakness would significantly increase the need for postoperative mechanical ventilation.</p><p><strong>Methods: </strong>It was a single-center, prospective, observational study that included 90 older adult patients aged more than 50 years who underwent abdominal surgery under general anaesthesia. A portable ultrasound was used to assess the percentage increase in the diaphragm thickening fraction (TFdi) during a maximal inspiratory effort, preoperatively and before extubation. The perioperative change in diaphragmatic function, the development of outcomes, i.e., extubation/mechanical ventilation, and the optimal cut-off of TFdi to predict outcomes were analyzed.</p><p><strong>Results: </strong>The patients with a preoperative TFdi <35% had a higher requirement for mechanical ventilation (24.5% or 1:3) as compared to those with TFdi ≥35% (7.3% or 1:13). In multivariate linear regression analysis, TFdi (preoperative) was the only independent predictor of TFdi (before extubation), explaining a substantial proportion of the variance (adjusted R²=0.71). The optimal cut-off value of TFdi (preoperative) ≤28.9 predicted intensive care unit stay with 73% sensitivity and 73% specificity, and a high negative predictive value (93.2%).</p><p><strong>Conclusion: </strong>Our study found that a significant percentage of older adult patients had a preexisting diaphragmatic weakness that was associated with extubation failure and the need for postoperative mechanical ventilation.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"54 4","pages":"291-298"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolving Role of Regional Anaesthesia in Organ Transplantation: Raising the Bar in Perioperative Outcomes.","authors":"Serkan Tulgar, Alper Kılıçaslan, Özlem Selvi Can, Zekeriyya Alanoğlu","doi":"10.4274/TJAR.2026.262860","DOIUrl":"10.4274/TJAR.2026.262860","url":null,"abstract":"","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"54 4","pages":"231-232"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaesthetic Management of CHARGE Syndrome with Anorectal Malformation in an Infant: A Case Report.","authors":"Nidhi Singh, Geeta Kamal, Charu Charu","doi":"10.4274/TJAR.2026.262595","DOIUrl":"10.4274/TJAR.2026.262595","url":null,"abstract":"<p><p>CHARGE syndrome is a rare congenital disorder with multisystem involvement, posing significant anaesthetic challenges. We report the perioperative management of an 11-month-old male who was diagnosed with anorectal malformation and CHARGE syndrome and who underwent posterior sagittal anorectoplasty. Key anaesthetic considerations included craniofacial asymmetry, facial nerve palsy, and anticipated airway difficulties. Inhalational induction with careful preoxygenation, video laryngoscopy, and caudal analgesia facilitated safe anaesthesia. Post-operative airway compromise was managed with continuous positive airway pressure, and the patient recovered without further complications or intervention. Ultrasound guidance may facilitate identification of relevant anatomy and real-time visualization of injectate spread during caudal block. This case highlights the importance of meticulous pre-anaesthetic planning and multidisciplinary evaluation in children with CHARGE syndrome.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"54 4","pages":"338-341"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ERAS Protocol Elements and Neurosurgery-Specific Considerations: A Narrative Review.","authors":"Rudin Domi, Sarah Saxena, Joana Berger-Estilita, Daniele Guerino Biasucci, Başak Ceyda Meco, Krenar Lilaj, Gentian Huti, Idit Matot, Francesca Rubulotta, Anne Marie Camilleri Podesta","doi":"10.4274/TJAR.2026.2606","DOIUrl":"10.4274/TJAR.2026.2606","url":null,"abstract":"<p><p>Enhanced recovery after surgery (ERAS) is a structured, evidence-based, multimodal perioperative framework designed to reduce surgical stress and accelerate recovery. Although these pathways are widely established across surgical specialties, their implementation in neurosurgery presents unique challenges because recovery-enhancing interventions must be balanced against neurological protection, haemodynamic stability, intracranial physiology, and procedure-specific safety considerations. This narrative review synthesises current evidence regarding ERAS implementation across cranial and spinal neurosurgical procedures, including elective craniotomy, spine surgery, pituitary surgery, vascular neurosurgery, and selected paediatric and geriatric populations. While available studies consistently demonstrate reductions in hospital length of stay, opioid consumption, and resource utilisation without increasing perioperative complications, interpretation of these findings is limited by substantial heterogeneity in protocol design, outcome definitions, and adherence reporting, and by the scarcity of long-term neurological and patient-reported outcomes. Beyond summarising existing evidence, this review proposes a conceptual framework distinguishing two fundamentally different ERAS paradigms within neurosurgery: a function-driven model predominantly applicable to spine surgery, where recovery acceleration is the principal objective, and a safety-constrained model characteristic of cranial neurosurgery, where neurological monitoring, intracranial pressure management, and haemorrhagic risk frequently limit implementation of conventional ERAS elements. This distinction provides a physiological and clinical rationale for procedure-specific adaptation rather than uniform application of these principles. The review further argues that the benefits of ERAS arise primarily from pathway standardisation, multidisciplinary coordination, and high protocol adherence rather than from isolated perioperative interventions. By identifying the limitations of current evidence and highlighting the need for neurosurgery-specific outcome measures, standardised reporting, and protocol stratification by surgical pathology, this review offers a framework for future research and more tailored implementation of ERAS pathways within neurosurgical practice.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"54 4","pages":"248-261"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}