Turkish journal of anaesthesiology and reanimation最新文献

{"title":"Triple Nerve Analgesia Block for Facial Dog-bite Laceration in a Child.","authors":"Bheemas B Atlapure, Mahammad Azeez Aspari, Dalim Kumar Baidya, Habib M Reazaul Karim","doi":"10.4274/TJAR.2025.241827","DOIUrl":"https://doi.org/10.4274/TJAR.2025.241827","url":null,"abstract":"","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041360","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":"Effects of Intravenous Dextrose Timing on Postoperative Nausea, Vomiting and Anxiety.","authors":"Yusuf Özgüner, Savaş Altınsoy, İsmet Uluhan, Funda Atar, Derya Özkan, Jülide Ergil","doi":"10.4274/TJAR.2025.252018","DOIUrl":"https://doi.org/10.4274/TJAR.2025.252018","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative nausea and vomiting (PONV) is a significant issue encountered in surgical patients. This study aims to investigate the effects of dextrose infusion timing on PONV incidence.</p><p><strong>Methods: </strong>Ninety patients undergoing laparoscopic cholecystectomy were included in this randomized controlled trial. Patients were assigned to one of three equal groups. In Group I, patients received an infusion of 400 mL of 0.9% saline 2 hours before surgery. In Group D, patients received 400 mL of 5% dextrose at the same infusion rate. Both Groups I and D received 0.9% saline at 10 mL kg^-1 h^-1 during the intraoperative period. In Group DD, patients received 200 mL of 5% dextrose preoperatively and 200 mL intraoperatively. To ensure the total maintenance fluid volume was the same as in the other groups, an infusion of 0.9% saline was administered along with the 200 mL dextrose. The primary outcome in our study was PONV incidence. Secondary outcomes were postoperative pain and anxiety levels.</p><p><strong>Results: </strong>Postoperative PONV incidence, antiemetic consumption, and anxiety levels were lowest in Group DD, while they were highest in Group I (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>In this study, we found that dextrose infusion reduced the incidence of PONV, antiemetic consumption, and anxiety levels. We observed that administering the same volumes of dextrose in divided doses during the preoperative and intraoperative periods reduced the incidence of PONV and improved anxiety scores compared to sole preoperative dextrose infusion.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837923","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":"Central Line Guidewire Knot in a Paediatric Patient with Bronchial Leiomyosarcoma Undergoing Left Pneumonectomy: A Case Report.","authors":"Suruchi Richhariya, Sunaina Tejpal Karna, Pramod Kumar Sharma, Roshan Chanchalani","doi":"10.4274/TJAR.2025.252060","DOIUrl":"https://doi.org/10.4274/TJAR.2025.252060","url":null,"abstract":"<p><p>We report the unanticipated intraoperative complication of a guidewire knot during central venous line insertion in the left internal jugular vein (IJV), in a child scheduled for a left pneumonectomy for leiomyosarcoma of the left lung under general anaesthesia. After an uneventful guidewire placement in the left IJV under ultrasound guidance, difficulty was encountered in advancing the central venous catheter over the guidewire. Resistance was felt when initiating the removal of the guidewire. The guidewire knot was identified with intraoperative fluoroscopic imaging. After consultation with the surgical team, the knot in the guidewire was removed by immediate venotomy. Intraoperative lung isolation and tracheal extubation after the surgery were uneventful. This report emphasises the importance of vigilance during central venous catheterisation in paediatric patients whose anatomical variations and smaller vessels exacerbate the risk of such complications. Ultrasound-based preprocedural Rapid Central Venous Assessment, and intra-procedural guidewire-tip navigation may help prevent coiling/knotting. Furthermore, it highlights the need for rapid recognition and surgical readiness to resolve unexpected issues during routine procedures.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817510","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":"Continuous Low-dose Epidural Morphine and Ketamine Analgesia Improves Quality of Recovery after Major Lumbar Spine Surgery: A Randomised Controlled Trial.","authors":"Sailaja Karri, Ramamani Mariappan, Gandham Edmond Jonathan, Thenmozhi Mani, Prasadkanna Prabhakar, Jemimah Samuel, Krishnaprabhu Raju","doi":"10.4274/TJAR.2025.251950","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251950","url":null,"abstract":"<p><strong>Objective: </strong>The effect of postoperative analgesia on the quality of recovery (QoR) after major lumbar spine surgery is understudied. We hypothesized that continuous epidural morphine and ketamine administration would provide effective analgesia, thereby improving QoR compared to continuous intravenous morphine and ketamine using the QoR-15 questionnaire.</p><p><strong>Methods: </strong>A total of 40 patients were randomised to receive either continuous low-dose epidural morphine and ketamine via an intraoperatively placed epidural catheter (Group A) or intravenous morphine and ketamine using a patient-controlled analgesia system (Group B) for 48 hours. All patients were anaesthetized using standard anaesthesia drugs. The primary outcome was QoR at 24 and 48 hours after surgery using the QoR-15 questionnaire. The secondary outcomes were pain score at various time points during the first 48 hours, rescue analgesic requirements, ambulation time, length of hospital stay, and patient satisfaction.</p><p><strong>Results: </strong>Forty patients were recruited (20 in each group), and all patient data were included in the analysis. The total QoR-15 scores for Group A and Group B at 24 hours were 134.8±6.65 and 128.9±6.12, respectively (P=0.006). The QoR-15 scores at 48 hours for groups A and B were 136.7±6.02 vs 132.10±6.8 (P=0.029), respectively. The pain score was lower in Group A than in Group B at rest and during movement, with P=0.015 and 0.001, respectively, and all the other secondary outcomes were comparable between the groups.</p><p><strong>Conclusion: </strong>Postoperative analgesia with continuous low-dose epidural morphine and ketamine via an intraoperatively placed epidural catheter provides superior QoR after major lumbar spine surgery as compared to intravenous morphine and ketamine.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817511","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048574","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592449","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576351","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043693","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699605","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029787","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}