Turkish journal of anaesthesiology and reanimation最新文献

{"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":0.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731884","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":"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}

{"title":"A Randomized Controlled Study to Compare the Efficacy of High Frequency Nasal Oxygenation with Conventional Oxygen Therapy for Postoperative Oxygenation in Patients Undergoing Exploratory Laparotomies.","authors":"Geetanjali T Chilkoti, Poonam Sehrawat, Medha Mohta, Michell Gulabani","doi":"10.4274/TJAR.2025.251895","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251895","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative pulmonary complication (PPC) is one of the leading causes of poor surgical outcome leading to longer hospital or intensive care unit stay and mortality especially with upper abdominal surgeries having long duration. High-frequency nasal oxygenation (HFNO) has recently been employed for postoperative oxygenation following extubation in surgical patients.</p><p><strong>Methods: </strong>Fifty consenting adult patients aged 18-65 years of either sex scheduled for exploratory abdominal surgeries under general anaesthesia (GA) with Assess Respiratory Risk in Surgical Patients in Catalonia score ≥ 26 i.e., moderate to high risk were enrolled. After instituting all routine the American Society of Anesthesiologists recommended monitoring, baseline haemodynamic parameters were recorded. Patients were preoxygenated with 100% oxygen and GA was administered as per standard institutional protocol. Following extubation, patients were randomly allocated into one of the groups comprising 25 patients each where Group C and Group H received conventional oxygen therapy via simple face mask and HFNO respectively. The FiO₂ was titrated (from 45% to 100%) by the anaesthesiologist to maintain a SpO₂ of 95% or more. Arterial blood samples were collected after extubation at various designated time points i.e. 2^nd, 6^th,12^th and 24^th hr, The P/F ratio, PaO₂, PaCO₂, S/F ratio along with haemodynamic parameters, incidence of PPCs/acute hypoxemic respiratory failure (AHRF), atelectasis and comfort score were also recorded.</p><p><strong>Results: </strong>Significant improvement in all oxygenation parameters following the use of HFNO for postoperative oxygenation; however, PaCO₂, haemodynamic variables, complications, incidence of PPCs/AHRF and atelectasis remained comparable between the two groups.</p><p><strong>Conclusion: </strong>Preventive use of HFNO for post operative oxygenation amongst moderate to high-risk patients scheduled for exploratory abdominal surgery improves oxygenation.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643622","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 Analysis of King Vision aBlade Video Laryngoscopy and Direct Laryngoscopy for Endotracheal Intubation in Paediatric Age Group: a Prospective Randomized Study.","authors":"Mamta Harjai, Chaya Devi D, Sujeet Rai, Shilpi Misra, Tanveer Roshan Khan","doi":"10.4274/TJAR.2025.251902","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251902","url":null,"abstract":"<p><strong>Objective: </strong>Paediatric airway management is challenging due to anatomical differences, making effective endotracheal intubation crucial during surgery. While direct laryngoscopy (DL) has been the standard method, video laryngoscopy (VL) has emerged as a promising alternative. This study compared the effectiveness of King Vision aBlade non-channeled VL with Miller/Macintosh DL for intubation in children.</p><p><strong>Methods: </strong>In this prospective, randomized, single-blinded study, 150 children aged 2-10 years undergoing elective surgery were randomly assigned to either Group DL (n = 75) or Group KVL (n = 75). Data was collected on intubation success, time, glottic view, external maneuvers, and hemodynamic parameters [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), peripheral oxygen saturation (SpO₂)] at various intervals.</p><p><strong>Results: </strong>The mean age of patients was similar in both groups (<i>P</i>=0.15). The DL group had a higher success rate on the first attempt (<i>P</i> < 0.001) and shorter intubation times (9.97±3.12 sec vs. 14.35±2.99 sec, <i>P</i> < 0.001) compared to King Vision aBlade VL (KVL). Although KVL provided a better glottic view, this difference was not statistically significant (<i>P</i>=0.059). Hemodynamic parameters (SBP, DBP) were significantly higher in the DL group post-intubation (<i>P</i> < 0.05), with no significant differences in HR or SpO₂ between groups. The DL group required more external maneuvers for intubation (<i>P</i>=0.022).</p><p><strong>Conclusion: </strong>DL showed a higher success rate, faster intubation times, and greater hemodynamic stability compared to KVL. While KVL offered better glottic views, it had longer intubation times and lower success rates. Further studies with larger sample sizes are recommended to validate these findings.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627187","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":"Incidence and Risk Factors of Postoperative Complications in Patients Undergoing Robot-assisted Laparoscopic Radical Prostatectomy: A Retrospective Study.","authors":"Oya Kılcı, Feryal Korkmaz Akçay, Özlem Balkız Soyal, Murat Akçay, Betül Güven Aytaç","doi":"10.4274/TJAR.2025.251973","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251973","url":null,"abstract":"<p><strong>Objective: </strong>Robot-assisted laparoscopic radical prostatectomy (RALP) is increasingly used in the treatment of prostate cancer due to its minimally invasive nature, reduced perioperative bleeding, and shorter hospital stays. However, the steep Trendelenburg position and CO₂ pneumoperitoneum required for the procedure present unique anaesthetic challenges, particularly in elderly patients with comorbidities. This study aimed to determine the incidence of anaesthetic complications during RALP and identify independent risk factors associated with these events.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at Ankara Bilkent City Hospital between 2019 and 2024. A total of 1,020 patients who underwent RALP were evaluated. Collected data included demographic characteristics, the American Society of Anesthesiologists (ASA) physical status classification, comorbidities, and intra- and postoperative outcomes. Anaesthetic complications were analyzed, and multivariate logistic regression was performed to identify independent predictors.</p><p><strong>Results: </strong>The mean patient age was 65.0±6.3 years, with 65.3% classified as ASA II and 61.6% having at least one comorbidity. Anaesthetic complications occurred in 4.4% of patients. Those with complications were significantly older (67.9±6.2 vs. 64.9±6.3 years, <i>P</i>=0.004), had longer hospital stays (8.98±4.45 vs. 6.83±3.18 days, <i>P</i> < 0.001), and were more frequently admitted to the post-anaesthesia care unit (PACU) (73.3% vs. 46.8%, <i>P</i> < 0.001). Multivariate analysis identified age, hospital stay duration, and PACU admission as independent risk factors.</p><p><strong>Conclusion: </strong>RALP can be safely performed in experienced centers with individualized anaesthetic management. However, older age, longer hospitalization, and PACU admission significantly increase the risk of anaesthetic complications. These findings emphasize the need for preoperative risk stratification and tailored perioperative care to improve safety outcomes. Prospective, multicenter studies are needed to confirm these results and guide future anaesthetic strategies in robotic urologic surgery.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601716","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 Relationships Between Patients' Demographic Characteristics, Comorbid Diseases, American Society of Anesthesiologists Scores and Inflammation Indexes: A Retrospective Study.","authors":"Ali Genç, Mehtap Gürler Balta, Vildan Kölükçü, Ahmet Tuğrul Şahin, Yunus Emre Şakacı, Hakan Tapar, Tuğba Karaman, Serkan Karaman","doi":"10.4274/TJAR.2025.251959","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251959","url":null,"abstract":"<p><strong>Objective: </strong>Parameters that can provide information about patients' current status are very important in preoperative evaluation. The systemic immune inflammation index (SII), and systemic inflammation response index (SIRI) can be easily calculated with a simple hemogram test, and this testing is frequently requested in preoperative preparation. The aim of this research was to examine the relationship between the SII, and SIRI, along with the demographic characteristics and postoperative clinical course of the patient.</p><p><strong>Methods: </strong>In the study, the records of patients who presented to the anesthesia outpatient clinic for preoperative preparation were retrospectively reviewed. In this study, the relationships between the SII, and SIRI and each patients' demographic characteristics, and the American Society of Anesthesiologists (ASA) score, comorbid disease, and length of hospital stay were examined.</p><p><strong>Results: </strong>For the SII value, there was a statistically significant difference between the ASA1 and ASA2 groups and between the ASA2 and ASA3 groups there was no significant difference between the ASA3 and ASA4 groups (<i>P</i> < 0.001, <i>P</i> < 0.001, P=0.17, respectively). There were statistically significant differences between the ASA1 and ASA2, ASA2 and ASA3, and ASA3 and ASA4 groups for the SIRI value (<i>P</i> < 0.001, <i>P</i> < 0.001, <i>P</i> < 0.001, respectively).</p><p><strong>Conclusion: </strong>The findings showed relationships between the SII, SIRI, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio and an increase in patients' ASA scores. In multivariate analysis, some demographic characteristics of the patients, comorbidities, and the postoperative course were found to be independent risk factors predicting SII and SIRI.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576352","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":"Anaesthetic Management and Multidisciplinary Approach in a Case of Aortic Foreign Body Impalement Following Thoracolumbar Instrumentation.","authors":"Burhan Dost, Esra Turunç, Belkıs Eroğlu Çelik, Yunus Emre Durmuş, Mustafa Kemal Demirağ","doi":"10.4274/TJAR.2025.252014","DOIUrl":"https://doi.org/10.4274/TJAR.2025.252014","url":null,"abstract":"<p><p>Iatrogenic thoracic aortic injury caused by misplaced spinal instrumentation is a rare but potentially fatal complication of posterior spinal fusion and fixation procedures. The close anatomical relationship between the vertebral column and descending thoracic aorta puts the aortic wall at risk, especially when pedicle screws are malpositioned. While such injuries may remain asymptomatic initially, progressive erosion of the aortic wall can lead to catastrophic rupture. This case report highlights a 72-year-old woman with a history of diabetes, hypertension, and Takotsubo cardiomyopathy who developed a thoracic aortic injury following thoracolumbar instrumentation. Imaging revealed a pedicle screw at the T5 level, directly impinging on the aortic wall. A multidisciplinary approach involving cardiovascular, neurosurgery, and anaesthesiology teams was utilized, and thoracic endovascular aortic repair (TEVAR) was performed to stabilize the aorta before hardware removal. Despite successful surgical intervention, the patient later developed a right-sided middle cerebral artery infarction, possibly due to thromboembolism from the TEVAR site. This case underscores the importance of a staged surgical approach with TEVAR in managing aortic injury during spinal instrumentation, especially in high-risk patients with comorbidities such as Takotsubo cardiomyopathy. Careful anaesthesia management and multidisciplinary collaboration are essential to optimize outcomes in such complex cases.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576350","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":"Foundations and Advancements in Hemodynamic Monitoring: Part II - Advanced Parameters and Tools.","authors":"Muhammed Enes Aydın, Aslıhan Aykut, Ümit Karadeniz, Emre Sertaç Bingül, Zeliha Aslı Demir, Gamze Talih, Başak Akça, Burhan Dost","doi":"10.4274/TJAR.2025.251926","DOIUrl":"https://doi.org/10.4274/TJAR.2025.251926","url":null,"abstract":"<p><p>Advanced hemodynamic monitoring has revolutionized perioperative medicine and critical care by providing comprehensive insights into cardiovascular physiology and facilitating precise assessment and management of complex parameters such as cardiac output, systemic vascular resistance, fluid responsiveness, and tissue perfusion. These technologies enhance the capacity of clinicians to detect subtle physiological alterations, enabling timely interventions and individualized therapeutic strategies, particularly for critically ill patients and those undergoing major surgical procedures. This two-part review offers a comprehensive analysis of hemodynamic monitoring. Part I examined the fundamental principles of macrohemodynamics and microhemodynamics. Part II focuses on advanced hemodynamic monitoring tools, tracing the evolution of cardiac output measurement techniques from Fick's oxygen consumption method in 1870 to contemporary innovations, such as pulse contour analysis, bioimpedance/bioreactance, and real-time non-invasive modalities like advanced echocardiography. By examining the underlying principles, devices, invasiveness, clinical applications, advantages, and limitations of various monitoring techniques, this review elucidates the clinical utility of advanced tools in addressing the limitations of standard monitoring and optimizing patient outcomes in modern anaesthesia and critical care practices.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318037","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}