Turkish journal of anaesthesiology and reanimation最新文献

{"title":"Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients.","authors":"Nazih Khater, Anna G Morris, Delena M Vanvalkenburg, Andrew J Garcia, Kevin Jin, Shahab Ahmadzadeh, Sahar Shekoohi, Elyse M Cornett, Alan David Kaye","doi":"10.4274/TJAR.2023.231315","DOIUrl":"10.4274/TJAR.2023.231315","url":null,"abstract":"<p><p>Obesity is associated with many significant physiological changes. These considerations are important to surgery, especially in urological procedures. Obese patients often undergo surgical procedures and are at higher risk of complications. This investigation reviews physiological and anaesthesia considerations for obese and morbidly obese patients. In addition, urological surgeries and procedures should be considered for these higher risk patients. Clinical anaesthesiologists must use detailed assessment and, when appropriate, consultation in developing safe anaesthesia plans for these patients. Newer technologies have improved safety related to airway management, advanced airway devices, and regional anaesthesia with ultrasound-guided nerve blocks, which can reduce the need for opioids postoperatively. Recent developments in drug and monitoring technologies have also been developed and can be effective for obese and morbidly obese patients undergoing urological procedures and perioperative surgery, thus improving the likelihood of safety in this higher risk population.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"52 2","pages":"39-48"},"PeriodicalIF":0.5,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11074599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858123","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":"Could MicroRNA be Neurological Prognosis Biomarkers after Cardiac Arrest?","authors":"Şule Özbilgin, Necati Gökmen","doi":"10.4274/TJAR.2024.241557","DOIUrl":"10.4274/TJAR.2024.241557","url":null,"abstract":"<p><p>For patients monitored in intensive care units in the aftermath of a cardiac arrest, one of the well-established difficulties of care after resuscitation is the ability to perform the necessary prognostic assessments as accurately and early as possible. Although current guidelines include algorithms to determine prognosis, there are still missing links and uncertainties. Biomarkers obtained from peripheral blood are generally non-invasive and easy to obtain. Although the potential to use microRNA as a prognostic biomarker after cardiac arrest has received less interest recently, its popularity has increased in the last few years. By identifying prognostic biomarkers within 24 h of cardiac arrest, clinicians in intensive care could gain valuable insights to guide patient outcomes and predict both mortality and survival rates.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"52 2","pages":"49-53"},"PeriodicalIF":0.5,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11074598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863042","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 the Effects of Sevoflurane and Desflurane on Endothelial Glycocalyx in Patients Undergoing Laparoscopic Hysterectomy: A Randomized, Double-Blind Trial.","authors":"Kemal Tolga Saraçoğlu, Tahsin Şimşek, Hande Gürbüz, Fatih Doğu Geyik, Ebru Kale, Kürşad Nuri Baydili, Raghad Giuma M Kordi, Ahmet Kale, Ayten Saraçoğlu","doi":"10.4274/TJAR.2024.231323","DOIUrl":"10.4274/TJAR.2024.231323","url":null,"abstract":"<p><strong>Objective: </strong>Various enzymes, reactive oxygen species, inflammatory conditions, and major surgeries cause endothelial glycocalyx breakdown. Inhalation of anaesthetic agents may have protective effects on the endothelium. This study compared syndecan-1 and heparan sulfate levels to evaluate the effects of sevoflurane and desflurane on the endothelial glycocalyx.</p><p><strong>Methods: </strong>This prospective randomized, double-blind study included 46 patients undergoing laparoscopic hysterectomy. The participants were allocated into sevoflurane and desflurane groups. Subsequently, blood samples were drawn at three time points: before anaesthesia induction for a baseline value (T0), after pneumoperitoneum (T1), and after extubation (T2). Heparan sulfate and syndecan-1 levels were measured.</p><p><strong>Results: </strong>There was no statistical difference between the sevoflurane and desflurane groups in terms of heparan sulfate and syndecan-1 levels at any time point. A significant difference was found only in the desflurane group in the intragroup comparisons of the measurements of heparan sulfate levels (χ²=29.826, <i>P</i> < 0.001). Matched pairs of the time points in the desflurane group showed that <i>P</i>=0.036 (Z=-2.099) for T1-T0, <i>P</i> < 0.001 (Z=-3.924) for T2-T0, and <i>P</i> < 0.001 (Z=-4.197) for T2-T1. The change in percentage between T2 and T1 of heparan sulfate in the desflurane group was found to be statistically significant (<i>P</i>=0.034).</p><p><strong>Conclusion: </strong>The damage caused by surgical stress on the endothelial glycocalyx can be reduced by both desflurane and sevoflurane. The protective effect of desflurane is more prominent than that of sevoflurane.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"52 2","pages":"76-82"},"PeriodicalIF":0.5,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11074596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864926","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":"Impact of Burnout on Anaesthesiologists.","authors":"Joana Berger-Estilita, Dominic Salvisberg, Ekin Köselerli, Stefan Haupt, Başak Ceyda Meço","doi":"10.4274/TJAR.2024.241565","DOIUrl":"10.4274/TJAR.2024.241565","url":null,"abstract":"<p><p>Professional burnout syndrome (PBS) is an issue affecting individuals and organizations alike, characterized by emotional exhaustion and reduced effectiveness resulting from overwhelming work demands. Root causes include excessive workload, unrealistic expectations, and blurred work-life boundaries, which are often intensified by organizational culture and inadequate support systems. The consequences range from decreased productivity and creativity to high turnover rates and financial strain on organizations. Mitigating PBS requires a comprehensive approach that addresses both individual and organizational levels. Individually, stress management techniques and self-care practices are crucial for building resilience and coping with work-related stressors. Organizations play a vital role in promoting employee well-being by fostering a supportive work environment, promoting work-life balance and providing access to support systems such as counseling and mentorship programs. Leadership is key in creating a culture that values employee health and prioritizes open communication and empathy. Policy interventions can further support efforts to combat PBS by enforcing labor laws that protect employee rights, such as setting limits on working hours and ensuring access to mental health services. Additionally, incentivise organizations to prioritize employee well-being through tax incentives or certification programs can encourage proactive measures against burnout. The aim of this review is to provide a comprehensive exploration of PBS, examining its causes, consequences, and potential mitigation strategies in individuals and organizations, with a focus on anaesthesiology.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"52 2","pages":"54-59"},"PeriodicalIF":0.5,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11074597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867589","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 Preoperative Oral Carbohydrate Intake on Perioperative Hyperglycemia in Indian Patients Undergoing Hip Fracture Fixation.","authors":"Evelyn Eliza Minz, Rashmi Salhotra, Asha Tyagi, Aditya N Aggarwal, Mohit Mehndiratta, S V Madhu, Venu George Toppo, Edelbert Anthonio Almeida","doi":"10.4274/TJAR.2024.231506","DOIUrl":"10.4274/TJAR.2024.231506","url":null,"abstract":"<p><strong>Objective: </strong>Preoperative fasting leads to a catabolic state aggravated by surgical stress. This leads to poor patient outcomes. This study aimed to determine the effect of preoperative oral carbohydrate administration on perioperative hyperglycemia and patient comfort.</p><p><strong>Methods: </strong>This prospective, randomized study was conducted on 60 adult American Society of Anesthesiologist I/II patients undergoing hip fracture fixation after obtaining institutional ethical committee clearance. Patients were randomly kept conventionally fasted before surgery (group F, n = 30) or were given oral carbohydrate 2 h before surgery (group C, n = 30). Under all aseptic precautions, a combined spinal epidural block was administered, and surgery was allowed. The primary outcome was blood glucose, and secondary outcomes included incidence of postoperative hyperglycemia, insulin level, blood urea, hunger, thirst, and anxiety.</p><p><strong>Results: </strong>Blood glucose levels were not statistically different between the two groups at baseline (T0; <i>P</i>=0.400), immediately after surgery (T1; <i>P</i>=0.399) and 24h after surgery (T2; <i>P</i>=0.619). The incidence of postoperative hyperglycemia was significantly higher in group F than in group C (<i>P</i>=0.045) at T2. Insulin levels, blood urea levels, and hunger scores were also not statistically different between the groups. The thirst and anxiety scores were lower at T0 and T1 in group C.</p><p><strong>Conclusion: </strong>Preoperative oral carbohydrate administration does not prevent perioperative increases in blood glucose levels. However, it reduces the incidence of perioperative hyperglycemia and decreases perioperative thirst and anxiety, thereby improving the quality of perioperative patient care.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"52 2","pages":"68-75"},"PeriodicalIF":0.5,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11074600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859018","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":"Effects of Pulsatile and Non-Pulsatile Cardiopulmonary Bypass Techniques in Coronary Artery Bypass Grafting Surgeries on Cerebral Perfusion.","authors":"İpek Bostancı, Beyhan Güner, Evrim Kucur Tülübaş, Güray Demir, Zafer Çukurova","doi":"10.4274/TJAR.2024.231331","DOIUrl":"10.4274/TJAR.2024.231331","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the effects of cardiopulmonary bypass (CPB) machines used in coronary artery bypass grafting surgeries on cerebral perfusion by performing cerebral oximetry monitoring [near-infrared spectroscopy (NIRS)], S100-β protein measurements, and neurocognitive function assessment tests using both pulsatile and non-pulsatile modes.</p><p><strong>Methods: </strong>A total of 44 patients, 22 non-pulsatile (Group NP) and 22 pulsatile (Group P), were included in the study. Hemodynamic parameters, arterial blood gas values, NIRS values and blood S100β protein levels were analyzed at five points: pre-induction (T1), initiation of CPB (T2), termination of CPB (T3), end of surgery (T4), and postoperative 24 h (T5). Two different neuropsychological tests were administered to patients in the preoperative and postoperative periods.</p><p><strong>Results: </strong>There were no significant differences between the groups for demographic characteristics such as age, gender, body mass index, aortic cross-clamping, CPB, and operation durations. The mean arterial blood pressure and PaO₂ values for the T2 measurements were significantly higher in group NP (<i>P</i> < 0.05). Regional cerebral oxygen saturation (rSO₂) (NIRS) values at T3 and T4 were significantly higher in group P (<i>P</i> < 0.05). Serum S100β measurement values at T3 and T5 were significantly higher in group NP than in group P (<i>P</i> < 0.05). Serum S100β protein levels at T3 correlate with rSO₂ results. There was no statistically significant difference between the two groups in terms of pH, lactate, glucose, partial pressure of carbon dioxide, and peripheral oxygen saturation values.</p><p><strong>Conclusion: </strong>Despite no difference between the two groups for neurocognitive function tests, we believe that pulsatile perfusion may be more beneficial for cerebral perfusion when S100β protein and NIRS values are considered. Further clinical studies are needed to evaluate the benefits of the pulsatile technique for cerebral perfusion.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"52 1","pages":"22-29"},"PeriodicalIF":0.5,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983912","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 Lumbar-Sacral Plexus Block in Facioscapulohumeral Muscular Dystrophy for Hip Fracture Surgery: A Case Report.","authors":"Mete Manici, İlayda Kalyoncu, Cemil Cihad Gedik, Mehmet Ali Deveci, Yavuz Gürkan","doi":"10.4274/TJAR.2024.231471","DOIUrl":"10.4274/TJAR.2024.231471","url":null,"abstract":"<p><p>Facioscapulohumeral muscular dystrophy (FSHD) is a muscular dystrophy that can affect individuals of all age groups. Its prevalence is reported to be 0.4-1 in 10,000 people. Because of the low occurrence of FSHD, anaesthetic management is primarily based on expert opinions, case reviews, or brief series. Here, we present the case of a 72-year-old woman with FSHD who underwent hip fracture (HF) surgery. To prevent respiratory compromise due to FSHD, we opted for lumbar-sacral plexus block. To the best of our knowledge, there is no information in the literature regarding the use of combined lumbar-sacral plexus block in patients with FSHD undergoing HF surgery.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"52 1","pages":"36-38"},"PeriodicalIF":0.5,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983911","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":"Prevalence and Causes of Elective Surgery Cancellations After Patients are Taken to the Operating Room: A Prospective, Cross-Sectional Study.","authors":"Mustafa Soner Özcan, Eyyüp Sabri Özden, Filiz Alkaya Solmaz, Ayşe Kösem, Yiğit Akyol, Pakize Kırdemir","doi":"10.4274/TJAR.2024.231454","DOIUrl":"10.4274/TJAR.2024.231454","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the causes and prevalence of elective surgery cancellations in the operating room, and the clinical outcomes of affected patients.</p><p><strong>Methods: </strong>This prospective, cross-sectional study assessed the prevalence and causes of elective surgery cancellations once patients are in the operating room. A tertiary academic referral center hosted the study between January 2022 and January 2023. The study sample consisted of 7,482 adult patients scheduled for elective surgeries and taken to the operating room. The 7,415 completed procedures were in Group 2, whereas the 67 cancelled surgeries were in Group 1. Patients were divided into two groups on the basis of whether their surgeries were completed or cancelled. Factors such as age, American Society of Anesthesiologists (ASA) status, and surgical department were analyzed. The two groups were compared on the basis of age, ASA status, surgical department, and surgery time (month and day).</p><p><strong>Results: </strong>Elective surgery cancellations occurred in the operating room at a rate of 0.9%. Group 1 was substantially older than Group 2 (p<0.001). Group 1 had a larger number of ASA III patients (p<0.001). The department with the highest cancellation rate was ophthalmology (2.5%), followed by general surgery (2.1%), urology (1.5%), and ear, nose, and throat (1.4%). It was possible to avoid 59.7% of cancelations.</p><p><strong>Conclusion: </strong>The study revealed a 0.9% prevalence rate of elective surgery cancelations in the operating room. Older age and higher ASA status greatly influenced these cancellations. Optimized surgery scheduling and patient assessment processes may prevent many of these cancellation.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"52 1","pages":"14-21"},"PeriodicalIF":0.5,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983914","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":"Use of an Endobronchial Blocker in a Patient with Tracheobronchial Anomaly for Minimally Invasive Cardiac Surgery: A Case Report.","authors":"Emine Nilgün Zengin, Nevriye Salman, Ayşegül Özgök","doi":"10.4274/TJAR.2024.231493","DOIUrl":"10.4274/TJAR.2024.231493","url":null,"abstract":"<p><p>Tracheal bronchi (TB) is a rare anomaly and is usually asymptomatic. Although it is generally not a problem when a single lumen tube is used, it may cause ventilation difficulties in the intraoperative period in procedures requiring one lung ventilation, such as minimally invasive cardiac surgery. Therefore, these difficulties may cause intraoperative and postoperative complications. While a double-lumen tube is recommended as the primary choice for one-lung ventilation in patients with TB, bronchial blockers can be used to avoid the need for tube exchange in patients who will remain intubated in the postoperative period.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"52 1","pages":"30-32"},"PeriodicalIF":0.5,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983915","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":"Visual Evaluation of Plethysmographic Waveforms: Introducing the Simple Systolic Ratio as an Indicator of Fluid Responsiveness.","authors":"Muhammet Selman Söğüt, Kamil Darçın, Muhammet Ahmet Karakaya, Mete Manici, Yavuz Gürkan","doi":"10.4274/TJAR.2024.231452","DOIUrl":"10.4274/TJAR.2024.231452","url":null,"abstract":"<p><strong>Objective: </strong>For patient safety, maintaining hemodynamic stability during surgical procedures is critical. Dynamic indices [such as systolic pressure variation (SPV) and pulse pressure variation (PPV)], have recently seen an increase in use. Given the risks associated with such invasive techniques, there is growing interest in non-invasive monitoring methods-and plethysmographic waveform analysis. However, many such non-invasive methods involve intricate calculations or brand-specific monitors. This study introduces the simple systolic ratio (SSR), derived from pulse oximetry tracings, as a non-invasive method to assess fluid responsiveness.</p><p><strong>Methods: </strong>This prospective observational study included 25 adult patients whose SPV, PPV, and SSR values were collected at 30-min intervals during open abdominal surgery. The SSR was defined as the ratio of the tallest waveform to the shortest waveform within pulse tracings. The correlations among SSR, SPV, and PPV were analyzed. Additionally, anaesthesia specialists visually assessed pulse oximetry tracings to determine fluid responsiveness using the SSR method.</p><p><strong>Results: </strong>Strong correlations were observed between SSR and both SPV (r = 0.715, <i>P</i> < 0.001) and PPV (r = 0.702, <i>P</i> < 0.001). Receiver operator curve analysis identified optimal SSR thresholds for predicting fluid responsiveness at 1.47 for SPV and 1.50 for PPV. A survey of anaesthesia specialists using the SSR method to visually assess fluid responsiveness produced an accuracy rate of 83%.</p><p><strong>Conclusion: </strong>Based on the strong correlations it exhibits with traditional markers, SSR has great potential as a clinical tool, especially in resource-limited settings. However, further research is needed to establish its role, especially as it pertains to its universal applicability across monitoring devices.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"52 1","pages":"8-13"},"PeriodicalIF":0.5,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983916","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}