Turkish journal of anaesthesiology and reanimation最新文献

{"title":"ERAS in Cardiac Surgery: Wishful Thinking or Reality.","authors":"Z Aslı Demir,&nbsp;Nandor Marczin","doi":"10.4274/TJAR.2023.231238","DOIUrl":"10.4274/TJAR.2023.231238","url":null,"abstract":"<p><p>Enhanced recovery after cardiac surgery (ERACS) is a multi-disciplinary approach to improve patient outcomes and reduce complications following cardiac surgery. The aim of ERACS protocol is to optimize pre-operative preparation, reduce surgical trauma, and minimize post-operative stress.The protocol has been shown to improve patient outcomes, including shorter hospital stays, lower rates of complications, and faster return to normal activities. It is important to note that ERACS is a multi-disciplinary approach, and requires close collaboration between surgeons, anaesthesiologists, nurses, and other healthcare professionals to ensure successful implementation. Anaesthesiologists play a crucial role in the ERACS protocol, as they are responsible for the management of the patient's anaesthesia and pain management during and after surgery. In this paper provide an overview of the ERACS protocol from the perspective of an anaesthesiologist.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"370-373"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158859","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":"Serum Cholinesterase, C-reactive Protein, Interleukin 6, and Procalcitonin Levels as Predictors of Mortality in Patients in the Intensive Care Unit.","authors":"Qin Liu,&nbsp;Xiaoguang Fan,&nbsp;Wenjuan Cui,&nbsp;Xincheng Wang,&nbsp;Zhaolong Zhang,&nbsp;Naizhi Wang,&nbsp;Lujun Qiao","doi":"10.4274/TJAR.2023.231349","DOIUrl":"10.4274/TJAR.2023.231349","url":null,"abstract":"<p><strong>Objective: </strong>The prognostic utility of inflammatory markers in survival has been suggested in patients with cancer; however, evidence on their prognostic value in severely ill patients is very limited. We aimed to explore the prognostic value of cholinesterase (ChE), C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT) in predicting mortality in patients from the intensive care unit (ICU).</p><p><strong>Methods: </strong>Serum levels of ChE, CRP, IL-6 and PCT were measured in ICU patients from December 13^th, 2019 to June 28^th, 2022. We assessed the predictive power of ChE, CRP, IL-6, and PCT using the receiver operating characteristic (ROC) curves. Furthermore, we evaluated their diagnostic accuracy by comparing the areas under the ROC curve (AUCs) along with their corresponding 95% confidence intervals (CIs). The cut-off values were determined to dichotomise these biomarkers, which were then included in multivariable logistic regression models to examine their relationship with ICU mortality.</p><p><strong>Results: </strong>Among 253 ICU patients included in the study, 66 (26%) died during the ICU stay. The AUCs to predict ICU mortality were 0.643 (95% CI, 0.566-0.719), 0.648 (95% CI, 0.633-0.735), 0.643 (95% CI, 0.563-0.723) and 0.735 (95% CI, 0.664-0.807) for ChE, CRP, IL-6 and PCT, respectively. After adjusting for age, sex and disease severity, lower ChE level (<3.668 × 10³ U L^-1) and higher levels of CRP (>10.546 mg dL^-1), IL-6 (>986.245 pg mL^-1) and PCT (>0.505 μg L^-1) were associated with higher mortality risk, with odd ratios of 2.70 (95% CI, 1.32-5.54), 4.99 (95% CI, 2.41-10.38), 3.24 (95% CI, 1.54-6.78) and 3.67 (95% CI, 1.45-9.95), respectively.</p><p><strong>Conclusion: </strong>ChE, CRP, IL-6 and PCT were independent ICU mortality risk factors in severely ill patients. Elevated PCT levels exhibited better predictive value than the other three biomarkers that were evaluated.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"408-413"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158862","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 Two Different Methods for ProSeal^TM Laryngeal Mask Fixation.","authors":"Funda Atar,&nbsp;Gülsen Keskin,&nbsp;Filiz Karaca Akaslan,&nbsp;Yasemin Tıraş,&nbsp;Aslı Dönmez","doi":"10.4274/TJAR.2023.231225","DOIUrl":"10.4274/TJAR.2023.231225","url":null,"abstract":"<p><strong>Objective: </strong>This prospective randomized study compared 2 different methods for Proseal^TM Laryngeal Mask Airway (PLMA) fixation.</p><p><strong>Methods: </strong>Patients scheduled for ureterorenoscopic lithotripsy surgery in the lithotomy position were included in the study. General anaesthesia with PLMA was administered to the patients. To achieve PLMA fixation, patients were randomly assigned to either adjustable elastic band (Group I) or adhesive tape fixation (Group II). Fiberoptic bronchoscope (FOB) evaluation and glottic image grading (grade 1-4) and lip margin distances of PLMA (M1 and M2) were evaluated before and after the surgical procedure.</p><p><strong>Results: </strong>We enrolled 116 patients. Surgery of 7 patients was postponed. PLMA dislocated in 2 patients in group II during positioning. For another patient who used adhesive tape in Group II, it was removed because it could not adhere to properly, and a new sticking plaster was used. The study was completed with 106 patients. In FOB evaluation, the number of patients with optimal FOB grade (FOB grade 1) after PLMA was inserted and fixed was more in Group I than in Group II (<i>P</i> = 0.01). FOB evaluation was repeated at the end of the operation, and the number of patients with the worst FOB grade (FOB grade 4) was 0 (0%) and 11 (10.5%) in Groups I and II, respectively. PLMA displaced more than 1 cm in 10 (18.9%) patients in Group I and in 30 patients (56.6%) in Group II.</p><p><strong>Conclusion: </strong>The adjustable elastic band method is simple, easy, and convenient and can be used in any surgical procedure for PLMA fixation.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"395-401"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158842","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":"Precision Anaesthesia: Advancing Patient-Centered Precision Care Through Repetitive Assessment of PROMs with the Safe Brain Initiative Approach","authors":"Başak Ceyda Meço,&nbsp;Ana Borda de Agua Reis,&nbsp;Joana Berger-Estilita,&nbsp;Karina Jakobsen,&nbsp;Neslihan Alkış,&nbsp;Finn Michael Radtke","doi":"10.4274/TJAR.2023.231420","DOIUrl":"10.4274/TJAR.2023.231420","url":null,"abstract":"<p><p>This article aims to introduce the Safe Brain Initiative (SBI) approach, focusing on collecting and leveraging Patient-Reported Outcome Measures (PROMs) to enhance patient-centred precision anaesthesia and prevent postoperative delirium (POD) and neurocognitive disorders (NCD). The SBI was implemented to systematically address the feedback gap in perioperative care by collecting and analysing real-world data. The initiative focuses on monitoring and preventing POD and NCD, providing effective anaesthesia care, assessing patient and team satisfaction, and evaluating environmental sustainability impact. Based on international guidelines, 18 core recommendations were established to address potential complications and challenges associated with anaesthesia. Preliminary results showed a notable reduction in POD and increased awareness among anaesthesia team members regarding PROMs. The SBI approach demonstrated significant benefits during emergency situations, such as the February 2023 earthquake in Turkey, by providing crucial support and comfort to victims requiring multiple surgical interventions. The SBI presents an innovative, cost-effective, and patient-centred approach to perioperative care. By integrating PROMs and systematic feedback mechanisms, the SBI aims to expedite the advancement of efficient, patient-centered precision perioperative care, improve patient outcomes, and elevate the quality of care. The initiative has shown promising results, and its adoption is growing globally. Collaboration among healthcare providers, researchers, and patients is crucial in shaping the future of anaesthesia practice and further improving patient outcomes. Turkish hospitals are encouraged to join the SBI to benefit from international collaborations and contribute to positive change in perioperative care standards. The SBI project significantly advances precision anaesthesia, emphasising personalised care and patient well-being.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"374-379"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149858","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":"Nasogastric Tube Insertion in Intubated Patients: Comparison of Three Different Positions; Standard Sniffing Position, Additional Flexion of the Neck, and Standard Sniffing Position with Lateral Neck Pressure.","authors":"Shyam Mohanan,&nbsp;Madhu Gupta,&nbsp;Manisha Dabas","doi":"10.4274/TJAR.2023.221133","DOIUrl":"https://doi.org/10.4274/TJAR.2023.221133","url":null,"abstract":"<p><strong>Objective: </strong>Our study aimed to evaluate two modified nasogastric tube (NGT) insertion techniques in intubated patients compared to the conventional method in respect of first attempt success rate, time taken for insertion, and complications.</p><p><strong>Methods: </strong>In this prospective interventional study, patients with orotracheal intubation requiring NGT insertion were randomly allocated into three groups by SNOS Group A (control group- standard sniffing position, n = 40), Group B (additional flexion of the neck, n = 40), Group C (standard sniffing position with lateral neck pressure, n = 40). The number of attempts for successful NGT insertion, time for insertion, and complications were compared.</p><p><strong>Results: </strong>Modified positions showed a high first-attempt success rate in Group B (55%) and Group C (85%) as compared to conventional Group A (32.50%) (<i>P</i> < 0.001). On intergroup analysis of modified groups (B and C), Group C was superior to Group B in 1^st attempt success rate with a significant <i>P</i> value of 0.003.</p><p><strong>Conclusion: </strong>In intubated patients, NGT insertion in standard sniffing position with lateral neck pressure has the highest first attempt success rate followed by additional flexion of neck position. Both the modified positions are better positions for NGT insertion in intubated patients.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 4","pages":"318-323"},"PeriodicalIF":0.5,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10440490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10402952","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":"Clinical Experience for Modified Thoracoabdominal Nerve Block Through Perichondrial Approach (M-TAPA) in Five Patients. Dermatomal Evaluation and Application of Different Volumes: A Case Series and Review of Literature.","authors":"Bahadır Çiftçi,&nbsp;Hande Güngör,&nbsp;Selçuk Alver,&nbsp;Ayşe Nurmen Akın,&nbsp;Yaşar Özdenkaya,&nbsp;Serkan Tulgar","doi":"10.4274/TJAR.2022.221042","DOIUrl":"https://doi.org/10.4274/TJAR.2022.221042","url":null,"abstract":"<p><p>Thoracoabdominal nerves block through perichondrial approach (TAPA) is a novel block and provides abdominal analgesia. TAPA block targets the both anterior and the lateral branches of the thoracoabdominal nerves. Modified-TAPA (M-TAPA) was defined due to the need for blocking certain dermatomes depending on the surgical incision sites. In the literature, the knowledge about the efficiency and dermatomal coverage of M-TAPA is limited. In this case series, we want to report our experiences with this issue.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 4","pages":"354-357"},"PeriodicalIF":0.5,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10440489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10421298","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":"Authors' Response: Comment on: \"Transversus Thoracic Muscle Plane Block for Attenuating the Haemodynamic Response to Median Sternotomy\".","authors":"Ashish Walian,&nbsp;Rohan Magoon,&nbsp;Iti Shri,&nbsp;Ramesh Chand Kashav","doi":"10.4274/TJAR.2023.231423","DOIUrl":"https://doi.org/10.4274/TJAR.2023.231423","url":null,"abstract":"","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 4","pages":"364-365"},"PeriodicalIF":0.5,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10440477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10422657","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":"Mode of Mechanical Ventilation in a Case of Venolymphatic Malformation: Spontaneous-Saves, Positive-Precludes.","authors":"Prateek Arora,&nbsp;Subrata Kumar Singha,&nbsp;Omer Md Mujahid,&nbsp;Snigdha Kumari,&nbsp;Abinaya Prakashbabu","doi":"10.4274/TJAR.2023.221115","DOIUrl":"https://doi.org/10.4274/TJAR.2023.221115","url":null,"abstract":"<p><p>Mediastinal venolymphatic malformations (VLM) are rare tumours, with very few reported cases in the literature. Arising often from the anterior mediastinum, VLM manifests symptoms based on invaded surrounding structures. Masses from the anterior and superior mediastinum pose an anaesthetic challenge for airway and hemodynamic management. A 7-month-old male child presented with a progressively growing mass over the left anterior chest wall for one month, about 4x4 cm, with diffuse margins and now expanded to involve the root of the neck and into the axilla. The patient was free from any apparent systemic illness. The breathing difficulty worsened in the past week with noisy respiration associated with feeding difficulty and hence sought medical admission to the paediatrics emergency unit. In conclusion, such huge mediastinal masses are managed better under spontaneous ventilation with an adequate surgical depth of anaesthesia to maintain appropriate respiratory compliance and necessitate lower peak inspiratory pressure. Given rare cases reported in the literature, similar topics would help choose the modus of ventilation and their safe management.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 4","pages":"358-361"},"PeriodicalIF":0.5,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10440486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10103469","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":"Atrial Fibrillation and Perioperative Inflammation (FIBRILLAMMED Study): A Retrospective Analysis of the Predictive Role of Preoperative Albumin-Adjusted Platelet-Leukocytic Indices in OPCABG.","authors":"Rohan Magoon,&nbsp;Iti Shri,&nbsp;Ramesh C Kashav,&nbsp;Souvik Dey,&nbsp;Jasvinder K Kohli,&nbsp;Vijay Grover,&nbsp;Vijay Gupta","doi":"10.4274/TJAR.2023.22995","DOIUrl":"https://doi.org/10.4274/TJAR.2023.22995","url":null,"abstract":"<p><strong>Objective: </strong>New-onset atrial fibrillation (NOAF), an important postoperative complication, has pertinent inflammatory links. Motivated by the encouraging literature on the prognostic role of hypoalbuminemia, leukocytic indices [LIs: neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR)], systemic inflammation response index (SIRI=NLR×monocyte) and platelet-leukocytic indices [PLIs: platelet-to-lymphocyte ratio (PLR)], systemic immune inflammation index (SII=NLR×platelet), aggregate index of systemic inflammation (AISI=NLR×platelet×monocyte), we sought to investigate the NOAF-predictive value of preoperative albumin-adjusted indices (aa-LIs and aa-PLIs) in an off-pump coronary artery bypass grafting (OPCABG) setting.</p><p><strong>Methods: </strong>Of 899 patients, 151 patients (16.79%) developed the primary outcome i.e. NOAF that was analyzed further retrospectively for its predictors instead of the highlighted text perioperative data of 899 patients undergoing elective OPCABG, were retrospectively analyzed. The study participants were categorized into non-NOAF and NOAF groups (defined as new-onset atrial arrhythmia with irregular RR interval with indistinct <i>P</i> wave in the first week postoperatively).</p><p><strong>Results: </strong>One hundred and fifty-one patients (16.79%) developed NOAF. On univariate analysis: age, smoker status, The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, systemic hypertension, diabetes mellitus, prior congestive heart failure (CHF), and a higher preoperative NLR, PLR, SII, and albumin were significant predictors of NOAF. While age, CHF, and EuroSCORE II retained predictive significance in multivariate analysis, LI-PLIs and albumin did not emerge as independent NOAF predictors. Notably, aa-NLR, aa-PLR, and aa-SII independently predicted NOAF on the computation of model-estimates in the regression analysis (Odds ratio; 95% confidence interval: 31.05;15.75-70.61, 1.04;1.02-1.05, 1.12;1.10-1.14, respectively, <i>P</i> < 0.001). aa-NLR ≥1.32, aa-PLR ≥52.64, and aa-SII ≥344.38 predicted NOAF with the respective AUC;sensitivity;specificity of 0.66;63.6%;73.3%, 0.63;66.2%;59.0%, and 0.65;58.3%;78.2%. Preoperative aa-NLR, aa-PLR and aa-SII also positively correlated with CHA₂DS₂-VASc score (R=0.40, 0.45 and 0.42; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The independent NOAF predictive value of aa-NLR, aa-PLR, and aa-SII reiterates the inflammatory relationship of the arrhythmic complication following OPCABG.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 4","pages":"331-340"},"PeriodicalIF":0.5,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10440484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10402951","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 Intrathecal Morphine on Postdural Puncture Headache in Obstetric Anaesthesia.","authors":"Meryem Onay,&nbsp;Sema Şanal Baş,&nbsp;Arda Işıker,&nbsp;Ümit Akkemik,&nbsp;Ayten Bilir","doi":"10.4274/TJAR.2023.221140","DOIUrl":"https://doi.org/10.4274/TJAR.2023.221140","url":null,"abstract":"<p><strong>Objective: </strong>Intrathecal morphine is used as an effective component of multimodal analgesia in postoperative analgesia in cesarean section patients. We aimed to analyze the relationship between intrathecal morphine administration and postdural puncture headache (PDPH), pain score and analgesia consumption in the postoperative period, and maternal fetal effects.</p><p><strong>Methods: </strong>One hundred four pregnant women aged ≥18 years (American Society of Anesthesiology physical status I or II, >36 weeks gestation) who were scheduled for elective cesarean section under spinal anaesthesia were included in this study. Spinal anesthesia consisted of bupivacaine with or without morphine (Group M: 10 mg heavy marcaine + 25 mcg fentanyl + 100 mcg morphine; Group F: 10 mg heavy marcaine + 25 mcg fentanyl). The effect of intrathecal morphine on PDPH, postoperative pain score, analgesia consumption, and maternal and fetal effects were recorded for 5 days.</p><p><strong>Results: </strong>PDPH developed in a total of 33 patients (Group M: 18 and Group F: 15, <i>P</i>=0.274). When we evaluated PDPH with the VAS, there was no significant difference between the groups. The postoperative visual analogue scale (VAS) was lower in the morphine group, and no statistically significant difference was found in the VAS 1^st hr and VAS 2^nd hr, whereas the VAS 6^th hr and VAS 24^th hr were found to be statistically significant. There was no difference in terms of PDPH, the first analgesic requirement and postoperative nausea-vomiting, but meperidine consumption was lower in the morphine group.</p><p><strong>Conclusion: </strong>Low-dose intrathecal morphine did not affect the incidence of PDPH. It is an effective method that can be used in cesarean section patients without increasing the maternal and fetal side effects from postoperative analgesia.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 4","pages":"297-303"},"PeriodicalIF":0.5,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10440479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10402955","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}