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Anesthesiologists’ approach to the treatment of catheter related bladder discomfort: A survey study 麻醉医师治疗导管相关性膀胱不适的方法:一项调查研究
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5222/jarss.2021.60566
Ü. C. Köksoy, Z. K. Bengisun, H. Yılmaz, B. K. Kazbek, F. Tüzüner
INTRODUCTION: Urinary catheterization causes catheter related bladder discomfort (CRBD) in the early postoperative period following all surgeries. CRBD mostly develops after urological interventions and has two independent predictors: Male gender and urinary catheters ≥ 18F. We aimed to investigate the awareness of anesthesiology and reanimation specialists to CRBD and its treatment. METHODS: After ethics committee approval, a questionnaire with informed consent of 20 multiple-choice and open-ended questions was transferred to docs.google.com. and Turkish Society of Anesthesiology and Reanimation Specialists were contacted for contribution. RESULTS: 144 anesthesiologists, 26-66 years old (39.5±8.02 years), 54.5% males, 45.5% females, 66.4% with a teaching position and 55.5% with >10 years of experience participated. 54.4% reported encountering >1 CRBD per week and mostly following urology (70.9%), obstetrics and gynecology (52.5%) and general surgery (51.1%) cases. The frequency and severity (66% and 69.5%) of CRBD was reported higher in male patients. 94.4% agreed that CRBD should be treated. 37.8% believed the surgeon should manage CRBD, 60.1% believed it should be planned together. All male participants stated treatment was necessary (p=0.008). Participants chose preemptive (19.9%, n=28), symptomatic (80.1%, n=113) or both (4.3%, n=6) treatments. The choices for preemptive and symptomatic treatment were similar; non-steroidal anti-inflammatory drugs (70.8%, 59%), paracetamol (43.4%, 50.7%) and tramadol (18.9%, 21.6%). Participants’ knowledge on factors effecting CRBD was lacking. DISCUSSION AND CONCLUSION: Anesthesiologists do not utilize preemptive and effective treatment for CRBD; one thirds of them do not consider it their responsibility. Anesthesiologists should be aware of CRBD and participate in the treatment using multimodal approaches.
导尿在所有手术后早期都会引起导管相关性膀胱不适(CRBD)。CRBD主要发生在泌尿外科干预后,有两个独立的预测因素:男性和导尿管≥18F。我们的目的是调查麻醉和复苏专家对CRBD及其治疗的认识。方法:经伦理委员会批准后,将一份包含20个选择题和开放式问题的知情同意问卷转移至docs.google.com。和土耳其麻醉学和复苏专家协会进行了联系,征求他们的意见。结果:144名麻醉医师参与调查,年龄26 ~ 66岁(39.5±8.02岁),男性占54.5%,女性占45.5%,66.4%为教学职称,55.5%为从业经验>10年。54.4%报告每周遇到>1例CRBD,主要是泌尿科(70.9%)、妇产科(52.5%)和普外科(51.1%)病例。CRBD的发生率和严重程度(66%和69.5%)在男性患者中较高。94.4%的人认为应该治疗CRBD。37.8%的人认为CRBD应由外科医生处理,60.1%的人认为CRBD应由外科医生共同计划。所有男性受试者均表示治疗是必要的(p=0.008)。参与者选择先发制人(19.9%,n=28)、对症治疗(80.1%,n=113)或两者兼而有之(4.3%,n=6)。先发制人和对症治疗的选择相似;非甾体类抗炎药(70.8%,59%)、扑热息痛(43.4%,50.7%)、曲马多(18.9%,21.6%)。参与者对影响CRBD的因素缺乏认识。讨论与结论:麻醉医师对CRBD不采用先发制人的有效治疗;三分之一的人不认为这是他们的责任。麻醉师应了解CRBD,并参与多模式治疗。
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引用次数: 0
Perioperative Complications And Concomitant Diseases Of Patients Followed In Intensive Care Unit After Cleft Lip-Palate Surgery 唇腭裂术后重症监护病人围手术期并发症及伴随疾病分析
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5222/JARSS.2021.85856
M. Tümer, A. Ayyıldız, Başak Akça, A. Yilbas, F. Uzumcugil, O. Canbay
INTRODUCTION: Cleft lip/palate (CLCP) patients might need postoperative care in Intensive Care Unit (ICU) due to several reasons like difficult airway management, associated abnormalities and perioperative respiratory complications. Our aim was to evaluate the factors associated with difficult airway and need for postoperative ICU follow-up in CLCP patients operated in our institution. METHODS: CLCP patients followed in ICU after surgery between 2005-2013 were retrospectively reviewed. RESULTS: Twenty patients were included to the study. Ten had CLCP together, ten had isolated cleft palate. Difficult intubation was seen in 8 patients. Difficult mask ventilation was seen only in one patient with 22q11 deletion. All patients with difficult intubation had micrognathia. Nasal fiberoptic bronchoscopy was more commonly used in patients with difficult intubation. There was a statistically significant relationship between the presence of any systemic disease and difficult intubation. Main reasons for ICU follow-up were the need for close monitoring and airway related problems. DISCUSSION AND CONCLUSION: Difficult airway is a frequent problem in CLCP patients even in the absence of a diagnosed syndrome. Patients with difficult airway or risk of postoperative airway obstruction could be better followed in ICU during early postoperative period for rapid diagnosis and treatment of possible complications by experienced staff.
摘要:唇腭裂(CLCP)患者由于气道管理困难、相关异常和围手术期呼吸并发症等原因,可能需要在重症监护病房(ICU)进行术后护理。我们的目的是评估在我院手术的CLCP患者气道困难的相关因素和术后ICU随访的必要性。方法:回顾性分析2005-2013年在ICU随访的CLCP患者。结果:20例患者纳入研究。10例合并CLCP, 10例孤立性腭裂。8例患者插管困难。只有1例22q11缺失患者出现口罩通气困难。插管困难患者均有小颌畸形。鼻纤维支气管镜更常用于插管困难的患者。任何系统性疾病的存在与插管困难之间存在统计学上显著的关系。ICU随访的主要原因是需要密切监测和气道相关问题。讨论与结论:即使在没有诊断综合征的CLCP患者中,气道困难也是一个常见的问题。对于有气道困难或术后有气道梗阻风险的患者,术后早期应在ICU进行随访,由经验丰富的医护人员对可能出现的并发症进行快速诊断和治疗。
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引用次数: 2
The Effect Of Intraoperative Restrictive Fluid Therapy On Postoperative Outcomes In Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy 术中限制性液体治疗对腹腔高温化疗患者术后预后的影响
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5222/jarss.2021.93063
H. Özay, N. Salman, Demet Bölükbaşı, Perihan Kemerci, Aslı demirci, Ü. Karadeniz
INTRODUCTION: Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRC) are effective multimodal treatment options in patients with peritoneal carcinomatosis. Procedures are long-lasting operations with excessive blood and fluid loss. Intraoperative fluid management is very important because of major hemodynamic, respiratory and metabolic changes. This study aims to investigate the effect of intraoperative restrictive fluid therapy on postoperative outcome in patients undergoing HIPEC and SRS. METHODS: Patients who underwent HIPEC and SRS in our clinic between 2014-2018 were included in the study. The demographic, intraoperative and postoperative data of all patients were retrospectively analyzed. The patients who underwent restrictive fluid replacement were named Group R, and the group with liberal fluid replacement was named Group L. RESULTS: It was observed that the mean age was 54.6 ± 11.4 years, the female gender was 60.5% and the malignancy originating from the gastrointestinal system was 76.3%. There was no effect of liberal and restrictive fluid treatments on postoperative minor and major complications, length of stay in hospital and intensive care, and mortality. DISCUSSION AND CONCLUSION: We concluded that intraoperative restrictive fluid therapy did not affect postoperative complications and mortality in HIPEC and SRS surgeries.
腹膜内高温化疗(HIPEC)和细胞减少手术(CRC)是腹膜癌患者有效的多模式治疗选择。手术是长时间的手术,有大量的血液和液体流失。术中液体管理是非常重要的,因为主要的血流动力学,呼吸和代谢的变化。本研究旨在探讨术中限制性液体治疗对HIPEC和SRS患者术后预后的影响。方法:2014-2018年间在我院接受HIPEC和SRS治疗的患者纳入研究。回顾性分析所有患者的人口学、术中及术后资料。限制性补液组命名为R组,自由补液组命名为l组。结果:患者平均年龄54.6±11.4岁,女性占60.5%,胃肠道恶性肿瘤占76.3%。自由和限制性液体治疗对术后轻微和严重并发症、住院时间和重症监护时间以及死亡率没有影响。讨论和结论:我们得出结论,术中限制性液体治疗不会影响HIPEC和SRS手术的术后并发症和死亡率。
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引用次数: 0
Analgesic Efficacy and Safety of Dexmedetomidine as an Adjuvant to Caudal Levobupivacaine for Infraumbilical Surgeries in Children 右美托咪定辅助左旋布比卡因用于儿童脐下手术的镇痛疗效和安全性
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5222/jarss.2021.84756
Amanjot Singh, K. Gupta, A. Kaur, Haramritpal Kaur
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引用次数: 0
Comparison of Endotracheal Intubation Successes with Macintosh, Glidescope and Airtraq Laryngoscopes Macintosh、Glidescope和Airtraq喉镜气管插管成功率的比较
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5222/jarss.2021.05025
Tuna Ertürk, Hasan Ömür Özkan, G. İnangil, Fuat Gürbüz, S. Özkan
Objective: Successful airway management is the primary and most crucial step required for patient safety in anesthetic application. Due to the increase in the variety of materials used for ventilation and intubation in recent years, successful airway management has become more advantageous in difficult airway management. The development of Glidescope and Airtraq laryngoscopes are used as alternative laryngoscopy devices. The aim of the present prospective randomized study is to compare superiority of the success of endotracheal intubation performed with Macintosh, Glidescope and Airtraq laryngoscopes in terms of Cormack-Lehane laryngoscopic classification, intubation duration, number of attempts, and use of facilitating maneuvers required for intubation. Methods: Totally 180 patients over 18 years of age, in ASA I-II physiological risk group, who would undergo elective surgery were included in the study. The patients were randomly divided into three groups. Cormack-Lehane laryngoscopic classification, intubation duration, number of intubation attempts, facilitating maneuvers required for intubation, and complications related to intubation were recorded and compared in patients who were intubated with Macintosh laryngoscope in Group-A, Glidescope laryngoscope in Group-B, and Airtraq laryngoscope in Group-C. Results: It was found that demographic data were similar between groups. Cormack-Lehane laryngoscopic score, intubation duration, number of attempts and use of facilitating maneuver parameters of the Glidescope and Airtraq laryngoscope groups were similar and superior to the Macintosh group. In terms of intubation success rates and complications related to intubation, the frequency of the Macintosh laryngoscope group was similar to the Glidescope and Airtraq laryngoscope groups. Conclusion: According to the result of the study, it was concluded that Glidescope and Airtraq laryngoscopes provide a better view of glotis and ease intubation compared to Macintosh laryngoscope. However, we did not find any difference in intubation success and complication rates between the groups.
目的:成功的气道管理是麻醉应用中患者安全的首要和最关键的一步。近年来,由于通气和插管所用的材料越来越多,成功的气道管理在困难的气道管理中变得更加有利。Glidescope和Airtraq喉镜的发展被用作替代喉镜检查设备。本前瞻性随机研究的目的是比较Macintosh、Glidescope和Airtraq喉镜在Cormack-Lehane喉镜分类、插管时间、尝试次数和插管所需便利操作的使用方面的优势。方法:选取180例年龄在18岁以上ASA I-II型生理危险组的择期手术患者作为研究对象。患者随机分为三组。记录a组采用Macintosh喉镜、b组采用Glidescope喉镜、c组采用Airtraq喉镜插管患者的Cormack-Lehane喉镜分类、插管时间、插管次数、插管所需的辅助操作及插管相关并发症。结果:组间人口统计数据相似。Glidescope和Airtraq喉镜组的Cormack-Lehane喉镜评分、插管时间、插管次数和便利操作参数的使用与Macintosh组相似且优于Macintosh组。在插管成功率和插管相关并发症方面,Macintosh喉镜组的频率与Glidescope和Airtraq喉镜组相似。结论:与Macintosh喉镜相比,Glidescope喉镜和Airtraq喉镜能更好地观察声门,便于插管。然而,我们没有发现两组间插管成功率和并发症发生率有任何差异。
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引用次数: 0
A Prospective Randomized Study to Evaluate and Compare ILMA and Air-Q Intubating Laryngeal Airway 一项评价和比较ILMA和Air-Q气管插管的前瞻性随机研究
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5222/jarss.2021.59454
Reema Wadhawa, Anisha Singh, A. Bhalotra, V. Chugh
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引用次数: 0
Comparison of Rebound Pain and Postoperative Tramadol Requirement in Patients Who Had Femoral Nerve Block or Adductor Canal Block for Pain After Total Knee Arthroplasty 全膝关节置换术后行股神经阻滞或内收管阻滞治疗疼痛患者的反跳性疼痛和术后曲马多需求的比较
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5222/jarss.2021.60590
Yusuf Özgüner, A. Alptekin
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引用次数: 0
Von Willebrand Hastalığı Olan Üç Gebenin Anestezi Yönetimi
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5222/jarss.2021.60490
Gozde Inan, Naciye Turk Ozterlemez, Melis Altuğ, Dudu Berrin Günaydın
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引用次数: 1
The Role of Education in Reducing the Disposal Costs of Anesthesia-Related Medical Wastes 教育在降低麻醉相关医疗废物处置成本中的作用
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5222/jarss.2021.63935
G. Keskin, A. Dönmez
INTRODUCTION: Although it constitutes a small part of the general waste, medical waste management is important both due to its environmental impact and its cost. Creating education and awareness on reducing the amount of medical waste and increasing the amount of waste-recycling are some of the most important steps. The primary purpose of the study is to determine the role of education in reducing the cost of medical waste belonging to anesthesia, and the secondary purpose is to provide data for the development of educational materials used. METHODS: The anesthesia wastes of 22 operating rooms and 3 PACU were evaluated.Anesthetic wastes were collected and weighed at the end of the day without informing 26 anesthesiologists, 37 anesthesia technicians, and 30 anesthesia assistants.On the 2nd day, the education video link was shared with the participants, and afterwards they were asked to watch and answer the questionnaire prepared.The wastes were collected and weighed again after the training.The approximate annual saving cost was calculated over the medical waste disposal cost, which was determined as 3.50 ₺kg-1 (excluding VAT). RESULTS: The amount of anesthesia waste obtained from 22 operating rooms and 3 PACU was 36.90 kg for 57 cases before training, and 43.36 kg for 64 cases after training.The amount of medical waste was weighed as 461.2 g per case before the training, and 453.8 g per case after the training.It was observed that although not statistically significant, the amount of medical waste decreased (p=0.949).The cost of medical waste disposal decreased by 1.6%. It was learned that 51.3% of the anesthesia team had received training before, and 60.4% benefited from the training provided. DISCUSSION AND CONCLUSION: With education, the amount of medical waste can be reduced.Although there is awareness about waste classification in our clinic, we believe that regular training should be done to reduce the amount of medical waste.
导言:虽然医疗废物只占一般废物的一小部分,但由于其环境影响和成本,医疗废物管理很重要。开展关于减少医疗废物数量和增加废物回收数量的教育和认识是一些最重要的步骤。本研究的主要目的是确定教育在降低麻醉医疗废物成本方面的作用,次要目的是为开发使用的教育材料提供数据。方法:对22间手术室和3间PACU的麻醉浪费进行评价。在不通知26名麻醉医师、37名麻醉技术人员和30名麻醉助理的情况下,收集麻醉废物并在一天结束时称重。第2天,与参与者分享教育视频链接,然后让他们观看并回答准备好的问卷。训练结束后,收集废物并再次称重。大约每年节省的成本是根据医疗废物处理成本计算的,该成本被确定为3.50价格(不含增值税)。结果:22间手术室和3个PACU的麻醉浪费量训练前57例为36.90 kg,训练后64例为43.36 kg。培训前的医疗废物重量为每箱461.2 g,培训后的医疗废物重量为每箱453.8 g。观察发现,虽然没有统计学意义,但医疗废物的数量有所减少(p=0.949)。医疗废物处置成本下降1.6%。据了解,51.3%的麻醉团队之前接受过培训,60.4%的麻醉团队从培训中受益。讨论与结论:通过教育,可以减少医疗废物的数量。虽然我们诊所对废物分类有一定的认识,但我们认为应该定期进行培训,以减少医疗废物的数量。
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引用次数: 0
Impact of COVID-19 pandemic on the management of blood supply and demand in Turkey 2019冠状病毒病大流行对土耳其血液供需管理的影响
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5222/jarss.2021.62534
B. Tezcan
INTRODUCTION: Coronovirus disease(COVID-19)rapidly spread worldwide after its first report in December 2019,in China.This spread drastically reduced the number of blood donations,thereby creating a shortage at blood banks in the whole world.Turkish Red Crescent(TRC) is the only legal authority that organizes collection,production,storage and distribution of blood and blood components in Turkey.Only in case of emergencyTRC gives permanent permission to hospitals;for collecting blood and producing its components through their own transfusion centers.This report describes how theCOVID-19 impacted blood supplies ofTRC and hospital demands in Turkey with an aim to improve the management of blood supply and demand during theCOVID-19 and future pandemics. METHODS: A cross-sectional study was conducted for a period of nine months;from November 1,2019 to July 31,2020.Data were retrospectively obtained from donor attendance and blood inventory records ofTRC and included;1)the number of donated units of apheresis platelet concentrates(APC) and blood toTRC,2)the number of units ofAPC and erythrocyte suspensions(ES) supplied by the hospitals themselves,3)the number of units of APC andES supplied to hospitals by TRC(APCHandESH).The periods before(first period) and after(third period)arrival of COVID-19 to Turkey are compared. RESULTS: An increase of 52%in the number of APCdonations,but a decrease of 22% in the number of blood donations(NBD) were detected in the third period compared to the first one.Mean APCH were 7081±550 and5121±255 units in the first and third periods,respectively.The mean ESH in the first period was 873±326 units,while it was3694±3143 units in the third period. DISCUSSION AND CONCLUSION: It is obvious that we have learnt many lessons from theCOVID-19 pandemic,like how to face challenges in maintaining the balance between blood demandandblood supply.Utilizing media to encourage donors and implementation of PatientBloodManagement on national and institutional levels may be some some of the key components of a comprehensive strategy.The collaboration ofMinistry of Health,TRC and hospitalswassuccessful in securing a balance between blood supply and demand in Turkey,which COVID-19 pandemic impacted significantly.
导语:2019年12月,冠状病毒病(COVID-19)在中国首次报告后,迅速在全球传播。这种传播大大减少了献血的数量,从而造成全世界血库的短缺。土耳其红新月会是在土耳其组织血液和血液成分收集、生产、储存和分发的唯一合法机构。只有在紧急情况下,trc才允许医院通过自己的输血中心采集血液和生产血液成分。本报告描述了2019冠状病毒病如何影响土耳其医疗中心的血液供应和医院需求,旨在改善2019冠状病毒病和未来大流行期间的血液供应和需求管理。方法:横断面研究于2019年11月1日至2020年7月31日进行,为期9个月。回顾性分析TRC的献血者出勤记录和血液库存记录,包括:1)单采血小板浓缩液(APC)和血液捐献单位数,2)医院自行提供的APC和红细胞悬液(ES)单位数,3)TRC向医院提供的APC和红细胞悬液(APCHandESH)单位数。比较了2019冠状病毒病抵达土耳其之前(第一期)和之后(第三期)的情况。结果:第三期apc献血次数较第一期增加52%,而献血次数(NBD)较第一期减少22%。第一期和第三期平均APCH分别为7081±550和5121±255单位。第一期平均ESH为873±326单位,第三期平均ESH为3694±3143单位。讨论与结论:很明显,我们从2019冠状病毒病大流行中吸取了许多教训,例如如何面对维持血液供需平衡的挑战。利用媒体鼓励献血者并在国家和机构层面实施患者血液管理可能是一项综合战略的一些关键组成部分。在受到COVID-19大流行严重影响的土耳其,卫生部、TRC和医院的合作在确保血液供需平衡方面取得了成功。
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引用次数: 1
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Anestezi Dergisi
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