Pub Date : 2023-04-28DOI: 10.54875/jarss.2023.26122
Nejdiye Gungordu, Hazal Cansu Çulpan, H. Yılmaz Ak, Yasemin Ozsahin, Seher Kurtul, A. Nizamoğlu, Y. Dikmen, Fatiş Altındaş, M. S. Erdoğan
Objective: Anesthesia healthcare workers work under more intense hazard, risk and excessive workload specific to their field, in addition to the problems of other healthcare workers. This study aims to identify perception of occupational risks in the working environment, knowledge about occupational health and safety (OHS), and the use of personal protective equipment in the working environment among the anesthesia healthcare workers. Methods: This descriptive study was conducted with 153 anesthesia healthcare workers. The healthcare workers participating in the study were divided into 2 groups according to their work: physicians and non-physician healthcare workers. The questionnaire included sociodemographic, knowledge about occupational risks and Occupational Health and Safety Law (OHSL), use of personal protective equipment and knowledge of OHS in the institution questions. Results: The frequencies of the working conditions and professional practice areas of the group of doctors being not ergonomically appropriate (p=0.005), insufficient lighting (p=0.001), insufficient heat (p<0.015), chemical agent exposure (p=0.024), ionizing radiation exposure (p=0.003), exposure to biological agents (p=0.022), exposure to psychological risk factors (p=0.017) were found to be statistically significantly higher. In this study, it was found that the perception of working environment conditions and occupational risk factors was higher in doctors, and their knowledge of OHSL and OHS practices in the institution was higher in the non-physician group. Conclusion: The OHS trainings received by the health care workers were effective for the results. Increasing knowledge about occupational risks and preventive measures against them can reduce the incidence and consequences of possible occupational diseases. Keywords: Anesthesia, occupational health, occupational safety
{"title":"Evaluation of Perception, Knowledge and Attitudes of Anesthesia Healthcare Workers on Occupational Health and Safety","authors":"Nejdiye Gungordu, Hazal Cansu Çulpan, H. Yılmaz Ak, Yasemin Ozsahin, Seher Kurtul, A. Nizamoğlu, Y. Dikmen, Fatiş Altındaş, M. S. Erdoğan","doi":"10.54875/jarss.2023.26122","DOIUrl":"https://doi.org/10.54875/jarss.2023.26122","url":null,"abstract":"Objective: Anesthesia healthcare workers work under more intense hazard, risk and excessive workload specific to their field, in addition to the problems of other healthcare workers. This study aims to identify perception of occupational risks in the working environment, knowledge about occupational health and safety (OHS), and the use of personal protective equipment in the working environment among the anesthesia healthcare workers. Methods: This descriptive study was conducted with 153 anesthesia healthcare workers. The healthcare workers participating in the study were divided into 2 groups according to their work: physicians and non-physician healthcare workers. The questionnaire included sociodemographic, knowledge about occupational risks and Occupational Health and Safety Law (OHSL), use of personal protective equipment and knowledge of OHS in the institution questions. Results: The frequencies of the working conditions and professional practice areas of the group of doctors being not ergonomically appropriate (p=0.005), insufficient lighting (p=0.001), insufficient heat (p<0.015), chemical agent exposure (p=0.024), ionizing radiation exposure (p=0.003), exposure to biological agents (p=0.022), exposure to psychological risk factors (p=0.017) were found to be statistically significantly higher. In this study, it was found that the perception of working environment conditions and occupational risk factors was higher in doctors, and their knowledge of OHSL and OHS practices in the institution was higher in the non-physician group. Conclusion: The OHS trainings received by the health care workers were effective for the results. Increasing knowledge about occupational risks and preventive measures against them can reduce the incidence and consequences of possible occupational diseases. Keywords: Anesthesia, occupational health, occupational safety","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44732250","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}
Pub Date : 2023-04-28DOI: 10.54875/jarss.2023.15010
Ummugulsum Gaygisiz, L. Karabıyık
Objective: High sound levels measured in intensive care units cause harmful effects on the health of patients and employees. In this context, the World Health Organization (WHO) recommends sound level values that are safe for health in hospitals. The aim of this study is to compare the sound levels measured before and after the training given to the employees, and to evaluate the sound levels measured in the intensive care unit according to the recommended safe values, retrospectively. Methods: In our unit, sound measurements were made with a noise analyzer (FLUKE model: Biotek: Biotek serial no: 6050274) from 17 different points of the unit at 14 different times per day. Unit employees are given training on the harms of noise and the success of the education is evaluated. In this study, based on the data obtained from the recordings, the 10-day sound level measurements before and after the education were compared. Based on data obtained from hospital records, ten-day sound level measurements before and after training were compared. Results: There was no difference between the measurements made at 17 points within the unit. For this reason, the mean of 17 measurement values was taken and the time-dependent changes of the data were analyzed. After the training, it was observed that there were significant decreases in the mean sound levels in the follow-up at night (p<0.05). However, all these values were above the safe threshold values recommended by WHO for hospitals. Conclusion: Although the behavioral changes provided by the training of the employees in our unit decreased the sound levels in our unit, they could not fall below the recommended safe threshold value. We concluded that safe values can be achieved by using sound reducing barriers in the design of the units and controlling all sources and devices that produce sound. Keywords: Intensive care, noise, training, sound level
{"title":"Retrospective Evaluation of the Effects of Staff Training on Sound Levels Measurements in the Intensive Care Unit","authors":"Ummugulsum Gaygisiz, L. Karabıyık","doi":"10.54875/jarss.2023.15010","DOIUrl":"https://doi.org/10.54875/jarss.2023.15010","url":null,"abstract":"Objective: High sound levels measured in intensive care units cause harmful effects on the health of patients and employees. In this context, the World Health Organization (WHO) recommends sound level values that are safe for health in hospitals. The aim of this study is to compare the sound levels measured before and after the training given to the employees, and to evaluate the sound levels measured in the intensive care unit according to the recommended safe values, retrospectively. Methods: In our unit, sound measurements were made with a noise analyzer (FLUKE model: Biotek: Biotek serial no: 6050274) from 17 different points of the unit at 14 different times per day. Unit employees are given training on the harms of noise and the success of the education is evaluated. In this study, based on the data obtained from the recordings, the 10-day sound level measurements before and after the education were compared. Based on data obtained from hospital records, ten-day sound level measurements before and after training were compared. Results: There was no difference between the measurements made at 17 points within the unit. For this reason, the mean of 17 measurement values was taken and the time-dependent changes of the data were analyzed. After the training, it was observed that there were significant decreases in the mean sound levels in the follow-up at night (p<0.05). However, all these values were above the safe threshold values recommended by WHO for hospitals. Conclusion: Although the behavioral changes provided by the training of the employees in our unit decreased the sound levels in our unit, they could not fall below the recommended safe threshold value. We concluded that safe values can be achieved by using sound reducing barriers in the design of the units and controlling all sources and devices that produce sound. Keywords: Intensive care, noise, training, sound level","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47816803","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}
Pub Date : 2023-04-28DOI: 10.54875/jarss.2023.47560
Hüseyin Yilmaz, B. K. Kazbek, Ulku Ceren Koksoy, P. Ekmekci, T. Çandar, Mehmet Ali Yavuzekinci, F. Tuzuner
Objective: Laryngoscopy and intubation cause hypertension, tachycardia and arrhythmia. Ischemia modified albumin (IMA) is formed secondary to endothelial or extracellular hypoxia, acidosis and free oxygen radicals and can be detected in the early stages of ischemia. In this study, we aimed to compare the effects of two agents on preventing hypertension and tachycardia by measuring IMA levels. Methods: Following ethics approval and randomization, dexmedetomidine 0.5 μg kg-1 in Group D (n=21) or esmolol 0.5 mg kg-1 in Group E (n=21) diluted in 20 mL saline was given as infusion for 5 minutes prior to induction. Patients in Group C (n=21) received only 20 mL saline infusion. An automated perfusor was set at 4 mL min-1 for the delivery of study solutions. Blood samples for IMA measurement were taken following monitorization and at 10th and 20th minutes after intubation. Results: There was no statistically significant difference concerning IMA levels at 10 minutes following intubation. However, IMA levels in Group C were significantly lower compared to Group E and Group D (p=0.025 and 0.015 respectively) at 20 minutes. There was no significant difference between Group E and Group D (p=0.980). In Group D and E, a significant drop in systolic, diastolic and mean arterial pressures compared to baseline was observed after the study drugs were given. Groups were similar in terms of heart rate in the first 5 minutes however Groups E and D had lower heart rates compared to Group C starting from the 6th minute until the end of study period. Conclusion: Inhibiton of hemodynamic response to intubation may have negative results, and pharmacological interventions for this should be carried out with caution in critical patients and close hemodynamic monitorization should be kept in mind. Keywords: Dexmedetomidine, esmolol, ischemia-modified serum albumin
{"title":"The Effect of Pre-Intubation Esmolol and Dexmedetomidine on Ischemia Modified Albumin Levels: A Prospective Randomized Trial","authors":"Hüseyin Yilmaz, B. K. Kazbek, Ulku Ceren Koksoy, P. Ekmekci, T. Çandar, Mehmet Ali Yavuzekinci, F. Tuzuner","doi":"10.54875/jarss.2023.47560","DOIUrl":"https://doi.org/10.54875/jarss.2023.47560","url":null,"abstract":"Objective: Laryngoscopy and intubation cause hypertension, tachycardia and arrhythmia. Ischemia modified albumin (IMA) is formed secondary to endothelial or extracellular hypoxia, acidosis and free oxygen radicals and can be detected in the early stages of ischemia. In this study, we aimed to compare the effects of two agents on preventing hypertension and tachycardia by measuring IMA levels. Methods: Following ethics approval and randomization, dexmedetomidine 0.5 μg kg-1 in Group D (n=21) or esmolol 0.5 mg kg-1 in Group E (n=21) diluted in 20 mL saline was given as infusion for 5 minutes prior to induction. Patients in Group C (n=21) received only 20 mL saline infusion. An automated perfusor was set at 4 mL min-1 for the delivery of study solutions. Blood samples for IMA measurement were taken following monitorization and at 10th and 20th minutes after intubation. Results: There was no statistically significant difference concerning IMA levels at 10 minutes following intubation. However, IMA levels in Group C were significantly lower compared to Group E and Group D (p=0.025 and 0.015 respectively) at 20 minutes. There was no significant difference between Group E and Group D (p=0.980). In Group D and E, a significant drop in systolic, diastolic and mean arterial pressures compared to baseline was observed after the study drugs were given. Groups were similar in terms of heart rate in the first 5 minutes however Groups E and D had lower heart rates compared to Group C starting from the 6th minute until the end of study period. Conclusion: Inhibiton of hemodynamic response to intubation may have negative results, and pharmacological interventions for this should be carried out with caution in critical patients and close hemodynamic monitorization should be kept in mind. Keywords: Dexmedetomidine, esmolol, ischemia-modified serum albumin","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43762303","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}
Pub Date : 2023-04-28DOI: 10.54875/jarss.2023.83435
H. Acar
{"title":"Sir I. W. Magill; The Anaesthetist of President Celal Bayar’s Surgery in Gülhane Military Hospital","authors":"H. Acar","doi":"10.54875/jarss.2023.83435","DOIUrl":"https://doi.org/10.54875/jarss.2023.83435","url":null,"abstract":"","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46974578","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}
Pub Date : 2023-01-30DOI: 10.54875/jarss.2023.71473
G. Emmez, I. Gungor, T. Tezer, U. Kanatlı
Objective: Interscalene block (ISB) has become an accepted and effective technique of anesthetic and perioperative analgesia, in arthroscopic shoulder surgery. We aimed to retrospectively evaluate a series of patients who underwent arthroscopic shoulder surgery under combined ISB and general anesthesia. Methods: A retrospective chart review was performed consisting 641 patients who had ISB performed between June 2007 – January 2013 for success rates, side effects and complications. Results: The overall success rate of the blocks was 96.5%, with a mean postoperative analgesia time of 15.5 hours. While no patient suffered permanent nerve injury as a result of ISB, the most common complication noted in this analysis was local anesthetic-related convulsion, which occurred in only one patient. Conclusion: Interscalene block and general anesthesia combination, which provides high patient satisfaction with low side effects and complication profile, can be recommended for patients undergoing arthroscopic shoulder surgery. Keywords: Shoulder, arthroscopy, brachial plexus block, general anesthesia
{"title":"A Retrospective Analysis of the Analgesic and Adverse Effects of Interscalene Brachial Plexus Block During Arthroscopic Shoulder Surgery","authors":"G. Emmez, I. Gungor, T. Tezer, U. Kanatlı","doi":"10.54875/jarss.2023.71473","DOIUrl":"https://doi.org/10.54875/jarss.2023.71473","url":null,"abstract":"Objective: Interscalene block (ISB) has become an accepted and effective technique of anesthetic and perioperative analgesia, in arthroscopic shoulder surgery. We aimed to retrospectively evaluate a series of patients who underwent arthroscopic shoulder surgery under combined ISB and general anesthesia. Methods: A retrospective chart review was performed consisting 641 patients who had ISB performed between June 2007 – January 2013 for success rates, side effects and complications. Results: The overall success rate of the blocks was 96.5%, with a mean postoperative analgesia time of 15.5 hours. While no patient suffered permanent nerve injury as a result of ISB, the most common complication noted in this analysis was local anesthetic-related convulsion, which occurred in only one patient. Conclusion: Interscalene block and general anesthesia combination, which provides high patient satisfaction with low side effects and complication profile, can be recommended for patients undergoing arthroscopic shoulder surgery. Keywords: Shoulder, arthroscopy, brachial plexus block, general anesthesia","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42801790","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}
Pub Date : 2023-01-30DOI: 10.54875/jarss.2023.88942
A. Tas Tuna, H. Kocayiğit, Gürkan Demir, Ozcan Budak, M. S. Bostancı, H. Cakiroglu, D. B. Gunaydin
Objective: We aimed to evaluate the potential apoptotic effects of propofol, dexmedetomidine and medetomidine that were used during oocyte retrieval on cumulus cells in rat ovulation induction model. Methods: After the ovulation induction model was created, rats were received dexmedetomidine in Group D, propofol in Group P, medetomidine in Group M. Oocytes collection was performed 10 minutes after the administration of study drugs. For Caspase-3 immunohistochemical evaluation, the staining level was scored in five randomly selected areas and the areas with the highest score were determined. Immunohistochemical staining scoring for each section was performed using a scoring algorithm called H-score. Results: Caspase-3 expression in cumulus cells was found to be lowest in Group D and highest in Group P. The mean caspase-3 H-score was lower in Group D than that of Group P and M (p<0.001), and in Group M than that of Group P (p<0.001). Conclusion: Our results demonstrate that dexmedetomidine and medetomidine exhibit less apoptotic effects in terms of caspase-3 activity in oocyte cumulus cells than propofol in a rat ovulation induction model. Keywords: Apoptosis, cumulus cells, dexmedetomidine, medetomidine, propofol, oocyte retrieval
{"title":"Investigation of Apoptotic Effect of Propofol, Dexmedetomidine and Medetomidine on Oocyte Cumulus Granulosa Cells in Rats","authors":"A. Tas Tuna, H. Kocayiğit, Gürkan Demir, Ozcan Budak, M. S. Bostancı, H. Cakiroglu, D. B. Gunaydin","doi":"10.54875/jarss.2023.88942","DOIUrl":"https://doi.org/10.54875/jarss.2023.88942","url":null,"abstract":"Objective: We aimed to evaluate the potential apoptotic effects of propofol, dexmedetomidine and medetomidine that were used during oocyte retrieval on cumulus cells in rat ovulation induction model. Methods: After the ovulation induction model was created, rats were received dexmedetomidine in Group D, propofol in Group P, medetomidine in Group M. Oocytes collection was performed 10 minutes after the administration of study drugs. For Caspase-3 immunohistochemical evaluation, the staining level was scored in five randomly selected areas and the areas with the highest score were determined. Immunohistochemical staining scoring for each section was performed using a scoring algorithm called H-score. Results: Caspase-3 expression in cumulus cells was found to be lowest in Group D and highest in Group P. The mean caspase-3 H-score was lower in Group D than that of Group P and M (p<0.001), and in Group M than that of Group P (p<0.001). Conclusion: Our results demonstrate that dexmedetomidine and medetomidine exhibit less apoptotic effects in terms of caspase-3 activity in oocyte cumulus cells than propofol in a rat ovulation induction model. Keywords: Apoptosis, cumulus cells, dexmedetomidine, medetomidine, propofol, oocyte retrieval","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47297179","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}
Pub Date : 2023-01-30DOI: 10.54875/jarss.2023.92063
O. Miniksar, T. Honca, Aysegul Parlak Cikrikci, A. Gocmen
Objective: In this study, we aimed to investigate the relationship between vitamin D, frailty and postoperative outcomes in geriatric patients undergoing elective surgery. Methods: In this prospective observational study, a total of 90 elderly patients who had undergone non-cardiac surgery were included. The patients were classified according to the frailty index (FI) score as “Non-frail (FI 0), Pre-frail (FI 1–2) and Frail (FI ≥3)”. In addition, patients were divided into two groups according to serum vitamin D concentration: vitamin D insufficiency group (n=41) and vitamin D sufficiency group (n=49). Clinical characteristics and postoperative outcomes of the patients were compared between the groups. Results: The mean age of the patients was 75.7 ± 7.6 years, the admission rate to Intensive Care Unit (ICU) was 43.3%, and the 30-day mortality rate after surgery was 21.1%. The ICU admission was significantly higher in the “vitamin D insufficiency” group (n=24 versus n=15, p=0.014). In addition, fragility status patients were significantly higher in the “vitamin D insufficiency” group (n=19 versus n=7, p=0.004). Most of the non-frail patients were in the “vitamin D sufficiency” group (n=18 versus n=9). Conclusion: In our study, we observed higher frailty in vitamin D insufficiency patients. In addition, admission to the postoperative ICU was higher in vitamin D insufficiency and frail patients. Our findings show that frailty and vitamin D insufficiency play an important role in postoperative outcomes. Keywords: Vitamin D, frailty, geriatrics, intensive care unit
目的:在本研究中，我们旨在探讨维生素D、虚弱和老年患者择期手术后预后之间的关系。方法:本前瞻性观察研究共纳入90例接受过非心脏手术的老年患者。根据衰弱指数(FI)评分将患者分为“非虚弱(FI 0)、预虚弱(FI 1-2)和虚弱(FI≥3)”。根据血清维生素D浓度将患者分为维生素D不足组(n=41)和维生素D充足组(n=49)。比较两组患者的临床特点及术后结局。结果:患者平均年龄75.7±7.6岁，重症监护病房(ICU)住院率为43.3%，术后30天死亡率为21.1%。“维生素D不足”组ICU住院率显著高于“维生素D不足”组(n=24 vs n=15, p=0.014)。此外，脆弱状态患者在“维生素D不足”组中明显更高(n=19 vs n=7, p=0.004)。大多数非虚弱患者属于“维生素D充足”组(n=18对n=9)。结论:在我们的研究中，我们观察到维生素D不足患者的脆弱性更高。此外，术后ICU的住院率在维生素D不足和体弱患者中较高。我们的研究结果表明，虚弱和维生素D不足在术后结果中起着重要作用。关键词:维生素D，衰弱，老年病学，重症监护病房
{"title":"Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study","authors":"O. Miniksar, T. Honca, Aysegul Parlak Cikrikci, A. Gocmen","doi":"10.54875/jarss.2023.92063","DOIUrl":"https://doi.org/10.54875/jarss.2023.92063","url":null,"abstract":"Objective: In this study, we aimed to investigate the relationship between vitamin D, frailty and postoperative outcomes in geriatric patients undergoing elective surgery. Methods: In this prospective observational study, a total of 90 elderly patients who had undergone non-cardiac surgery were included. The patients were classified according to the frailty index (FI) score as “Non-frail (FI 0), Pre-frail (FI 1–2) and Frail (FI ≥3)”. In addition, patients were divided into two groups according to serum vitamin D concentration: vitamin D insufficiency group (n=41) and vitamin D sufficiency group (n=49). Clinical characteristics and postoperative outcomes of the patients were compared between the groups. Results: The mean age of the patients was 75.7 ± 7.6 years, the admission rate to Intensive Care Unit (ICU) was 43.3%, and the 30-day mortality rate after surgery was 21.1%. The ICU admission was significantly higher in the “vitamin D insufficiency” group (n=24 versus n=15, p=0.014). In addition, fragility status patients were significantly higher in the “vitamin D insufficiency” group (n=19 versus n=7, p=0.004). Most of the non-frail patients were in the “vitamin D sufficiency” group (n=18 versus n=9). Conclusion: In our study, we observed higher frailty in vitamin D insufficiency patients. In addition, admission to the postoperative ICU was higher in vitamin D insufficiency and frail patients. Our findings show that frailty and vitamin D insufficiency play an important role in postoperative outcomes. Keywords: Vitamin D, frailty, geriatrics, intensive care unit","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46879803","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}
Pub Date : 2023-01-30DOI: 10.54875/jarss.2023.67799
H. Bilgin, Seda Cansabuncu
Tissue damage and inflammation-induced nociception during surgery are the primary reasons for administering general anesthesia to the patient. During general anesthesia, analgesics inhibit autonomic and somatic responses, hypnotic agents prevent awareness, and neuromuscular blocking agents inhibit reflex movements. Careful monitoring of the effects of general anesthesia is necessary to avoid over- or under-dosing of anesthetics and thus to prevent associated complications and adverse effects. In general, hemodynamic parameters have been used to guide the intraoperative administration of analgesics such as opioids, but hemodynamic parameters are not standardized and cannot always provide a clear assessment. There is growing interest in techniques that can objectively monitor the analgesic component of anesthesia to achieve an appropriate balance of nociception and anti-nociception and to guide analgesic administration. The purpose of this review is to provide information about nociception monitoring techniques, which are increasingly used in clinical practice. Keywords: General anesthesia, nociception, anti-nociception, monitoring
{"title":"Nociception Monitoring","authors":"H. Bilgin, Seda Cansabuncu","doi":"10.54875/jarss.2023.67799","DOIUrl":"https://doi.org/10.54875/jarss.2023.67799","url":null,"abstract":"Tissue damage and inflammation-induced nociception during surgery are the primary reasons for administering general anesthesia to the patient. During general anesthesia, analgesics inhibit autonomic and somatic responses, hypnotic agents prevent awareness, and neuromuscular blocking agents inhibit reflex movements. Careful monitoring of the effects of general anesthesia is necessary to avoid over- or under-dosing of anesthetics and thus to prevent associated complications and adverse effects. In general, hemodynamic parameters have been used to guide the intraoperative administration of analgesics such as opioids, but hemodynamic parameters are not standardized and cannot always provide a clear assessment. There is growing interest in techniques that can objectively monitor the analgesic component of anesthesia to achieve an appropriate balance of nociception and anti-nociception and to guide analgesic administration. The purpose of this review is to provide information about nociception monitoring techniques, which are increasingly used in clinical practice. Keywords: General anesthesia, nociception, anti-nociception, monitoring","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42625490","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}
Pub Date : 2023-01-30DOI: 10.54875/jarss.2023.87059
Omur Ilban, F. Şimşek
Objective: Platelets play an important role in cases of inflammation and infection, along with in the hemostatic process. The aim of study is to evaluate prognostic efficiency of platelet count (PC), mean platelet volume (MPV) and MPV/PC for mortality prediction in patients with ventilator-associated pneumonia (VAP). Methods: A total of 150 VAP patients were divided into two groups as Survivors (n=98) and Non-survivors (n=52) according to intensive care unit mortality. The PC and MPV on days 1 and 4 of VAP were evaluated. Results: Thirty (31%) patients in the survivors group and 35 (67%) patients in the non-survivor group had thrombocytopenia, respectively (p<0.05). The non-survivor group had higher MPV and a higher MPV/PC on the 1st and 4th days, while the survivor group had higher PC levels, respectively (p<0.05). Platelet count, MPV and MPV/PC had the highest AUC levels at day 4 (0.68, 0.80, 0.73, respectively). The prognostic values of day 4 MPV and MPV/PC measurements were similar (p=0.17). Day 4 PC were found to be negatively correlated with mortality (adjusted hazard ratio (aHR): 0.91, p=0.01). Day 4 MPV and MPV/PC values were the independent mortality predictors (aHR: 2.59, p<0.01 and aHR: 1.63, p=0.01). The survival probability of VAP patients with <9.25 fL of MPV day 4 was significantly higher than those with ≥9.25 fL (p=0.002, log-rank test) Conclusion: In addition to thrombocytopenia, MPV and MPV/PC are useful predictors of poor outcomes. Changes in MPV responses may be a more useful prognostic assessment tool for VAP patients than PC. Keywords: Immune response, mean platelet volume, platelets, prognosis, ventilator-associated pneumonia
{"title":"Prognostic Significance of Platelet and Mean Platelet Volume Kinetics for Ventilator-Associated Pneumonia","authors":"Omur Ilban, F. Şimşek","doi":"10.54875/jarss.2023.87059","DOIUrl":"https://doi.org/10.54875/jarss.2023.87059","url":null,"abstract":"Objective: Platelets play an important role in cases of inflammation and infection, along with in the hemostatic process. The aim of study is to evaluate prognostic efficiency of platelet count (PC), mean platelet volume (MPV) and MPV/PC for mortality prediction in patients with ventilator-associated pneumonia (VAP). Methods: A total of 150 VAP patients were divided into two groups as Survivors (n=98) and Non-survivors (n=52) according to intensive care unit mortality. The PC and MPV on days 1 and 4 of VAP were evaluated. Results: Thirty (31%) patients in the survivors group and 35 (67%) patients in the non-survivor group had thrombocytopenia, respectively (p<0.05). The non-survivor group had higher MPV and a higher MPV/PC on the 1st and 4th days, while the survivor group had higher PC levels, respectively (p<0.05). Platelet count, MPV and MPV/PC had the highest AUC levels at day 4 (0.68, 0.80, 0.73, respectively). The prognostic values of day 4 MPV and MPV/PC measurements were similar (p=0.17). Day 4 PC were found to be negatively correlated with mortality (adjusted hazard ratio (aHR): 0.91, p=0.01). Day 4 MPV and MPV/PC values were the independent mortality predictors (aHR: 2.59, p<0.01 and aHR: 1.63, p=0.01). The survival probability of VAP patients with <9.25 fL of MPV day 4 was significantly higher than those with ≥9.25 fL (p=0.002, log-rank test) Conclusion: In addition to thrombocytopenia, MPV and MPV/PC are useful predictors of poor outcomes. Changes in MPV responses may be a more useful prognostic assessment tool for VAP patients than PC. Keywords: Immune response, mean platelet volume, platelets, prognosis, ventilator-associated pneumonia","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49098984","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}
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