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Effects of Non-Laryngoscopic and Standard Laryngoscopic Intubation Methods on Hemodynamic Responses and Intraocular Pressure 非喉镜和标准喉镜插管方法对血液动力学反应和眼压的影响
Q4 Medicine Pub Date : 2022-04-28 DOI: 10.54875/jarss.2022.49091
G. Emmez, L. Karabıyık, Ş. Özdek
Objective: The effects of laryngoscopy on hemodynamic response and intraocular pressure (IOP) are well known. The use of Supra-glottic Airway Devices (SGAD) provides more stable hemodynamic parameters. Aim of this study is to compare the effects of laryngoscopic intubation on hemodynamic responses and IOP with intubation using Cobra Perilaryngeal Airway (Cobra-PLA) and Intubating Laryngeal Mask Airway (ILMA), without laryngoscopy. Methods: Sixty ASA I-II patients, without history of difficult intubation or ophtalmic pathology were randomly allocated into Cobra-PLA (G-PLA), ILMA (G-ILMA), and laryngoscopic intubation (G-L) groups. Induction was achieved with intravenous lidocaine 0.5 mg kg -1 , propofol 1.5-2.5 mg kg -1 and rocuronium 0.6 mg kg -1 . Propofol infusion of 2-4 mg kg -1 h -1 was continued until the 10 th minute following intubation. Intubation was achieved by placing endotracheal tubes through the SGAD into the trachea in G-PLA and G-ILMA, and with a laryngoscope in G-L. Hemodynamic pa-rameters and IOP were recorded before and after induction, the placement of SGAD, before and after intubation, extubation. Results: Demographic characteristics, mouth opening, thyromen-tal distance, and Mallampati score of the groups were similar. Heart rate was significantly higher in G-L than the other groups after intubation (p<0.05). Mean arterial pressure increased with intubation and extubation in all groups, these changes were similar among groups. In comparison between groups, Mean IOP was found to be higher in G-L at the 1st, 2nd and 10th minutes after intubation compared to G-PLA and G-ILMA (p<0.05). Conclusion: It has been found that intubation without laryngoscopy with Cobra-PLA and ILMA cause similar hemodynamic response, especially intubation with Cobra-PLA leads to less IOP rise compared to laryngoscopic intubation.
目的:喉镜检查对血液动力学反应和眼压(IOP)的影响是众所周知的。声门上气道装置(SGAD)的使用提供了更稳定的血液动力学参数。本研究的目的是比较喉镜插管与使用眼镜蛇喉周气道(Cobra PLA)和插管喉罩气道(ILMA)插管(无喉镜)对血液动力学反应和眼压的影响。方法:将60例ASA I-II患者,无困难插管史或眼角膜病变史,随机分为眼镜蛇PLA(G-PLA)、ILMA(G-ILMA)和喉镜插管(G-L)组。诱导采用静脉注射利多卡因0.5 mg kg-1、丙泊酚1.5-2.5 mg kg-2和罗库0.6 mg kg-3。丙泊酚输注2-4 mg kg-1 h-1持续至插管后第10分钟。在G-PLA和G-ILMA中,通过SGAD将气管插管放入气管,在G-L中使用喉镜进行插管。记录诱导前后、放置SGAD、插管前后、拔管前后的血液动力学参数和眼压。结果:两组的人口学特征、口腔张开度、甲状腺距离和Mallampati评分相似。插管后G-L组的心率明显高于其他组(p<0.05)。各组的平均动脉压随着插管和拔管而升高,各组之间的变化相似。与G-PLA和G-ILMA相比,两组之间的比较发现,G-L在插管后第1、2和10分钟的平均IOP更高(p<0.05)。
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引用次数: 0
Incompatibility, Y-Site Incompatibility and Incompatibility Management for Intravenously Administered Drugs in Intensive Care Unit 重症监护病房静脉给药的配伍、y位点配伍及配伍管理
Q4 Medicine Pub Date : 2022-04-28 DOI: 10.54875/jarss.2022.49002
A. Pehlivanlı, Çiğdem Özgün, Çağatay Fikret Erad, A. Özçelikay, M. N. Ünal
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引用次数: 0
Evaluation of the Attitudes of Anesthesia Residents and Specialists in Patients Who Have Had COVID-19 Before Elective Surgery 择期手术前麻醉住院医师和专科医师对COVID-19患者态度的评价
Q4 Medicine Pub Date : 2022-04-28 DOI: 10.54875/jarss.2022.69335
Oya Kale
Objective: To evaluate the knowledge and opinions and increase awareness of anesthesia residents and specialists about the timing of elective surgery of patients who have had COVID-19. Methods: After the approval of the hospital ethics committee, the link of the questionnaire form was sent to the anesthesia residents and specialist online via e-mail and social media application (WhatsApp mobile application). Questions were asked regarding demographic data, sources of information regarding COVID-19 infection, timing of elective surgery, preoperative preparation and risk factors, and informed consent. Results: In the study, 78% were specialist physicians, 66% were in the 30-50 age range and 63% were female of the 174 participants. The most used resource was the Ministry of Health Guidelines (79% specialist, 63% resident). Among the information sources used, hospital and in-clinic training, World Health Organization website and scientific publications responses were significantly different between the groups (p=0.002;p=0.015 and p=0.013). The times of taking elective surgery after COVID-19;While the responses of specialists and residents were significantly different in asymptomatic patients, they were found to be similar in patients with symptomatic disease at home, symptomatic in hospital and in intensive care unit. Conclusion: Responses of specialists and residents about the timing of the operation;while it was significantly different in asymptomatic patients, it was found to be similar in those who had symptomatic disease at home and in the hospital and those who had admitted to intensive care.
目的:评价麻醉住院医师和专科医师对新冠肺炎患者择期手术时机的认识和意见,提高他们的择期手术意识。方法:经医院伦理委员会批准后,将问卷表格的链接通过电子邮件和社交媒体应用程序(WhatsApp移动应用程序)在线发送给麻醉住院医师和专科医生。问题涉及人口统计数据、COVID-19感染的信息来源、择期手术的时机、术前准备和风险因素以及知情同意。结果:在174名参与者中,78%是专科医生,66%在30-50岁之间,63%是女性。使用最多的资源是卫生部指南(79%是专家,63%是居民)。在使用的信息来源中,医院和诊所培训、世界卫生组织网站和科学出版物的反应在两组之间存在显著差异(p=0.002;p=0.015和p=0.013)。在无症状患者中,专科医生和住院医生的反应有显著差异,而在有症状的家庭、有症状的医院和重症监护病房患者中,专科医生和住院医生的反应相似。结论:专家和住院医师对手术时机的反应,无症状患者有显著差异,在家和在医院有症状的患者与重症监护患者有相似之处。
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引用次数: 0
Retinopathy of Prematurity and Anesthesia Management 早产视网膜病变与麻醉管理
Q4 Medicine Pub Date : 2022-04-28 DOI: 10.54875/jarss.2022.99266
Selin Erel, A. Kaptan, D. Coşkun, A. Mahli
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引用次数: 0
The Effect of Previous COVID-19 Infection on Patient Outcomes After Colorectal Surgery: A Retrospective Cohort Study 既往新冠肺炎感染对结直肠手术后患者预后的影响:回顾性队列研究
Q4 Medicine Pub Date : 2022-04-28 DOI: 10.54875/jarss.2022.63625
S. Karadag Erkoc, Ahmet Cem Ceran
Objective: Mortality and complication rates are increasing in emergency and delayed cancer surgeries during the COVID-19 pandemic. However, curing can be provided when colorectal cancer surgery is performed without delay. In this study, it was aimed to evaluate the results in patients who underwent colorectal cancer surgery after having COVID-19 infection during the pandemic process. Methods: Data on patients undergoing colorectal cancer surgery after or without COVID-19 infection were recorded from the hospital’s electronic database and file records. It was investigated whether there was a difference in 30-day complication and mortality rates in patients with COVID-19 infection. Results: Of the 77 patients between the ages of 20 and 85 who underwent colorectal cancer surgery, 34 were female, 43 were male. Thirty six of the patients who were infected with the COVID-19 (Group-C), 41 of the patients had undergone surgery without infection (Group-N). There was no difference between the groups in terms of lenght of stay in Hospital and Intensive Care Unit. The 30-day mortality rate in Group-C was 11.1%. The 30-day complication rate in Group-C was significantly higher than in Group-N (p=0.048). The most common complication in Group-C was acute kidney injury (11.1%). Being infected with COVID-19 virus within 7 weeks before the operation had no effect on postoperative results. Conclusion: While the surgical procedure is optimized to prevent complications in patients with COVID-19, delaying surgery can lead to local-remote metastases due to waiting and losing the possibility of operation. Decisions should be made according to the patient’s status and planning should be made according to the risk-gain balance.
目的:在新冠肺炎大流行期间,癌症急诊和延迟手术的死亡率和并发症率正在上升。然而,当毫不拖延地进行结直肠癌癌症手术时,可以提供治愈。在这项研究中,旨在评估在大流行过程中感染新冠肺炎后接受结直肠癌癌症手术的患者的结果。方法:从医院的电子数据库和文件记录中记录新冠肺炎感染后或未感染的结直肠癌癌症手术患者的数据。调查新冠肺炎感染患者的30天并发症和死亡率是否存在差异。结果:在77例年龄在20岁至85岁之间的癌症大肠癌患者中,34例为女性,43例为男性。36名感染新冠肺炎的患者(C组),41名患者在没有感染的情况下接受了手术(N组)。两组在住院时间和重症监护室的住院时间方面没有差异。C组30天死亡率为11.1%,C组30日并发症发生率显著高于N组(p=0.048),C组最常见的并发症为急性肾损伤(11.1%),术前7周内感染新冠肺炎病毒对术后效果无影响。结论:在优化手术程序以预防新冠肺炎患者并发症的同时,延迟手术可能会因等待而导致局部远处转移,并失去手术的可能性。应根据患者的状况做出决定,并根据风险收益平衡做出计划。
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引用次数: 1
Retrospective Evaluation of the Effectiveness of Superior Hypogastric Plexus Block in Chronic Pelvic Pain 上胃下丛阻滞治疗慢性盆腔疼痛的疗效回顾性评价
Q4 Medicine Pub Date : 2022-01-28 DOI: 10.54875/jarss.2022.52824
Dostali Aliyev, Umit Akkemik, İ. Aşık
Objective: Chronic pain is a cause that negatively affects the quality of life and functional capacity. As with most chronic pain syndromes, chronic pelvic pain requires a multimodal approach. Hypogastric plexus blockade and neurolysis may be effective in cases that do not respond to conservative treatments. In this study, we retrospectively evaluated the effect of hypogastric plexus blockade in patients with chronic pelvic pain. Methods: Forty patients with chronic pelvic pain (duration of pain> 6 months) who underwent hypogastric plexus block under fluoroscopy were evaluated retrospectively. Neurolysis was performed after diagnostic block in 19 patients with chronic pelvic pain associated with pelvic cancer. Results: While the visual analogue scale (VAS) of the patients who underwent superior hypogastric block was 8.8 before the procedure, the VAS scores at 1 month, 3 months and 6 months after the procedure were recorded as 3.7, 2.2, and 1.1, respectively (p<0.05). While the mean Oswestry Disabilty Index (ODI) score of the patients before the procedure was 46.0% (severe disability), it was recorded as 3% at the 6th month. The changes in VAS and ODI scores were statistically significant (p<0.05). Conclusion: Hypogastric plexus blockade should be considered as an effective treatment option in the treatment of chronic pelvic pain. Keywords: Pelvic pain, nerve block, pain management, chemical neurolysis, fluoroscopy
目的:慢性疼痛是一种对生活质量和功能能力产生负面影响的原因。与大多数慢性疼痛综合征一样,慢性骨盆疼痛需要多模式的治疗方法。胃下丛阻滞和神经松解术在保守治疗无效的情况下可能有效。在这项研究中,我们回顾性评估了腹下神经丛阻滞在慢性盆腔疼痛患者中的效果。方法:回顾性分析40例慢性盆腔疼痛(疼痛持续时间>6个月)患者在荧光镜下接受下腹丛阻滞的情况。19例慢性盆腔疼痛伴盆腔癌症患者在诊断阻滞后进行神经松解术。结果:上腹部阻滞患者术前视觉模拟量表(VAS)为8.8,术后1个月、3个月和6个月的VAS评分分别为3.7、2.2和1.1(p<0.05),在第6个月记录为3%。VAS和ODI评分的变化具有统计学意义(p<0.05)。结论:胃下神经丛阻滞是治疗慢性盆腔疼痛的有效方法。关键词:骨盆疼痛,神经阻滞,疼痛管理,化学神经松解术,荧光透视
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引用次数: 0
Surgical and Anesthetic Management of Postpartum Hemorrhage Forty-Five Days After Cesarean Section 剖宫产术后四十五天产后出血的手术及麻醉处理
Q4 Medicine Pub Date : 2022-01-28 DOI: 10.54875/jarss.2022.38358
M. F. Cevher Akdulum, Nuray Camgoz Eryilmaz, D. B. Gunaydin, Ayse Borkluce, E. İşçi Bostancı, A. Erdem
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引用次数: 0
Intravenous Port Catheter Implantation: Retrospective Study in Single Center Experience 静脉端口置管:单中心经验回顾性研究
Q4 Medicine Pub Date : 2022-01-28 DOI: 10.54875/jarss.2022.18894
M. Manici, K. Darcin, A. Isguzar, Sami Kaan Coşarcan, Baris Kucukerdem, O. Erçelen
Objective: Totally implantable venous access ports (TIVAPs) are widely preferred for oncology patients who need chemotherapy. Although peripheral cannula or catheter in a large vein may help chemotherapy treatment; some complications such as vascular irritation, thrombosis may interrupt the treatment. To avoid this interruption, TIVAPs are usually preferred. The aim of the study was to evaluate device related complications and safety with anesthesia team implanted TIVAPs. Methods: This retrospective study was conducted on patients who underwent procedure for implantation of TIVAPs in our hospital between the dates of January 2017 - December 2020. The demographic data, vascular access side, complications seen related to TIVAPs insertion procedure, the number of removed catheters, reasons of removal of catheters were recorded. Results: During this study period 700 TIVAPs procedure have been performed in our clinic. While 646 patients (92.3%) had right sided TIVAPs, 678 patients (96.8%) had TIVAPs inserted to subclavian vein. When the most common cancer seen in this patient group was colorectal cancer, hepatobiliary tract cancer group came second. Total number of removed catheters for some reasons was 107 which is 15.2% of all patients. When the causes for catheter removal were examined, it was discovered that although systemic infection was the most common reason (47 patients, or 6.7%), the number of patients with positive culture from the port was extremely rare (19 patients) (2.71%). Conclusion: We think that when TIVAPs are inserted under ultrasound guidance and fluoroscopy control in the operating room, the incidence of complications will be relatively low. Especially in cancer patients, TIVAPs can be inserted and used safely with high patient comfort. Keywords: Totally implantable venous access port systems, complications, patient safety, port infection
目的:全植入式静脉通道(TIVAPs)广泛应用于肿瘤化疗患者。虽然外周大静脉插管或导管可能有助于化疗;一些并发症如血管刺激、血栓形成可能会中断治疗。为了避免这种中断,通常首选tivap。本研究的目的是评估麻醉团队植入TIVAPs的器械相关并发症和安全性。方法:回顾性研究2017年1月至2020年12月在我院行TIVAPs植入术的患者。记录患者的人口学资料、血管通路侧、与TIVAPs插入术相关的并发症、拔除导管的数量、拔除导管的原因。结果:在本研究期间,我院共实施了700例TIVAPs手术。646例(92.3%)患者右侧植入tivap, 678例(96.8%)患者锁骨下静脉植入tivap。当该患者组中最常见的癌症是结肠直肠癌时,其次是肝胆道癌组。因某种原因拔管107例,占全部患者的15.2%。在检查拔管原因时发现,虽然全身性感染是最常见的原因(47例,占6.7%),但端口培养阳性的患者极少(19例,占2.71%)。结论:我们认为在超声引导和透视控制下在手术室内置入TIVAPs,并发症的发生率相对较低。特别是在癌症患者中,TIVAPs可以安全插入和使用,患者舒适度高。关键词:全植入式静脉通道系统,并发症,患者安全,端口感染
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引用次数: 0
Truncal Cutaneous Temperature Changes and Anthropometry in Spinal Anaesthesia - An Observational Study 脊髓麻醉中躯干皮肤温度变化和人体测量-一项观察性研究
Q4 Medicine Pub Date : 2022-01-28 DOI: 10.54875/jarss.2022.24865
S. Ej, Janani Ramachandran, Gautham Ganesan, Arulmozhiyal Ramasamy
Objective: The predictability of onset of sympathetic block in spinal anaesthesia is poor. The role of the structures around the dural sac, in determining the spread of local anaesthetic in the subarachnoid space, is evaluated by studying the effect of the peri-spinal frustum volume on the change in cutaneous temperature and perception of cold sensation. Methods: In patients planned for spinal anaesthesia with 2.5 mL of 0.5% heavy bupivacaine intrathecally, volume of frustum between T8 and L3 was calculated using abdominal circumference at T8 and L3 and the distance between these spinous processes. The speed of onset at T8 level was measured as a change of 0.5 °C in cutaneous temperature probe and loss of cold sensation. Results: Of the 40 patients analysed, 22 patients had increase in cutaneous temperature while 14 had a decrease and 4 had no change. The onset time of loss of cold sensation in seconds was 327.68±169.65 (99% CI:234.51–420.85) and 232.64±75.47 (99% CI 180.69-284.60) in patients with increase and decrease of the skin probe respectively. The square of correlation coefficient (R2) of frustum volume was 0.55 (99% CI -0.15-0.88, p=<0.01) in the group with decrease in skin temperature and 0.03 (99% CI -0.51-0.55, p=0.46) in group with increase in skin temperature. Conclusion: The effect of peri-spinal volume on the speed of onset of block at T8 level is variable and somatic block correlates only in patients who had a decrease in skin temperature. Keywords: Anthropometry, skin temperature, spinal anaesthesia, sympathetic nerve block
目的:脊髓麻醉中交感神经阻滞发作的可预测性较差。硬膜囊周围结构在决定蛛网膜下腔局部麻醉扩散方面的作用,通过研究截头体周围体积对皮肤温度变化和冷感觉的影响来评估。方法:在计划鞘内注射2.5mL 0.5%重布比卡因进行脊柱麻醉的患者中,使用T8和L3处的腹围和这些棘突之间的距离计算T8和L3。T8水平下的发病速度测量为皮肤温度探头中0.5°C的变化和冷感的丧失。结果:在分析的40名患者中,22名患者的皮肤温度升高,14名患者的温度降低,4名患者没有变化。皮肤探针增加和减少患者的冷感丧失起始时间(秒)分别为327.68±169.65(99%CI:234.51–420.85)和232.64±75.47(99%CI180.69-284.60)。在皮肤温度降低的组中,截头体体积的相关系数(R2)的平方为0.55(99%CI-0.15-0.88,p=<0.01),在皮肤温度升高的组中为0.03(99%CI-0.51-5.55,p=0.46)。结论:在T8水平上,脊柱周围容积对传导阻滞发作速度的影响是可变的,而体细胞传导阻滞仅在皮肤温度降低的患者中相关。关键词:人体测量法,皮肤温度,脊髓麻醉,交感神经阻滞
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引用次数: 0
Experiences of Anesthesiology and Reanimation Specialists in the COVID-19 Pandemic: A Focus Group Study 麻醉和复苏专家在COVID-19大流行中的经验:焦点小组研究
Q4 Medicine Pub Date : 2022-01-28 DOI: 10.54875/jarss.2022.60362
P. Ayvat
Objective: To reveal the opinions and experiences of anesthesiologists, who are actively working during the pandemic that emerged in 2020 and continue, regarding the problems, changes, needs, and solution suggestions regarding the COVID-19 process. Methods: The research was conducted with the qualitative research method. A focus group meeting was held with 6 anesthesiologists who agreed to participate in the study. Thematic content analysis was performed on the data via MAXQDA 20. Results: As a result of the research, 4 main themes and 11 sub-themes were reached. These main themes are experienced problems and changes, needs, contributions to the field of Anesthesiology and Reanimation, and suggestions. Anesthesiologists said that they were adversely affected by the COVID-19 process, working conditions changed, they had problems in the management of emergencies and in the supply of equipment for a long time, and that these problems increased their anxiety and fear with the uncertainty of the COVID-19 disease. When their needs in the COVID-19 process are evaluated, they need the fair distribution of assignments in the health sector, the well-equipped personnel, the improvement of physical conditions, and the elimination of their economic concerns. In addition to the problems experienced, when the contributions of the COVID-19 process were evaluated, anesthesiologists declared that they used the equipment more efficiently and conducted more research by developing treatment techniques. Conclusion: It was determined that the experienced COVID-19 process forced the anesthesiologists, the probability of contracting the COVID-19 disease was high due to their active work, they suffered the loss of rights in the process. It was concluded that it is important to protect the physiological, economic, and psychological conditions of the anesthesiologists and to meet their needs. Keywords: COVID-19, anesthesiologist, qualitative research, focus groups
目的:了解在2020年新冠肺炎疫情期间和持续期间积极工作的麻醉医师对新冠肺炎疫情防控过程中出现的问题、变化、需求和解决建议的看法和经验。方法:采用定性研究方法。与6名同意参与本研究的麻醉师举行焦点小组会议。利用MAXQDA 20对数据进行主题内容分析。结果:通过研究得出了4个主要主题和11个次要主题。这些主题是经历过的问题和变化,需求,对麻醉和复苏领域的贡献,以及建议。麻醉医师表示,他们受到新冠肺炎过程的不利影响,工作条件发生了变化,他们在应急管理和设备供应方面长期存在问题,这些问题增加了他们对新冠肺炎疾病的不确定性的焦虑和恐惧。在评估他们在COVID-19过程中的需求时,他们需要公平分配卫生部门的任务、配备精良的人员、改善身体条件以及消除他们的经济担忧。除了遇到的问题外,在评估COVID-19过程的贡献时,麻醉师声称他们更有效地使用了设备,并通过开发治疗技术进行了更多的研究。结论:经验丰富的新冠肺炎疫情对麻醉医师造成了一定的压力,由于麻醉医师工作主动,感染新冠肺炎的概率较高,在此过程中遭受了权利的丧失。保护麻醉医师的生理、经济和心理状况,满足麻醉医师的需求是重要的。关键词:COVID-19,麻醉师,定性研究,焦点小组
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引用次数: 0
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Anestezi Dergisi
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