Pub Date : 2022-04-28DOI: 10.54875/jarss.2022.16878
Sami Kaan Coşarcan, Alper Doğan, O. Erçelen
media (excessive absorption of liquid or gas), thermal and/or mechanical injuries, or a combination of all of them. During hysteroscopic surgery, there is a potential risk for air or gas to entery the circulation through exposed uterine veins. Large open venous sinuses allow entry of air or gas into the right side of the heart and pulmonary system, especially when there is a favorable pressure gradient created by the Trendelenburg position of the patient and/or the intrauterine distension due to the fluid. Therefore, pulmonary gas embolism is a known complication during operative hysteroscopy that may have significant consequences (3,4). The gas entering ABSTRACT Operative hysteroscopic procedures can be performed safely in the outside the operating room. During hysteroscopic surgery, there is a potential risk for air or gas to enter the circulation from exposed uterine veins. Therefore, pulmonary gas embolism is a complication during operative hysteroscopy that can have significant consequences. In this case report, we wanted to talk about air/gas embolism that developed during hysteroscopy. A 21-year-old, 160 cm, 61 kg patient underwent hysteroscopic myomectomy. At the 70 th minute of surgery, ETCO 2 suddenly dropped from 35 mmHg to 15 mmHg, and SpO 2 regressed to 93%. Transesophageal echocardiography revealed enlargement of the right atrium and severe stretching of the right atrial septum. The patient, whose hemodynamics improved after fluid resuscitation and cardiac supportive treatment, was extubated at the end of the operation. Avoiding excessive Trendelenburg position, selection of irrigation fluid and pressure control, surgical technique and surgical time, selection of cauterization, awareness of the anesthesia team, and rapid response time play critical roles in the management of venous air or gas embolism.
{"title":"Venous Air Embolism During Hysteroscopic Myomectomy: A Case Report and Evidence Based-Management","authors":"Sami Kaan Coşarcan, Alper Doğan, O. Erçelen","doi":"10.54875/jarss.2022.16878","DOIUrl":"https://doi.org/10.54875/jarss.2022.16878","url":null,"abstract":"media (excessive absorption of liquid or gas), thermal and/or mechanical injuries, or a combination of all of them. During hysteroscopic surgery, there is a potential risk for air or gas to entery the circulation through exposed uterine veins. Large open venous sinuses allow entry of air or gas into the right side of the heart and pulmonary system, especially when there is a favorable pressure gradient created by the Trendelenburg position of the patient and/or the intrauterine distension due to the fluid. Therefore, pulmonary gas embolism is a known complication during operative hysteroscopy that may have significant consequences (3,4). The gas entering ABSTRACT Operative hysteroscopic procedures can be performed safely in the outside the operating room. During hysteroscopic surgery, there is a potential risk for air or gas to enter the circulation from exposed uterine veins. Therefore, pulmonary gas embolism is a complication during operative hysteroscopy that can have significant consequences. In this case report, we wanted to talk about air/gas embolism that developed during hysteroscopy. A 21-year-old, 160 cm, 61 kg patient underwent hysteroscopic myomectomy. At the 70 th minute of surgery, ETCO 2 suddenly dropped from 35 mmHg to 15 mmHg, and SpO 2 regressed to 93%. Transesophageal echocardiography revealed enlargement of the right atrium and severe stretching of the right atrial septum. The patient, whose hemodynamics improved after fluid resuscitation and cardiac supportive treatment, was extubated at the end of the operation. Avoiding excessive Trendelenburg position, selection of irrigation fluid and pressure control, surgical technique and surgical time, selection of cauterization, awareness of the anesthesia team, and rapid response time play critical roles in the management of venous air or gas embolism.","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47235803","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 : 2022-04-28DOI: 10.54875/jarss.2022.49002
A. Pehlivanlı, Çiğdem Özgün, Çağatay Fikret Erad, A. Özçelikay, M. N. Ünal
{"title":"Incompatibility, Y-Site Incompatibility and Incompatibility Management for Intravenously Administered Drugs in Intensive Care Unit","authors":"A. Pehlivanlı, Çiğdem Özgün, Çağatay Fikret Erad, A. Özçelikay, M. N. Ünal","doi":"10.54875/jarss.2022.49002","DOIUrl":"https://doi.org/10.54875/jarss.2022.49002","url":null,"abstract":"","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43045327","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 : 2022-04-28DOI: 10.54875/jarss.2022.99266
Selin Erel, A. Kaptan, D. Coşkun, A. Mahli
{"title":"Retinopathy of Prematurity and Anesthesia Management","authors":"Selin Erel, A. Kaptan, D. Coşkun, A. Mahli","doi":"10.54875/jarss.2022.99266","DOIUrl":"https://doi.org/10.54875/jarss.2022.99266","url":null,"abstract":"","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43073788","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 : 2022-04-28DOI: 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.
{"title":"Evaluation of the Attitudes of Anesthesia Residents and Specialists in Patients Who Have Had COVID-19 Before Elective Surgery","authors":"Oya Kale","doi":"10.54875/jarss.2022.69335","DOIUrl":"https://doi.org/10.54875/jarss.2022.69335","url":null,"abstract":"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.","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46865751","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 : 2022-04-28DOI: 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.
{"title":"The Effect of Previous COVID-19 Infection on Patient Outcomes After Colorectal Surgery: A Retrospective Cohort Study","authors":"S. Karadag Erkoc, Ahmet Cem Ceran","doi":"10.54875/jarss.2022.63625","DOIUrl":"https://doi.org/10.54875/jarss.2022.63625","url":null,"abstract":"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.","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47776622","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 : 2022-01-28DOI: 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
{"title":"Retrospective Evaluation of the Effectiveness of Superior Hypogastric Plexus Block in Chronic Pelvic Pain","authors":"Dostali Aliyev, Umit Akkemik, İ. Aşık","doi":"10.54875/jarss.2022.52824","DOIUrl":"https://doi.org/10.54875/jarss.2022.52824","url":null,"abstract":"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","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47638021","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 : 2022-01-28DOI: 10.54875/jarss.2022.38358
M. F. Cevher Akdulum, Nuray Camgoz Eryilmaz, D. B. Gunaydin, Ayse Borkluce, E. İşçi Bostancı, A. Erdem
{"title":"Surgical and Anesthetic Management of Postpartum Hemorrhage Forty-Five Days After Cesarean Section","authors":"M. F. Cevher Akdulum, Nuray Camgoz Eryilmaz, D. B. Gunaydin, Ayse Borkluce, E. İşçi Bostancı, A. Erdem","doi":"10.54875/jarss.2022.38358","DOIUrl":"https://doi.org/10.54875/jarss.2022.38358","url":null,"abstract":"","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42184618","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 : 2022-01-28DOI: 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
{"title":"Intravenous Port Catheter Implantation: Retrospective Study in Single Center Experience","authors":"M. Manici, K. Darcin, A. Isguzar, Sami Kaan Coşarcan, Baris Kucukerdem, O. Erçelen","doi":"10.54875/jarss.2022.18894","DOIUrl":"https://doi.org/10.54875/jarss.2022.18894","url":null,"abstract":"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","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41496553","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 : 2022-01-28DOI: 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
{"title":"Truncal Cutaneous Temperature Changes and Anthropometry in Spinal Anaesthesia - An Observational Study","authors":"S. Ej, Janani Ramachandran, Gautham Ganesan, Arulmozhiyal Ramasamy","doi":"10.54875/jarss.2022.24865","DOIUrl":"https://doi.org/10.54875/jarss.2022.24865","url":null,"abstract":"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","PeriodicalId":36000,"journal":{"name":"Anestezi Dergisi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44058130","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 : 2022-01-28DOI: 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
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