Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item A Cosmetic Complication After Supraorbital/Supratrochlear Nerve Block(2023) Araz, Coskun; Bihorac, Edvin; 37052162; AAJ-4576-2021Item Anesthetic Management in Pediatric Orthotopic Liver Transplant For Fulminant Hepatic Failure and End-stage Liver Disease(2014) Camkiran, Aynur; Araz, Coskun; Balli, Sevgi Seyhan; Torgay, Adnan; Moray, Gokhan; Pirat, Arash; Arslan, Gulnaz; Haberal, Mehmet; https://orcid.org/0000-0003-1470-7501; https://orcid.org/0000-0002-4927-6660; https://orcid.org/0000-0002-6829-3300; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24635805; AAJ-4576-2021; AAJ-5221-2021; AAE-1041-2021; AAJ-8097-2021Objectives: We assessed the anesthetic management and short-term morbidity and mortality in pediatrics patients who underwent an orthotopic liver transplant for fulminant hepatic failure or end-stage liver disease in a university hospital. Material and Methods: We retrospectively analyzed the records of children who underwent orthotopic liver transplant from May 2002 to May 2012. Patients were categorized into 2 groups: group fulminant hepatic failure (n=22) and group end-stage liver disease (n=19). Perioperative data related to anesthetic management and intra-operative events were collected along with information related to postoperative course and survival to hospital discharge. Results: Mean age and weight for groups fulminant hepatic failure and end-stage liver disease were 8.6 +/- 2.7 years and 10.8 +/- 3.8 years (P= .04) and 29.2 +/- 11.9 kg and 33.7 +/- 16.9 kg (P= .46). There were no differences between the groups regarding length of anhepatic phase (65 +/- 21 min vs 73 +/- 18 min, P= .13) and operation time (9.1 +/- 1.6 h vs 9.5 +/- 1.8 h, P= .23). When compared with the patients in group fulminant hepatic failure, those in group end-stage liver disease more commonly had a Glasgow Coma score of 7 or less (32% vs 6%, P= .04). Compared with patients in group fulminant hepatic failure, those in group end-stage liver disease were more frequently extubated in the operating room (31.8% versus 89.5% P <.001). Postoperative duration of mechanical ventilation (2.78 +/- 4.02 d vs 2.85 +/- 10.21 d, P = .05), and the mortality rates at 1 year after orthotopic liver transplant (7.3% vs 0%, P = .09) were similar between the groups. Conclusions: During pediatric orthotopic liver transplant, those children with fulminant hepatic failure require more intraoperative fluids and more frequent perioperative mechanical ventilation than those with end-stage liver disease.Item Accuracy of Continuous Noninvasive Arterial Pressure Monitoring in Living-Liver Donors During Transplantation(2015) Araz, Coskun; Zeyneloglu, Pinar; Pirat, Arash; Veziroglu, Nukhet; Firat, Aynur Camkiran; Arslan, Gulnaz; 0000-0003-2312-9942; 0000-0002-4927-6660; 0000-0003-1470-7501; 25894178; C-3736-2018; AAJ-4576-2021Objectives: Hemodynamic monitoring is vital during liver transplant surgeries because distinct hemodynamic changes are expected. The continuous noninvasive arterial pressure (CNAP) monitor is a noninvasive device for continuous arterial pressure measurement by a tonometric method. This study compared continuous noninvasive arterial pressure monitoring with invasive direct arterial pressure monitoring in living-liver donors during transplant. Materials and Methods: There were 40 patients analyzed while undergoing hepatic lobectomy for liver transplant. Invasive pressure monitoring was established at the radial artery and continuous noninvasive arterial pressure monitoring using a finger sensor was recorded simultaneously from the contralateral arm. Systolic, diastolic, and mean arterial pressures from the 2 methods were compared. Correlation between the 2 methods was calculated. Results: A total of 5433 simultaneous measurements were obtained. For systolic arterial blood pressure, 55% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.479, continuous noninvasive arterial pressure bias was -0.3 mm Hg, and limits of agreement were 32.0 mm Hg. For diastolic arterial blood pressure, 50% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.630, continuous noninvasive arterial pressure bias was -0.4 mm Hg, and limits of agreement were 21.1 mm Hg. For mean arterial blood pressure, 60% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.692, continuous noninvasive arterial pressure bias was +0.4 mm Hg, and limits of agreement were 20.8 mm Hg. Conclusions: The 2 monitoring techniques did not show acceptable agreement. Our results suggest that continuous noninvasive arterial pressure monitoring is not equivalent to invasive arterial pressure monitoring in donors during living-donor liver transplant.Item Fatal Outcome After Renal Transplant in a Pediatric Patient With Noonan Syndrome(2015) Araz, Coskun; Kaval, Ebru; Torgay, Adnan; Moray, Gokhan; Haberal, Mehmet; 0000-0003-2498-7287; 0000-0002-6829-3300; 0000-0002-4927-6660; 0000-0002-3462-7632; 25894171; AAE-1041-2021; AAJ-5221-2021; AAJ-4576-2021; AAJ-8097-2021Noonan syndrome is a congenital, common, hereditary disorder. Facial dysmorphism, growth retardation, and various heart defects are typical clinical features. In patients with minor cardiac pathology, life expectancy is normal. We report a case of renal transplant in a pediatric patient with Noonan syndrome that ended with death of the patient. Our patient presented with unexpected and refractory postoperative neurological complications that were unresponsive to intensive therapy, and the patient died because of secondary complications.Item Anesthesia Management of a Deceased Cadaveric-Donor Combined Liver and Kidney Transplant for Primary Hyperoxaluria Type 1: Report of a Case(2015) Ersoy, Zeynep; Araz, Coskun; Kirnap, Mahir; Zeyneloglu, Pinar; Torgay, Adnan; Arslan, Gulnaz; 0000-0003-2312-9942; 0000-0003-0767-1088; 0000-0002-6829-3300; 0000-0002-4927-6660; 26640925; AAH-9198-2019; C-3736-2018; AAF-3066-2021; AAJ-5221-2021; AAJ-4576-2021Primary hyperoxaluria type 1 is an autosomal recessive disorder that is responsible for the overproduction of oxalate and has an incidence of 1 in 120 000 live births. Indications for combined liver and kidney transplant are still debated. However, combined liver and kidney transplant is preferred in various conditions, including primary hyperoxaluria, liver-based metabolic abnormalities affecting the kidney, and structural diseases affecting both the liver and the kidney, such as congenital hepatic fibrosis and polycystic kidney disease. When compared with sequential liver and kidney transplant, the rejection rate of both liver and kidney allografts was reported to be lower than with combined liver and kidney transplant. With proper anesthesia management, the probable increased complications with combined liver and kidney transplant can be prevented. In this report, we present the anesthesia care of a 22-year-old patient with primary hyperoxaluria type 1 who had deceased-donor combined liver and kidney transplant.Item Case Reports: Should We Do Away with Them?(2017) Firat, Aynur Camkiran; Araz, Coskun; Kayhan, Zeynep; 0000-0002-4927-6660; 0000-0003-0579-1115; 0000-0003-1470-7501; 28235534; AAJ-4576-2021; AAJ-4623-2021Study objective: There has been a gradual decline in the number of case reports published in leading medical journals in recent years. Since case reports are not highly cited they have an adverse effect on the journal impact factor. On the other hand sharing new experiences, challenges, or discoveries with colleagues is essential for medical community. Should case reports be eliminated from the journals or published only in journals devoted to case reports? Design: Observational study. Setting: Web of Science database was searched, between 2005 and 2009, with terms: "anesthesia", "anesthesiology" and "case report" yielding 25 969, 9532, and 661 publications, respectively. Since some reports contained large number of cases, only those involving up to three cases (n = 425) were evaluated by the authors with respect to their type, contribution to knowledge and/or practice (Likert scale) and times they were cited. Main results: Distribution of answers to the statement "Case has added to my knowledge and/or improved my practice" was; 3% (strongly disagree), 10.5% (disagree), 33.2% (neither agree nor disagree), 39.3% (agree) and 13.7% (strongly agree). Average citations per item was 4.43 (1883/425), 7.32 (4838/661), and 7.82 (74 529/ 9532). As to the types of the reports; 50% unexpected event in the course of anesthesia, 31% unusual and instructive cases, 9.6% novel/unique anesthetic techniques, 6% novel use of equipment, 1.6% new information on diseases of importance to anesthesiology and 1% scientific observations. Conclusion: Case reports have been an important source of clinical guidance and scientific insight, and play an important role in medical education. They can be published quickly, providing publication opportunity for juniors and for clinicians who may not have the time or finance to conduct large-scale research. On the other hand some argue, that case reports are irrelevant in current medical practice and education, being at the bottom of the hierarchical ladder of medical evidence. We conclude that case reports should not be done away with but be published in websites and journals like the venue to be launched in 2013 by the International Anesthesia Research Society, devoted entirely to them to meet the need for the publication of interesting cases. (C) 2016 Elsevier Inc. All rights reserved.Item Effects of Music on Sedation Depth and Sedative Use During Pediatric Dental Procedures(2016) Ozkalayci, Ozlem; Araz, Coskun; Cehreli, Sevi Burcak; Tirali, Resmiye Ebru; Kayhan, Zeynep; 0000-0002-4927-6660; 0000-0001-6487-3984; 0000-0003-0579-1115; 27687464; AAJ-4576-2021; AAD-6138-2021; HZK-4947-2023; AAD-2907-2020; AAJ-4623-2021Study objective: The study aimed to investigate the effects of listening to music or providing sound isolation on the depth of sedation and need for sedatives in pediatric dental patients. Design: Prospective, randomized, and controlled study. Setting: Tertiary, university hospital. Patients: In total, 180 pediatric patients, American Society of Anesthesiologists physical status I and II, who were scheduled for dental procedures of tooth extraction, filling, amputation, and root treatment. Interventions: Patients were categorized into 3 groups: music, isolation, and control. During the procedures, the patients in the music group listened to Vivaldi's The Four Seasons violin concertos by sound isolating headphones, whereas the patients in the isolation group wore the headphones but did not listen to music. All patients were sedated by 0.1 mg/kg midazolam and 1 mg/kg propofol. During the procedure, an additional 0.5 mg/kg propofol was administered as required. Measurements and main results: Bispectral index was used for quantifying the depth of sedation, and total dosage of the propofol was used for sedative requirements. The patients' heart rates, oxygen saturations, and Observer's Assessment of Alertness and Sedation Scale and bispectral index scores, which were monitored during the operation, were similar among the groups. In terms of the amount of propofol used, the groups were similar. Prolonged postoperative recovery cases were found to be significantly frequent in the control group, according to the recovery duration measurements (P = .004). Conclusions: Listening to music or providing sound isolation during pediatric dental interventions did not alter the sedation level, amount of medication, and hemodynamic variables significantly. This result might be due to the deep sedation levels reached during the procedures. However, listening to music and providing sound isolation might have contributed in shortening the postoperative recovery duration of the patients. (C) 2016 Elsevier Inc. All rights reserved.Item Anesthetic Management of Renal and Liver Transplantation Recipients During Cesarean Section(2018) Firat, Aynur Camkiran; Ayhan, Asude; Araz, Coskun; Haberal, Mehmet; Kayhan, Zeynep; 0000-0003-3299-6706; 0000-0002-4927-6660; 0000-0002-3462-7632; 0000-0003-0579-1115; AAJ-2066-2021; AAJ-4576-2021; AAJ-8097-2021; AAJ-4623-2021Item Ultrasound-Guided Multisite Transversus Abdominis Plane Block For The Treatment Of Scar-Caused Neuropathic Pain In A Child(2022) Araz, Coskun; Kayhan, Zeynep; Demir, Tugba A. C. E. R.; https://orcid.org/0000-0001-5391-9094; 35848813; E-4455-2019Item Pain Management of a Critically Ill Oldest-old Trauma Patient with Multiple Rib Fractures in Intensive Care Unit(2022) Yazar, Cagla; Yesiler, Fatma Irem; Sahinturk, Helin; Araz, Coskun; Zeyneloglu, Pinar; 0000-0002-3887-0314; 0000-0002-0612-8481; 0000-0003-0159-4771; AAJ-4212-2021; AAJ-1419-2021Rib fracture due to blunt chest trauma is a painful condition with high morbidity and mortality and it is two times prevalent among the elderly compared to young people. If adequate an analgesic treatment is not administered, respiratory complications, need for mechanical ventilation, and length of stay in intensive care unit may increase. Erector spinal plane (ESP) block is a regional unaesthetic method that can provide effective analgesia in the unilateral thoracic region. In this study, we present ESP block, which is used successfully in pain management of a critically ill old patient with multiple rib fractures.