Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Author: search.filters.author.Bali, Caglasearch.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/openAccess

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    Supra-Inguinal Fascia Iliaca Block in Older-Old Patients for Hip Fractures: A Retrospective Study
    (2023) Bali, Cagla; Ozmete, Ozlem; 34582902
    Background Pain management in hip fracture patients is of great importance for reducing postoperative morbidity and mortality. Multimodal techniques, including peripheral nerve blocks, are preferred for postoperative analgesia. Older-old hip fracture patients with high ASA scores are highly sensitive to the side effects of NSAIDs and opioids. Our aim was to investigate the effectiveness of the recently popularized Supra-Inguinal Fascia Iliaca Block (SIFIB) in this population.Methods Forty-one ASA III...IV patients who underwent SIFIB...+...PCA (G-SIFIB) or PCA alone (Group Control: GC) after general anesthesia were evaluated retrospectively. In addition to 24-hour opioid consumption, Visual Analog Scale (VAS) scores, opioid-related side effects, block-related complications, and length of hospital stay were compared.Results Twenty-two patients in G-SIFIB and 19 patients in GC were evaluated. The postoperative 24-hour opioid consumption was lower in G-SIFIB than in GC (p<0.001). There was a statistically significant reduction in VAS scores at the postoperative 1(st), 3(rd), and 6(th) hours at rest (p<0.001) and during movement (p<0.001 for the 1(st) and 3(rd) hours, and p=0.02 for the 6(th) hour) in G-SIFIB compared to GC. There was no difference in pain scores at the 12(th) and 24(th) hours postoperatively. While there was no difference between the groups in terms of other side effects, respiratory depression was significantly higher in GC than in G-SIFIB (p=0.01).Conclusion The SIFIB technique has a significant opioid-sparing effect and thus reduces opioid-related side effects in the first 24 hours after hip fracture surgery in older-old patients.
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    "Factors Associated with Mediastinal Lymph Node Positivity in Proximal Gastric Tumor Patients Undergoing Curative Surgery"
    (2023) Parsak, Cem Kaan; Topal, Ugur; Altiok, Merih; Capkinoglu, Emir; Bali, Cagla; Yalav, Orcun; Rencuzogullari, Ahmet; Sakman, Gurhan
    Background: Gastric cancer is the fifth most common cancer worldwide. Objectives: This study investigated the risk factors associated with mediastinal lymph node metastases due to proximal gastric cancer. Methods: The study included patients with curative surgical resection and transcural lymphadenectomy for proximal gastric tumors between January 2012 and January 2020. The patients (n=88) were divided into Group 1 (n=54, negative) and Group 2 (n=34, positive) according to the positivity of mediastinal lymph nodes. The diagnostic value of composite immunonutritional and inflammatory indices in predicting lymph node positivity was examined. Results: It was found that only C-reactive protein (CRP) (P=0.044), the rate of postoperative respiratory complications (P=0.002), tumor size (P=0.0001), the total number of lymph nodes, and the number of metastatic lymph nodes were higher in Group 2. Moreover, pT stage (P=0.008) and pN stage (P<0.001) were more advanced in Group 2. Among the composite indices, only the neutrophil-to-lymphocyte ratio (NLR) had a diagnostic value, with a sensitivity of 67.65% and a specificity of 55.56% at a cut-off point of > 2.19. According to the multivariate analysis, a tumor size of > 3 cm, a CRP value of > 7, and tumor localization were independent risk factors. Conclusion: Our study found that mediastinal lymph node positivity was associated with elevated CRP and that these patients had more advanced tumors and poor histopathological characteristics. Mediastinal lymph node positivity was also associated with increased postoperative respiratory complications. We established the diagnostic value of the NLR in predicting lymph node positivity. It is helpful to establish the relationship between clinicopathological characteristics and mediastinal lymph node positivity in proximal gastric tumors since it can be useful in determining the surgical strategy for esophagogastric junction tumors.
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    Bifid Epiglottis In Anesthesia Practice
    (2022) Bali, Cagla
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    Anaesthesia Management for Edward's Syndrome (Trisomy 18)
    (2016) Bali, Cagla; Ozmete, Ozlem; Ergeneoglu, Pinar; Akin, Sule; Aribogan, Anis; 27366581; AAI-8790-2021; AAI-7779-2021; J-5282-2013; AAJ-2094-2021; S-8336-2019
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    Anesthesia management for laparoscopic bariatric surgery: retrospective analysis of 62 patients
    (2017) Ozmete, Ozlem; Bali, Cagla; Ergenoglu, Pinar; Akin, Sule; Aribogan, Anis; AAJ-2094-2021; AAI-7779-2021; AAI-8790-2021; J-5282-2013; S-8336-2019
    Purpose: The aim of this study was to present our experience in patients who underwent laparoscopic bariatric surgery and to discuss the current literature on the perioperative management Material and Methods: Sixty two patients with ASA risk classification II-III were evaluated retrospectively who underwent obesity surgery in our hospital. Demographic characteristics of the patients, surgical time, complications that seen in the perioperative period and the length of hospital stay were recorded Results: The age of the patients ranged from 19 to 59 years and 75.9% of them were female. Mean operation time was 167 minutes and the length of hospital stay was 5 days. Complications seen during intraoperative period were tachycardia, hypertension and arrhythmia. In the following days, 6 (9.7%) patients were re-operated and there was no mortality Conclusion: The prevention of complications that may occur in laparoscopic obesity surgery is required with a equipped team and teamwork, a good preoperative preparation, thromboembolism prophylaxis, tight hemodynamics and blood gas monitoring for safe anesthesia
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    Congenital insensitivity to pain: How should anesthesia be managed?
    (2017) Ozmete, Ozlem; Sener, Mesut; Bali, Cagla; Caliskan, Esra; Aribogan, Anis; 0000-0003-2615-1918; 0000-0001-6497-0610; 0000-0002-4419-5693; 0000-0001-5845-699X; 29168371; AAI-7779-2021; AAI-8790-2021; S-8336-2019; AAI-7866-2021
    Congenital insensitivity to pain syndrome is a rare, sensorial and autonomic neuropathy characterized by unexplained fever, insensitivity to pain and anhidrosis. Patients may require anesthesia even for minor surgical procedures due to mental retardation and trauma arising from self-mutilating behavior. A child diagnosed with congenital insensitivity to pain syndrome was scheduled for gastric endoscopy under sedation due to suspected ingestion of a household cleaning disinfectant. Deep sedation was achieved, and spontaneous respiration was maintained. We did not encounter any complications. There is limited data regarding the safe anesthesia management in these patients because of the rarity of the disease. Therefore, we think that more clinical experience, case reports and studies are needed to establish the appropriate anesthesia management.