Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Bali, Cagla

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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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    The Impact of Multimodal Analgesia Timing on Postoperative Pain in Cesarean Delivery. A Prospective Randomized Study
    (2023) Ozmete, Ozlem; Sener, Mesut; Bali, Cagla; Caligan, Esla; Durdag, Gulsen Dorgan; Aribogan, Anis; 38131366
    AIM: The issue of preemptive or preventive use of paracetamol still raises questions in terms of multimodal analgesia in cesarean delivery. A combination of paracetamol and opioid is commonly used for pain management after cesarean delivery. This study aims to compare postoperative pain level and analgesic consumption when using paracetamol at two different perioperative times in cesarean section. MATERIAL AND METHODS: Sixty patients recruited for elective cesarean section under general anesthesia were included in this prospective study. Patients were randomly assigned to receive iv 1 g paracetamol 15 minutes before incision (Group PE) or after delivery of newborn (Group PV). Visual analog scale (VAS) values, 24-hour morphine consumption, additional analgesic requirement, side effects, and patient and surgeons' satisfaction were recorded. RESULTS: Demographic data and hemodynamic values of the patients were similar in both groups. There was no differences between groups in terms of VAS scores at rest and during movement, additional analgesic requirement during the postoperative 1st hour, and 24-hour total morphine consumption. There was no difference in side effects, and patient and surgeon satisfaction scores postoperatively. CONCLUSIONS: Preemptive and preventive use of paracetamol provides the same quality of analgesia and opioid sparing effect without increasing the frequency of adverse effects.
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    Inappropriate Use of Anticoagulant Drugs in Older Adults
    (2014) Bali, Cagla; Ergenoglu, Pinar; Akin, Sule; Aribogan, Anis; https://orcid.org/0000-0003-2615-1918; https://orcid.org/0000-0002-6366-941X; https://orcid.org/0000-0001-6423-1076; https://orcid.org/0000-0002-4419-5693; 24802992; AAI-8790-2021; GON-8465-2022; AAJ-2094-2021; S-8336-2019
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    Anesthesia Management of A Patient with Jervell and Lange-Nielsen Syndrome
    (2015) Bali, Cagla; Ozmete, Ozlem; Ergenoglu, Pinar; Akin, Sule; 0000-0002-6366-941X; 0000-0001-6423-1076; 0000-0001-5845-699X; 0000-0003-2615-1918; 26153335; AAJ-2094-2021; AAI-8790-2021; GON-8465-2022; S-8336-2019; J-5282-2013; AAI-7779-2021
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    Comparison of the Early Term Complications and Patency Rates of the Standard (Parachute) and Diamond-Shaped End-To-Side Anastomosis Techniques in Arteriovenous Fistulas Created for Hemodialysis
    (2018) Yabanoglu, Hakan; Kus, Murat; Arer, Ilker Murat; Bali, Cagla; Avci, Tevfik; Akdur, Aydincan; Caliskan, Kenan; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0001-6529-7579; https://orcid.org/0000-0003-2615-1918; https://orcid.org/0000-0001-5225-959X; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-8767-5021; 30060787; AAJ-7865-2021; AAJ-7870-2021; AAI-8790-2021; AAF-1698-2021; AAA-3068-2021; AAJ-7201-2021
    Objective: To compare the early-term patency and complication rates of the end-to-side anastomosis techniques parachute and diamond-shaped techniques in arteriovenous fistulas. Study Design: Prospective randomised study. Place and Duration of Study: Department of General Surgery, Adana Baskent University Application and Research Hospital, Adana, Turkey, between October 2014 and January 2015. Methodology: Patients with end stage renal disease who underwent arteriovenous fistula creation for hemodialysis were grouped into two according to the anastomosis technique performed. Group 1 was composed of the patients undergoing the standard parachute technique and Group 2 consisted of the patients operated with the diamond-shaped anastomosis technique. The two groups were compared with each other with respect to clinical and demographic data, operative and postoperative variables, and complication and patency rates. Results: A total of 56 patients underwent arteriovenous fistula creation. The overall complication rate was 12.5%. The early-term patency rate was higher in the diamond-shaped anastomosis technique than the standard parachute end-to-side anastomosis technique. Effective dialysis was established after 4 weeks in 48 (85.7%) patients in the overall study group, 23 (82.1%) in Group 1, and 25 (89.2%) in Group 2. However, there was no significant difference between both the techniques with respect to effectiveness of dialysis. Conclusion: Both end-to-side anastomosis techniques have their own advantages and disadvantages. Using a patient-specific suitable technique rather than a standard technique would be more appropriate in arteriovenous fistulas formation.
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    Anesthesia Management and Sugammadex Experience in A Neonate For Galen Vein Aneurysm
    (2016) Ozmete, Ozlem; Bali, Cagla; Ergenoglu, Pinar; Andic, Cagatay; Aribogan, Anis; https://orcid.org/0000-0001-5845-699X; https://orcid.org/0000-0003-2615-1918; https://orcid.org/0000-0002-6366-941X; https://orcid.org/0000-0001-8581-8685; https://orcid.org/0000-0002-4419-5693; 27185673; AAI-7779-2021; AAI-8790-2021; GON-8465-2022; AAM-3180-2021; S-8336-2019
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    A Patient with Churg-Strauss Syndrome Complicated with Pulmonary Hemoptysis
    (2016) Bali, Cagla; Ozmete, Ozlem; Ergenoglu, Pinar; Gedikoglu, Murat; Aribogan, Anis; https://orcid.org/0000-0003-2615-1918; https://orcid.org/0000-0001-5845-699X; https://orcid.org/0000-0002-6366-941X; https://orcid.org/0000-0002-9884-3190; https://orcid.org/0000-0002-4419-5693; 27041254; AAI-8790-2021; AAI-7779-2021; GON-8465-2022; S-8336-2019
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    A Short View of Chronic Graft-Vs-Host Disease
    (2016) Bali, Cagla; Ozmete, Ozlem; Ozyilkan, Nesrin Bozdogan; Akin, Sule; Aribogan, Anis; https://orcid.org/0000-0003-2615-1918; https://orcid.org/0000-0001-5845-699X; https://orcid.org/0000-0002-4973-8132; https://orcid.org/0000-0001-6423-1076; https://orcid.org/0000-0002-4419-5693; 27041253; AAI-8790-2021; AAI-7779-2021; AAI-7880-2021; AAJ-2094-2021; S-8336-2019
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    Preoperative Paracetamol Improves Post-Cesarean Delivery Pain Management: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial
    (2016) Ozmete, Ozlem; Bali, Cagla; Cok, Oya Yalcin; Ergenoglu, Pinar; Ozyilkan, Nesrin Bozdogan; Akin, Sule; Kalayci, Hakan; Aribogan, Anis; 0000-0003-3004-2626; 0000-0002-4973-8132; 0000-0002-6366-941X; 0000-0001-5845-699X; 0000-0001-6423-1076; 0000-0003-2615-1918; 0000-0002-4419-5693; 27555133; AAI-8790-2021; S-8336-2019; AAI-7998-2021; J-5282-2013; AAI-7779-2021; AAJ-2094-2021; AAI-7880-2021; GON-8465-2022
    Study Objective: To evaluate the analgesic effect of preoperative single dose intravenous paracetamol on postoperative pain and analgesic consumption within 24 hours after elective cesarean surgery. Design: Prospective, randomized, double-blind, placebo-controlled clinical trial. Setting: University Teaching Hospital. Patients: American Society of Anesthesiologists (ASA) I and II 60 patients between 18-40 years of age who were scheduled to undergo elective cesarean section. Interventions: Patients were randomized into two groups to receive either intravenous 1 g paracetamol (100 mL) (Group P) or 0.9% NaCl solution (100 mL) (Group C) 15 minutes before the induction of general anesthesia. After delivery of newborn 0.15 mg kg(-1) morphine was administered to all patients in both groups. Postoperative analgesia was provided with patient-controlled intravenous analgesia with morphine in the postoperative period. Measurements: Pain which is the primary outcome measure was assessed at 15th, 30th minutes and 1st, 2nd, 4th, 6th, 12th, 24th hours by the Visual Analogue Scale. Patients' demographics, hemodynamics, Apgar score, additional analgesic requirement, side effects, patients' satisfaction and postoperative total morphine consumption within 24 hours were recorded. Main Results: Median visual analogue scale for pain in Group P was significantly lower compared to Group C at all time points except for the score at 24th h postoperatively (P <.05). Additional analgesic requirement during postoperative first hour was lower in Group P (P <.05). Total morphine consumption was higher in Group C compared with Group P (P <.05). There was no difference between groups with respect to Apgar scores, side effects, and patient satisfaction (P >.05). Conclusions: Preoperative use of single-dose intravenous 1 g paracetamol was found to be effective in reducing the severity of pain and opioid requirements within 24 hours after cesarean section. (C) 2016 Elsevier Inc. All rights reserved.