Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Relationship Between Perioperative Factors and Splenic Artery Steal Syndrome After Orthotopic Liver Transplant: A Retrospective Clinical Study(2023) Kuscu, Ozlem Ozkan; Kus, Murat; Incekas, Caner; Ozmete, Ozlem; Ergenoglu, Pinar; Yildirim, Sedat; Torgay, Adnan; Haberal, Mehmet; 37885290Objectives: After orthotopic liver transplant, ischemia of biliary tract and graft loss may occur due to impaired hepatic arterial blood flow. This situation with hypersplenism and impaired hepatic arterial blood flow is defined as splenic artery steal syndrome. The aim of this study was to investigate the relationship between perioperative factors and splenic artery steal syndrome in orthotopic liver transplant patients. Materials and Methods: Forty-five patients who underwent orthotopic liver transplant between 2014 and 2022 were included in the study. The data for the patients were obtained from the hospital database, including the intraoperative anesthesiology and postoperative intensive care records. Results: Eleven patients were diagnosed with splenic artery steal syndrome. Patients with splenic artery steal syndrome had higher need for intraoperative vasopressor agents (P = .016) and exhibited lower intraoperative urine output (P = .031). In the postoperative intensive care follow-up, patients with splenic artery steal syndrome had higher levels of C-reactive protein during the first 48 hours (P = .030). Conclusions: Intraoperative administration of vasopressor drugs, low urine output, and early postoperative high C-reactive protein levels were associated with the development of splenic artery steal syndrome in patients undergoing orthotopic liver transplant. Future studies should focus on investigation of biomarkers associated systemic hypoperfusion that may contribute to the development of splenic artery steal syndrome.Item 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; 38131366AIM: 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.Item Reversal of Rocuronium Induced Neuromuscular Block with Sugammadex in Patients Under 2 Years of Age. A Series of 280 Cases(2023) Ozmete, Ozlem; Dardag, Emre; Civi, Soner; 38131376AIM: Neuromuscular muscle relaxants are still indispensable for surgical procedures requiring general anesthesia, and the use of these agents may result in postoperative residual curarization. Sugammadex may offer a distinct advantage to pediatric patients where residual neuromuscular blockade may be poorly tolerated. Sugammadex is approved for use in adults and children over two years. This is the main reason why large-scale studies could not be conducted in the group of patients younger than two years old. This study aimed to evaluate the efficacy and safety of sugammadex for reversing deep rocuronium-induced neuromuscular blockade in children under two years of age. METHODS: Pediatric patients younger than two years of age who underwent neurosurgery under sevoflurane anesthesia were included in the study. Neuromuscular block was achieved by the administration of rocuronium. It was antagonized by the administration of 5 mg/kg sugammadex and evaluated using train-of-four (TOF). Primary outcome measure was the time from sugammadex administration to return of the TOF ratio to 0,9. Postoperative adverse events were also recorded. RESULTS: Two hundred eighty patients (10 day-24 months of age; 3-18 kg) were included in this study. Reversal of deep rocuronium-induced neuromuscular block with sugammadex was rapid in all patients. No residual curarization or recurarization was observed. No adverse events or hypersensitivity reactions were observed after administration of sugammadex. CONCLUSION: Reversal of rocuronium-induced deep neuromuscular block in infants was rapid and safe. Sugammadex provided safe extubation in patients younger than two years of age who had undergone neurosurgery. Research Fund.Item 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-7779-2021Item 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-8336-2019Item 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-8336-2019Item 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-8336-2019Item 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-8465-2022Study 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.Item Resuscitation Experience in A Patient with Left Ventricular Assist Device(2016) Ozmete, Ozlem; Bali, Cagla; Ergenoglu, Pinar; Suner, Halil Ibrahim; Aribogan, Anis; 0000-0002-6366-941X; 0000-0002-5957-8611; 0000-0003-2615-1918; 0000-0002-4419-5693; 0000-0001-5845-699X; 27687385; AAI-7779-2021; S-8336-2019; GON-8465-2022; J-5282-2013; AAI-8790-2021; AAJ-5381-2021Item Postoperative Analgesic Efficacy of Fascia Iliaca Block Versus Periarticular Injection for Total Knee Arthroplasty(2016) Bali, Cagla; Ozmete, Ozlem; Eker, H. Evren; Hersekli, Murat A.; Aribogan, Anis; 0000-0002-7901-0185; 0000-0003-2615-1918; 0000-0001-5845-699X; 0000-0002-4419-5693; 27871565; AAW-9940-2021; AAI-8769-2021; AAI-8790-2021; AAI-7779-2021; S-8336-2019Study objective: This study evaluated the postoperative analgesic efficacies of fascia iliaca block and periarticular drug injection techniques after TKA (total knee arthroplasty) surgeries. Design: Prospective, randomized clinical trial. Setting: University Teaching and Research Center. Patients: Seventy-one American Society of Anesthesiologists (ASA) I-III patients between 48 and 70 years of age who underwent total knee arthroplasty were randomized. Interventions: Tenoxicam (20 mg) was administered intramuscularly to both groups of patients 30 minutes before surgery. Patients were randomized into two groups to receive fascia iliaca block before the induction of anesthesia (Group FI) or periarticular drug injection during the surgery (Group PI). All surgeries were performed under general anesthesia using standard techniques. Postoperative analgesia was provided with patient-controlled intravenous morphine. Measurements: Total morphine consumption was the primary outcome measure and was recorded postoperatively at 1, 2, 6,12 and 24 hours. Pain levels at rest and on movement (knee flexion) were evaluated using the Visual Analogue Scale (VAS) and recorded at the same time points. Patients' demographics, rescue analgesic demands, side effects, hemodynamics, and satisfaction scores were also recorded. Main results: The groups had similar VAS scores both at rest and on movement (P > .05). However, the amount of cumulative morphine and use at each follow-up period was higher in Group PI (P < .0001). The groups did not differ significantly in rescue analgesic use or side effects, such as nausea/vomiting, hemodynamic variables, and patient satisfaction scores (P > .05). Conclusions: Fascia iliaca block may be used as an alternative method to periarticular injection, and it effectively reduces the amount of morphine used to relieve post-TKA pain. (C) 2016 Elsevier Inc. All rights reserved.