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  • Küçük Resim Yok
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    Effects of combining nicardipine and remifentanil on surgical visual field and hemodynamic parameters in functional endoscopic sinus surgery
    (2025) Karaaslan, Erol; Gülhas, Nurçın; Ozkan, Ahmet Selim; Tunç, Yeliz; Özdeş, Oya Olcay
    Aim: This study examined the impact of using a Nicardipine/Remifentanil combination inducing controlled hypotension (CH) in Functional Endoscopic Sinus Surgery (FESS). The goal was to minimize bleeding and enhance the visibility of the endoscopic field. The study focused on surgical field visibility, asccess, its hemodynamic consequences, and the impact on postoperative paraöeters such as nausea, vomiting, and pain. Materials and Methods: Our study included 73 patients whose age ranging between 18 and 65 years. The patients were randomly assigned to two groups. Group R (Remifentanil) (n=36) patients, and Group RN (Remifentanil/Nicardipine combination) (n=37) patients. Following intubation, In Group R, patients were administered an intravenous (IV) infusion of Remifentanil at a rate of 0.05–2.0 µg/kg/min, while Group RN received Remifentanil at 0.025–1 µg/kg/min, Nicardipine at 0.5–3.5 µg/kg/min. Target mean arterial pressure (MAP) was set at 50–65 mmHg. After the surgical procedure began, bleeding volume, suction requirements, and surgical field visibility were assessed at 15-minute intervals using the Boezaart scale. Duration of stay in the Post-Anesthesia Care Unit (PACU), incidence of nausea, vomiting, and pain assessment with the Numeric Rating Scale (NRS) were evaluated. Results: PACU length of stay was considerably shorter in Group RN compared to Group R (p=0.003). Pain scoring was greater in Group R (p=0.001). Nausea and vomiting scores were less in group RN (p=0.037). SAP and MAP were considerably lower in group RN (p=0.018 and p=0.023). HR values şin all time intervals were greater in group RN (p= <0.001). Boezaart score was lower in group RN during in all intervals (p= <0.001). Conclusion: The Remifentanil/Nicardipine combination provides better surgical field access and visibility byb inducing controlled hypotension (CH) in FESS. This combination is preferable over Remifentanil alone. It effectively maintains CH and shows greater success in reducing postoperative pain, nausea, and vomiting scores.
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    Fonksiyonel endoskopik sinüs cerrahisi olgularında nikardipin ve remifentanil kombinasyonunun cerrahi görme alanı ve hemodinamik parametreler üzerineetkileri
    (İnönü Üniversitesi, 2023) Özdeş, Oya Olcay; Karaaslan, Erol
    Amaç: Bu çalışmada Fonksiyonel Endoskopik Sinüs Cerrahisi Olgularında kanamayı azaltmak ve endoskopik görüş alanını iyileştirmek amacıyla uygulanan kontrollü hipotansiyon (KH) için kullanılan Nikardipin/Remifentanil kombinasyonunun cerrahi görüş alanı, hemodinamik veriler, postoperatif bulantı kusma ve ağrı üzerine etkilerini araştırdık. Materyal ve Metot: Çalışmamıza 18-65 yaş arası 73 hasta dahil edildi. Hastalar randomize olarak iki gruba ayrıldı. Grup R (Remifentanil) 36 hasta, Grup RN (Remifentanil/Nikardipin kombinasyonu) 37 hastayı kapsamaktadır. Entübasyon işlemini takiben Grup R'de: Remifentanil: 0.05–2.0 ?g/kg/dk, Grup RN'de: Remifentanil 0.025- 1 ?g/kg/dk, Nikardipin: 0.5-3.5 ?g/kg/dk intravenöz (ıv) dozu ile infüzyona başlandı. GrupR ve Grup RN'de hedeflenen ortalama arter basıncı (OAB) 50-65 mmHg olarak belirlendi ve ilaç dozları hedeflenen OAB sağlanana kadar arttırıldı. Sistolik arter basıncı (SAB), diastolik arter basıncı (DAB), OAB, kalp hızı (KAH) değerleri T0; İndüksiyon öncesi olmak üzere her on beş dakikada bir, T8; Ekstübasyon sırasında, T9; anestezi? sonrasi bakim ünı? tesı? (PACU)' nde 10. dk'da kaydedildi. Indüksiyon sonrası ekstübasyona kadar her on beş dakikada bir End-tidal karbondioksit (EtCO2) değerleri kaydedildi. Cerrahi operasyon başladıktan sonra 15 dakikada bir kanama miktarı, aspirasyon ihtiyacı ve cerrahi alan görünürlüğü Boezaart skalası ile değerlendirildi. PACU 'da kalış süresi, bulantı kusma ve Sayısal Derecelendirme Skalası (NRS) ağrı ölçeği ile ağrı değerlendirmesi yapıldı. Bulgular: Grup RN'de PACU kalış süresi Grup R'den anlamlı olarak daha kısa izlendi (p=0,003). NRS ağrı skorlamasında gruplar arasında istatistiksel olarak anlamlı farklılık izlendi ve grup R'de daha yüksekti (p=0,001). Bulantı kusma skorlarında gruplar arasında istatistiksel olarak anlamlı farklılık görüldü ve grup RN'de daha düşüktü (p=0,037). SAB ve OAB grup RN'de anlamlı olarak daha düşük bulundu (p=0,018 ve p=0,023). Tüm zaman periyotları boyunca KAH değerinin her iki grup içinde dağılımında anlamlı farklılık belirlendi ve grup RN'de daha yüksekti (p= ?0,001). Tüm zaman periyotları boyunca Boezaart skorunun her iki grup içinde dağılımında anlamlı farklılık vardı ve grup RN'de daha düşüktü (p= ?0,001). Sonuç: Fonksiyonel endoskopik sinüs cerrahisinde KH uygulaması için Remifentanil/Nikardipin kombinasyonu daha iyi bir cerrahi alan kalitesi sağlar. Bu kombinasyonun bir yandan KH'nun sürdürülmesinde bir yandan da postoperatif ağrı ve bulantı kusma skorları üzerinde daha başarılı oluşu nedeniyle remifentanilin tek başına uygulanmasına göre tercih edilebilir bir seçenektir. Anahtar Kelimeler: kontrollü hipotansiyon, nikardipin/remifentanil kombinasyonu, fonksiyonel endoskopik sinüs cerrahisi
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    Publication trends and global collaboration in MAKO robotic-arm assisted total knee arthroplasty: A bibliometric analysis of the last 10 years and future research directions
    (2025) Özdeş, Hüseyin Utku; Özdemir, Ekrem; Özdeş, Oya Olcay
    Total knee arthroplasty (TKA) is a prevalent intervention for end-stage knee osteoarthritis. MAKO robotic-arm assisted technology has emerged to enhance surgical precision, implant positioning, and patient outcomes. This study presents a bibliometric analysis of global research trends on MAKO robotic-arm assisted TKA from 2014 to 2024, aiming to map publication growth, key contributors, and collaboration networks, specifically focusing on the MAKO platform to delineate system-specific research dynamics often obscured in broader robotic TKA analyses, thereby informing future research directions. This study adopts a platform-specific focus to delineate system-level research dynamics often obscured in pooled robotic TKA analyses. A total of 902 publications indexed in the Web of Science database were analyzed using bibliometric tools including VOSviewer, CiteSpace, and Bibliometrix. Publication trends, citation impact, geographic distribution, co-authorship networks, and keyword co-occurrence were examined to identify research hotspots and influential factors. Findings reveal a significant increase in annual publications (CAGR ~28%) and citations, with the United States, India, Germany, and China leading research output. Strong international collaborations were identified, primarily among institutions in the US, Europe, and East Asia. Dominant research themes include implant alignment accuracy, patient-specific surgical planning, and early functional recovery. Most studies were published in high-impact Q1 orthopedic journals. MAKO robotic-arm assisted TKA research has rapidly expanded, reflecting its growing clinical adoption and scientific interest. Despite promising outcomes, challenges such as high costs, learning curves, and limited long-term data persist. While focused on a single CT-based, haptics-enabled platform, these findings complement pooled robotic TKA bibliometrics and motivate cross-platform comparative analyses. Beyond mapping, we synthesize clinical and health-system implications of dominant MAKO-related themes to inform practice and policy. Future research should emphasize long-term clinical outcomes, cost-effectiveness, and integration of artificial intelligence to further optimize robotic TKA and enhance its role in improving patient care.
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    The effects of erector spinae plane block on pain scores and patient experience in unilateral breast cancer surgery: A prospective, randomized clinical trial
    (2025) Ucar, Muharrem; Sanli, Mukadder; Ozkan, Ahmet Selim; Özdeş, Oya Olcay; Ozdemir, Emine; Şanlı, Bayram
    Aim: Breast cancer incidence continues to rise, leading to increased demand for surgical interventions. Postoperative analgesia following breast operations remains an area requiring optimization. The erector spinae plane block (ESP) represents a newer regional technique that may provide advantages over alternative methods. In breast cancer surgeries, We investigated whether unilateral ESP blockade before surgery affected opioid consumption during surgery and improved postoperative pain management and patient satisfaction. Materials and Methods: The study was prospectively randomized and controlled. One hundred women scheduled for unilateral breast cancer surgery were enrolled in the study and randomly assigned to either the ESP block group (Group I, n=50) or the standard care group without block (Group II, n=50). The primary outcome was perioperative opioid consumption. Secondary outcomes included postoperative narcotic consumption, Visual Analog Scale (VAS) pain ratings, urgent analgesic requirements, and patient satisfaction. Results: Intraoperative opioid consumption was lower in Group I; postoperative pain scores, opioid consumption, and patient satisfaction scores were better compared to Group II.Conclusion: ESP block, a recently developed regional analgesia approach, improved postoperative pain outcomes and enhanced patient satisfaction following breast cancer surgery.