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The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study
(2019) Akbas, Sedat; Ozkan, Ahmet Selim; Sevimli, Reşit; Alan, Saadet
Aim: Peripheral nerve blockade is a common regional anesthetic technique in surgical procedures in daily clinical practice. The aim of this experimental study was to compare perineural dexmedetomidine alone with perineural sodium bicarbonate added to dexmedetomidine for measurement of analgesia, sensorial and motor blockade and histopathologic evaluation. Material and Methods: Twenty-four rabbits were randomly allocated to 3 groups; Group S: sham, Group D: perineural dexmedetomidine (20 mcg/kg) and Group D+SB: perineural dexmedetomidine (20 mcg/kg) plus sodium bicarbonate. (8.4%, 0.125 mL). Analgesia measurement was evaluated by hotplate test, the paw withdrawal response was performed for sensorial and motor blockades, also were recorded at baseline, 30, 60, 90 and 120 min after drug administration. Dissected nerve tissue was also examined for histopathologic evaluation. Results: Latency times of Group D or Group D+SB were significantly longer when compared with Group S at 30, 60, 90 and 120 min. There was no significant difference between Group D and Group D+SB for the all scheduled times. Sensorial and motor blockade scores were similar in all groups. Group D or Group D+SB caused edema, inflammation with neutrophil leukocytes, and degeneration of myelin fibers, increased in vacuolization, granulation tissue and fibrosis. Conclusion: Perineural dexmedetomidine alone or in combination with sodium bicarbonate prolonged the duration of analgesia, but did not enhance the sensorial and motor blockade, when compared with placebo. Perineural dexmedetomidine combined with sodium bicarbonate didn’t enhance the blockage. Dexmedetomidine caused edema, inflammation and degeneration of myelin fibers, increased in granulation tissue and fibrosis.
Comparison of effects of low-flow and normal-flow anesthesia on cerebral oxygenation and bispectral index in morbidly obese patients undergoing laparoscopic sleeve gastrectomy: a prospective, randomized clinical trial
(Termedia Publishing House Ltd, 2019) Akbas, Sedat; Ozkan, Ahmet Selim
Introduction: The effects of low-flow anesthesia on cerebral oxygenation in high-risk, morbidly obese patients are not well known. Aim: In this prospective randomized study, we compared the effects of low-flow (0.75 l/min) and normal-flow (1.5 l/min) anesthesia on regional cerebral oxygen saturation (rSO(2)) and the bispectral index (BIS) in morbidly obese patients undergoing laparoscopic bariatric surgery. Material and methods: Fifty-two morbidly obese patients undergoing laparoscopic bariatric surgery (sleeve gastrectomy) were enrolled in this study. Patients were randomly allocated to two study groups: low flow and normal-flow anesthesia groups. Heart rate, mean arterial pressure, peripheral oxygen saturation, end-tidal carbon dioxide, BIS, left and right rSO(2) and duration of anesthesia and surgery were recorded. Results: The groups were similar with respect to age, gender, height, weight, body mass index, American Society of Anesthesiology physical status, heart rate, duration of anesthesia, and procedure. Mean arterial pressure and end-tidal carbon dioxide, both before and after insufflation of carbon dioxide and after the reverse Trendelenburg position, were significantly higher in the low-flow group. BIS values and left and right rSO(2) during the preoperative and intraoperative periods were similar. Although the difference in right rSO(2) between the two groups after awakening from anesthesia was statistically significant, the results of both groups remained within the normal range and were not clinically meaningful. Conclusions: Low-flow anesthesia is safe regarding hemodynamic and respiratory characteristics, depth of anesthesia, and regional cerebral oxygen saturation in morbidly obese patients undergoing laparoscopic bariatric surgery.
A comparison of general versus regional anesthesia in patients over 100 years old: A retrospective cohort study
(2021) Akbas, Sedat; Özkan, Ahmet Selim; Korkmaz, Mehmet Fatih
Abstract: Aim: As the life expectancy maintains to rise, the number of centenarians applied for surgery is increasing. Functional and anatomical changes in elderly patients may cause postoperative morbidity and mortality. The aim of this retrospective cohort study is to analyze and compare general and regional anesthesia in centenarians underwent different surgeries. Material and Methods: Patients aged over 100 years (American Society of Anesthesiology scores of II–IV) were included in our study. The centenarians were divided into two study groups: general anesthesia (Group GA, n=20) and regional anesthesia (Group RA, n=18). The demographic characteristics, procedure, and hospital data were evaluated. Results: There were no significant differences betveen two groups with regards to gender, height, weight, body mass index, ASA scores, perioperative colloid and crystalloid fluid consumptions. Duration of anesthesia and procedure in Group RA was shorter than that in Group GA. The requirement for invasive arterial monitorization, central venous catheterisation, and nasogastric tube in Group GA was higher than that in Group RA. Postoperative delirium was similar in both groups. Heart rate, mean arterial pressure, and peripheral oxygen saturation were similar. In-hospitality mortality was 26.3% in the entire group of centenarians. Conclusions: This study examined the role of different anesthetic methods in extremely elderly patients over 100 years old during different surgeries. Anesthetic agent preferences, long duration of anesthesia and surgery, and hemodynamic instability can cause serious complications. We therefore conclude that careful considerations are required in extremely elderly patients.
A comparison of general versus regional anesthesia in patients over 100 years old: A retrospective cohort study
(2021) Akbas, Sedat; Ozkan, Ahmet Selim; Korkmaz, Mehmet Hakan
Aim: As the life expectancy maintains to rise, the number of centenarians applied for surgery is increasing. Functional and anatomical changes in elderly patients may cause postoperative morbidity and mortality. The aim of this retrospective cohort study is to analyze and compare general and regional anesthesia in centenarians underwent different surgeries. Material and Methods: Patients aged over 100 years (American Society of Anesthesiology scores of II–IV) were included in our study. The centenarians were divided into two study groups: general anesthesia (Group GA, n=20) and regional anesthesia (Group RA, n=18). The demographic characteristics, procedure, and hospital data were evaluated. Results: There were no significant differences betveen two groups with regards to gender, height, weight, body mass index, ASA scores, perioperative colloid and crystalloid fluid consumptions. Duration of anesthesia and procedure in Group RA was shorter than that in Group GA. The requirement for invasive arterial monitorization, central venous catheterisation, and nasogastric tube in Group GA was higher than that in Group RA. Postoperative delirium was similar in both groups. Heart rate, mean arterial pressure, and peripheral oxygen saturation were similar. In-hospitality mortality was 26.3% in the entire group of centenarians. Conclusions: This study examined the role of different anesthetic methods in extremely elderly patients over 100 years old during different surgeries. Anesthetic agent preferences, long duration of anesthesia and surgery, and hemodynamic instability can cause serious complications. We therefore conclude that careful considerations are required in extremely elderly patients.
A comparison of laryngeal mask airway-supreme and endotracheal tube use with respect to airway protection in patients undergoing septoplasty: a randomized, single-blind, controlled clinical trial
(Bmc, 2021) Karaaslan, Erol; Akbas, Sedat; Ozkan, Ahmet Selim; Colak, Cemil; Begec, Zekine
Background There are doubts among anesthesiologists on the use of the Laryngeal Mask Airway (LMA) in nasal surgeries because of concerns about the occurrence of blood leakages to the airway. We hypothesized that the use of LMA-Supreme (LMA-S) in nasal surgery is comparable with endotracheal tube (ETT) according to airway protection against blood leakage through the fiberoptic bronchoscopy, oropharyngeal leakage pressure (OLP), heart rate (HR), mean arterial pressure (MAP), and postoperative adverse events. Methods The present study was conducted in a prospective, randomized, single-blind, controlled manner on 80 patients, who underwent septoplasty procedures under general anesthesia, after dividing them randomly into two groups according to the device used (LMA-S or ETT). The presence of blood in the airway (glottis/trachea, distal trachea) was analyzed with the fiberoptic bronchoscope and a four-point scale. Both groups were evaluated for OLP; HR; MAP; postoperative sore throat, nausea, and vomiting; dysphagia; and dysphonia. Results In the fiberoptic evaluation of the airway postoperatively, less blood leakage was detected in both anatomic areas in the LMA-S group than in the ETT group (glottis/trachea, p = 0.004; distal trachea, p = 0.034). Sore throat was detected less frequently in the LMA-S group at a significant level in the 2nd, 6th, and 12th hours of postoperative period; however, other adverse events were similar in both groups. Hemodynamic parameters were not different between the two groups. Conclusion The present findings demonstrate that the LMA-S provided more effective airway protection than the ETT in preventing blood leakage in the septoplasty procedures. We believe that the LMA-S can be used safely and as an alternative to the ETT in septoplasty cases.
A Comparison of McGrath MAC Versus C-MAC Videolaryngoscopes in Morbidly Obese Patients Undergoing Bariatric Surgery: A Randomized, Controlled Clinical Trial
(Mary Ann Liebert, Inc, 2019) Akbas, Sedat; Ozkan, Ahmet Selim; Karaaslan, Erol
Introduction: Airway management in morbidly obese patients is a technical challenge for the anesthesiologists. In this study, we aimed to compare the McGrath MAC with C-MAC videolaryngoscopes for tracheal intubation in morbidly obese patients. Materials and Methods: Eighty morbidly obese patients, scheduled for bariatric surgery, were randomly allocated to two study groups: McGrath-MACA (R) and C-MACA (R). The preoperative airway assessment, incidence and attempts for successful intubation, time to intubation, position for successful intubation, percentage of glottic opening (POGO score), ease of intubation, hemodynamic response, and adverse events of tracheal intubation were recorded. Results: Incidence and attempts for successful intubation and position for successful intubation were similar. Time to intubation was significantly shorter in C-MAC than McGrath (p < 0.001). The POGO scores were similar in both groups (p = 0.057). The heart rate and mean arterial pressure of McGrath was significantly higher than C-MAC after tracheal intubation at first minute (p = 0.002). Also adverse events of tracheal intubation were similar. Conclusions: Both devices were efficient and improved the glottic view. However, the C-MAC demonstrated shorter tracheal intubation times, better glottic visualization, and less hemodynamic response than the McGrath. We, therefore, conclude that the C-MAC videolaryngoscope may contribute advantages in performing tracheal intubations in morbidly obese patients.
Comparison of the effects of the McGRATH MAC, C-MAC, and Macintosh laryngoscopes on the intraocular pressures of non-ophthalmic patients: A prospective, randomised, clinical trial
(Elsevier France-Editions Scientifiques Medicales Elsevier, 2021) Ozkan, Ahmet Selim; Akbas, Sedat; Karaaslan, Erol; Polat, Nihat
Introduction: In this prospective, randomised study, we compared the effects of the Macintosh, McGRATH MAC, and C-MAC laryngoscopes on intraocular pressure (IOP) and [13_TD$DIFF]haemodynamics of non-ophthalmic patients during endotracheal intubation. Methods: [14_TD$DIFF]One hundred and twenty adult patients undergoing non[15_TD$DIFF]ophthalmic surgeries performed in the supine position under general [16_TD$DIFF]anaesthesia requiring orotracheal intubation [17_TD$DIFF]were included in this study. The patients were separated randomly and prospectively into 3 groups: Macintosh group (n = 40), McGRATH MAC group (n = 40), and C-MAC group (n = 40). Mean arterial pressure (MAP), heart rate (HR) and IOP of left and right eye were measured at specified times. Results: There were no significant differences with regard to patients characteristics. After intubation, the HR increased significantly in the Macintosh group when compared to the other groups ([18_TD$DIFF]p = 0.001) and the MAP increased significantly in the Macintosh group when compared to the McGRATH MAC group ([18_TD$DIFF]p = 0.001) and the C-MAC group ([19_TD$DIFF]p < 0.001). The IOP values increased in the Macintosh group when compared to the McGRATH MAC group ([20_TD$DIFF]p < 0.001) and the C-MAC group ([20_TD$DIFF]p < 0.001) after intubation. [21_TD$DIFF]Additionally, there was a significant difference between the McGRATH MAC group and C-MAC group in the IOP values of the eyes after intubation ([19_TD$DIFF]p < 0.001). According to the evaluation within the groups, there were significant differences in all of the groups at all times when compared with the baseline values ([19_TD$DIFF]p < 0.001). Conclusions: In this study, we concluded that the C-MAC VL may be preferable when compared to the Macintosh and McGRATH MAC laryngoscopes for use in ophthalmic patients in whom a rise in the IOP is undesirable. (C) 2021 Socie acute accent te acute accent franc , aise d'anesthe acute accent sie et de re acute accent animation (Sfar). Published by Elsevier Masson SAS. All rights reserved.
Difficult airway management of a child with Blepharophimosis Syndrome: Case report
(2018) Ozkan, Ahmet Selim; Polat, Nihat; Akbas, Sedat; Koylu, Zeynep; Durmus, Mahmut
Blepharophimosis syndrome (BS) is a rare autosomal dominant syndrome characterized by eyelid malformations, and abnormal facial morphology. Flat and wide nasal roots, short neck, restricted mouth opening and neck extension, characteristic facial appearance, microcephaly and micrognathia make airway management of patients with BS important for anesthesiologists. Due to systemic pathologies and craniofacial anomalies, difficult airway may be seen in these patients and anesthesia management is important in patients with BS. Because of the difficult airway risk, it is important to determine the anesthetic method and make the necessary preparations. In this case report, we aimed to present difficult airway management of a patient with BS who underwent surgery for ocular disorders. This case report is the second case presented by successful airway management in general anesthesia practice
Difficult airway management of a child with Blepharophimosis Syndrome: Case report
(İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi, 2018) Özkan, Ahmet Selim; Polat, Nihat; Akbas, Sedat; Köylü, Zeynep; Durmus, Mahmut
Öz: Blepharophimosis syndrome (BS) is a rare autosomal dominant syndrome characterized by eyelid malformations, and abnormal facial morphology. Flat and wide nasal roots, short neck, restricted mouth opening and neck extension, characteristic facial appearance, microcephaly and micrognathia make airway management of patients with BS important for anesthesiologists. Due to systemic pathologies and craniofacial anomalies, difficult airway may be seen in these patients and anesthesia management is important in patients with BS. Because of the difficult airway risk, it is important to determine the anesthetic method and make the necessary preparations. In this case report, we aimed to present difficult airway management of a patient with BS who underwent surgery for ocular disorders. This case report is the second case presented by successful airway management in general anesthesia practice.
The effect of intracameral bevacizumab on current hyphema
(2019) Polat, Nihat; Ozkan, Ahmet Selim; Akbas, Sedat; Parlakpinar, Hakan; Akpolat, Nusret
Aim: The aim of this study was to investigate the effect of intracameral bevacizumab on the current hyphema. Material and Methods: The animals were assigned to the following 4 groups; Group 1: One 2.5 mg bevacizumab injection to the anterior chamber; Group 2: One 1.25 mg bevacizumab injection to the anterior chamber; Group 3: One 1cc balanced salt solution injection to the anterior chamber; and Group 4: Untreated hyphema group. Non-heparinized blood that obtained from the rabbit ear was used to fill the anterior chamber to create total hyphema. Intraocular pressures (IOP), hyphema resorption time, clot formation, peripheral synechia formation, and corneal staining were recorded. Results: IOP results were 26±1.2, 30±2.1, 24±2.9, and 22±0.0 mm Hg for groups 1, 2, 3, and 4, respectively, and were significantly higher in group 2 than in the other groups (p= 0.001). Resorption times of hyphema were 13±2.2, 13±3.2, 9±1.7, and 9±1.6 days for groups 1, 2, 3, and 4, respectively, and were significantly longer for the groups receiving bevacizumab than for the others (p=0.018). The clot formation scores were 0.16±0.41, 0.14±0.38, 0.86±0.38, and 1.0±0.0 for groups 1, 2, 3, and 4, respectively, and were significantly lower for the groups receiving bevacizumab than in the other groups (p= 0.002). The peripheral synechia formation scores were 0.0±0.0, 0.0±0.0, 0.43±0.53, and 0.50±0.54 for groups 1, 2, 3, and 4, respectively, and were not significantly different (p= 0.213). The corneal staining scores were 0.85±0.35, 0.86±0.38, 0.14±0.38, and 0.14±0.38 for groups 1, 2, 3, and 4, respectively, and were significantly higher for the groups receiving bevacizumab (p= 0.035). Conclusion: Intracameral bevacizumab may increase complications that related current hyphema.
The effect of perineural application of bupivacaine combined with sodium bicarbonate on the synatic nerve block in rabbits after sevofluran anesthesia
(2020) Sevimli, Reşit; Ozkan, Ahmet Selim; Akbas, Sedat; Alan, Saadet; Turkmen, Ersen
Aim: The aim of this study was to investigate the effect of combining sodium bicarbonate with bupivacaine on prolonging peripheral nerve block time.Material and Method: Following the approval of the required Ethics Committee, 24 male New Zealand rabbit (4250-5350 g) were randomized and divided into three groups. Group 1 sham n:8; Group 2 (bupivacaine): 0.5 mL of 0.5% bupivacaine (0.5 mg / kg) injected into the perineural area. n:8; and Group 3 (bupivacaine + sodium bicarbonate): 0.5 ml of 0.5% bupivacaine + sodium bicarbonate (125 ml of 8.4% injected into the perineural area. n: 8. After the skin was closed in all groups, the paw pull response was monitored and recorded every 30 minutes until the sensory block of the experimental animal returned back. Hot-plate test was used for analgesia evaluation. In addition, tissue histopathology was examined for histopathological evaluation of the injection site. Sensory block was evaluated with claw tightening test and claw pull test (hot-plate) response. The measurements were carried out every 30 minutes for 120 minutes or until the block was completely resolved.Results: 30., 60. and 90.min paw pull response in Group 2 and Group 3 showed statistically significant elongation when compared to Group 1, this difference disappeared in 120 minutes. Compared to the sham group, the 30 min hot plate and claw pull response was significantly longer in group 3 (sodium bicarbonate and bupivacaine), this difference disappeared in 60 minutes (p = 0.018).Conclusion: When sodium bicarbonate and bupivacaine are combined, it was seen in this study that the sensory block was prolonged. We believe that the current results can be used as a guide for future studies.
Effects of preemptive intravenous paracetamol and ibuprofen on headache and myalgia in patients after electroconvulsive therapy A placebo-controlled, double-blind, randomized clinical trial
(Lippincott Williams & Wilkins, 2019) Karaaslan, Erol; Akbas, Sedat; Ozkan, Ahmet Selim; Zayman, Esra Porgali
Background: The aim of this study is to determine the efficacy of preemptive analgesia with paracetamol and ibuprofen to reduce the intensity and incidence of headache and myalgia after electroconvulsive therapy (ECT). Methods: Sixty patients with major depression who were treated with ECT were randomized to receive ECT 3 times a week. The first 3 sessions were included in the study. The patients were divided into 3 groups; Group C (Control, Saline, n = 20), Group P (Paracetamol, n = 20), and Group I (Ibuprofen, n = 20). Demographics, duration of seizure, visual analog scale (VAS) for headache and myalgia and nausea, vomiting and pruritus were evaluated at postoperative 24 hours period. Results: Duration of seizure after ECT was similar in all groups (P=.148). In the study, heart rate and mean arterial pressure were found to be some changes in some of the sessions. There were no significant differences in any comparison for all groups in all sessions regarding VAS scores for headache and myalgia. Incidence of headache and myalgia in Group I was lower than the other groups (P=.233, P=.011, respectively). But, there was no significant difference between the other groups. There was no significant difference in vomiting, intergroups, and intragroup. Conclusions: The findings of our study indicate that pain intensity of headache and myalgia did not show a significant change between groups and within groups. While pain intensity of myalgia between the groups reached no statistical significance, ibuprofen was significantly lowered the incidence of myalgia at postoperative 24 hours period.
The Effects of Secondhand Smoke Exposure on Postoperative Pain and Ventilation Values During One-Lung Ventilation: A Prospective Clinical Trial
(W B Saunders Co-Elsevier Inc, 2019) Ozkan, Ahmet Selim; Ucar, Muharrem; Akbas, Sedat
Objectives: To investigate the relationships between secondhand smoke (SHS) exposure and oxygenation during one-lung ventilation (OLV) in lobectomy surgery and between SHS exposure and postoperative analgesic consumption. Design: Prospective study. Setting: University, Faculty of Medicine, operating room. Participants: Sixty adult patients with American Society of Anesthesiologists score II to III, aged 18 to 65 years, with a body mass index (BMI) <35 kg/m(2) scheduled for lobectomy surgery by open thoracotomy. Interventions: Patients were divided into 2 groups: the SHS group (n = 30) (urine cotinine level >= 6.0 ng/mL) and the NS (nonsmoker) group (n = 30) (urine cotinine level <6.0 ng/mL and no smoking history). SHS exposure was defined according to a previously published algorithm. Measurements and Main Results: Noninvasive blood pressure, electrocardiography, capnography, and peripheral oxygen saturation were monitored, and intra- and postoperative arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2), and intraoperative peak airway pressure were compared between the 2 groups. Postoperative analgesic consumption was calculated. No significant differences in demographics or preoperative data were noted between the 2 groups. PaO2 values 10 minutes after OLV onset and 10 minutes after the end of OLV were increased significantly in the NS group compared with those in the SHS group (p < 0.05). PaO2 values after 10 minutes of OLV in the NS and SHS groups were 285.5 +/- 90 mmHg and 186.7 +/- 66 mmHg, respectively. PaO2 values after OLV termination in the NS and SHS groups were 365.8 +/- 58 mmHg and 283.6 +/- 64 mmHg (p < 0.05), respectively. PaCO2 values 10 minutes after OLV onset, 10 minutes after the end of OLV, at the end of surgery, and upon arrival in the intermediate care unit were significantly different between the 2 groups (p < 0.05). Conclusion: The present study demonstrated that during OLV, patients exposed to SHS exhibited significantly lower arterial oxygen pressure compared with nonsmokers. Arterial carbon dioxide values were increased significantly in SHS-exposed patients. Morphine consumption for postoperative analgesia also was increased in patients exposed to SHS compared with that in nonsmokers. (C) 2018 Elsevier Inc. All rights reserved.
Emergency Difficult Airway Management in a Patient with Severe Epidermolysis Bullosa
(Aves, 2016) Ozkan, Ahmet Selim; Kayhan, Gulay Erdogan; Akbas, Sedat; Kacmaz, Osman; Durmus, Mahmut
Epidermolysis bullosa (EB) is a rare disease characterised by vesiculobullous lesions with minimal trauma to the skin and mucous membranes. Bleeding, scar tissue, contractures, oedema and lesions that can spread throughout the body can cause a difficult airway and vascular access in patients with EB. Therefore, anaesthetic management in patients with EB is a major problem even for experienced anaesthesiologists. Herein, we report a case of difficult airway management in a patient diagnosed with severe EB who presented for emergency tracheostomy because of respiratory failure under general anaesthesia.
Hospice Units as a requirement for terminal stage patients in need of intensive care in Turkey
(E-Century Publishing Corp, 2016) Karaoren, Gulsah; Akbas, Sedat; Serin, Sibel Ocak; Balta, Musa; Koksal, Guniz; Ikizceli, Ibrahim; Oz, Huseyin
Background: Intensive care units (ICUs) are special units providing intensive observation, monitoring and supportive treatments, which can be applied as standardised and continuous patient care. Patients at the terminal stage of illness require monitoring in special units that are staffed by a multi-disciplinary team, which are known as a hospice unit. In this study, we determined whether or not there is a need for a 'hospice unit'. Material and method: In this retrospective study, data for demographic characteristics, diagnoses, comorbidities, examination and laboratory findings were obtained from the emergency department patient records for each patient. Predicted mortality (PM) rates were calculated for each patient using the Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Simplified Acute Physiology Score (SAPS) II score. The Surveillance, Epidemiology and End Results (SEER) grading score was used for grading the patients diagnosed with cancer. Results: We reviewed the records of patients presenting at the emergency department over a 1-year period and found that the majority (63.8%) of patients for whom tertiary level IC monitoring was recommended were over the age of 60 years, 20% had a diagnosis of advanced stage cancer and the predicted mortality rate was almost 60%. Conclusion: The establishment of hospice units in regional reference center would reduce the load on ICU and could be considered to partially resolve the problem of bed unavailability in ICUs.
Intracardiac thrombosis after liver transplantation: Can be detected before surgery?
(Medknow Publications & Media Pvt Ltd, 2017) Ozkan, Ahmet Selim; Kacmaz, Osman; Akbas, Sedat; Sahin, Mahmut; Durmus, Mahmut
[Abstract Not Available]
Nasotracheal intubation for dental surgery: A comparison of direct laryngoscopy with McGrath MAC videolaryngoscopy
(2021) Toy. Erol; Ozkan, Ahmet Selim; Akbas, Sedat; Sanli, Mukadder; Durmus, Mahmut
Aim: The purpose of our study was to compare the McGrath MAC videolaryngoscope (VL) with the Macintosh direct laryngoscope (DL) for the efficacy during nasotracheal intubation (NTI) in patients undergoing dental surgery. Material and Methods: In total, 70 American Society of Anesthesiologist physical status (ASA) I-II patients who underwent elective dental surgery requiring NTI were included in this study. The patients were divided to two groups based on intubation using McGrath MAC VL (n=35) and Macintosh DL (n=35). The patients were monitored via electrocardiography (ECG), noninvasive arterial pressure, and peripheral oxygen saturation (SpO2) after they were taken to the operating room. Preoxygenation was performed with face mask for at least 3 minutes with 100 % O2. In addition, 2 mg/kg propofol and 1 µg/kg fentanyl were administered for anesthesia induction, and 0,6 mg/kg rocuronium was administered for muscular relaxation. NTI was performed 3 minutes after rocuronium injection with a nasotracheal tube. Anesthesia was maintained with sevoflurane and 50% air in oxygen. Mean arterial pressure (MAP), heart rate (HR), SpO2 and end tidal-carbon dioxide (EtCO2) were recorded at baseline; after anesthesia induction; and 1st, 2nd, 3th and 5th minutes after intubation. Cormack-Lehane and Mallampati Scores (MPS), laryngeal compression, duration of intubation, using Magill forceps, ease of intubation, and the incidence of complications due to intubation were recorded. Results: The demographic characteristics of the groups were similar. Regarding the success of the intubation, no significant difference was detected between the McGrath MAC VL group and the Macintosh DL group (p >0,05). However, when intubation times were compared, a significant difference was noted between groups (p<0,05). The intubation time was reduced in the McGrath MAC VL group. No statistically significant difference was observed regarding MAP and HR values. Intubation using McGrath MAC VL was significantly easier than direct laryngoscopy (p<0,05). No difference in complications was observed (p>0,05). Conclusion: We compared the McGrath MAC VL with the Macintosh DL for NTI and found that intubation was applied in less time using McGrath MAC VL than Macintosh DL. Intubation was more easy with McGrath MAC VL than Macintosh DL. We believe that McGrath MAC VL can be preferred to DL for NTI.
North Polar Tube Reduces the Risk of Epistaxis during Nasotracheal Intubation: A prospective, Randomized Clinical Trial
(Elsevier Science Inc, 2019) Ozkan, Ahmet Selim; Akbas, Sedat; Toy, Erol; Durmus, Mahmut
Objective: In this study, a north polar tube (Portex (R) North Polar tube [Ivory PVC Portex tube; Smiths Medical International, Hythe, United Kingdom]) (NPT) and spiral tube (ST) were compared for their ability to provide a nasal airway in patients during maxillofacial surgery. Methods: Patients who were aged 18 to 65 years with American Society of Anaesthesiologists score 1 to 2 and Mallampati score 1 to 2 were included in the study. The anesthesia technique was standardized in all patients. Patients were divided into 2 groups randomly: the NPT (n=35) and ST groups (n=35). Anesthesia was administered with 1% to 2% sevoflurane and a mixture of 50% oxygen+ 50% air in both groups. The mean arterial pressure and heart rate values of preinduction; preintubation; and the first, second, third, and fifth minutes of intubation were recorded. Epistaxis, intraoral bleeding, cuff burst, use of Magill pens, duration of intubation, intubation difficulty, laryngeal compression, head position change, and glottic grade were evaluated. Results: There were no significant differences between groups in terms of demographic data (gender, age, height, weight, body mass index, American Society of Anaesthesiologists score, and Mallampati score). Macintosh laryngoscopes were used during intubation in all patients. There was no significant difference between groups in terms of intubation difficulty, duration of intubation, use of Magill pens, and determination of the glottic grade (P > 0.05). Epistaxis was significantly lower in the NPT group than in the ST group (P= 0.012). Intraoral bleeding was significantly higher in the ST group than in the NPT group (P=0.001). During intubation, laryngeal compression (Sellick maneuver) and head position changes were significantly lower in the NPT group than in the ST group (P=0.003 and P < 0.001, respectively). There were no significant differences in mean arterial pressure and heart rate between the 2 groups. Conclusions: We conclude that the NPT was associated with less epistaxis and manipulations such as laryngeal compression and head position changes when compared with the ST during nasotracheal intubation. The velvet-soft polyvinyl chloride material of the NPT appears to be responsible for this advantage. (C) 2018 Published by Elsevier Inc.
Privacy awareness among healthcare professionals in intensive care unit: A multicenter, cross-sectional study
(Lippincott Williams & Wilkins, 2023) Ozdinc, Ahmet; Aydin, Zuleyha; Calim, Muhittin; Ozkan, Ahmet Selim; Bakir, Huseyin; Akbas, Sedat
This multicenter, cross-sectional study aimed to determine and examine the privacy awareness and patient rights education of healthcare professionals working in intensive care units (ICUs). The primary purpose of this study was to determine the privacy awareness of healthcare professionals working in the ICU. In addition, the secondary aim was to examine the relationship between patient rights education and awareness scores, as well as to question the need for privacy awareness education. The study population consisted of ICU physicians, nurses, and allied health personnel working in university hospitals, training and research hospitals, state hospitals, and private hospitals in Turkey. The data were collected through a questionnaire prepared by the researchers, including a question set about sociodemographics, a question about patient rights education, and the privacy awareness scale (PAS) scores using online Google Forms. In the results of the study conducted among 569 participants, the mean total PAS score was 38.31 +/- 2.54. The PAS score was significantly different according to the occupation. The PAS scores of the nurses were higher than physicians and allied health personnel. The PAS scores differed according to whether the participants had received patient rights education. This study found that nurses were the group with the highest PAS scores among healthcare professionals. In addition, the PAS scores of nurses working in private and training and research hospitals were higher than those of other hospital employees. On the other hand, the lowest scores belonged to university hospitals and receiving patient rights education increased the PAS score of the nurses. This study showed that all enrolled healthcare professionals required in-service training to gain privacy awareness.
Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study
(2018) Akbas, Sedat; Ozkan, Ahmet Selim
Aim: To determine the optimum anesthetic technique, namely general or regional anesthesia, for elderly patients over 80 years old with hip fracture surgery with respect to demographic characteristics, hemodynamics, length of hospital stay, and mortality. Material and Methods: Patients with the American Society of Anesthesiology (ASA) scores of II–IV aged over 80 years old were included in our study. The patients were retrospectively allocated to two cohort study groups: regional anesthesia (Group GA, n=41) and general anesthesia (Group RA, n=19). The demographic characteristics, hemodynamics, length of hospital stay, and mortality were recorded. Results: The two groups were similar with respect to age, sex, height, weight, body mass index, ideal body weight, ASA scores, and smoking. The number of patients using drugs in Group RA was significantly more than Group GA. The need for invasive arterial monitorization, central venous catheter, and nasogastric tube in Group RA were significantly less. The duration of anesthesia and surgery in Group RA were significantly shorter than Group GA. The length of ICU and hospital stays in Group RA were significantly shorter than Group GA. Hospital mortality of Group GA was significantly higher than that in Group RA. Conclusion: The present retrospective cohort study showed that perioperative complications, duration of anesthesia and surgery, admission to the postoperative ICU, length of ICU and hospital stay, and also mortality in regional anesthesia were significantly lower in comparison with general anesthesia. We therefore conclude that regional anesthesia can be used safely with patients during hip fracture surgery.

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