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    Comparison of thoracic epidural vs paravertebral patient controlled analgesia after donor hepatectomy
    (2012) Koç E.; Toprak H.I.; Aslan S.; Özgül Ü.; Kizilyel C.; Ersoy M.Ö
    Objective: We aimed to compare thoracic epidural vs paravertebral blockade in terms of the relief of postoperative pain in donor hepatectomy. Material and Methods: 50 patients, aged 18-60 years, ASA I-II undergoing donor hepatectomy operation were enrolled in this study. Patients were randomly allocated into two groups of 25 patients each (Group 1, paraver-tebral analgesia; and Group 2, epidural analgesia) and either paravertebral or epidural analgesia was applied at the level of T6-8. Postoperative VAS, vital signs, sedation score, overall patients' satisfaction, cumulative consumption of local anesthetic, rescue analgesic requirements and side effects were evaluated for 24 hours after surgery. Results: Cumulative local anesthetic consumption in Group 1 was higher when compared with Group 2 at 2 and 4 hrs after surgery (p<0.05). In Group 1, rescue analgesic requirement was higher than in Group 2, but the difference was not statistically significant. There was no difference in patient satisfaction between groups. There were no complications except for nausea and vomiting in one patient within each group. Conclusion: Paravertebral analgesia may be a good alternative to thoracic epidural analgesia for postoperative pain control in patients undergoing donor hepatectomy.
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    Retrospective analysis of intoxication patients admitted to intensive care unit: Evidence based management vs personal experience
    (2011) Ertan C.; Gedik E.; Yucel N.; Sinem Akgun F.; Aslan S.; Togal T.; Ozcan Ersoy M.
    Objective: Intoxication is a major problem in emergency departments (ED). Patients shall either be hospitalized or discharged after ED care. This decision requires a thorough evaluation of the patients' risk of mortality and cost effective approach. Aim of this study was to define characteristics of our poisoning patients and appropriateness of their hospitalization decisions to ICU. Methods: Adult patients hospitalized to ICU following admittance to ED within three years period with acute poisoning were retrospectively enrolled. Demographics, poisoning data, former psychiatric history, ICU follow up information, outcome at hospital discharge and in the first 28 days and predominant pathological clinical findings were recorded. Results: Our study group accounted for 3.6 per 1000 ED visits and 16.6% of ICU admittance. Mean age of the patients was 30.21±12.83 years, F/M ratio was 2.2 and 48.9% of the patients were married. Foremost encountered substances were psychoactive drugs (39.4%). 94.2% of our patients were suicidal and 39.8% of them used two or more agents. Intubation and mechanical ventilation was performed for 14 patients (5.1%), mean duration for intubated follow up was 7.07 days. Only two patients with caustic ingestions were dead (0.8%). Mean hospitalization period was 4.78±8.77 days and mean ICU bed use was 2.62±3.18 days. Total hospitalization duration was ?48 hours 198 (72.3%) patients and > 48 hours in 76 patients (27.7%). Conclusion: We speculate that, high rates of early discharge from ICU may support the necessity of a solid ICU admission criterion.