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    Comparison of the lateral decubitus and beach chair positions in terms of their effects on airway pressure in arthroscopic shoulder surgery
    (2019) Duman Aydin, Pinar; Saylan, Sedat; Besir, Ahmet; Gul, Orkun
    Aim: The aim of this study was to investigate the effects of extravasated fluid on the airway pressure of the patients in different surgical positions.Material and Methods: This prospective observational study included 50 arthroscopic shoulder surgery patients (18-65 years) placed in lateral decubitus (Group L) and beach chair (Group B) positions under general anesthesia. Peak airway pressure (Ppeak) and internal PEEP (iPEEP) measurements were recorded after intubation. The neck, chest, and shoulder circumferences were measured before induction and after operation.Results: The increases in Ppeak and iPEEP values were not statistically significant between the groups (p> 0.05). The total amount of irrigation fluid was significantly higher in Group L (p=0.042), not significantly correlated with Ppeak but positively correlated with the surgery time (r=0.51099; p=0.001 0.05). The neck circumference measurements were statistically significant between the groups. No respiratory complications were observed during the follow-up period.Conclusion: The lateral decubitus and beach chair positions do not cause a clinically significant compromise on the airway pressure in arthroscopic shoulder surgery but a longer operation duration will cause a higher amount of irrigation fluid to be used, leading to an increased circumference of the neck in the postoperative period.Keywords: Shoulder arthroscopy; airway pressure; lateral decubitus position; beach chair position
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    Information on local anesthetics and toxicity for doctors in surgical department of Karadeniz Technical University Medical Faculty Hospital
    (2020) Buran, Sibel; Akdogan, Ali; Besir, Ahmet; Dohman, Davut
    Aim: Local anesthetics are commonly used in surgical interventions and anesthesia applications. The aim of this study was to increase the sensitivity of local anesthetic toxicity to the presence of symptoms, precautions to be taken and the use of 20% lipid infusion for treatment. Material and Methods: The questionnaire was applied on 160 of 205 physicians who were prescribed local anesthetics.Results: Of the 160 participants included in the study, 108 (67.5%) were research assistants, 47 (29.4%) were faculty members and the remaining 5 (3.1%) were expert medical practitioners. 63 of the participants (39.4%) had been working in the medical profession for more than 5 years. While 42.5% of the participants administered local anesthetics every day, 33.1% had not received any training in the area. On the basis of their training status, it was the anesthetists among specialist doctors who were the most trained in anesthetics with a statistically high rate of 86.3%. Thirty-three of the surveyed physicians (20.6%) who responded stated that they had experienced a case of local anesthetic toxicity previously. The most frequent answer to the question in early findings concerning local anesthetic toxicity was anaphylaxis (74.4%). 38.1% of the participants had not heard the use of 20% lipid solution in local anesthetic toxicity. Although there was 20% lipid solution in the university hospital where the research was conducted, 31.9% of the participants knew this.Conclusion: Although local anesthetic toxicity is rare, it frequently occurs in clinical practice. Therefore, physicians should have general knowledge regarding local anesthetic drugs, maximum doses, side effects, toxicity symptoms and the required treatment in the case of toxicity. We also think local anesthetic toxicity should be included in annual training programs and practical applications by other clinical branches that apply local anesthetic drugs as we currently do at our Clinic and physicians should be given appropriate guidance.
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    A retrospective study on the effects of diabetes mellitus on perioperative fibrinogen and bleeding amount in coronary artery bypass surgery patients
    (2018) Tugcugil, Ersagun; Erdivanli, Basar; Sen, Ahmet; Besir, Ahmet
    Aim: In this study, the effects of changes in the coagulation system of diabetic patients that undergo heart surgery on postoperative bleeding amount and complications was investigated. Material and Methods: A total of 106 patients (35 females, 71 males) were retrospectively examined in the study. Patients were divided into two groups: diabetic (Group D, n = 47) and non-diabetic (Group C, n = 59). Preoperative and postoperative hematologic values, postoperative bleeding, and transfusion amounts of all groups were recorded. Results: Preoperative and postoperative fibrinogen and C-reactive protein (CRP) values in Group D were significantly higher compared to those in Group C (p< 0.05 and p< 0.01, respectively). Postoperative bleeding amount, erythrocyte, and fibrinogen transfusion need were found to be significantly lower in Group D compared to Group C (p = 0.04, p = 0.01, and p< 0.001, respectively). Conclusion: Diabetic patients had decreased amount ofpostoperative bleeding, possibly due to a thrombotic tendency caused by chronic inflammation related to diabetes mellitus.