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    The effect of subarachnoid or epidural bupivacaine on the QTc and P-wave dispersion
    (2020) Ozcan, Sibel; Secen, Ozlem; Yildiz Altun, Aysun; Demirel, Ismail
    Aim: Bupivacaine, which is widely used in neuraxial anesthesia, may lead to negative inotropic effect and arrhythmias. In this study, our objective is to evaluate the effects of bupivacaine on corrected QT interval (QTc) and P wave dispersion in epidural anesthesia and to compare them with those in spinal anesthesia. Material and Methods: Ninety patients (59 male, 31 female) who applied neuraxial anesthesia for unilateral inguinal hernia repair were randomly allocated into two groups: Group S (Spinal, n = 49), Group E (Epidural, n = 41). Neuraxial anesthesia was performed by bupivacaine in both groups. We calculated heart rate, QT interval, corrected QT interval and P wave dispersion from electrocardiography, before anesthesia and after the operation. Results: Postoperative QT interval was significantly longer than preoperative value in both groups (preoperative 0.388 sec in Group S and Group E versus, postoperative 0.407 sec in Group S and 0.397 sec in Group E), (p=0.001). Postoperative QTc prolongation was significantly higher in Group S, but there was no statistically significant difference between the groups (preoperative 0.418 sec versus, postoperative 0.424 sec in Group S), (p = 0.129). Preoperative and postoperative P wave dispersion value revealed no statistically significant differences in both inter- and intragroup comparisons. Conclusion: Bupivacaine caused a postoperative QTc interval prolongation in spinal and epidural anesthesia, which did not reach levels that were regarded as risky for ventricular arrhythmias despite being more prominent in the spinal anesthesia group compared with the epidural anesthesia group
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    Evaluation of the Reasons for the Cancellation of Elective Procedures at Level 3 University Hospital on the Day of Surgery
    (Elsevier Science Inc, 2020) Altun, Aysun Yildiz; Ozer, Ayse Belin; Aksoku, Berna Turhan; Karatepe, Umit; Kilinc, Mikail; Erhan, Omer Lutfi; Demirel, Ismail
    Purpose: Unexpected cancellations of planned elective procedures are a global problem for hospitals, causing a waste of hospital resources and manpower, and reduces the efficiency of hospitals. In this study, we tried to identify the causes of cancellations of elective procedures, and to examine the relationship between the causes. Design: A retrospective, descriptive single-center study. Methods: Nine thousand five hundred sixty-six elective procedures scheduled between January 2015 and December 2015 were retrospectively examined. Reasons for cancellation, the associated surgical clinic, and the day and season of the canceled procedures were recorded. Findings: Of the total 9,566 procedures, 496 (5.2%) were canceled. Of the cancellations, 31.3% were due to patient-related reasons, 29.2% because of inadequate anesthesia preparation, and 19% because of nonavailability of operating rooms. Conclusions: Cancellation of elective surgeries causes a waste of time and resources. Determining the reasons for cancellations to reduce cancellation rates is important for each hospital. (c) 2020 American Society of PeriAnesthesia Nurses. Published by Elsevier, Inc. All rights reserved.