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    Airway management in patients with cleft lip and palate: Evaluation of intubation conditions with videolaryngoscopy
    (2021) Mengu, Servet; Ganidagli, Suleyman; Emeli, Yusuf; Mendes, Ergun; Gocergil, Huseyin; Sevimli, Reşit
    Cleft lip and palate are one of the most common congenital head and neck anomalies and are seen at a frequency of 11-15%. In this study we aimed to observe airway management and intubation conditions with videolaryngoscopy in patients with cleft lip and palate. 40 patients with cleft lip and palate (Group Y) and 40 normal patients (Group N) aged between 4 months and 10 years undergoing elective surgery were included in this prospective randomized study. Mallampati Classification (MMC), Cormack-Lehane Classification (CL-S), thyromental distance (TMM) and mouth opening were evaluated to predict difficult airway. Intubation times, number of intubation attempts, heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation (SpO2) and end-tidal CO2 (Et-C02) values were also recorded. Intubation times was significantly higher in Group Y than Group N. HR and MAP values measured in Group Y were found to be significantly higher than Group N at the 5th and 10th minutes (p <0.05). Et-CO2 values in Group Y were found significantly higher than Group N at the 0 and 2 minutes of measurement times. It was observed that intubation was more difficult and the duration of intubation was longer in patients with cleft lip and palate compared to normal patients in the same age group. Because of this reasons hemodynamic and respiratory parameters were negatively affected in these patients.
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    Comparative analysis of the effects of combined spinal epidural anesthesia versus psoas compartment and sciatic nerve block for partial hip prosthesis in the geriatric population
    (2020) Ozden, Mehmet Mustafa; Cesur, Mehmet; Emeli, Yusuf; Sevimli, Reşit
    Aim: We aimed to compare combined spinal-epidural anesthesia (CSE) and combined psoas compartment & sciatic nerve block (PCSNB) peripheral nerve blocks, in terms of intraoperative and postoperative pain, hemodynamics and side effects in geriatric population who underwent partial hip prosthesis.Material and Methods: A total of 50 patients who underwent elective partial hip prosthesis and PCSNB or CSE were included. The age range was between 60-99 years and ASA scores were ≤ 3. Twenty-five patients underwent CSE anesthesia with 1 mL plain bupivacaine, while PCSNB and iliac crest blocks were employed in 25 patients. Perioperative anesthetic efficacy, blood pressures, pulse rates, saturation values, need for postoperative analgesia and side effects were compared. Results: At the end of the operation, the mean arterial pressure was lower in both groups compared to the baseline (initial) values and the decline in the CSE group was statistically significant. Hypotension was detected in 11 patients (44%) in the CSE group and 2 patients (8%) in the PCSNB group. Effective analgesia was provided in all patients in the CSE group, while 5 patients (20%) required additional analgesic medications through the epidural catheter in the follow-up. The first postoperative analgesic hour was remarkably longer in the PCSNB group (4.84 ± 2.54 hours vs. 1.64 ± 0.9 hours).Conclusion: Our data demonstrated that the combination of the psoas compartment, parasacral, sciatic and iliac crest blocks provides effective analgesia and maintains hemodynamic stability after hip prosthesis operations in elderly patients.
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    Comparative analysis of the effects of combined spinal epidural anesthesia versus psoas compartment and sciatic nerve block for partial hip prosthesis in the geriatric population
    (2020) Özden, Mehmet Mustafa; Cesur, Mehmet; Emeli, Yusuf; Sevimli, Reşit
    Aim: We aimed to compare combined spinal-epidural anesthesia (CSE) and combined psoas compartment & sciatic nerve block (PCSNB) peripheral nerve blocks, in terms of intraoperative and postoperative pain, hemodynamics and side effects in geriatric population who underwent partial hip prosthesis.Material and Methods: A total of 50 patients who underwent elective partial hip prosthesis and PCSNB or CSE were included. The age range was between 60-99 years and ASA scores were ? 3. Twenty-five patients underwent CSE anesthesia with 1 mL plain bupivacaine, while PCSNB and iliac crest blocks were employed in 25 patients. Perioperative anesthetic efficacy, blood pressures, pulse rates, saturation values, need for postoperative analgesia and side effects were compared. Results: At the end of the operation, the mean arterial pressure was lower in both groups compared to the baseline (initial) values and the decline in the CSE group was statistically significant. Hypotension was detected in 11 patients (44%) in the CSE group and 2 patients (8%) in the PCSNB group. Effective analgesia was provided in all patients in the CSE group, while 5 patients (20%) required additional analgesic medications through the epidural catheter in the follow-up. The first postoperative analgesic hour was remarkably longer in the PCSNB group (4.84 ± 2.54 hours vs. 1.64 ± 0.9 hours).Conclusion: Our data demonstrated that the combination of the psoas compartment, parasacral, sciatic and iliac crest blocks provides effective analgesia and maintains hemodynamic stability after hip prosthesis operations in elderly patients.