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    Comparison of intravenous paracetamol and caudal block in terms of analgesic effects in patients at pediatric surgery
    (2019) Erol, Mehmet Kenan; Sengel, Abdulhakim; Kaya, Firdevs
    Aim: In our study, we aimed to evaluate retrospectively the efficacy of postoperative analgesia in patients with caudal block versus paracetamol in 67 cases, between the ages of 2-8 years who had undergone elective inguinal hernia and circumcision surgery after induction of general anesthesia.Material and Methods: In this study, we evaluated retrospectively the files of 67 cases between 2-8 years old patients who had caudal block or I.V. paracetamol who undergone inguinal hernia and circumcision operation between September 2017 and September 2018. The files of the cases, anesthesia follow-up forms and nurse observation forms were examined; demographic data, vital signs, duration of surgery, postoperative analgesic requirement and recorded complications were evaluated.Results: The mean age was 3.2±2.35 years in the caudal group and 4.3±2.15 years in the paracetamol group, the mean body weight was 15.1±4.51 kg in the caudal group and 19.4±6.4 in the paracetamol group. The surgical period of patients in the caudal group was 51±12.2 minutes and it was 37.8±15.8 in the paracetamol group. The mean duration of postoperative analgesia was 8.1±1.42 hours in the caudal group and 1.05±1.0 hours in the paracetamol group. There were no complications in any of the patients in the postoperative period. No significant results were found in the vital signs of both groups. While VAS values were statistically significant at 6th and 12th hours, VAS value at 24th hour was not statistically significant.Conclusion: Caudal epidural anesthesia may be a simple and safe method of anesthesia effective in postoperative pain control. May it ensure serious patient comfort with reduced analgesic requirements after surgery. It may be recommended to use pediatric surgery under umbilicus for high success rates and low complication rates.Keywords: Caudal block; analgesia; circumcision; inguinal hernia; paracetamol.
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    The effect of midazolam on delirium in patients undergoing coronary artery bypass surgery
    (2020) Erol, Mehmet Kenan; Kankilic, Nazim; Kay, Firdevs
    Aim: Delirium is a serious complication seen postoperatively in patients undergoing cardiovascular surgery. In this study, we aimed to investigate the effect of midazolam given preoperatively on the incidence of delirium in the postoperative period in patients undergoing open heart surgery. Material and Methods: The files of patients who underwent open heart surgery between 2017-2019 in Cardiovascular Surgery Intensive Care Unit were retrospectively reviewed. 50 patients were included in the study. Ramsey Agitation Sedation Scale (RASS) and Confusion Assessment Method (CAM-ICU) values were recorded preoperatively, before and after extubation, in the ICU (after the first 24 hours) and after service transfers. Patients were divided into two groups as midazolam used or midazolam-free.Results: 28 patients were male (56%) and 22 were female (44%). The rate of delirium before extubation (T0) during the ICU stay period was significantly higher in the group without midazolam (p = 0.01). Similarly, the rate of delirium after extubation (T1) was found to be high in the group without midazolam (p = 0.00). There were also significant differences in extubation times. It was found 5.48 ± 1.08 hours in the group using midazolam and 8.3 ± 0.69 hours in the group without midazolam (p = 0.00).Conclusion: The use of midazolam in induction and perfusion in patients undergoing cardiopulmonary bypass could reduce the development of delirium in the postoperative period. Besides, RASS and CAM-ICU evaluation forms could be useful in early detection and monitoring of postoperative delirium.
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    A new seton tightening method for anal fistula treatment: sailor's knot
    (Edizioni Luigi Pozzi, 2021) Tatli, Faik; Bardakci, Osman; Ozgonul, Abdullah; Erkmen, Firat; Karaca, Emre; Erol, Mehmet Kenan; Yilmaz, Mehmet
    AIM: There are certain problems experienced while retightening the seton material during the patient follow-ups, such as pain and anaesthesia requirements in perianal fistula. The aim of the present study was to compare a sailor's knot with other seton tightening methods for the surgical treatment of perianal fistulas. MATERIAL AND METHODS: The records of 105 patients who underwent surgeries for perianal fistulas using the seton method between 2016 and 2019 were analysed retrospectively. The demographic characteristics, complaints, fistula localizations, surgery types, hospital stay lengths, postoperative complications and imaging modalities of the patients included in the study were recorded. The patients were divided into two groups according to the surgical treatment method. Those patients who underwent seton procedures with a sailor's knot were included in Group 1. Group 2 included those patients who underwent other seton procedures, including silk and penrose drain procedures. Groups were compared with regard to success rates and postoperative recurrence. RESULTS: There was no statistically significant difference between the groups in terms of the age, gender, fistula type and follow-up duration. Success rate in all patient was 88.6%, 91.2% in group 1 and 87.1% in group 2 (p=0.36). The number of patients with a kind of incontinence was 7 (7.1%), 3 (5.8%) in Group 1 and 4 (7.4%) in Group 2 (p = 0.297). CONCLUSION: There were no statistically significant differences with regard to complications and recurrences between the sailor's knot and the other seton tightening methods used for the treatment of anal fistulas. The sailor's knot is recommended with regard to its easy application and seton retightening with satisfactory outcomes.