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Öğe Comparison of the postoperative effects of the erector spinae plane block and local infiltration analgesia in patients operated with lumbotomy surgery incision: Randomized clinical study(Lippincott Williams & Wilkins, 2024) Hakimoglu, Sedat; Ozdemir, Taner; Comez, Mehmet Selim; Urfali, Senem; Yildirak, Ekrem; Gorur, Sadik; Turhanoglu, SelimBackground:Our aim was to observe the effects of local infiltration analgesia (LIA) or erector spinae plane block (ESPB) methods, which we applied preemptively in patients who were scheduled for surgery with a lumbotomy surgical incision and on intraoperative remifentanil consumption, and to compare the postoperative numerical rating scale (NRS), morphine demand, consumption, and pain degrees.Methods:Sixty American Society of Anesthesiologists I to III patients aged 18 to 75 years who were due to be operated on with a lumbotomy surgical incision were included in the study. The present study was conducted via prospective, randomized controlled, double-blind trials. After the induction of standard anesthesia, LIA was applied to 30 patients and ESPB was applied to 30 patients preemptively. The dose of remifentanil consumed in the intraoperative period was measured, and the hemodynamic parameters were measured every 5 minutes. Morphine bolus treatment with the postoperative patient-controlled analgesia and rescue analgesia with paracetamol were planned for the patients. Postoperative morphine and additional analgesia consumption, NRS, hemodynamic parameters, and complications were recorded for 48 hours.Results:There was no difference between the groups in terms of demographic and hemodynamic data. The mean consumption of remifentanil was measured as 455 +/- 165.23 mu g in the intraoperative ESPB group and 296.67 +/- 110.59 mu g in the LIA group, and a statistical difference was observed (P = .001). In the postoperative follow-ups, the ESPB group drug consumption and NRS score averages were significantly lower at all times (P = .01; patient-controlled analgesia-morphine, 41.93 +/- 14.47 mg vs 57.23 +/- 15.5 mg and additional analgesic-paracetamol: 2.1 +/- 1.06 vs 4.27 +/- 1.14 g). The mean duration of additional analgesic intake of the groups was 10.6 +/- 8.1 in the LIA group, while it was 19.33 +/- 8.87 in the ESPB group, a significant difference. The patient satisfaction questionnaire was also significantly in favor of ESPB (P = .05).Conclusions:In conclusion, it has been shown that the intraoperative LIA method is more effective in terms of remifentanil consumption and in controlling pain in operations performed with a flank incision, but the ESPB method provides longer and more effective pain control in postoperative follow-ups.Öğe THE EFFECT OF LOW-FLOW VERSUS HIGHFLOW ANESTHESIA ON POSTOPERATIVE COGNITIVE FUNCTIONS IN GERIATRIC PATIENTS UNDERGOING TUR-P SURGERY(Turkish Geriatrics Soc, 2024) Unal, Ekin Anil; Comez, Mehmet Selim; Demirkiran, Hilmi; Koyuncu, Onur; Hakimoglu, Sedat; Urfali, SenemIntroduction: This paper investigates the effect of low -flow anesthesia applications on postoperative cognitive function in geriatric age group (>= 65 years old) patients who underwent elective transurethral resection of the prostate surgery. Materials and Method: A total of 98 patients aged 65 and over who underwent elective transurethral resection of the prostate surgery under general anesthesia between December 2021 and November 2022 in Hatay Mustafa Kemal University Research Hospital's Department of Anesthesiology and Reanimation were included in the study. The patients were subjected to a mini mental test the day before the operation and postoperatively at six hours, one day, three days, and seven days. Visual analogue scale scores were evaluated at 3, 6, 12, 24, 48, and 72 hours. The data obtained were compared between the patient groups who underwent low -flow (1 L/min, n: 49) and high flow (4 L/min, n: 49) anesthesia. P< 0.05 was considered statistically significant. Results: A comparison between the postoperative 6thhour, 1st day, 2nd day, 3rd day, and 7th day mini mental testing scores of the low -flow anesthesia and high flow anesthesia groups did not exhibit any notable variations (p: 0.668, 0.785, 0.745, 0.705, respectively). The visual analogue scale scores of the cases at 3, 6, 12, 24, 48, and 72 hours did not differ statistically according to the type of flow applied (p: 0.316, 0.925, 0.651, 0.548, 0.624, 0.466, respectively). Conclusion: It is thought that low -flow anesthesia can be applied safely, but it does not have a significant effect on cognitive functions compared to high flow anesthesia.Öğe Effects of Dexamethasone on Bupivacaine-Induced Peripheral Nerve Injection Injury in the Rat Sciatic Model(Taylor & Francis Inc, 2021) Comez, Mehmet Selim; Borazan, Yakup; Ozgur, Tumay; Isler, Cafer Tayer; Cellat, Mustafa; Guvenc, Mehmet; Altug, Muhammed EnesIntroduction The aim of this study was to investigate the effect of perineural dexamethasone against intraneural bupivacaine. Material and Methods Rats were divided into 9 groups with 6 animals in each group; Group 1 (Intraneural saline 600 mu L-2ndday), Group 2 (Intraneural saline 600 mu L-7th day), Group 3 (Intraneural saline 600 mu L + perineural dexamethasone 0.5 mg/kg-2nd day), Group 4 (Intraneural saline 600 mu L + perineural dexamethasone 0.5 mg/kg-7th day), Group 5 (Intraneural bupivacaine 10 mg/kg-2nd day), Group 6 (Intranueral bupivacaine 10 mg/kg-7th day), Group 7 (Intraneural bupivacaine 10 mg/kg + perineurald exam ethasone 0.5 mg/kg-2nd day), Group 8 (Intraneural bupivacaine 10 mg/kg + perineural dexamethasone 0.5 mg/kg-7th day), Group 9 (Control group). At the end of the application period, histopathological and immunohistochemical examinations were analyzed. Results and Conclusion It was observed that caspase 3 levels significantly increased in the 5th and 6th groups compared to the 1st and 2nd groups (p < 0.01). However, in the 7th and 8th groups, these levels were similar with 1st and 2nd groups. While a significant decrease in S 100 levels was detected in group 6 (p < 0.05), a significant increase occurred in Group 8 and reached the same levels as Group 2. According to histopathological evaluation, edema, vacuolization and myelin degeneration were significantly increased in groups 5 and 6 (p < 0.05). However, in the 8th group, the mentioned data showed a significant decrease and reached the same levels as group 2. As a result, perineural dexamethasone was found to have protective effects against intraneural bupivacaine induced sciatic nerve damage.Öğe Evidence-Based Recommendations for Pulmonary Function Measurement and Outcomes(Springer International Publishing, 2021) Comez, Mehmet Selim; Esquinas, Antonio M.The pulmonary function test is most often performed by a spirometer. It is important to provide objective information in monitoring lung health and recognizing pulmonary diseases. To this end, some standardizing guidelines have been published since 1979. The guideline, which was updated jointly by ATS and ERS in 2019, offers standards and common recommendations to manufacturers, clinicians, operators, and researchers. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021.Öğe Idiopathic pulmonary fibrosis (IPF) and evidence-based guidelines(Nova Science Publishers, Inc., 2020) Comez, Mehmet SelimIdiopathic pulmonary fibrosis (IPF) is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown cause. The first guideline on IPF management, published in 2000, is based on the consensus of an international group of experts in the field. The guideline, created by hard work by the American Thoracic Society (ATS), European Respiratory Society (ERS), Japanese Respiratory Society (JRS), and Latin American Thoracic Society (ALAT) in 2011, reviewed all available evidence, clarified the definition of IPF, provided precise diagnostic criteria, described the natural course of the disease, and provided evidence-based recommendations for treatment. In 2015, recommendations for the treatment of IPF were updated on the basis of new scientific evidence. No pharmacological intervention has received strong recommendations for treatment. Clinicians should make individualized decisions based on conditional recommendations in the treatment of patients with IPF. © 2020 Nova Science Publishers, Inc.Öğe Nasal oxygenation cannula during noninvasive positive pressure ventilation: Two things better than one?(W B Saunders Co-Elsevier Inc, 2018) Comez, Mehmet Selim; Esquinas, Antonio M.[Abstract Not Available]Öğe Protective effect of oleuropein on ketamine-induced cardiotoxicity in rats(Springer, 2020) Comez, Mehmet Selim; Cellat, Mustafa; Ozkan, Huseyin; Borazan, Yakup; Aydin, Tuba; Gokcek, Ishak; Turk, ErdincThe antioxidant and cardioprotective effects of oleuropein have been reported in several studies; however, its effect on ketamine cardiotoxicity has not been known yet. The aim of this study was to investigate the effects of oleuropein in ketamine-induced cardiotoxicity model in rats. A total of 28 male Wistar Albino rats were included in the study and they were randomly divided into four groups, each having seven rats. Group 1 (control): rats were given 1 mL of DMSO by oral gavage method for 7 days. Group 2 (ketamine): on the seventh day of the study, 60 mg/kg ketamine was administered intraperitoneally. Then, 60 mg/kg ketamine was administered intraperitoneally every 10 min for 3 h. Group 3 (oleuropein): rats were given 200 mg/kg/day oleuropein by oral gavage method for 7 days. Group 4 (oleuropein + ketamine): rats were given 1 x 200 mg/kg oleuropein by oral gavage method for 7 days. Furthermore, 60 mg/kg ketamine was administered intraperitoneally on the seventh day of the experiment. Then, 60 mg/kg ketamine was administered intraperitoneally every 10 min for 3 h. Serum cardiac marker (TnI, CK-MB and CK) levels were measured. Histopathological analysis was performed on a portion of the cardiac tissue. Cardiac tissue oxidative stress and antioxidant markers (MDA, GSH, GSH.Px and CAT), TNF-alpha, IL-6, NF-kappa B, COX-2 and Nrf-2 gene expressions, and protein conversion levels of related genes were determined. Data obtained showed that ketamine administration increased MDA (p < 0.001), TNF-alpha (p < 0.01), IL-6 (p < 0.01), COX-2 (p < 0.001) and NF-kappa B (p < 0.001) levels, as well as serum TnI (p < 0.001), CK-MB (p < 0.001) and CK (p < 0.01) levels whereas decreased GSH (p < 0.05) and Nrf-2 (p < 0.05) levels, as well as GSH-Px (p < 0.001) and CAT (p < 0.05) enzyme activities. Oleuropein administration was observed to decrease MDA, TNF-alpha, IL-6, COX-2, NF-kappa B, TnI, CK-MB and CK levels close to the control group and to increase GSH levels and GSH-Px and CAT enzyme activities close to the control group. This study showed that oleuropein administration reversed the increased oxidative stress and inflammation as a result of the use of ketamine and had protective effects on the heart.Öğe Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?(Aves, 2022) Comez, Mehmet Selim; Aydin, PelinObjective: Postcircumcision pain in children can cause restlessness, crying and bleeding due to trauma. However, there are various methods to prevent postoperative pain, caudal and penile blocks are in the foreground. The primary objective of this study is to evaluate the effectiveness of CB and PB for the relief of postcircumcision pain. The secondary aim is to evaluate the postoperative additional analgesic requirement and side effects of these blocks. Materials and Methods: A total of 148 children between the ages of 2 and 10 who underwent circumcision surgery were randomly assigned to two groups in terms of postoperative analgesia. 1) A group of caudal block (0,5 ml/kg %0.25 levobupivacaine) and 2) A group of penile block (0,3 ml/kg %0,25 levobupivacaine). Premedication and sedoanalgesia were standardized. The pain (FLACC Pain Score), analgesic consumption, motor block (Brornage Scale) and side effects (vomiting, hematoma, urinary retention) were assessed post-operatively for 4 hours. Results: Postoperative FLACC scores were lower for caudale block group in the 1st, 3rd and 4th hours. There was no significant difference in postoperative analgesic consumption between the groups. The most common postoperative side effect was vomiting in both groups. Conclusion: Caudal block provided more effective analgesia than penile block in postcircumcision pain control.Öğe What is the Current Situation of HBV, HCV and HIV Seroprevalence Among Syrian Refugees? Patients Evaluated Preoperatively Over Ten Years(Galenos Publ House, 2022) Comez, Mehmet Selim; Bal, Tayibe; Cabalak, MehmetObjectives: Migration can change the demographic dynamics of host populations in terms of communicable diseases in destination countries. This is a potential public health challenge for the health authorities. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections can lead to the development of chronic liver diseases, cirrhosis and hepatocellular carcinoma, whereas human immunodeficiency virus (HIV) infection can lead to the development of serious opportunistic diseases. The aim of this study was to evaluate the seroprevalence of HBV, HCV and HIV in Syrian refugees and Turkish patients who were evaluated preoperatively in our hospital.Materials and Methods: Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B core antibody, anti-HCV and anti-HIV results of Syrian refugee and Turkish patients who applied to surgical clinics approximately 2011-2021 were retrospectively reviewed.Results: The study comprised 54,446 patients: Turkish patient group (n=20569) and Syrian refugee patient group (n=33877). The Syrian refugee patients had a significantly higher HBsAg seropositivity rate and a significantly lower anti-HBs seropositivity rate than the Turkish patients (p=0.002 and p<0.001, respectively). The anti-HCV and anti-HIV seropositivity rates were similar. The annual preoperative prevalence of HBsAg seropositivity in the Syrian refugee patients tended to significantly decrease gradually from 2011 to 2021 (p<0.001 for <= 30 and p=0.001 for >30 years old).Conclusion: Although HBV seroprevalence gradually decreases and HCV and HIV seroprevalence is low; screening, information and treatment programs should be given due importance because of the serious disease potential and preventable conditions with precautions. Additionally, preoperative screening of refugee patients coming for major surgery may be important for the safety of healthcare professionals.
