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Acetaminophen reduces acute and persistent incisional pain after hysterectomy
(Edizioni Luigi Pozzi, 2018) Koyuncu, Onur; Hakimoglu, Sedat; Ugur, Mustafa; Akkurt, Cagla; Turhanoglu, Selim; Sessler, Daniel; Turan, Alparslan
OBJECTIVE: Acetaminophen is effective for acute surgical pain, but whether it reduces persistent incision pain remains unknown. We tested the primary hypothesis that patients given perioperative acetaminophen have less incisional pain three months after surgery. Our secondary hypotheses were that patients randomized to acetaminophen have less postoperative pain and analgesic consumption, and better functional recovery at three months. METHODS: 140 patients having abdominal hysterectomy were randomly assigned to: 1)intravenous acetaminophen (4 g/day for 72 postoperative hours); or, 2) saline placebo. The primary outcome was incisional pain visual analog scale (VAS) at three months after surgery. The secondary outcomes were (1, 2) postoperative VAS scores while laying and sitting and (3) total patient-controlled intravenous tramadol consumption during the initial 24 hours, (4) DN4 questionnaires and (5) SF-12 at three months after surgery. RESULTS: The persistent incisional pain scores at three months were significantly lower in acetaminophen (median [121, Q3]: 0 [0, 01) as compared with saline group (0 [0, 1]) (P = 0.002). Specifically, 89%, 9%, and 2% of acetaminophen patients with VAS pain score at three months of 0, 1, and 2 or more, as compared with 66%, 23%, and 10% in the saline group (odds ratio: 2.19 (95% CI: 1.33, 3.59), P = 0.002). Secondly, postoperative pain scores both laying and sitting were significantly lower in the acetaminophen group. Acetaminophen group had significantly better DN4 score and mental health related but not physical health related quality of life. CONCLUSIONS: Our results suggest that acetaminophen reduces the risk and intensity of persistent incisional pain. However, there are other mechanisms by which acetaminophen might reduce persistent pain.
Anesthesia management for emergency cesarean section in a patient with takotsubo cardiomyopathy
(Osman Celbiş, 2020) Hakimoğlu, Sedat; Koyuncu, Onur; Akkurt, Çağla; Yeşil, Sümeyra; Urfalı, Senem
Takotsubo cardiomyopathy (TCM) is a clinical entity resembling acute myocardial infarction that develops due to catecholamine discharge and coronary artery spasm following acute stress in postmenopausal women. The most common symptoms are chest pain, syncope and dyspnea. Moreover ST interval and T wave abnormalities are frequently seen on electrocardiogram (ECG). 19-year-old pregnant with TCM undervent for emergency caesarean section (C/S). Ejection fraction was measured 60% in preoperative echocardiography. Anesthesia induction was achieved with 2 mg/kg propofol and 1 mg/kg fentanyl, after rapid serial endotracheal intubation was performed by using 1.2 mg/kg rocuronium bromide. Anesthesia was maintained with sevoflurane. Residual block was reversed by 4 mg/kg dose of sugammadex and there was no there was complication in the perioperative period. In anesthesia management of patients with TCM, minimization of situations that caused an increase in catecholamine, if possible follow-up with advanced cardiac monitoring and it should be postoperative intensive care unit (ICU) preparation. Keywords:
Assessment of the perioperative period in civilians injured in the Syrian Civil War
(Elsevier Science Inc, 2015) Hakimoglu, Sedat; Karcioglu, Murat; Tuzcu, Kasim; Davarci, Isil; Koyuncu, Onur; Dikey, Ismail; Turhanoglu, Selim
Background: Wars and its challenges have historically afflicted humanity. In Syria, severe injuries occurred due to firearms and explosives used in the war between government forces and civilians for a period of over 2 years. Materials and methods: The study included 364 cases, who were admitted to Mustafa Kemal University Hospital, Medicine School (Hatay, Turkey), and underwent surgery. Survivors and non-survivors were compared regarding injury site, injury type and number of transfusions given. The mortality rate found in this study was also compared to those reported in other civil wars. Results: The mean age was 29 (3-68) years. Major sites of injury included extremities (56.0%), head (20.1%), abdomen (16.2%), vascular structures (4.4%) and thorax (3.3%). Injury types included firearm injury (64.4%), blast injury (34.4%) and miscellaneous injuries (1.2%). Survival rate was 89.6% while mortality rate was 10.4%. A significant difference was observed between mortality rates in this study and those reported for the Bosnia and Lebanon civil wars; and the difference became extremely prominent when compared to mortality rates reported for Vietnam and Afghanistan civil wars. Conclusion: Among injuries related to war, the highest rate of mortality was observed in head-neck, abdomen and vascular injuries. We believe that the higher mortality rate in the Syrian Civil War, compared to the Bosnia, Vietnam, Lebanon and Afghanistan wars, is due to seeing civilians as a direct target during war. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.
Castleman sendromlu bir olguda anestezi yaklaşımı
(2013) Koyuncu, Onur; Özbakış Akkurt, Çağla; Sarı, Ali; Turhanoğlu, Selim
Castleman hastalığı etyolojisi tam olarak bilinmeyen nadir bir lenfoproliferatif bozukluktur. Her ne kadar hastalık en sık mediastinal lenf nodlarında görülse de, bunun dışında servikal, retroperitoneal, aksiller ve diğer lenf nodlarını da tutabilir. Castleman sendromlu bir hastada anestezi yaklaşımı, total kalça protezi operasyonu yapılacak bir olgu nedeniyle tartışılmaktadır.
Comparison of Preoperative Acetaminophen, DeksketoprofenTrometamol on Headache Treatment after Electroconvulsive Therapy
(2021) Koyuncu, Onur; Hakimoğlu, Sedat; Patarroyo, Fabio Rodrıguez; Urfalı, Senem; Kokaçya, Mehmet Hanifi; Turan, Alparslan
INTRODUCTION: Electroconvulsive therapy (ECT) is aneffective, life-saving treatment method with no significant sideeffects in the treatment of serious psychiatric disorders such asmania, schizophrenia, and acute catatonia. Headache is aserious complication seen with a high incidence (26-85%) afterthis treatment. Our hypothesis in the study is that pre procedure administration of dexketoprofen trometamol willreduce headache more effectively than acetaminophen withinsix hours after ECT. METHODS: In this prospective, double-blind, single-centerstudy,we studied a total of 225 psychiatric patients aged 18 to80 years having ECT.Before ECT, three analgesic strategieswere (1) acetaminophen 1g / 100ml isotonic, (2) dexketoprofentrometamol 50mg / 100ml isotonic; and (3) 100 ml of placebowas administered intravenously.Headache intensity using VAS(Visual Analog Scale ), heart rate, noninvasive blood pressure,oxygen saturation, respiratory rate, sedation (Ramsey SedationScale), were evaluated at 2, 4 and 6 hours after the ECT.Analgesic requirements and side effects were recorded. RESULTS: The most common diagnosis was depression(41%), followed by schizoaffective disorder (38%), andobsessive compulsive disorder (21%). No difference was foundbetween groups in the headache VAS scores at 2 and 4 hoursbut patients who received dexketoprofen-trometamol havepersistent headache at 6 hours after the procedure. At the 4thhour, 11% of patients in placebo group required rescueanalgesia compared to the other two groups (p = 0,000). DISCUSSION AND CONCLUSION: We found no clinicallysignificant difference between the efficacy of dexketoprofen,acetaminophen, and placebo for reducing headache within thesix-hour period after the ECT procedure.
Comparison of sugammadex and conventional reversal on postoperative nausea and vomiting: a randomized, blinded trial
(Elsevier Science Inc, 2015) Koyuncu, Onur; Turhanoglu, Selim; Akkurt, Cagla Ozbakis; Karcioglu, Murat; Ozkan, Mustafa; Ozer, Cahit; Sessler, Daniel I.
Study Objective: To determine whether the new selective binding agent sugammadex causes less postoperative nausea and vomiting (PONY) than the cholinesterase inhibitor neostigmine. Design: Prospective, randomized, double-blinded study. Setting: University-affiliated hospital. Patients: One hundred American Society of Anesthesiologists physical status 1 and 2 patients scheduled for extremity surgery. Interventions: Patients were randomly assigned to neostigmine (70 mu g/kg) and atropine (0.4 mg per mg neostigmine) or sugammadex 2 mg/kg for neuromuscular antagonism at the end of anesthesia, when 4 twitches in response to train-of-four stimulation were visible with fade. Measurements: We recorded PONY, recovery parameters, antiemetic consumption, and side effects. Main Results: Nausea and vomiting scores were lower in the sugammadex patients upon arrival in the postanesthesia care unit (med: 0 [min-max, 0-3] vs med: 0 [min-max, 0-3]; P <.05), but thereafter low and comparable. Postoperative antiemetic and analgesic consumption were similar in each group. Extubation (median [interquartile range], 3 [1-3.25] vs 4 [1-3.25]; P <.001) first eye opening (4 [3-7.25] vs 7 [5-11]; P <.001), and head lift (4 [2-7.25] vs 8 [11-25]; P <.001) in minutes were shorter in patients given sugammadex. Postoperative heart rates were significantly lower in all measured times patients given neostigmine. Conclusions: Nondepolarizing neuromuscular blocking antagonism with sugammadex speeds recovery of neuromuscular strength but only slightly and transiently reduces PONY compared with neostigmine and atropine. (C) 2014 Elsevier Inc. All rights reserved.
Deneysel kolit modelinde centella asiatika ekstresinin etkinliği
(2017) Özgür, Tümay; Özcan, Oğuzhan; Akküçük, Seçkin; Kılıç, Erol; Koyuncu, Onur; Oruç, Cem; Aydoğan, Akın; Öztürk, Ozan Utku; Motor, Sedat; Yetim, İbrahim; Temiz, Muhittin
Amaç: İnflamatuvar barsak hastalıkları (İBH) çevresel, genetik ve immün faktörlerin sebep olduğu düşünülen bir grup kronik ve inflamatuvar durum olarak tanımlanmaktadır. Tedavisinde başlıca antiinflamatuvar, immünsupresif ve sitotoksik ilaç kombinasyonları kullanılmaktadır. Fakat bu ajanların ciddi yan etkilerinden dolayı yeni tedavi yöntemleri bulmak için araştırmalar yapılmaktadır. Bu çalışmanın amacı dekstran sülfat sodium (DSS) ile indüklenmiş deneysel kolit modelinde Centella Asiatica (CA) ekstresinin etkinliğini araştırmaktır. Gereç ve Yöntem: Çalışmada 24 adet Wistar Albino rat üç eşit gruba ayrıldı. Grup 1' e (kontrol) sadece su verildi. Grup 2' ye (kolit) DSS' li içme suyu ve Grup 3'e (medikasyon grubu) 200mg/kg/gün CA ekstresi ve DSS' li içme suyu verildi. Deney sonunda kolonun histopatolojik incelemesi ve myeloperoksidaz (MPO), malonildialdehit (MDO), tümör nekroz factör alfa (TNF-?) ve interlökin-10 (IL-10) düzeyleri belirlendi. Bulgular: CA ekstratı veilen grupta kolit grubu ile kıyaslandığında TNF- ? düzeyi daha düşüktü ve İL 10 düzeyi daha yüksekti. MPO ve MDA düzeyleri kolit grubunda diğer gruplarla karşılaştırıldığında anlamlı düzeyde daha yüksek bulundu. (p<0.05). Histopatolojik incelemede medikasyon grubunda daha az doku hasarı saptandı. Sonuç: CA ekstresi proinflamatuvar ve antiinflamatuvar sitokin düzeyini değiştirerek immünregulatuvar bir etki göstermektedir. Ayrıca serbest oksijen radikalleri oluşumunu önleyerek doku hasarını önlemektedir. Bu etkilerinden dolayı CA ekstresinin İBH tedavisinde faydalı bir ajan olarak kullanılabileceğini düşünmekteyiz.
Effect of carboxyhemoglobin on postoperative complications and pain in pediatric tonsillectomy patients
(Wiley, 2015) Koyuncu, Onur; Turhanoglu, Selim; Tuzcu, Kasim; Karcioglu, Murat; Davarci, Isil; Akbay, Ercan; Cevik, Cengiz
Background: Carbon monoxide (CO) is a product of burning solid fuel in stoves and smoking. Exposure to CO may provoke postoperative complications. Furthermore, there appears to be an association between COHb concentrations and pain. We thus tested the primary hypothesis that children with high preoperative carboxyhemoglobin (COHb) concentrations have more postoperative complications and pain after tonsillectomies, and secondarily that high-COHb concentrations are associated with more pain and analgesic use. Methods: 100 children scheduled for elective tonsillectomy were divided into low and high carbon monoxide (CO) exposure groups:COHb 3 or 4gdl(-1). We considered a composite of complications during the 7days after surgery which included bronchospasm, laryngospasm, persistent coughing, desaturation, re-intubation, hypotension, postoperative bleeding, and reoperation. Pain was evaluated with Wong-Baker Faces pain scales, and supplemental tramadol use recorded for four postoperative hours. Results: There were 36 patients in the low-exposure group COHb [1.81.2gdl(-1)], and 64 patients were in the high-exposure group [6.4 +/- 2.1gdl(-1)]. Indoor coal-burning stoves were reported more often by families of the high- than low-COHb children (89% vs 72%, P<0.001). Second-hand cigarette smoke exposure was reported by 54% of the families with children with high COHb, but only by 24% of the families of children with low COHb. Composite complications were more common in patients with high COHb [47% vs 14%, P=0.0001, OR:7.4 (95%Cl, lower=2.5-upper=21.7)], with most occurring in the postanesthesia care unit. Pain scores in postanesthesia care unit and one hour after surgery were statistically significantly lower in the low-exposure group [respectively, P=0.020 (95%CI, lower=-1.21-upper=-0.80), P=0.026 (95%CI, lower=-0.03-upper=0.70)], and tramadol use increased at 4h (3.5 (interquartile range: 0-8) vs 6 (5-9) mg, P=0.012) and 24h (3.5 (0-8) vs 6 (5-9) mg, P=0.008). Conclusion: High preoperative COHb concentrations are associated with increased postoperative complications and pain.
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, Senem
Introduction: 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.
The effect of ondansetron on analgesic efficacy of acetaminophen after hysterectomy: A randomized double blinded placebo controlled trial
(Elsevier Science Inc, 2017) Koyuncu, Onur; Leung, Steve; You, Jing; Oksar, Menekse; Turhanoglu, Selim; Akkurt, Cagla; Dolapcioglu, Kenan
Objectives: To determine that perioperative ondansetron reduces the analgesic efficacy of acetaminophen. Design: Randomized, double-blinded study. Patients: 120 patients ASA I-II who underwent abdominal hysterectomy. Interventions: All the patients were given 1 g acetaminophen at skin closure. Patients were divided into two groups; ondansetron HCI (8 mg, 2 ml IV) (Group I, N = 60) and saline (2 ml IV) (Group II, N = 60) at the skin closure. Measurement: Postoperative pain scores (VAS) while resting in bed and sitting, total opioid consumption were noted. Main results: Patients randomized to ondansetron had significantly worse pain scores upon arrival to the recovery unit [by 1.7 (99.7% CI: 0.75, 2.59) cm] and at 1 h [by 13 (0.5, 2.1) cm] while resting in bed. Pain scores while sitting were also significantly greater in ondansetron group at arrival in PACU by 0.6 (99.7% CI: 0.1, 1.0) cm. Thereafter, pain scores did not differ significantly. Median total opioid (tramadol) consumption was 441 [QI, Q3: 280, 578] mg in the ondansetron group and 412 [309, 574] mg in the placebo group, P = 0.95. Conclusions: Ondansetron significantly decreased the analgesic effect of acetaminophen during the initial postoperative period. Our results thus confirm that acetaminophen analgesia is partially mediated by serotonin receptors. However, the reduction was of marginal clinical importance and short-lived. (C) 2017 Elsevier Inc. All rights reserved.
Erector spinae plane block for postoperative analgesia in surgeries with lumbotomy approach : Case series
(İnönü Üniversitesi, 2019) Hakimoğlu, Sedat; Urfalı, Senem; Koyuncu, Onur; Özdemir, Taner
Ultrasound-guided Erector spinae plane (ESP) block is gaining more importance day by day due to its easy applicability, effective results and safety. ESP block is an interfacial plane block technique that is preferred for postoperative analgesia in hip surgery in addition to thoracic and abdominal surgeries. After the standard anesthesia induction, ESP block was performed in the lateral decubitus position by using in-plane technique from the level of T8 vertebra spinous process. A total of 20 ml local anesthetics consisting of 10 ml 0.5% bupivacain and 10 ml 2% lidocaine were given to the interfacial area. Hemodynamic parameters of the patients were quite stable in the intraoperative period. Additional analgesic requirement of the patients was prolonged until 12-36 hours. Consequently ESP block may contribute to multimodal analgesia in surgery with lumbotomy approach.
THE RELATIONSHIP BETWEEN DISEASE SEVERITY AND PREDICTORS OF DIFFICULT INTUBATION IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME
(Carbone Editore, 2015) Akkurt, Buket Cagla Ozbakis; Dogru, Sibel; Koyuncu, Onur; Davarci, Isil; Genc, Sebahat
Objectives: The objective of our study was to identify clinical and polysomnographic predictors of difficult intubation, through the correlation between commonly used measurements to predict difficult intubation. Methods: Consecutive patients diagnosed with moderate or severe obstructive sleep apnea syndrome (OSAS) using polysomnography (PSG), and sex and age matched normal controls were included in the study. The patient group was divided into two subgroups as mild/moderate and severe desease groups. Body mass index (BMI), neck circumference (NC), abdominal circumference (AC), Epworth Sleepiness Scale (ESS) score, Apnea/Hypopnea Index (AHI), Arousal Index (AI) were recorded. Predictive tests for difficult intubation were recorded for each subject. Records were compared between all groups. Results: Forty OSAS patients and 39 control subjects were enrolled in the study. Class III-IV Modified Mallampati Test (MMT) score was found in 37 (%92.5) OSAS patients, while in 10 (25.6 %) of the control subjects. There was statistically significant difference between two groups in terms of NC, AC, interincissor distance (IID). There was a significant inverse correlation between sternomental distance (SMD) and AHI in patients with OSAS. Conclusion: AHI is a reliable predictor of difficult intubation in patients with OSAS and is correlated with the sternomental distance.
The relationship between disease severity and predictors of difficult intubation in patients with obstructive sleep apnea syndrome
(Acta Medica Mediterranea, 2015) Akkurt, Buket Cagla Ozbakis; Dogru, Sibel; Koyuncu, Onur; Davarci, Isil; Genc, Sebahat
Objectives: The objective of our study was to identify clinical and polysomnographic predictors of difficult intubation, through the correlation between commonly used measurements to predict difficult intubation. Methods: Consecutive patients diagnosed with moderate or severe obstructive sleep apnea syndrome (OSAS) using polysomnography (PSG), and sex and age matched normal controls were included in the study. The patient group was divided into two subgroups as mild/moderate and severe desease groups. Body mass index (BMI), neck circumference (NC), abdominal circumference (AC), Epworth Sleepiness Scale (ESS) score, Apnea/Hypopnea Index (AHI), Arousal Index (AI) were recorded. Predictive tests for difficult intubation were recorded for each subject. Records were compared between all groups. Results: Forty OSAS patients and 39 control subjects were enrolled in the study. Class III-IV Modified Mallampati Test (MMT) score was found in 37 (%92,5) OSAS patients, while in 10 (25.6 %) of the control subjects. There was statistically significant difference between two groups in terms of NC, AC, interincissor distance (IID). There was a significant inverse correlation between sternomental distance (SMD) and AHI in patients with OSAS. Conclusion: AHI is a reliable predictor of difficult intubation in patients with OSAS and is correlated with the sternomental distance.
Safety and Complications of Sedation Anesthesia during Pediatric Auditory Brainstem Response Testing
(Karger, 2022) Urfali, Senem; Urfali, Boran; Sarac, Elif Tugba; Koyuncu, Onur
Objective: The auditory brainstem response (ABR) test has been widely used in childhood. Although it is a painless procedure, sedation can be needed in pediatric patients. Thus, this study aimed to evaluate safety and complications of sedation anesthesia applied in pediatric patients during ABR testing. Methods: Medical records of 75 children who underwent ABR testing between 2018 and 2020 were evaluated retrospectively in terms of applicability, safety, and complications of sedation anesthesia. Results: The ages ranged from 3 to 9 (mean 6.2) years. Comorbidity was detected in 20% (n = 15); 3 had multiple comorbidities, and the most common comorbidity was Down syndrome (4%). The drugs used in sedation anesthesia were midazolam in 81.3% (n = 61), a combination of propofol and ketamine in 14.7% (n = 11), and only propofol in 4% (n = 3) of the patients. An additional drug use was needed in 44% (n = 33). The mean procedure time was 40 (range 30-55) min. The mean anesthesia duration was 45 (range 35-60) min. The mean recovery time was 10 (range 5-15) min. Complications related to anesthesia developed in 4 (5.33%) of the patients; respiratory distress, agitation, cough, and nausea-vomiting were seen in one of the patients, respectively. Complications like bradycardia and respiratory or cardiac arrest were not seen at all. Conclusions: The complication rate of sedation anesthesia performed during ABR testing of pediatric patients is quite low. It may be more beneficial to use combinations of sedation drugs instead of using a single sedation drug. Although sedation anesthesia appears to be safe in general, the potentially life-threatening complications of sedative agents should be remembered, especially in children who have comorbidities.
Scientific Publication Performance of Turkish Anaesthesia Clinics in High Impact Factor International Journals Between 2005 and 2014: A Bibliometric Analysis
(Aves, 2017) Yilmaz, Huseyin Oguz; Babazade, Rovnat; Turan, Oguz Alp; Babazade, Betul; Koyuncu, Onur; Turan, Alparslan
Objective: International scientific publication productivity is a tangible indicator for the accuracy of scientific policies. The quality of scientific publications is not increasing despite the fast increase in the publication count in Turkey. The international publication activities of Turkish anaesthesia clinics have not been previously explored. Thus, we aimed to evaluate the high quality scientific productivity of Turkish anesthesia clinics within the last 10 years. Methods: We searched for studies conducted by anaesthesiologists in Turkey within the last 10 years and published in journals listed under the medical subject categories of anaesthesiology and critical care using 'Thomson Reuters InCites' and PubMed databases. We recorded publication year, subject, method, citation count and origin of each paper and conducted descriptive analyses. Results: There were 630 papers meeting our inclusion criteria. Among those, 525 (83%) were studies on anaesthesia, 66 (10%) were studies on critical care and 39 (6%) were studies on pain. The average citation count was 9.90. There were 376 controlled/randomized controlled trials, 98 observational studies, 66 laboratory studies, 64 case series/reports, 5 reviews and 21 letters to the editor. Studies were conducted by universities (82.4%), by training and research hospitals (15.56%), by state and military hospitals (0.63%) and by physicians in private practice (1.27%). Baskent University had the highest publication count, Istanbul University had the highest citation count and Trakya University had the highest publication count per faculty teaching staff. Conclusion: The high-impact scientific productivity of Turkish anesthesia clinics is in a downward trend in the last 10 years, and the average citation count is lower than the global average.
Servikal blok altında karotis endarterektomi operasyonu sonuçlarımız: Anadolu’da bir merkezde ilk uygulama
(2022) Beyaz, Metin Onur; Urfalı, Senem; Kaya, Sefer; Oruç, Dilan; Çömez, Mehmet Selim; Hakimoğlu, Sedat; Koyuncu, Onur
Amaç: Karotis endarterektomi operasyonu genel anestezi ile uygulanabildiği gibi, bölgesel uygulanabilen; servikal rejyonel blok, lokal-rejyonel kombine anestezi ya da lokal infiltrasyon anestezisi altında yapılabilir. Bu çalışmada rejyonel blok uygulaması ile karotis endarterektomi uygulama deneyimlerimizi sunmayı amaçlıyoruz. \rYöntem: Eylül 2020- Ocak 2022 tarihleri arasında karotis arterine endarterektomi operasyonu yapılan 61 hastanın cerrahi sonrası 30 gün süreyle erken dönem sonuçları retrospektif irdelenmiştir. Hastalara ait yaş, cinsiyet, risk faktörleri, şant kullanımı, operasyon süresi, nörolojik olaylar, mortalite ve morbidite değerlendirilmiştir.\rBulgular: Toplam 61 hastanın verileri retrospektif olarak incelenmiştir. Hastalardan 15’i kadın, 46’sı erkekti. Ortalama yaş 61.6±9.1 (48-88) yıl olarak hesaplandı. Semptomatik hasta sayısı 51 idi. 10 hasta asemptomatik olup stenoz derecesi %70’in üzerindeydi. 11 hastada her iki tarafa endarterektomi uygulandı. Toplam olarak 72 karotis endarterektomi operasyonu gerçekleştirildi.\rOrtalama işlem süresi 77.6±19.7 dakika, karotis klemp süresi 29.4±11.5 dakika olarak hesaplandı. Taburcu edilen hiçbir hastada postoperatif ilk ay içinde majör nörolojik olay, kanama, enfeksiyon ya da ölüm ile karşılaşılmadı. \rSonuç: Karotis endarterektomi operasyonu artan tecrübe ile birlikte rejyonel servikal blok altında güvenle gerçekleştirilebilir.
Severe hypoxemia follows hypoxic pulmonary vasoconstriction and/or hypoxic pulmonary vasoconstriction inhibition by inhaled anesthetics: prognostic potential of 100% shunt fractions
(Elsevier Science Inc, 2017) Oksar, Menekse; Koyuncu, Onur; Turhanoglu, Selim
[Abstract Not Available]
Strategies to Prevent Postoperative Nausea and Vomiting
(Kare Publ, 2020) Koyuncu, Onur; Urfali, Senem; Hakimoglu, Sedat; Tasdogan, A. Muhittin
Nausea and vomiting seen within the post-operative recovery room or 24 hours following the operation remain one of the most common complications in the postoperative period. Nausea and vomiting decrease the patient's postoperative satisfaction, which may lead to complications, such as aspiration of gastric contents, dehydration, electrolyte imbalance, hemorrhage, it may also bring about economic losses, prolongs recovery time and length of hospital stay. Therefore, in the preoperative process, it is very important to investigate the risks correctly for each patient concerning postoperative nausea and vomiting and to identify and apply risk-reducing pharmacological and non-pharmacological treatment methods. In this review, the importance of postoperative nausea and vomiting, risk factors, strategies to reduce risks and the treatment algorithm used in prophylaxis are presented.
Takotsubo Kardiyomyopatili Acil Hastada Anestezik Yaklaşım
(2020) Hakimoğlu, Sedat; Koyuncu, Onur; Yeşil, Sümeyra
Takatsubokardiyomiyopatisi (1) (TKM), sıklıkla postmenapozal kadınlarda görülen, akutstres sonrasında katekolamin deşarjına veya koroner arter spazmına bağlıgelişen, akut myokard infarktüsüne benzer bir tablodur. TKM genellikle geridönüşümlü sol ventrikül yetmezliği ile karakterizedir ve şüpheli akut koronersendromların %1-3’ünü oluşturur. En sık semptomlar göğüs ağrısı, senkop,dispnedir ve anormal ST ve T (-) değişiklikleri EKG’ de sıklıkla görülür. Buolgu sunumunda TKM’li acil sezeryan seksiyo nedeniyle operasyonuna alınmış 19yaşında gebedeki anestezi yaklaşımımız sunulmuştur.
Thermal ablation, nonthermal ablation and surgical striping applications: 1-year single center early results
(2022) Beyaz, Metin Onur; Urfalı, Senem; Koyuncu, Onur; Fansa, İyad
Objective: Starting from the 1990’s minimally invasive methods such as endovenous laser ablation (EVLA), radiofrequency ablation (RFA), and ultrasound-guided foam sclerotherapy (UGFS) developed. Method: This study includes a total of 136 patients (81 women/55 men), of whom 22 (10 women/12 men) were treated with classic surgical stripping, 54 (32 women/22 men) with thermal ablation and 60 (39 women/21 men) with non-thermal ablation. Results: Twenty-two patients (10 women/12 men) were treated with surgical stripping. In one female patient a hematoma arose in the medial crural region postoperatively. A radiofrequency catheter (ThermoBLOCK TM) was used in the thermal ablation procedures in 54 patients (32 female/22 male). While permanent paresthesia occurred in one female patient after the procedure, temporary paresthesia occurred in 3 male patients postoperatively. Non-thermal ablation was performed in 60 patients (39 female/21 male). Even through a severe burning sensation was present in 6 patients (5 female/1 male) during the procedure, this symptom was only transient. In one of the patients, deep venous thrombosis (DVT) occurred at the level of the popliteal vein postoperatively at the sixth day. Conclusion: Even if thermal and non-thermal ablation and surgical procedures have the same pain decreasing rates, hematomas and a longer hospital stay are more frequent in surgical procedures.

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