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    The effect of erector spinae plane block on postoperative analgesia and respiratory function in patients undergoing laparoscopic cholecystectomy: A double-blind randomized controlled trial
    (Elsevier Science Inc, 2021) Yildiz, Munise; Kozanhan, Betul; Iyisoy, Mehmet S.; Canitez, Ahmet; Aksoy, Nergis; Eryigit, Aysenur
    Study objective: Laparoscopic cholecystectomy (LC) causes moderate-to-severe postoperative pain. Postoperative pain is one of the leading contributors to respiratory dysfunction following surgery. This study investigated the effect of erector spinae plane (ESP) block on postoperative analgesia and respiratory function in patients undergoing LC. Design: Prospective, randomized, controlled trial. Setting: University of Health Science. Patients: Sixty-eight adult patients undergoing LC. Interventions: Both groups received a standardized analgesia protocol. Patients assigned to the ESP block group received an additional bilateral ESP block. Measurements: The primary outcome was assessed as postoperative pain intensity associated with a lower opioid requirement and significant respiratory function improvement. Main results: Numerical rating scale (NRS) scores both at rest and during coughing were significantly lower in the ESP block group than in the control group at all time intervals (p < 0.001 in each) except for hour 2 postoperatively (p = 0.06 and p = 0.13, respectively). Tramadol consumption at 2 h and 24 h postoperatively was significantly lower in the ESP block group than in the controls (p < 0.001 for each). There was significant preservation in forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in the ESP group in comparison to the control group at 2 and 24 h after surgery (p < 0.05 in each). FEV1/FVC and peak expiratory flow rate (PEFR) values were similar in each time interval. Conclusions: Bilateral ESP blocks provides adequate analgesia, allowing for a lower opioid requirement and significant respiratory function improvement after LC; therefore, we concluded that ESP block could be added to the multimodal analgesia protocol in LC.
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    Randomized prospective comparison of midline and off-midline closure techniques in pilonidal sinus surgery
    (Mosby-Elsevier, 2016) Sevinc, Baris; Karahan, Omer; Okus, Ahmet; Ay, Serden; Aksoy, Nergis; Simsek, Gurcan
    Background. Pilonidal sinus is a chronic inflammatory disorder of the intergluteal sulcus. The disorder often negatively affects patients' quality of life, and there are numerous possible methods of operative treatment for pilonidal sinus. The aim of our study was to compare the results of 3 different operative procedures (tension-free primary closure, Limberg flap, and Karydakis technique) used in the treatment of pilonidal disease. Methods. The study was conducted via a prospective randomized design. The patients were randomized into 3 groups via a closed envelope method. Patients were included in the study after admission to our clinic with pilonidal sinus disease and operative treatment already were planned. The 2 main outcomes of the study were early complications from the methods used and later recurrences of the disease. Results. A total of 150 patients were included in the study, and the groups were similar in terms of age, sex, and American Society of Anesthesiologists scores. The median follow-up time of the study was 24.2 months (range, 18.5-34.27) postsurgery. The recurrence rates were 6% for both the Limberg and Karydakis groups and 4% for the tension-free primary closure group. Therefore, there was no substantial difference in the recurrence rates. Conclusion. The search for an ideal treatment modality for pilonidal sinus disease is still ongoing. The main conclusion of our study is that a tension-free healing side is much more important than a midline suture line. Also, tension-free primary closure is as effective as a flap procedure, and it is also easier to perform.