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Öğe Anesthetic management for cesarean birth in pregnancy with the novel coronavirus (COVID-19)(Elsevier Science Inc, 2020) Yilmaz, Resul; Kilic, Fatma; Arican, Sule; Hacibeyoglu, Gulcin; Suslu, Halime; Koyuncu, Mustafa; Uzun, Sema Tuncer[Abstract Not Availabe]Öğe Brachial plexus block for elbow surgery in a patient with spinal muscular atrophy(Elsevier Science Inc, 2021) Hacibeyoglu, Gulcin; Kocadag, Gokhan; Ozkan, Asiye; Yilmaz, Resul; Arican, Sule[Abstract Not Availabe]Öğe Combined erector spinae plane and interscalene brachial plexus block for surgical anesthesia of scapula fracture(Elsevier Science Inc, 2019) Kilicaslan, Alper; Hacibeyoglu, Gulcin; Goger, Esra; Uzun, Sema Tuncer; Ozer, Mustafa[Abstract Not Availabe]Öğe Comparison of Patient Haemodynamics and Cost Analysis between Ketamine and Dexmedetomidine Used for Endoscopic Retrograde Cholangiopancreatography(Istanbul Training & Research Hospital, 2020) Arican, Sule; Yusifov, Merve; Hacibeyoglu, Gulcin; Yilmaz, ResulIntroduction: This study aimed to compare the ketamine-propofol and dexmedetomidine-propofol combinations used for endoscopic retrograde cholangiopancreatography (ERCP) performed under sedation. Primary outcomes were total propofol consumption, recovery and haemodynamic profiles of patients in each study group. Secondary outcomes were sedation-related complications and cost profiles of patients in each study group. Methods: Patients with American Society of Anaesthesiologists class I-III, aged 18-80 years, who underwent ERCP under sedation, were included in the study. Patients were randomly divided into two groups, namely the ketamine group (group KP) and the dexmedetomidine group (group DP). Group KP received 1 mg/kg ketamine plus 1 mg/kg propofol. Group DP received a loading dose of 1 mu g/kg of dexmedetomidine for 10 min and a maintenance dose of 0.5 mu g/kg plus 1 mg/kg of propofol. Moreover, propofol (10-20 mg) was added to keep the Ramsay Sedation scale at >= 3. Cardiopulmonary side effects, nausea, vomiting, hiccups, straining or retching were recorded in all patients. The ERCP procedure duration, as well as the awakening and recovery times, were recorded. Doses and costs of the drugs used were recorded. Patients were discharged when their Modified Alderete score was 10. Results: This study included 80 patients. The duration of ERCP in the groups KP and DP was 23.1 +/- 9.7 min and 24.4 +/- 15.2 min, respectively, and the duration of awakening was 6.0 +/- 3.2 min and 7.3 +/- 2.9 min, respectively. No statistically significant difference was noted. The recovery time was 18.6 +/- 10.6 min and 9.6 +/- 4.0 min in groups KP and DP, respectively, with a statistically significant difference noted. No statistically significant intergroup difference was noted regarding additional propofol doses; however, the total cost was $0.58 +/- 0.16 and $3.03 +/- 0.60 in groups KP and DP, respectively. Conclusion: Both ketamine-propofol and dexmedetomidine-propofol combinations provide safe and effective anaesthesia for ERCP performed under sedation. Even though the recovery time was significantly shorter in group DP, it had a significantly higher cost factor on analysis.Öğe Comparison of pre-operative platelet functions by thromboelastogram in patients selective serotonin reuptake inhibitors user and non-user(Turkish Assoc Trauma Emergency Surgery, 2022) Yilmaz, Resul; Yusifov, Merve; Hacibeyoglu, Gulcin; Arican, Sule; Topal, AhmetBACKGROUND: The use of antidepressant drugs, in particular selective serotonin reuptake inhibitors (SSRIs), has increased in recent years. Using SSRIs can cause changes in serotonin metabolism. Serotonin provides platelet aggregation and plays a role in the regulation of vascular tone and coagulation processes. The aim of this study was to evaluate the effects of SSRI use on coagulation functions with thromboelastogram (TEG) in patients undergoing surgical operation and to compare with non-user cases. METHODS: The study was designed for 60 patients whose physical status was classified according to the American Society of Anes-thesiology (ASA) classification as ASA I-II were included in the study. During routine pre-operative blood tests, 2 ml complete blood sample used and TEG performed. The cases were divided into two groups as SSRI user and non-user and analyzed. RESULTS: R value was higher in SSRI user patients than in non-user patients. The MA value was significantly lower in SSRI user. There was no statistically significant difference in other parameters. In the evaluation based on duration of SSRI use, there was no statistically significant difference between those whose duration of use was more than 1 year and <1 year. CONCLUSION: When the coagulation process was evaluated by TEG method, it was seen that the onset of clotting was prolonged and thrombus formation was slowed down in SSRI users. The results did not reveal that SSRI alone was the cause of bleeding, but it was concluded that slowing the process might be important, especially for surgical operations.Öğe Comparison of pre-operative platelet functions by thromboelastogram in patients selective serotonin reuptake inhibitors user and non-user(Turkish Assoc Trauma Emergency Surgery, 2022) Yilmaz, Resul; Yusifov, Merve; Hacibeyoglu, Gulcin; Arican, Sule; Topal, AhmetBACKGROUND: The use of antidepressant drugs, in particular selective serotonin reuptake inhibitors (SSRIs), has increased in recent years. Using SSRIs can cause changes in serotonin metabolism. Serotonin provides platelet aggregation and plays a role in the regulation of vascular tone and coagulation processes. The aim of this study was to evaluate the effects of SSRI use on coagulation functions with thromboelastogram (TEG) in patients undergoing surgical operation and to compare with non-user cases. METHODS: The study was designed for 60 patients whose physical status was classified according to the American Society of Anes-thesiology (ASA) classification as ASA I-II were included in the study. During routine pre-operative blood tests, 2 ml complete blood sample used and TEG performed. The cases were divided into two groups as SSRI user and non-user and analyzed. RESULTS: R value was higher in SSRI user patients than in non-user patients. The MA value was significantly lower in SSRI user. There was no statistically significant difference in other parameters. In the evaluation based on duration of SSRI use, there was no statistically significant difference between those whose duration of use was more than 1 year and <1 year. CONCLUSION: When the coagulation process was evaluated by TEG method, it was seen that the onset of clotting was prolonged and thrombus formation was slowed down in SSRI users. The results did not reveal that SSRI alone was the cause of bleeding, but it was concluded that slowing the process might be important, especially for surgical operations.Öğe The determination of histopathological and biochemical effects of the rabbit knee joint injected dexketoprofen trometamol(Wiley, 2015) Hacibeyoglu, Gulcin; Saritas, Tuba Berra; Saritas, Zulfikar Kadir; Korkmaz, Musa; Sevimli, Alper; Mehmetoglu, Idris; Otelcioglu, SerefThis study was conducted to investigate possible histopathological effects and biochemical reflections of intra-articular dexketoprofen trometamol. A total of 24 New Zealand rabbits were included in the study. Blood sampling was carried out from all animals on the first day, then they were randomly allocated either to the control group (GroupC, n=9) or the dexketoprofen trometamol group (GroupD, n=15). GroupC underwent each two intra-articular injections of saline, 0.25mL into right and 0.50mL into left knee. Group D was injected 0.25mL (6.25mg) dexketoprofen trometamol into the right knee and 0.50mL (12.5mg) into the left. The groups were divided randomly into three. Tissue and blood samples were collected from Groups C1 and D1 on the first day, C2 and D2 on the second day and C3 and D3 on the 10th day of the study. Interleukin-1 (IL-1), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-) and C-reactive protein (CRP) levels were studied. The histopathological examination of C and D groups did not present any deterioration. IL-6 basal levels were significantly higher in Group D2 compared with C2 and C3 compared with D3. Basal TNF- levels were higher compared with day 1 in Group C1, and IL-6 and CRP levels were higher in Group D3. Also, none of the increases in these values are supported by histopathological evaluation results. Consequently, we suppose that dexketoprofen trometamol does not cause histopathological deterioration in articular cartilage of rabbits, and the increases in biochemical parameters exclusively are not clinically significant.Öğe The effect of low dose ionizing radiation exposure on dynamic thiol-disulfide homeostasis and ischemia modified albumin levels: an observational study(Elsevier Science Inc, 2020) Arican, Sule; Dertli, Ramazan; Baktik, Suleyman; Hacibeyoglu, Gulcin; Erol, Atilla; Ulukaya, Sinan Oguzhan; Goger, EsraBackground: The primary objective of this study was to investigate the effect of low dose ionizing radiation exposure on thiol/disulfide homeostasis and ischemia modified albumin levels. The secondary objective is to compare thiol/disulfide homeostasis and ischemia modified albumin levels among the personnel exposed to low dose ionizing radiation in anesthesia application areas, in and out of the Operation room. Methods: The study included a total of 90 volunteers aged between 18 and 65 years old, with 45 personnel working in a setting with potential for radiation exposure (Exposed Group) and 45 personnel in a setting without radiation exposure (Control Group). Their native thiol, total thiol, disulphide, albumine and IMA levels were measured. Exposed group included personnel who were exposed to radiation outside the operating room - Operation room (-) Group and inside the Operating room - Operation room (+) Group. Results: Albumin, native and total thiol levels were significantly lower in the participants exposed to radiation in the anesthesia application area, no statistically significant difference was found in terms of disulfide and ischemia modified albumin levels. In the Operation room (-) group exposed to radiation, native thiol and total thiol values were significantly lower compared to the Operation room (+) groups. Conclusion: Awareness of being in danger of oxidative stress should be established in personnel exposed to radiation in the anesthesia application area following low dose ionizing radiation exposure, and the necessary measures should be taken. (C) 2020 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.Öğe Effects of Bilateral Infraorbital-Supraorbital Nerve Block on Postoperative Pain Control and Drug Consumption in Rhinoplasty(Aves, 2021) Yilmaz, Resul; Arican, Sule; Hacibeyoglu, Gulcin; Uzun, Sema TuncerObjective: Rhinoplasty is a common procedure performed in plastic surgery. Postoperative pain, edema, and periorbital ecchymosis are the most common acute complications of this surgical procedure. In this study, we aimed to evaluate the postoperative pain and analgesic consumption after rhinoplasty of patients who had bilateral supraorbital and infraorbital nerve block. Methods: Eighty-four patients who underwent rhinoplasty under general anesthesia, between 17 and 41 years of age, and who underwent intravenous patient-controlled morphine analgesia for postoperative analgesia were included in this study. The cases were divided into two groups: bilateral supra-infraorbital block with intravenous analgesic (Group B) and only intravenous analgesic (Group C). Demographic data, hemodynamic data, operation time, visual analog scale values, patient-controlled analgesia device data, complaints of nausea-vomiting, and antiemetic drug use were recorded. Results: The hemodynamic data of the cases included in this study were similar (P > .05). When compared with Group C, postoperative 1st, 6th, and 24th hour visual analog scale (VAS) scores were found to be significantly lower in Group B (P < .05). Morphine consumption at the end of the postoperative 24 hours was found to be significantly lower in Group B compared with Group C (P < .05). Conclusion: In this study, which cases undergoing bilateral supraorbital-infraorbital nerve block and IV morphine was used for postoperative analgesia after rhinoplasty, significant reductions were achieved in the postoperative VAS values and analgesic consumption of the cases where the block was used.Öğe The effects of sevoflurane anesthesia on hemodynamics and cerebral artery diameters in endovascular treatment of intracranial aneurysm: A pilot study(Turkish Assoc Trauma Emergency Surgery, 2021) Arican, Sule; Bakdik, Suleyman; Hacibeyoglu, Gulcin; Yilmaz, Resul; Koc, Osman; Tavlan, Aybars; Uzun, Sema TuncerBACKGROUND: Cerebral autoregulation is a steady-state of cerebral blood flow despite major changes in arterial blood pressure. Inhalation anesthetics are cerebral vasodilators. In <1 MAC values, the net effect is a moderate decrease in cerebral blood flow and maintenance of responsiveness to carbon dioxide. This study aims to investigate the effects of steady-state sevoflurane anesthesia on hemodynamic and cerebral artery diameter measurements in patients undergoing flow diverter device placement under general anesthesia. METHODS: Forty-six patients aged 18-70 years who underwent flow diverter devices under general anesthesia were included in this study. Routine monitoring was performed on the patients. Mean arterial pressure (MAP) values were recorded. Internal carotid artery, middle cerebral artery and anterior cerebral artery diameter measurements were made from digital subtraction angiography (DSA) images of patients with anterior aneurysms. Baseline artery, right posterior cerebral artery and left posterior cerebral artery diameter measurements were made from DSA images of patients with posterior aneurysms. These measurements were recorded as preoperative measurements. The same measurements were made from the DSA images performed before the Flow diverter device placement procedure performed under steady-state sevoflurane anesthesia for the same patients. These measurements were recorded as peroperative measurements. RESULTS: The average age of the patients was 56.6 +/- 15.1. The MAP of the patients before induction was 76.28 +/- 5.13 mmHg, MAP after induction was 64.36 +/- 3.23 mmHg, and MAP during sevoflurane anesthesia was 68.26 +/- 4.30 mmHg, there was a statistically significant difference. There was a statistically significant difference between the preoperative and perioperative values of anterior cerebral artery diameters. There was a strong relationship between the MAP change percentage and the ICA diameter change percentage (p<0.001, p=-0.785) and a moderate relationship between the MCA diameter change percentage (p=0.033, p=-0.338). CONCLUSION: In patients undergoing flow diverter devices, <1 MAC sevoflurane has a hemodynamic effect and creates significant vasodilation in the cerebral artery diameters.Öğe The effects of sevoflurane anesthesia on hemodynamics and cerebral artery diameters in endovascular treatment of intracranial aneurysm: A pilot study(Turkish Assoc Trauma Emergency Surgery, 2021) Arican, Sule; Bakdik, Suleyman; Hacibeyoglu, Gulcin; Yilmaz, Resul; Koc, Osman; Tavlan, Aybars; Uzun, Sema TuncerBACKGROUND: Cerebral autoregulation is a steady-state of cerebral blood flow despite major changes in arterial blood pressure. Inhalation anesthetics are cerebral vasodilators. In <1 MAC values, the net effect is a moderate decrease in cerebral blood flow and maintenance of responsiveness to carbon dioxide. This study aims to investigate the effects of steady-state sevoflurane anesthesia on hemodynamic and cerebral artery diameter measurements in patients undergoing flow diverter device placement under general anesthesia. METHODS: Forty-six patients aged 18-70 years who underwent flow diverter devices under general anesthesia were included in this study. Routine monitoring was performed on the patients. Mean arterial pressure (MAP) values were recorded. Internal carotid artery, middle cerebral artery and anterior cerebral artery diameter measurements were made from digital subtraction angiography (DSA) images of patients with anterior aneurysms. Baseline artery, right posterior cerebral artery and left posterior cerebral artery diameter measurements were made from DSA images of patients with posterior aneurysms. These measurements were recorded as preoperative measurements. The same measurements were made from the DSA images performed before the Flow diverter device placement procedure performed under steady-state sevoflurane anesthesia for the same patients. These measurements were recorded as peroperative measurements. RESULTS: The average age of the patients was 56.6 +/- 15.1. The MAP of the patients before induction was 76.28 +/- 5.13 mmHg, MAP after induction was 64.36 +/- 3.23 mmHg, and MAP during sevoflurane anesthesia was 68.26 +/- 4.30 mmHg, there was a statistically significant difference. There was a statistically significant difference between the preoperative and perioperative values of anterior cerebral artery diameters. There was a strong relationship between the MAP change percentage and the ICA diameter change percentage (p<0.001, p=-0.785) and a moderate relationship between the MCA diameter change percentage (p=0.033, p=-0.338). CONCLUSION: In patients undergoing flow diverter devices, <1 MAC sevoflurane has a hemodynamic effect and creates significant vasodilation in the cerebral artery diameters.Öğe Evaluation of the efficacy of erector spinae plane block and intercostal nerve block in the postherpetic neuralgia(Kare Publ, 2020) Hacibeyoglu, Gulcin; Arican, Sule; Ulukaya, Sinan Oguzhan; Yilmaz, Resul; Reisli, Ruhiye; Uzun, Sema TuncerObjectives: The aim of this study was to compare the efficacy of an intercostal nerve block, which has been used for many years in the treatment of postherpetic neuralgia, and the more recent alternative of an erector spinae plane (ESP) block. Methods: The records of 39 patients who were treated in the algology department for postherpetic neuralgia between May 1, 2015 and May 1, 2018 were evaluated retrospectively. Patients who received an intercostal nerve block constituted Group 1 and those who received an ESP block were categorized as Group 2. The change in numeric rating scale (NRS) and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scores in the short term and in the long term were the primary results of the study. Results: The NRS, LANSS, and sleep interference scale (SIS) scores of the patients in Group 1 and Group 2 were found to be significantly lower at the 24th hour, week 4, and week 12 compared with the values obtained before block application. In Group 1, the scores recorded at week 4 and week 12 were significantly higher than the 24th hour values, whereas no difference was observed between these results in Group 2.There was no significant difference between the groups in the week 4 and week 12 scores. Similarly, no significant difference was observed in the NRS, LANSS, or SIS scores before the block application or at the 24th hour. However, the scores at week 4 and week 12 were significantly lower in Group 2 compared with Group 1. Conclusion: The results indicated that an ESP block significantly decreased neuropathic pain symptoms and the need for additional treatment in postherpetic neuralgia treatment in the long term.Öğe Evaluation of the efficacy of erector spinae plane block and intercostal nerve block in the postherpetic neuralgia(Kare Publ, 2020) Hacibeyoglu, Gulcin; Arican, Sule; Ulukaya, Sinan Oguzhan; Yilmaz, Resul; Reisli, Ruhiye; Uzun, Sema TuncerObjectives: The aim of this study was to compare the efficacy of an intercostal nerve block, which has been used for many years in the treatment of postherpetic neuralgia, and the more recent alternative of an erector spinae plane (ESP) block. Methods: The records of 39 patients who were treated in the algology department for postherpetic neuralgia between May 1, 2015 and May 1, 2018 were evaluated retrospectively. Patients who received an intercostal nerve block constituted Group 1 and those who received an ESP block were categorized as Group 2. The change in numeric rating scale (NRS) and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scores in the short term and in the long term were the primary results of the study. Results: The NRS, LANSS, and sleep interference scale (SIS) scores of the patients in Group 1 and Group 2 were found to be significantly lower at the 24th hour, week 4, and week 12 compared with the values obtained before block application. In Group 1, the scores recorded at week 4 and week 12 were significantly higher than the 24th hour values, whereas no difference was observed between these results in Group 2.There was no significant difference between the groups in the week 4 and week 12 scores. Similarly, no significant difference was observed in the NRS, LANSS, or SIS scores before the block application or at the 24th hour. However, the scores at week 4 and week 12 were significantly lower in Group 2 compared with Group 1. Conclusion: The results indicated that an ESP block significantly decreased neuropathic pain symptoms and the need for additional treatment in postherpetic neuralgia treatment in the long term.Öğe Fluoroscopy-guided genicular nerves pulsed radiofrequency for chronic knee pain treatment(Kare Publ, 2020) Arican, Sule; Hacibeyoglu, Gulcin; Akkoyun, Ozlem; Tuncer Uzun, Sema; Reisli, RuhiyeObjectives: The primary objective of this study was to investigate the effects of Pulsed RF application in the genicular nerve on pain and function in patients with osteoarthritis (OA) and its side effects. Methods:This study was conducted between February 2018 and June 2018. Patients who were previously administered diagnostic blocks were evaluated a day later; a drop of at least 50% in numeric pain scores was considered a positive response, and these patients were included in the Pulsed RF neurotomy procedures. Radiofrequency (RF) cannula was advanced towards targeted nerves under the guidance of fluoroscopy. RF lesions were created by applying Pulsed RF treatment to the three genicular nerves three times with five minutes intervals at 42 degrees C using NT1000 RF Generator. Following the Pulsed RF application, 2 mL 0.5% bupivacaine was injected into each genicular nerve as an anesthetic agent. VAS, pain DETECT scores, WOMAC scores were evaluated preoperative baseline and postprocedure weeks 1, 4, and 12. Patient Global Impression of Change (PGIC) score was evaluated postprocedure weeks 12. Results:This study included 20 patients who were administered genicular nerve Pulsed RE The mean age was 55.2 +/- 3.24 years, and F/M ratio was 12/8. Compared to the pre-procedure period, patients' pain and function evaluation, WOMAC and VAS values decreased by approximately 50% at the end of the 12th week. No side effect was observed in any patients. Conclusion: Our findings suggest that Pulsed RF neurotomy of the genicular nerves is an efficient and safe treatment method for patients with chronic knee osteoarthritis.Öğe Fluoroscopy-guided genicular nerves pulsed radiofrequency for chronic knee pain treatment(Kare Publ, 2020) Arican, Sule; Hacibeyoglu, Gulcin; Akkoyun, Ozlem; Tuncer Uzun, Sema; Reisli, RuhiyeObjectives: The primary objective of this study was to investigate the effects of Pulsed RF application in the genicular nerve on pain and function in patients with osteoarthritis (OA) and its side effects. Methods:This study was conducted between February 2018 and June 2018. Patients who were previously administered diagnostic blocks were evaluated a day later; a drop of at least 50% in numeric pain scores was considered a positive response, and these patients were included in the Pulsed RF neurotomy procedures. Radiofrequency (RF) cannula was advanced towards targeted nerves under the guidance of fluoroscopy. RF lesions were created by applying Pulsed RF treatment to the three genicular nerves three times with five minutes intervals at 42 degrees C using NT1000 RF Generator. Following the Pulsed RF application, 2 mL 0.5% bupivacaine was injected into each genicular nerve as an anesthetic agent. VAS, pain DETECT scores, WOMAC scores were evaluated preoperative baseline and postprocedure weeks 1, 4, and 12. Patient Global Impression of Change (PGIC) score was evaluated postprocedure weeks 12. Results:This study included 20 patients who were administered genicular nerve Pulsed RE The mean age was 55.2 +/- 3.24 years, and F/M ratio was 12/8. Compared to the pre-procedure period, patients' pain and function evaluation, WOMAC and VAS values decreased by approximately 50% at the end of the 12th week. No side effect was observed in any patients. Conclusion: Our findings suggest that Pulsed RF neurotomy of the genicular nerves is an efficient and safe treatment method for patients with chronic knee osteoarthritis.Öğe Fulminant Liver Failure Due to Amanita Phalloides Toxicity Treated with Emergent Liver Transplantation(Modestum Ltd, 2015) Gok, Funda; Topal, Ahmet; Hacibeyoglu, Gulcin; Erol, Atilla; Biyik, Murat; Kucukkartallar, Tevfik; Yosunkaya, AlperThe clinical picture secondary to amanita phalloides, which began with gastrointestinal complaints, advanced to fulminant hepatic failure in two days. Emergency liver transplantation was decided for the case of a 48-year-old male patient, who at the same time had renal failure and acute pancreatitis. Bridge treatment with plasma diafiltration was applied until the liver transplantation, which was successfully performed on the fifth day of admission to the hospital. Acute pancreatitis and renal failure also resolved and the patient was discharged in a healthy condition on the 30th day of admission. The timing of the transplant in fulminant liver failure and criteria used to select the timing are particularly important. Transplantation should be performed not too early, nor too late. In addition, the development of multiple organ failure during the period until transplantation may result in the death of the patient. Therefore, extra corporeal liver support systems are suggested as an important treatment tool at this stage.Öğe Fulminant Liver Failure Due to Amanita Phalloides Toxicity Treated with Emergent Liver Transplantation(Modestum Ltd, 2015) Gok, Funda; Topal, Ahmet; Hacibeyoglu, Gulcin; Erol, Atilla; Biyik, Murat; Kucukkartallar, Tevfik; Yosunkaya, AlperThe clinical picture secondary to amanita phalloides, which began with gastrointestinal complaints, advanced to fulminant hepatic failure in two days. Emergency liver transplantation was decided for the case of a 48-year-old male patient, who at the same time had renal failure and acute pancreatitis. Bridge treatment with plasma diafiltration was applied until the liver transplantation, which was successfully performed on the fifth day of admission to the hospital. Acute pancreatitis and renal failure also resolved and the patient was discharged in a healthy condition on the 30th day of admission. The timing of the transplant in fulminant liver failure and criteria used to select the timing are particularly important. Transplantation should be performed not too early, nor too late. In addition, the development of multiple organ failure during the period until transplantation may result in the death of the patient. Therefore, extra corporeal liver support systems are suggested as an important treatment tool at this stage.Öğe Immunological mechanism of postherpetic neuralgia and effect of pregabalin treatment on the mechanism: a prospective single-arm observational study(Korean Pain Soc, 2021) Mercan, Aysel; Uzun, Sema Tuncer; Keles, Sevgi; Hacibeyoglu, Gulcin; Yilmaz, Resul; Reisli, RuhiyeBackground: Although neuropathic pain is a severe and common pain, its pathophysiology has not been elucidated yet. Studies in recent years have focused on the immune system's role in the pathogenesis of neuropathic pain. The aim of this study was to investigate the role of immunological mechanisms in neuropathic pain and the effect of pregabalin by measuring immunological marker levels in peripheral blood before and after pregabalin treatment in postherpetic neuralgia (PHN) patients with neuropathic pain. Methods: Forty patients diagnosed with PHN were included in the study. CD4, T follicular cells (If h: CD4(+)CXCR5(+)PD1(+)), Th17 (CD4(+)CCR6(+) and CD4(+)IL17A(+)), regulatory T cells (Treg: CD4(+)CD25(+)foxp3(+)), Th1 (CD4(+) CXCR3(+) and CD4(+ )IFN-gamma(+)) and Th2 (CD4(+) IL-4(+)) cell ratios were measured in peripheral blood samples before treatment and after 3 months of treatment. Results: When immunological marker and inflammation parameter levels were compared before and after treatment, the helper T cell ratio (CD3(+), CD4(+)) was 30.28 +/- 12.27% before treatment and 34.93 +/- 11.70% after treatment, so there was a statistically significant increase (P = 0.028). Th17 was 4.75 +/- 5.02% before treatment and 5.80 +/- 3.13% after treatment, and there was a statistically significant increase (P = 0.036). Conclusions: Immunological mechanisms play an essential role in the pathogenesis of neuropathic pain, immunologically based treatment approach will be the critical point of treatment.Öğe Investigation of the effect of ultrasonography-guided bilateral erector spinae plane block on postoperative opioid consumption and pain scores in patients undergoing hepatectomy: a prospective, randomized, controlled study(Associacao Paulista Medicina, 2022) Hacibeyoglu, Gulcin; Topal, Ahmet; Kucukkartallar, Tevfik; Yilmaz, Resul; Arican, Sule; Uzun, Sema TuncerBACKGROUND: There is still a debate about what constitutes effective and safe postoperative analgesia in hepatectomy surgery. Erector spinae plane (ESP) block may be an important part of multimodal analgesia application in hepatectomy surgery. OBJECTIVES: To compare the effects of ultrasound-guided bilateral erector spinae plane block combined with intravenous (iv) patient-controlled analgesia (iv PCA), in comparison with iv PCA alone, in hepatectomy surgery. DESIGN AND SETTINGS: Randomized prospective single-blinded study in a tertiary university hospital. METHODS: Fifty patients scheduled for elective hepatectomy surgery were included in the study. Patients were randomized into the ESP group or the control group. In the ESP group, bilateral ESP block was performed preoperatively and iv PCA was used. In the control group, only iv PCA was used. Numerical rating scale (NRS) scores at rest and coughing, analgesic requirements and occurrences of nausea and vomiting were recorded. RESULTS: Intraoperative and postoperative opioid consumption, rescue analgesia requirement and resting and dynamic NRS scores were significantly lower in the ESP group (P < 0.05). There was no significant difference between two groups in terms of the presence of dynamic pain after the first postoperative hour. While all patients in the control group had nausea and vomiting, 24% of the patients in the ESP group did not have nausea and vomiting. CONCLUSION: This study showed that ESP block can be used as a part of multimodal analgesia, with the benefit of reducing opioid consumption and postoperative nausea and vomiting in hepatectomy surgery.Öğe Investigation of the effect of ultrasonography-guided bilateral erector spinae plane block on postoperative opioid consumption and pain scores in patients undergoing hepatectomy: a prospective, randomized, controlled study(Associacao Paulista Medicina, 2022) Hacibeyoglu, Gulcin; Topal, Ahmet; Kucukkartallar, Tevfik; Yilmaz, Resul; Arican, Sule; Uzun, Sema TuncerBACKGROUND: There is still a debate about what constitutes effective and safe postoperative analgesia in hepatectomy surgery. Erector spinae plane (ESP) block may be an important part of multimodal analgesia application in hepatectomy surgery. OBJECTIVES: To compare the effects of ultrasound-guided bilateral erector spinae plane block combined with intravenous (iv) patient-controlled analgesia (iv PCA), in comparison with iv PCA alone, in hepatectomy surgery. DESIGN AND SETTINGS: Randomized prospective single-blinded study in a tertiary university hospital. METHODS: Fifty patients scheduled for elective hepatectomy surgery were included in the study. Patients were randomized into the ESP group or the control group. In the ESP group, bilateral ESP block was performed preoperatively and iv PCA was used. In the control group, only iv PCA was used. Numerical rating scale (NRS) scores at rest and coughing, analgesic requirements and occurrences of nausea and vomiting were recorded. RESULTS: Intraoperative and postoperative opioid consumption, rescue analgesia requirement and resting and dynamic NRS scores were significantly lower in the ESP group (P < 0.05). There was no significant difference between two groups in terms of the presence of dynamic pain after the first postoperative hour. While all patients in the control group had nausea and vomiting, 24% of the patients in the ESP group did not have nausea and vomiting. CONCLUSION: This study showed that ESP block can be used as a part of multimodal analgesia, with the benefit of reducing opioid consumption and postoperative nausea and vomiting in hepatectomy surgery.
