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Öğe Developing bone cement implantation syndrome under regional anesthesia: case report(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2017) Sargin, Mehmet; Borazan, Hale; Otelcioglu, SerefBone cement implantation syndrome is associated with hypoxia, hypotension, cardiac arrhythmias, increase in pulmonary vascular resistance and cardiac arrest and is a cause of mortality and morbidity in orthopedic patients when cement is used. Because it is rare and isn't well identified, literature is limited to case reports. In this article, bone cement implatation syndrome developed in a patient who had undergone surgery for hip replacement is reported with literature.Öğe The Effect of Transversus Abdominis Plane Block in Inguinal Hernioplasty on Chronic Pain(Modestum Ltd, 2015) Topal, Ahmet; Sargin, Mehmet; Kilicaslan, Alper; Uzun, Sema TuncerThe aim of the current study was to retrospectively evaluate the efficacy of IV analgesia after general anesthesia, transversus abdominis plane (TAP) block after the induction of general anesthesia and before the surgery and spinal analgesia on development of chronic pain following inguinal hernia repair. Forty patients, who underwent hernioplasty for the first-time and for whom at least 6 months had passed since the operation date were included in the study, were included in each group as follows: Group G received IV analgesia with general anesthesia; Group T included patients who received TAP block with general anesthesia; and Group S received spinal anesthesia. The study evaluated early and chronic postoperative pain, as well as pain severity, nature of the pain, predisposing factors, and the effect on various activities. No difference was found in pain incidence among the groups in the early postoperative pain evaluation; whereas VAS scores were lower in Group T. Chronic pain incidence was found to be lower in Group T. However, there was no difference among the groups in terms of VAS scores, pain nature, frequency, its effect on daily activities and sleep for patients with chronic pain. The TAP block is an effective method to prevent chronic pain development after inguinal hernioplasty compared to the other two methods. Because of the retrospective nature of the study, further prospective clinical trials are required.Öğe The Effect of Transversus Abdominis Plane Block in Inguinal Hernioplasty on Chronic Pain(Modestum Ltd, 2015) Topal, Ahmet; Sargin, Mehmet; Kilicaslan, Alper; Uzun, Sema TuncerThe aim of the current study was to retrospectively evaluate the efficacy of IV analgesia after general anesthesia, transversus abdominis plane (TAP) block after the induction of general anesthesia and before the surgery and spinal analgesia on development of chronic pain following inguinal hernia repair. Forty patients, who underwent hernioplasty for the first-time and for whom at least 6 months had passed since the operation date were included in the study, were included in each group as follows: Group G received IV analgesia with general anesthesia; Group T included patients who received TAP block with general anesthesia; and Group S received spinal anesthesia. The study evaluated early and chronic postoperative pain, as well as pain severity, nature of the pain, predisposing factors, and the effect on various activities. No difference was found in pain incidence among the groups in the early postoperative pain evaluation; whereas VAS scores were lower in Group T. Chronic pain incidence was found to be lower in Group T. However, there was no difference among the groups in terms of VAS scores, pain nature, frequency, its effect on daily activities and sleep for patients with chronic pain. The TAP block is an effective method to prevent chronic pain development after inguinal hernioplasty compared to the other two methods. Because of the retrospective nature of the study, further prospective clinical trials are required.Öğe Hemodynamic responses to endotracheal intubation performed with video and direct laryngoscopy in patients scheduled for major cardiac surgery(E-Century Publishing Corp, 2015) Sarkilar, Gamze; Sargin, Mehmet; Saritas, Tuba Berra; Borazan, Hale; Gok, Funda; Kilicaslan, Alper; Otelcioglu, SerefThis study aims to compare the hemodynamic responses to endotracheal intubation performed with direct and video laryngoscope in patients scheduled for cardiac surgery and to assess the airway and laryngoscopic characteristics. One hundred ten patients were equally allocated to either direct Macintosh laryngoscope (n = 55) or indirect Macintosh C-MAC video laryngoscope (n = 55). Systolic, diastolic, and mean arterial pressure, and heart rate were recorded prior to induction anesthesia, and immediately and two minutes after intubation. Airway characteristics (modified Mallampati, thyromental distance, sternomental distance, mouth opening, upper lip bite test, Wilson risk sum score), mask ventilation, laryngoscopic characteristics (Cormack-Lehane, percentage of glottic opening), intubation time, number of attempts, external pressure application, use of stylet and predictors of difficult intubation (modified Mallampati grade 3-4, thyromental distance <6 cm, upper lip bite test class 3, Wilson risk sum score >= 2, Cormack-Lehane grade 3-4) were recorded. Hemodynamic parameters were similar between the groups at all time points of measurement. Airway characteristics and mask ventilation were no significant between the groups. The C-MAC video laryngoscope group had better laryngoscopic view as assessed by Cormack-Lehane and percentage of glottic view, and a longer intubation time. Number of attempts, external pressure, use of stylet, and difficult intubation parameters were similar. Endotracheal intubation performed with direct Macintosh laryngoscope or indirect Macintosh C-MAC video laryngoscope causes similar and stable hemodynamic responses.Öğe Infraclavicular block experience in a case of multiple trauma patient(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2017) Sargin, Mehmet; Saritas, Tuba Berra; Sarkilar, Gamze; Otelcioglu, SerefAnesthetic applications in trauma patients have special features because of patient's traumatic reasons, preexisting systemic diseases and inappropriate fasting period as in most of the emergent multi traumatic patients. Ultrasound guided peripheral nevre blocks simplify anesthetic applications in suitable patients. In this article an ultrasound guided infraclavicular block in a multi traumatic patient was reported.Öğe Neuromuscular Characteristics of Rocuronium in Diabetic Patients(Cukurova Univ, Fac Medicine, 2014) Topal, Ahmet; Sargin, Mehmet; Et, Tayfun; Uzun, Sema TuncerPurpose: In diabetic patients, there may be obsserved functional loss of motor nerve fibers and this fact may affect the management of anesthesia in many ways. In our study we aimed to research if there is any differences between nondiabetic patients and the patients who have type 2 diabetes on the side of nueromuscular blockade characteristics of rocuronium. Material and Methods: 18 diabetic and 21 non-diabetic patients included to study, each patient evaluated by the NMT device after administiration of 0,6 mg/kg rocuronium intravenously. The onset of action time, clinical acting time, recovery time, total rocuronium dosage for each patient, amplitude of supramaximal excitation and Goldberg score were compared in the two groups. Results: Time of action (118,33 +/- 41,61 sn. & 142,00 +/- 28,68 sn.) and recovery time (13,33 +/- 9,83 dak. & 22,38 +/- 11,64 dak.) were longer than in diabetic patients (p<0,05), time of action and amplitude of supramaximal excitation were similar in two groups (p>0,05). Conclusion: We consider that the prolongation of onset of action time and recovery time in diabetic patients, is a complicaiton of diabetic neuropathy and diabetes may effect the pharmacodynamics of rocuronium.Öğe The Relationship Between Vasoactive-Inotropic Score and Mortality in Adult Patients with Traumatic Brain Injury(Turkish Neurosurgical Soc, 2019) Kara, Iskender; Sargin, Mehmet; Bayraktar, Yesim Serife; Sahinoglu, Mert; Ildarov, Gurban; Duman, Ipek; Celik, Jale BengiAIM: To assess the feasibility of the vasoactive-inotropic score (VIS) in determining the amount of vasoactive support and its relationship with the mortality rate and characteristics of the patients with traumatic brain injury (TBI). MATERIAL and METHODS: This study was conducted with a retrospective design involving the years 2013-2018 in a university hospital which provides tertiary intensive care service. A total of 102 patients who were admitted in the ICU with the diagnosis of severe TBI, and also were followed by neurosurgery service and who received vasoactive and inotropic support were analyzed concerning VIS value. RESULTS: The median age of the patients was 34 years, and 69.6% of the patients were male. Mortality rate was 43.1%. In the group with mean VIS >= 10, the admission duration in the ICU and hospital were shorter (p<0.0001) whereas mortality rates were higher (81.1% vs 21.5% and p<0.0001). Besides, the number of patients with a VIS score of >= 10, >= 15 and >= 20 were higher in the group of patients who died (p<0.0001). The results of the multivariate analysis such as VIS >= 10 were significant. CONCLUSION: We can conclude that VIS, which is used to determine the amount of vasoactive and inotropic medicines during cardiac surgery and in sepsis patients, may be useful in predicting mortality in TBI patients.Öğe Turkish Insulin Injection Technique Study: Population Characteristics of Turkish Patients with Diabetes Who Inject Insulin and Details of Their Injection Practices as Assessed by Survey Questionnaire(Springer Heidelberg, 2018) Dagdelen, Selcuk; Deyneli, Oguzhan; Olgun, Nermin; Siva, Zeynep Osar; Sargin, Mehmet; Hatun, Sukru; Kulaksizoglu, MustafaOver 7 million people in Turkey have diabetes. Of the 1 million who inject insulin little is known of their habits and injection techniques. We conducted an Injection Technique Questionnaire (ITQ) survey throughout Turkey that involved 1376 patients from 56 centers. Turkish values were compared with those from 41 other countries participating in the ITQ, known here as Rest of World (ROW). The majority (50.4%) of Turkish insulin users give four injections/ day as opposed to ROW, where only 30.9% do. The abdomen is the most common injection site used by Turkish patients, but they also inject insulin in multiple body sites more often than do patients in ROW. Body mass index values in Turkey were 0.75 units higher than those in ROW as was the mean total daily dose (average daily dose [ADD]) of insulin (54.0 IU in Turkey vs. 47.4 IU in ROW). Mean glycated hemoglobin (HbA1c) in Turkey was 9.1%, which is higher than in ROW and possibly related to the higher BMI and ADD. Turkish patients use insulin analogs (short and long-acting) more frequently than do patients in ROW. The shortest pen needles (4 mm) are used by about one-third of patients in Turkey, but the longer ones (8 mm) are equally common. Needles are reused in Turkey at a rate of 3.4 injections/single needle. However, needle reuse, whether with pens or syringes, is lower in Turkey than ROW, as is the number of times a reused needle is used. More than 75% of used sharps in Turkey go into the rubbish, with nearly 6% having no protection of the tip. The continued use of 8-mm needles raises the risk of intramuscular injections in Turkish patients. Despite full reimbursement, needle reuse still remains an important issue. More focus needs to be given to dwell times under the skin, reconstitution of cloudy insulant, correct use of skin folds and safe disposal of sharps. BD Diabetes Care.Öğe Turkish Insulin Injection Techniques Study: Complications of Injecting Insulin Among Turkish Patients with Diabetes, Education They Received, and the Role of Health Care Professional as Assessed by Survey Questionnaire(Springer Heidelberg, 2018) Dagdelen, Selcuk; Deyneli, Oguzhan; Olgun, Nermin; Siva, Zeynep Osar; Sargin, Mehmet; Hatun, Sukru; Kulaksizoglu, MustafaUsing the Turkish and rest of world (ROW) Injection Technique Questionnaire (ITQ) data we address key insulin injection complications. Summarized in first ITQ paper. Nearly one-third of Turkish insulin users described lesions consistent with lipohypertrophy (LH) at their injection sites and 27.4% were found to have LH by the examining nurse (using visual inspection and palpation). LH lesions in the abdomen and thigh of Turkish patients are slightly smaller than those measured in ROW but more than half of Turkish patients who have LH continue to inject into them at least daily. More than a quarter of Turkish patients have frequent unexplained hypoglycemia and nearly 2 out of 5 have glycemic variability, both of which have been linked to the presence of LH and the habit of injecting into it. Nearly half of Turkish injectors report having pain on injection. Of these, just over half report having painful injections only several times a month or year (i.e., not with every injection). In Turkey the diabetes nurse has by far the major role in teaching patients how to inject. Nearly 40% of Turkish injectors get their sites checked at least annually, and a larger proportion than ROW had received recent (within the last 12 months) instruction on how to inject properly. Turkish patients and professionals have clearly made progress in injection technique, but there are still considerable challenges ahead which the new Turkish guidelines will help address. BD Diabetes Care.Öğe The use of Vasoactive-Inotropic Score in Adult Patients with Septic Shock in Intensive Care(Turkish Soc Medical & Surgical Intensive Care Medicine, 2019) Kara, Iskender; Sargin, Mehmet; Bayraktar, Yeim Erife; Eyiol, Hatice; Duman, Ipek; Celik, Jale BengiObjective: Sepsis and septic shock are significant causes of mortality and morbidity. In septic shock, vasopressors and inotropic support are given for the treatment of hypotension. This study was designed to investigate the relationship between the vasoactive-inotropic score (VIS) and the results of sepsis patients in ICU. Methods: The data of 392 patients who were followed up with the diagnosis of septic shock in adult ICU were recorded retrospectively. Vasopressors and inotropic support of the patients during the first 48 hours after the diagnosis of septic shock were recorded. Mean and peak VIS values were calculated according to these values. The patients were divided into groups according to the mean VlS >= 10, peak VIS >= 10 and intensive care results and statistical analysis was performed. Results: The median ages of the patients were 68 (54.25-79) years and 239 (61%) were male. Dopamine 188 (47.9%), noradrenaline 365 (93.1%), adrenaline 53 (13.5%) and dobutamine 15 (3.8%) were used in the patients. The mean VIS was 9 (4-15), while the number of mean VIS >= 10 patients were 192 (49%). Peak VIS values were 11 (5-20), and the number of peak VIS >= 10 patients were 220 (56.1%). The mortality rate of the patients included in the study was 42.1%. The mean VIS score(13 vs 6, p=0.000), mean VIS >= 10 patient ratio (71.5% vs 32.6%, p=0.000), peak VIS score (16 vs 8, p=0.000), and peak VIS >= 10 patient ratio (73.3% vs 43.6%, p=0.000) were higher in non-survivors. The parameters such as mean VIS [OR 1.123, 95% CI 1.027-1.229, p=0.011], mean VIS >= 10 [OR 3.455, 95% CI 1.625-7.345, p=0.001] and peak VIS score [OR 0.917, 95% CI 0.851-0.989, p=0.024] were determined as independent risk factors for mortality. Conclusion: We conclude that vasoactive-inotropic score may be useful in predicting the outcome of septic shock patients in intensive care units.
