Ebru Canakci

Aim: A high Tp-e/QT ratio on electrocardiography is associated with adverse cardiovascular events. A prolonged QT interval is associated with mortality, while a prolonged Tp-e interval is associated with serious arrhythmias. The most significant undesirable events related to spinal anesthesia are bradycardia and hypotension. In this study, we investigated whether there is a relationship between a high preoperative Tp-e/QT ratio and cardiovascular adverse events related to spinal anesthesia.Methods: This prospective observational cohort study enrolled 249 adult patients who underwent spinal anesthesia. Preoperative Tp-e and QT intervals were measured manually, and the Tp-e/QT ratio was calculated. After spinal anesthesia, noninvasive mean arterial pressure (MAP) and heart rate (HR) were monitored at predetermined intervals.Results: Median Tp-e/QT ratios did not differ by sex (p = 0.336). An increase in the Tp-e/QT ratio was statistically significantly associated with decreases in MAP at the 1st, 5th, and 10th minutes (p = 0.007, p < 0.001, and p = 0.015, respectively). A statistically significant association was also found between the increase in the Tp-e/QT ratio and the decrease in HR at the 1st and 5th minutes (p = 0.011 and p < 0.001, respectively). Additionally, a statistically significant positive association was observed between increased Tp-e/QT ratios and ephedrine and atropine consumption (p = 0.018 and p < 0.001, respectively).Conclusion: This study demonstrated that patients with a high preoperative Tp-e/QT ratio may have a higher risk of developing hypotension and bradycardia following spinal anesthesia. Patients with high Tp-e/QT ratios should be closely monitored after spinal anesthesia.

Objective: Maternal hypotension is a common complication of spinal anesthesia for cesarean delivery, pose a risk to both mother and fetus. Prophylactic and therapeutic strategies must ensure hemodynamic stability. This prospective study examined whether single-nucleotide polymorphisms (SNPs) in codons 16 (Arg16Gly) and 27 (Gln27Glu) of the Beta-2 adrenergic receptor (β2AR) gene affect the incidence of hypotension and ephedrine requirements in Turkish women undergoing elective cesarean section under spinal anesthesia.Methods: Five hundred and twenty term pregnant women scheduled for elective cesarean delivery were enrolled. Preoperative, all patients received 500 mL lactated Ringer’s solution. Hemodynamic parameters (mean arterial pressure [MAP] and heart rate [HR] were recorded at baseline and at 5, 10, 20, 40, and 60 minutes. Ephedrine dosing followed a standardized systolic blood pressure (SBP) based protocol.Results: Genotype distribution was 270 homozygous variants (51.9%), 230 heterozygotes (44.2%), and 20 wild types (3.9%). Hypotension occurred in 330 patients (64.7%), all treated with ephedrine. No significant differences emerged among genotypes in MAP, HR, frequency of hypotension, or total ephedrine dose (respectively P=.061, P=.054). Although homozygous mutants trended toward slightly higher cumulative ephedrine usage and wild types toward lower usage, these differences were not statistically significant. Neonatal Apgar scores at 1 and 5 minutes remained within normal limits across all groups.Conclusion: β2AR Arg16Gly and Gln27Glu polymorphisms do not appear to influence the risk of spinal anesthesia–induced hypotension or ephedrine requirements in this cohort of Turkish parturients. These findings lay the groundwork for larger, multicenter studies spanning diverse ethnic populations.

Aim: The aim of this study is to investigate the effect of colchicine on contrast induced nephropathy(CIN). Methods: 42 female rats were included in the study. Group1 rats were not subjected to any process. Grup2 rats were given contrast alone. Group3 rats were administered 50μg/kg/day oral colchicine 12 hours before contrast administration and simultaneously with contrast. Group4 rats were given 100μg/kg/day oral colchicine 12 hours before contrast administration and simultaneously with contrast. Group5 rats were given 50μg/kg/day oral colchicine simultaneously with contrast. Group6 rats were administered 100μg/kg/day oral colchicine simultaneously with contrast. Blood samples were collected before administration of contrast and post-contrast 48th hour, and blood urea nitrogen and creatinine levels were studied. At the same time, kidney tissue were taken and evaluated histopathologically. Results: It was found that CIN was not developed in Group1 and the groups administered contrast+colchicine. CIN was observed by 28.5% in the group administered contrast alone. Mild tubular degeneration was found in Group2 compared to the other groups(p<0.001). Evaluating for tubular necrosis and congestion, mild damage was seen in all groups, while moderate damage was observed in Group2(p=0.05). Conclusion: CIN was not developed in the groups administered colchicine. Colchicine may be effective in preventing CIN.

A Retrospective Analysis of Intensive Care Unit Patients During the Pandemic Period

Objective:In our study, it was aimed to compare the postoperative analgesic efficacy of bilateral USG-guided ESP block and TEA in patients who underwent open heart surgery. Method:No interventional multimodal analgesia technique was applied to the patients in the control group, only iv patient-controlled analgesia (iv PCA) device was inserted at the end of the operation. The duration of postoperative mechanical ventilation (MV), the amount of opioid consumed in the first 24 hours, and the visual analog scale (VAS) scores during postoperative 1st, 2nd, 4th, 6th, 12th, 24th hours while resting/coughing were recorded. Results:There was a notabledifference thereamong the groups in terms of the amount of postoperative opioid consumption (p=0.001). There was a notable difference thereamong the groups in the resting VAS scores at the postoperative 1st, 2nd, 4th, 12th, and 24th hours(p<0.001, p=0.002, p=0.002, p=0.051, p=0.001, p=0.021 respectively). There was a notabledifference thereamong the groups in the VAS scores while coughing at the postoperative 1st, 2nd, 4th, 6th, and 24th hours (p<0.001, p<0.001, p<0.001 p=0.008, p=0.051, p=0.006 respectively). Conclusion:We think that ESP block is a good alternative to TEA, which is shown as the gold standard in pain control after open heart surgery

Backgraound: Optic nerve sheath diameter measurement is a non-invasive method that provides rapid results in intracranial pressure assessment. Our aim in this study is to investigate how spinal anesthesia and tourniquet use affect optic nerve sheath diameter values in total knee arthroplasty operations. Methods:30 cases were included in the study. After spinal anesthesia, the tourniquet cuff was inflated. Right and left optic nerve sheath diameter measurements were performed 5 times with ocular ultrasound before spinal anesthesia, after spinal anesthesia, at 10th minutes after tourniquet inflation, 30th minutes after tourniquet inflation, and after tourniquet was deflated. The measurements were recorded in centimeters. During the first 24 hours postoperatively, the patients were followed up for the headache and/or visual impairment. Results: A significant difference was found between optic nerve sheath diameter values before and after spinal anesthesia (p<0.001, p<0.001). When comparing the optical diameter, tourniquet and tourniquet deflation values obtained on the right and left sides over time, we found a linear increase. Conclusion: The use of a tourniquet in spinal anesthesia and orthopedic surgery increases intracranial pressure. Optical measurement of nerve sheath diameter is a non-invasive and successful method that can be used safely for diagnosis and follow-up of elevated intracranial pressure. We believe that anesthesiologists should pay more attention to the measurement of optic nerve sheath diameter in clinical practice.

Objective: Sleep is one of the basic daily activities that are important for an individual with physical, mental, social, and intellectual needs to be in good physical and mental health. Although many definitions are made, sleep; is a complex and physiological event affected by pathophysiological, physical, psychological, and environmental factors. Anesthesiologists often work in closed environments and with long working hours, which can cause severe, chronic sleep loss and sleep disruption. Sleeplessness and low sleep quality can cause decreased attention during the day, impaired judgment, and delays in decision-making. This study, it is aimed to determine the sleep quality of Anesthesiology and Reanimation specialists working in Turkey. Methods: The study included all anesthesiologists whose e-mail addresses were registered with the Turkish Society of Anesthesiology and Reanimation and who worked in Turkey. Survey questions, which the participants can answer electronically, were sent to the participant's e-mail addresses. To increase the number of participants, a reminder email was sent three weeks after the first email. The data were expressed as a number, percentage, mean, and standard deviation and the correlation between the parameters will be evaluated at a 95% confidence interval by performing Pearson correlation analysis; p< 0.05 was accepted as significant. Results: Due to seven people with sleep disorders being excluded from the study, 210 out of 217 people who answered the questionnaires sent by email to the anesthetists who are members of the Turkish Society of Anesthesiology and Reanimation were included in the study. Of the respondents who worked in the following fields: 30% (n = 63) State Hospital, 33.3% (n = 70) University Hospital, 17.1% (n = 36) Ministry of Health Affiliate Hospital, 19.5% (n = 41) Private Hospital, and 73.3% (n = 154) at the Operating Room, 10% (n = 21) at the Intensive Care, 15.2% (n = 32) at the Operating Room + Intensive Care, and 1.4% (n = 3) at other departments, 48.4% (n = 105) were male, 51.6% (n = 112) were female, with a mean age of 41.5±7.6 years. The average hourly shift for the participants, 61% of whom were on the night shift, was 50 hours per month, and 25% were working more than 45 hours per week. Conclusion: The sleep quality of anesthesiologists is poor, which causes daytime dysfunction. It is thought that the reason for poor sleep quality, in general, is the adverse effects of their duties and responsibilities, working environment, and operating conditions on sleep quality.

Background The Iowa Satisfaction with Anesthesia Scale (ISAS) is a valid and reliable measurement tool developed to evaluate patient satisfaction with anesthesia care during different surgical interventions. It is adapted to various languages and used in many studies. Considering the satisfaction of the patient with anesthesia applied in surgical procedures, the presence of such a measurement tool is crucial. Aim From this point of view, the study aimed to evaluate psychometric properties of the ISAS by adapting it to Turkish culture. Methods In this study, a descriptive, methodological and cross-sectional design was used. A total of 210 patients who underwent surgery under general or regional anesthesia were in the study. Results ISAS Turkish version (ISAS-T) shows good reliability which is obvious with a Cronbach’s alpha value of 0.80. The correlation levels of the items with the ISAS total score were calculated between .45 and .73. Test–retest reliability was calculated as 0.83. CFA analysis was applied to the one-dimensional 11-item final version of ISAS. The uni-dimensionality of the 11-item scale was confirmed on a Turkish patient sample. The fit indices for the model obtained were calculated as χ²/sd = 2.342, RMSEA = .80, SRMR = .04, CFI = .90, GFI = .92. The fit indices of the model have good and acceptable fit values. Conclusion Based on the psychometric evaluation, ISAS-T is a valid and reliable measurement tool for measuring patient satisfaction with anesthesia applied during different surgical procedures.

Purpose: Health workers have been greatly affected by the pandemic, both as a health worker and as a member of the society, and have gone out of their routine lifestyle and habits more than normal individuals. In the pandemic stage; intense, irregular and stressful work pace also disrupted the routine eating habits while increasing the need for nutrition. With this survey study, it is aimed to evaluate the nutritional habits, affecting factors and results of healthcare professionals during the Covid-19 pandemic stage. Materials and methods: For our study a questionnaire of 49 questions was prepared. It was continued between 01/06/2020 and 01/01/2021. Questionnaires were prepared on Google forms and sent to healthcare professionals via e-mail. Multiple-choice questions were asked about personal information such as the number of meals, whether they gained weight during the pandemic stage, foods believed to protect from Covid-19, nutritional supplements used during the pandemic period, and the reason for using supplements. The questions in the second category are; it mostly includes questions about changes in dietary and lifestyle of health workers during the pandemic period. It includes questions such as: ‘‘My meal count has increased’’, ‘‘My water consumption has increased’’, ‘‘My night eating behavior has improved’’, ‘‘My sleep pattern has been disrupted’’, ‘‘I gained weight during the pandemic’’, ‘‘I smoke more’’, ‘‘I drink more tea and coffee’’, ‘‘I try to exercise’’. The answers were obtained with a 3-point Likert scale (agree, undecided, disagree). Results: It was determined that health workers experienced weight gain during the pandemic stage. It was determined that the average weight and average BMI of health professionals showed a statistically significant increase (p

Amaç: Bu çalışmada yeni korona virüs hastalığı 2019 (Covid-19) salgınının sağlık çalışanları üzerinde oluşturduğu travmatik stres düzeylerini ve travmatik stres düzeyleri ile aleksitimi arasındaki ilişkiyi incelemeyi amaçladık. Gereç ve Yöntemler: Bu araştırma kesitsel tipte ve tanımlayıcı bir çalışmadır. Araştırmaya gönüllülük ilkesiyle, çevrimiçi anket formunu dolduran, Ordu ilinde görev yapan 252 sağlık çalışanı dahil edilmiştir. Tüm katılımcılara sosyodemografik veri formu, Toronto Aleksitmi Ölçeği (TAÖ-20), Olayların Etkisi Ölçeği (OEÖ) online ortamda uygulanmıştır. Bulgular: Çalışmaya alınan 252 katılımcıdan %60,3’si kadın, %39,6’si erkekti. Ayrıca mesleki durumlarına göre değerlendirildiğinde katılımcıların %67,8’si doktor, %20,8’si hemşire/sağlık memuru ve %2’si ise tıbbi sekreterdi. TAÖ-toplam skoru için katılımcılar 32-77 arasında skor alırken; OEÖ için ise 0-79 arası skorlar elde edilmiştir. TAÖ için cinsiyetler arası farklılık saptanmadı (p>0,05). OEÖ için ise; kadınların daha yüksek skorlar aldığı görüldü (p