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Aim: The aim of the study was to evaluate expiratory flows in smoker or non-smoker obese patients who underwent elective surgery. Material & Method: The ages, weight and height, BMI, smoking status, pulmonary function test (FVC, FEV 1, PEF, FEV 25/75, FEV 25, FEV 50, FEV 75, FEV 1/ FVC) values of the morbidly obese patients who admitted to the Anesthesiology polyclinic were recorded. Results: Of the 16 patients who smoker, BMI: 39.87 ± 5.42 and non-smoker 24 patients had BMI: 40.28 ± 5.17, no statistically significant difference was found between the two groups. When the parameters of the respiratory function tests were evaluated, the values of the patients who were smoker were found to be lower than those who were non-smoker and there was a statistically significant difference. Conclusion: In our study, tests showed that smokers had lower FEV1/ FVC than non-smokers. In conclusion, in obese patients, smoking adversely affects pulmonary function tests.

Bu olguda miyopatili bir hastada, triomalleolar kırık operasyonu nedeni ile uygulanılan genel anestezi yöntemi ile dikkat edilmesi gereken önemli noktalar belirtilerek, anlatıldı.

Amaç: Travma fonksiyonel kısıtlılık, sakatlık ve mortalitenin önemli bir sebebidir. Bu çalışmada, yoğun bakım ünitesinde (YBÜ) takip edilen travma hastalarının klinik özellikleri ile mortaliteyi etkileyen faktörler araştırılmıştır. Gereç ve Yöntem: Ocak 2019-2020 tarihleri arasında Sağlık Bilimleri Üniversitesi, İstanbul Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi YBÜ’sünde travma nedeniyle takip edilen hastaların verileri retrospektif olarak değerlendirildi. Hastaların demografik verileri, komorbiditeleri, travma etiyolojileri, yatış sırasındaki Glasgow koma skoru (GKS), Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi-II (APACHE-II) skoru, revize travma skoru (RTS), laktat düzeyleri ve mortaliteler araştırıldı. Bulgular: YBÜ’de travma nedenli 250 (%25,2) hasta takip edilmiştir. Hastaların %60,4’ü erkek ve medyan yaş 58,5 (1-97) idi. Hastaların %71,6’sının sistemik hastalığı yoktu. Hastaların %94’ünde künt travma gözlenirken, en sık travma şekli %64,4 ile düşme idi. YBÜ ve mekanik ventilatörde (MV) ortanca kalış süresi 4 (1-86) ve 1 (0-53) gün idi. Giriş GKS medyan 11 (3-15), APACHE-II skoru 22 (5-56), RTS 7 (2-10) ve laktat değeri 1,66 (0,7-19,8) mmoL idi. Hastaların %85,6’sı taburcu edilirken, %14,4’ü vefat etti. Mortalite gelişenlerde yaş, YBÜ ve MV’de kalma süreleri, laktat düzeyleri, APACHE-II skorları, anlamlı olarak yüksek saptanırken, GKS ve RTS skorları anlamlı düşük bulundu (p

Background: Achieving adequate pain control during and after the uterine D/C (dilatation and curettage) procedure is crucial for a good recovery process and early discharge.The study was conducted to find out whether intravenous dexketoprofen trometamol is more effective than tramadol and paracetamol in easing pain during the D/C procedure as well as to assess its effectiveness in the recovery period.Results: Significant differences were determined between the groups regarding the values of Ramsey sedation scores (p=0.048). VAS (visual analog scale) mean values of group T were higher compared to the VAS mean values of group D (p=0.02). A significant difference was found between group P and group D (p=0.016), the mean VAS values of group P were higher than group D.Conclusions: We found out that preemptive intravenous 25 mg dexketoprofen trometamol administered in the daily D/C procedure provides good quality postoperative analgesia with minimal adverse effects by reducing the need for rescue analgesia, and is more effective in postoperative analgesia than paracetamol and tramadol.

Background: Perioperative patient monitoring and follow-up is very important to minimize morbidity and mortality in pediatric neurosurgical interventions. In this study, it was aimed to evaluate the perioperative anesthesia management by examining the findings of the pediatric patients who underwent cranial surgery along with to examine the effects of hemorrhagic surgical procedures, which play an active role in morbidity, both intraoperatively and postoperatively, including hospitalization in intensive care unit. Methods: Follow-up files of 303 pediatric patients between the ages of 0-18, who were taken to cranial operation, between 2015-2018 years evaluated as retrospectively. Results: A total of 303 children 199 (65.7%) ≤1 year old, 104 (34.3%) >1 year old who underwent pediatric neurosurgery were included in our study. It was determined that the most frequently performed operation was shunting due to hydrocephalus and craniosynostosis. In subanalysis, in craniosynostosis operations performed frequently in infants aged ≤1, it was observed that bleeding amount was as much as subdural and epidural hematoma operations performed in children >1 year old (181ml and 196 ml, p =0.444, respectively). There was no difference between groups in intensive care unit admission. Conclusıons: We think that in pediatric neurosurgery patients' perioperative anesthesia management, it is important to closely monitor the vital signs of patients, to record complications and blood transfusions in detail. We believe that due to the more aggressive duration of hypotensive processes, more attention should be paid to morbidity and mortality, especially in cases of craniosynostosis.

İnvaziv meme kanseri teşhisi ile sol total mastektomi, aksiller diseksiyon ve protez operasyonu planlanan hastanın, preoperatif anestezi değerlendirilmesinde Multipl Skleroz (MS) tanısı aldığı, takipli ve son iki yıldır ise remisyon aşamasında olduğu öğrenildi. Nöroloji konsültasyonunda, taraf bulgusuna rastlanılmadığı, hastanın opere olmasında sakınca olmadığı belirtildi. Ameliyathane odasına alınan hasta elektrokardiyografi (EKG), non invaziv kan basıncı (KB), puls oksimetre, sağ orta parmak ve özofagial bölgeye yerleştirilen ısı probları ile monitörize edildi. Isıtıcı blanket kullanılmadı. Anestezi indüksiyonu, 0.03 mg kg-1 midazolam, 1µg kg-1 fentanil, 2 mg kg-1 propofol bolus infüzyonunu takiben 0.6 mg kg-1 roküronyum ile sağlandı. İdamesine volatil anestezik olarak desfluran ve ortalama 0.1 µg kg-1 dk-1 remifentanil infüzyonu ile devam edildi. Postoperatif analjezi amacıyla hastaya 1000 mg parasetamol ve 1mg kg-1 tramadol hidroklorür infüzyon şeklinde uygulandı. Operasyon süresince hastanın vital bulguları stabildi. Ek doz roküronyum kullanılmadı. Nöromüsküler blokaj 2 mg kg-1 sugammadeks ile antagonize edildi. Oksijenizasyonu, hemodinamik verileri ve sözlü uyaranlara yanıtı iyi olan hasta, postoperatif takip amacıyla derlenme ünitesine ekstübe edilmiş olarak transfer edildi. Postoperatif 15. günde telefonla yapılan görüşmede herhangi bir alevlenme bulgusuna rastlanılmadı. A patient scheduled for a left total mastectomy, axillary dissection, and prosthesis operation with a diagnosis of invasive breast cancer was found to have a history of Multiple Sclerosis (MS) during the preoperative anesthesia evaluation, which was being followed up and had been in remission for the past two years. In the neurology consultation, no lateralizing signs were found, and it was stated that there was no contraindication for the patient to undergo surgery. Upon being taken into the operating room, the patient was monitored with electrocardiography (ECG), non-invasive blood pressure (BP), pulse oximetry, and temperature probes placed on the right middle finger and esophageal region. A warming blanket was not used. Anesthesia induction was achieved with 0.03 mg kg⁻¹ midazolam, 1 µg kg⁻¹ fentanyl, and 2 mg kg⁻¹ propofol bolus infusion, followed by 0.6 mg kg⁻¹ rocuronium. Maintenance was continued with desflurane as the volatile anesthetic and an average of 0.1 µg kg⁻¹ min⁻¹ remifentanil infusion. For postoperative analgesia, 1000 mg paracetamol and 1 mg kg⁻¹ tramadol hydrochloride were administered to the patient via infusion. The patient's vital signs were stable throughout the operation. No additional doses of rocuronium were used. Neuromuscular blockade was antagonized with 2 mg kg⁻¹ sugammadex. The patient, whose oxygenation, hemodynamic data, and response to verbal commands were good, was transferred to the recovery unit extubated for postoperative follow-up. In a telephone interview conducted on the postoperative 15th day, no signs of exacerbation were observed.