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    Combined spinal-epidural anesthesia or local anesthesia + Sedoanalgesia in abdominal aortic Aneurism Repair?
    (Turkish Anaesthesiology and Intensive Care Society, 2015) Arar, Makbule Cavidan; Sezen, Ü.; Yüksek, A.; Sarıkaya, H.; Turan, F.; Turan, C.; Mordeniz, C.; Baran, O.; Günkaya, M.; Gür, O.; Saraçoğlu Varol, Gamze
    Objective: Anesthesia for the repair of abdominal aortic aneurism can be performed with different modalities of anesthesia or their combinations. The risk level for the morbidity and mortality of the patients, is increased in geriatric patients with the existence of accompanying pathology. To compare two different anesthesia methods (local anesthesia and sedation vs combined spinal and epidural anesthesia) for the repair of endovascular aneurism in a geriatric patient. Material and Methods: 16 high risk geriatric patients were included in the study. The parameters of 16 high risk patients who underwent elective or emergency treatment for endovascular aneurism were included. Group-I (n:8) was given local anesthesia and sedation, Group-II (n:8) was given combined spinal and epidural anesthesia. Intraoperative and postoperative hemodynamic parameters were reviewed and analyzed. The demographic data of the two groups ressembled each other. Results: The complication rate was calculated at an average of 6.25%, which was considered insignifcant (p>0.05). There was no signifcant difference between the duration of hospital and intensive care unit stay for the two groups (p>0.05). Conclusion: Combined spinal and epidural anesthesia requires much more experience, but it is safer than local anesthesia and sedation for endovascular aneurism patients.
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    Quadratus lumborum and erector spinae plane blocks are effective for analgesia in laparoscopic hysterectomy: a randomized controlled trial
    (Verduci Publisher, 2023) Baran, O.
    OBJECTIVE: Total laparoscopic hysterectomy is the preferred technique for hysterectomy in obstetrics and gynecology clinics. However, patients who undergo these procedures often experience acute pain that may progress to chronic pain over time. Erector spinae plane block (ESPB) and anterior quadratus lumborum block (QLB) under ultrasound guidance are reported to be effective as part of the multi-modal analgesia protocol. Therefore, this study aimed to compare the effectiveness of erector spinae plane block and anterior quadratus lumborum block in reducing postoperative opioid consumption and pain scores in patients undergoing total laparoscopic hysterectomy. PATIENTS AND METHODS: Eighty-one patients who met the inclusion criteria were divided into three groups: the erector spinae plane block, anterior quadratus lumborum block, and control groups. All patients received general anesthesia and tramadol-based patient-controlled analgesia (PCA) during the postoperative period. Tramadol consumption and pain scores during the first 24 h were evaluated by a blinded researcher. Postoperative opioid consumption was the primary outcome of the study. RESULTS: Postoperative tramadol consumption was lower in the erector spinae plane block and quadratus lumborum block groups than that in the control group, with no significant differences observed between the two intervention -al groups. Postoperative pain scores were lower for at least 12 h in both block groups, with no significant differences observed between both groups. CONCLUSIONS: Erector spinae plane block and quadratus lumborum block improved post-operative pain management as part of the multi-modal analgesia protocol; however, erector spinae plane block may be preferable due to its rapid procedure time. The findings suggest that incorporating erector spinae plane block and quadratus lumborum block into multi-modal analgesia protocols for laparoscopic hysterectomy would have important implications for the development and standardization of pain management protocols.
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    The Effect of Epidural Analgesia Added to General Anesthesia on Systemic Immune-Inflammation Index in Radical Prostatectomy Surgery: A Retrospective Study
    (Wolters Kluwer Medknow Publications, 2022) Gültekin, A.; Şahin, A.; Akgül, Murat; Yıldırım, I.; Altınöz, K.; Baran, O.; Arar, Cavidan
    Background: Systemic immune-inflammation index (SII) is increasingly valued for its simplicity and predictability. Anesthesia/analgesia technique may affect cancer survey. Aims: The primary aim of this study is to offer a comparative evaluation for the effect of different anesthesia/analgesia techniques employed in radical prostatectomy surgery on SII, a new inflammatory index. Patients and Methods: Eighty-one patients who underwent radical prostatectomy between January 1, 2012, and December 31, 2020, were included in the study. We recorded oncological demographic data of Group G (n = 45) and Group GE (n = 36), preoperative and postoperative (within the first 4 hrs and 24th hr) SII values, perioperative surgical bleeding, and amount of blood transfusion. Results: Despite the lack of significant difference in the SII values between the groups, both the peak SII level and the SII change in the postoperative period became higher in Group G than in Group GE. In addition, the amount of surgical bleeding and blood transfusion was observed to be significantly lower in Group GE (P < 0.001, P = 0.092, respectively). Conclusions: GE in radical prostatectomy surgery in terms of SII, the SII change in the postoperative period was more pronounced in Group G. However, a significant difference was noted in surgical bleeding in Group GE. We can conclude that comparing the SII values of different anesthesia techniques with prospective studies might thus create a difference in survival and metastasis at the micro-level.