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    A comparative randomized trial of intubation success in difficult intubation cases: the use of a frova intubation catheter versus a bonfils intubation fiberoscope
    (TERMEDIA PUBLISHING HOUSE LTD, 2019) Onal, Ozkan.; Gumus, Irem.; Ozdemirkan, Aysun.; Cicekci, Faruk.; Sari, Mehmet.; Bayram, Hasan Huseyin.; Ciftci, Cansu.; Aslanlar, Emine.; Celik, Jale Bengi.
    Introduction: A difficult airway is one of the main causes of morbidity and mortality in patients who undergo surgical interventions. Therefore, many devices and algorithms have been developed for the management of a difficult airway. However no study has been conducted comparing Frova catheter (FC) and a Bonfils fiberoscope (BF) to date. Aim: To compare the effectiveness and success of two devices, a FC and BF, in difficult intubation cases. Material and methods: Design: Single-centre randomized controlled trial in patients with difficult airways. The assignment order was created by unplanned number charts, and the assignment was hidden in dosed covers, which were not unlocked until case permission had been provided. Setting: The trial was undertaken in a university hospital in Turkey. The primary analysis was based on 60 participants (n = 30, n = 30) with difficult intubation. The main outcomes were the success rates of placement of the tracheal tube in the trachea and the duration of the tracheal intubation process. Results: In the BF group, successful intubation was carried out in 25 of the 30 (83.3%) patients, whereas intubation was successful in 28 of the 30 patients (93.3%) in the FC group. Patients who could not be intubated with the first device were intubated with the other device. The mean duration of intubation was 109 (85-140) s in the BF group, whereas it was 38.8 (26-60) s in the FC group. Conclusions: Both devices were successful in difficult intubation cases. However, given the shorter duration of intubation using the FC and its lower cost as compared with that of the BF, the FC can be considered superior to the BF in difficult intubation cases.
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    Comparison of glasgow coma scale and full outline of unresponsiveness (four) score: a prospective study
    (TURKISH NEUROSURGICAL SOC, 2019) Bayraktar, Yesim Serife.; Sahinoglu, Mert.; Cicekci, Faruk.; Kara, Inci.; Karabagli, Hakan.; Duman, Ates.; Celik, Jale Bengi.
    AIM: To assess reliability by comparing the Full Outline of Unresponsiveness (FOUR) scores and Glasgow Coma Scale (GCS) values assigned by specialists from two different fields to patients in the Anesthesiology and Reanimation and Neurosurgery intensive care units. MATERIAL and METHODS: This study was conducted between March 2017 and June 2017 at Selcuk University Faculty of Medicine, Departments of Anesthesiology and Reanimation and Neurosurgery. Seventy-nine patients aged 18-65 years who were treated for at least 24 hours in the intensive care unit were independently assessed by two raters, an anesthesiologist and a neurosurgeon,using FOUR and GCS. The Kolmogorov-Smirnov normality test was applied for continuous variables, and SPSS 20.0 version software was used for data analyses. RESULTS: There were no significant differences between FOUR scores and GCS values given by the two raters. The mortality rate among patients with low scores on both FOUR and GCS was higher than the hospital mortality rate. CONCLUSION: Considering that FOUR score allows a more detailed neurological evaluation than GCS, and our findings suggest that FOUR score is more useful for patients who are unconscious or dependent on mechanical ventilation.
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    Estimating the lumbar puncture needle depth in children
    (TAYLOR & FRANCIS INC, 2019) Celik, Derya.; Onal, Ozkan.; Apiliogullari, Seza.; Kara, Inci.; Celik, Jale Bengi.
    Background: Lumbar puncture's (LP) success is dependent on the skill of the physician, anatomy, size, and posture of the patient. Aims: The purpose of this study was to describe a method that could be used to help estimate the correct depth of needle (Y) insertion in children based on age, weight (W), and height (H). Methods: The study consisted of 200 children American Society of Anesthesiologist class I-II aged 0-12 years who underwent spinal block for orthopedic, pediatric, and genitourinary surgery. The distance from the skin entry point to the tip of the spinal needle was measured after the LP was performed. The relationship between the Y and W, H and body mass index (BMI) was calculated. Predictive statistical models were used to determine the LP needle depth. A paired sample t-test was conducted to compare the findings of the developed model with those of earlier models. Results: The patients were aged 2-144 months, with H and W of 43-154 cm and 2.5-48 kg, respectively. The BMI was 10.75-37.72 kg/m(2). Before the Y was estimated, the relationship between the independent variables and the depth variable, which was the dependent variable, was examined. According to the obtained results, the model consists of strong relationships with H, W, and H + W. The formula for predicting Y based on W plus H was as follows: for all patients: Y (cm) = 0.861 + 0.012 x H (cm) + 0.035 x W (kg). Based on H, the formula for predicting the required Y was as follows: For all patients: Y (cm) = 0.393 + 0.023 x H (cm). Based on W, the formula for predicting the required Y was as follows: For all patients: Y (cm) = 1.460 + [0.067 x W (kg)]. Conclusion: The formula may provide a more reliable estimate of the required LP depth in children than that obtained using current models. However, larger studies are needed to standardize the formula.
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    Ultrasound-guided adductor canal block using levobupivacaine versus periarticular levobupivacaine infiltration after total knee arthroplasty: A randomized clinical trial
    (ASSOCIACAO PAULISTA MEDICINA, 2019) Cicekci, Faruk.; Yildirim, Ahmet.; Onal, Ozkan.; Celik, Jale Bengi.; Kara, Inci.
    BACKGROUND: Both postoperative pain control and range of motion are important in total knee arthroplasty (TKA). However, in the literature, there is little comparison of peripheral nerve blocks and periarticular infiltration techniques using levobupivacaine. The aim of our study was to measure pain with visual analogue scale (VAS) and knee range of motion (ROM) between in patients undergoing adductor canal block (ACB) for TKA using levobupivacaine compared to periarticular levobupivacaine infiltration (PAI-L). DESIGN AND SETTING: Prospective randomized clinical trial in a university hospital. METHODS: Patients aged 40-85 years who underwent unilateral TKA were included; 39 were treated with periarticular infiltration using 40 ml (0.125 mg) of levobupivacaine (PAI-L group); and 40 were treated with ACB using 20 ml of 0.25% levobupivacaine (ACB-L group). Postoperative pain scores at rest and during active physical therapy were assessed using a VAS, along with knee ROM in flexion and extension. In addition, 100-foot walking time results, total morphine consumption and time of first analgesia requirement were recorded postoperatively. RESULTS: VAS scores at rest and during active physical therapy and the total amount of morphine consumed were lower in the ACB-L group than in the PAI-L group (P < 0.05). In contrast, knee ROM in flexion and extension and 100-foot walking times were greater in the PAI-L group than in the ACB-L group (P < 0.05). CONCLUSION: ACB-L was superior to PAI-L regarding pain treatment after TKA; however, PAI-L was superior to ACB-L regarding postoperative ROM and walking ability.