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Öğe Comparison of blood loss in spinal and general anesthesia for lumbar disc surgery(2018) Sargin, Mehmet; Uluer, Mehmet SelçukAim: Lumbar spine surgeries can be performed under general anesthesia or spinal anesthesia. We aimed to compare the effects of spinal and general anesthesia on intraoperative bleeding in patients undergoing lumbar disc surgery.Material and Methods: Fifty patients scheduled to undergo elective single-level lumbar discectomy under spinal or general anesthesia were studied. The amount of blood loss was calculated by subtracting the wash solutions from the amount in the aspirator reservoir and evaluating bleeding in the gauze used throughout the operation. The time between the first incision and the final suture was evaluated as the surgical time.Patients’demographic data, duration of surgery, amount of fluid given intraoperatively, intraoperative hemodynamic data, intraoperative blood loss, intraoperative/postoperative ephedrine requirements , postoperative nausea and vomiting and the duration of stay in PACU were evaluated.Results: In group S, intraoperative blood loss was 203.00108.73 ml, while in group G it was 198.00106.40. There were no statistically difference between the groups (p0.884). Inthe duration of surgery, amount of fluid given intraoperatively, intraoperative ephedrine requirements was compared, there wereno difference between the groups too (p0.085, p0.056 and 0.448, respectively).Conclusion: In this study, it was shown that general and spinal anesthesia did not affect major parameters such as intraoperative bleeding in patients undergoing.Öğe The effects of spinal neddle on skin puncture pain during spinal anesthesia for caesarian sections: Comparison of 26G Quincke and 26G atraumatic spinal needles(2018) Sargin, Mehmet; Toprak, Hatice; Cebeci, ZubeyirAim: Skin puncture pain during spinal anesthesia is the reason of wincing from spinal anesthesia in many patients. In this study we aimed to compare the effect of two different spinal needles on skin puncture pain during spinal anesthesia for caesarian sections.Material and Methods: Eighty pregnant women scheduled to undergo elective caesarean section under spinal anesthesia were studied. Spinal anesthesia was induced with hyperbaric bupivacaine 10-15 mg via a 26G Quincke (Group Q, n40) or 26G atraumatic (Group A, n40) spinal needle in the sitting position at the L3–4 or L4-5 vertebral level using median approach. Skin puncture pain during spinal anesthesia was assessed on a scale of 0 to 10, where 0 means refers no pain and 10 the worst possible pain (0 no, 1–3 mild, 4–6 moderate, 7–10 severe).Results: Skin puncture pain VAS values, median (range) [IQR], were 2(1-5)[1-3] in Group Q and 2(1-7)[1-3] in Group A. There were no statistically differences between the groups (p0.707).Conclusion: We believe that Quincke and Atraumatic spinal needles don’t have any difference in terms of skin puncture pain during spinal anesthesia for cesarean section.Öğe The Relationship Between Preoperative and Postoperative Neutrophil-lymphocyte and Platelet-İymphocyte Ratio with post-dural-puncture Headache in Patients Undergoing Cesarean Section(2019) Sargin, Mehmet; Uluer, Mehmet Selcuk; Tutar, Mahmut SamiAim: This study aims to evaluate whether there is a possible relationship between the preoperative and early postoperative periodneutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and post-dural-puncture headache in patients undergoing cesareansection.Material and Methods: Two hundred twenty pregnant women scheduled to undergo elective cesarean section under spinalanesthesia, were studied. Patiens demografic data and blood count parameters were noted. Blood was sampled from a peripheralvein for neutrophil/lymphocyte ratio ve platelet/lymphocyte ratio. The time points for sampling blood were as follows: Preoperative;1 day before and postoperative; within 6-12 hours after cesarean section. The patients were questioned for possible occurrenceof spinal anesthesia induced headache on the first and seventh postoperative days. Post-dural puncture headache was evaluatedaccording to the International Classification of Headache Disorders (ICHD-II) diagnostic criteria.Results: A total of 220 patients were enrolled in the study and 217 patients completed the investigation. Post-dural punctureheadache was detected in 78 patients and the incidence was 35.9%. The measurements of laboratory parameters were statisticallysimilar between two groups (P 0.05).Conclusion: Our study results showed no relationship between the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio,and post-dural-puncture headache in the preoperative and also, early postoperative period in patients who undergoing cesareansection.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 Bengi; Karabaglı, HakanAIM: 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 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, Yeşim Şerife; 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.