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Öğe CAN FRONTAL QRS-T ANGLE PREDICT MORTALITY IN PATIENTS WITH SEVERE CRIMEAN-CONGO HEMORRHAGIC FEVER?(Dokuz Eylul Univ Inst Health Sciences, 2023) Sahin, Anil; Gundogdu, Oguz; Avci, OnurPurpose: This study aims to determine whether frontal QRS-T (fQRS-T) angle measurements assist in predicting prognosis in severe CCHF (Crimean-Congo Hemorrhagic Fever) patients. Material and Method: The study was conducted with 140 intensive care patients diagnosed with CCHF between 01.01.2012 and 2022. Demographic data and length of stay were recorded. In addition, laboratory data were recorded, including hemoglobin, troponin T, C-reactive protein, lymphocyte numbers, neutrophil, and platelet. fQRS-T angles were measured on electrocardiographic (ECG) data of the patients. Results: The mean fQRS-T angle was 53.9 degrees +/- 29.3 degrees in non-survivors and 34.2 degrees +/- 17.3 degrees in the survivors (p<0.001). Regarding non-survivors, they were older, and their hemoglobin, platelet and lymphocyte levels were lower (p<0.001), and their QRS durations were broader (p=0.021) than survivors. The fQRS-T angle cutoff value in predicting mortality was determined as 41.5 degrees. For fQRS-T >= 41.5 degrees, specificity was 61.1%, and sensitivity was 80.9% (area under the curve: 0.711, 95% CI: 0.624-0.798, p<0.001). Conclusion: Current study's results showed the usability of the fQRS-T angle as an inexpensive, convenient, strong, and repeatable predictor to determine the prognosis of CCHF patients. A detailed electrocardiographic evaluation in the routine follow-up of high-risk CCHF patients may indicate the prognosis of the disease.Öğe Comparing the Clinical, Radiological and Laboratory Characteristics of Confirmed or Suspected COVID-19 Cases(Erciyes Univ Sch Medicine, 2021) Gundogdu, Oguz; Avci, OnurObjective: The present study aims to compare the clinical and laboratory characteristics of patients diagnosed with coronavirus disease (COVID-19) using Real-Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and Computed Tomography (CT). Materials and Methods: In this study, 240 adult patients were included. The demographic data, symptoms, COVID-19 findings in the initial pulmonary CT during admission and the first laboratory parameters were recorded. The patients were divided into three groups as Group 1 consisting of 100 PCR (+) CT (+) patients, Group 2 consisting of 40 PCR (+) CT (-) patients, Group 3 consisting of 100 PCR (-) CT (+) patients. Results: The mean symptom duration was 5.78 days in Group 1, 2.67 days in Group 2, and 5.26 days in Group 3 (p<0.05). The mean symptom duration was 5.52 days in CT (+) patients and 2.67 days in CT (-) patients (p<0.05). The findings showed that one unit increase in pathological lobe count decreased PCR positivity by 1.3 times (p=0.002). Conclusion: There may not be any findings in CT in the first 48-72 hours after the onset of the symptoms in symptomatic patients, and as the number of pathological pulmonary lobes detected in CT increases, PCR positivity decreases.Öğe Effect of Interscalene Brachial Plexus Block on Intracranial Pressure: Are the Measures of Optic Nerve Sheath Diameter Standardised with B-Scan? Reply(Coll Physicians & Surgeons Pakistan, 2023) Gundogdu, Oguz[Abstract Not Available]Öğe Effects of Modified Thoracoabdominal Nerve Block Through Perichondrial Approach on Postoperative Pain and Analgaesic Consumption in Patients Undergoing Laparoscopic Cholecystectomy(Coll Physicians & Surgeons Pakistan, 2024) Avci, Onur; Gundogdu, Oguz; Balci, Fatih; Tekcan, Muhammed NailObjective: To investigate postoperative analgaesic efficacy of modified thoracoabdominal nerve block through perichondrial approach (M-TAPA) and its effect on opioid consumption in patients undergoing laparoscopic cholecystectomy (LC) surgery.Study Design: Randomised, controlled trial.Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Sivas Cumhuriyet University, Sivas, Turkiye, from April to May 2023. Methodology: The study was conducted in two randomised groups: M-TAPA (n = 21) and control group (CG) (no block) (n = 21). All patients had standard general anaesthesia. M-TAPA patients had bilateral M-TAPA block with 0.25% bupivacaine (total volume, 40 ml) at the end of the surgery. In contrast, CG patients had only tramadol for postoperative pain. A numerical rating scale (NRS) and visual analogue scale (VAS) were used for postoperative pain assessment. Total tramadol consumption was calculated.Results: M-TAPA's NRS and VAS scores were lower in postoperative 24 hours (p<0.05). Total tramadol consumption was 116.67 +/- 32.91 mg in CG and 35.71 +/- 39.19 mg in M-TAPA (p<0.001).Conclusion: Bilateral M-TAPA block for postoperative pain control after LC surgery provided effective analgaesia for up to 24 hours and reduced total opioid consumption. Although the M-TAPA block is a novel approach, it will be a part of multimodal analgaesia for routine postoperative pain management in abdominal surgeries. However, more studies with higher numbers of patients will be needed.Öğe Efficacy of serratus posterior superior intercostal plane block (SPSIPB) on post-operative pain and total analgesic consumption in patients undergoing video-assisted thoracoscopic surgery (VATS): A double-blinded randomised controlled trial(Wolters Kluwer Medknow Publications, 2023) Avci, Onur; Gundogdu, Oguz; Balci, Fatih; Tekcan, Muhammed N.; Ozbey, MahmutBackground and Aims: Serratus posterior superior intercostal plane block (SPSIPB) is a novel technique that can provide analgesia in the hemithorax, shoulder, and back of the neck. This study aimed to evaluate the post-operative analgesic effect of SPSIPB in patients undergoing video-assisted thoracoscopic surgery (VATS). Methods: It is a double-blind, randomised controlled trial. Twenty-four adult patients who underwent VATS via the uniportal technique were randomised into two groups: the SPSIPB group (n = 12) received SPSIPB along with intravenous patient-controlled analgesia (PCA) with tramadol, whereas the control group (n = 12) received only PCA with tramadol. At the end of the surgery, patients in the SPSIPB group received a unilateral SPSIPB under ultrasound guidance with the use of 30-mL bupivacaine 0.25%. The primary outcome was the numerical rating scale (NRS) scores of the patients. Secondary outcomes included the amount of tramadol and rescue analgesic (paracetamol) consumed by the patients, followed up for post-operative 24 hours. Categorical variables were compared using the Chi-Square Test. Mann-Whitney U Test was used to compare groups of variables that were not normally distributed.Results: The SPSIPB group had lower NRS values during post-operative 24 hours (P < 0.001). Mean (standard deviation) total tramadol consumption was 58.33 (26.23) mg in the SPSIPB group and 144.17 (13.11) mg in the control group (P < 0.001). Rescue analgesic need was lower in the SPSIP group in the first 18 post-operative hours (P < 0.05). Conclusion: Serratus posterior superior intercostal plane block provides good analgesia in the thoracic region after video-assisted thoracoscopic surgery.Öğe Efficacy of Serratus Posterior Superior Intercostal Plane Block on Postoperative Pain and Total Analgesic Consumption in Patients Undergoing Reduction Mammoplasty Surgery: An Evidence Based Report(Coll Physicians & Surgeons Pakistan, 2024) Gundogdu, Oguz; Avci, Onur; Balci, Fatih; Tekcan, Muhammed Nail; Kol, Yusuf CelilSerratus posterior superior intercostal plane block (SPSIPB) is a novel technique that provides analgesia in shoulder, hemithorax and in the back of the neck. In this study, the efficacy of this block on postoperative pain and quality of recovery is reported in ten consecutive patients who had undergone reduction mammoplasty. Blocks were performed bilaterally with 30 ml 0.25 % bupivacaine for each side, at the end of surgery. Cumulative tramadol consumption and numerical rating scale (NRS) scores during rest (static) and coughing (dynamic) were assessed within the first postoperative 24 hours. Mean total tramadol consumption was 39 +/- 9.94 mg. NRS scores above 4 were observed in 5 patients in the dynamic NRS assessment at the postoperative 1st hour, while static and dynamic NRS scores were <= 4 at other durations. SPSIPB may play a part in postoperative multimodal analgesia following mammoplasty in the future and may reduce total analgesic consumption.Öğe Is Serratus Posterior Superior Intercostal Plane Block a Novel Indication for the Management of Pain in Thoracic Acute Herpes Zoster? A Case Report(Lippincott Williams & Wilkins, 2024) Balci, Fatih; Tekcan, Muhammed Nail; Gundogdu, Oguz; Avci, OnurPostherpetic neuralgia results from varicella-zoster virus reactivation post-chickenpox infection, manifesting as persistent and severe pain lasting a minimum of 3-mo post-herpes zoster onset. Traditional postherpetic neuralgia management comprises antiviral, analgesic medications, corticosteroids, and various agents. Ultrasound-guided nerve blocks have recently emerged as a promising postherpetic neuralgia treatment. In a case involving a 58-year-old man with severe thoracic herpes zoster lesions, the serratus posterior superior intercostal plane block was employed under ultrasound guidance, significantly reducing pain scores and enhancing quality of recovery. This study underscores serratus posterior superior intercostal plane block's secure, effective role in managing thoracic herpes zoster, and mitigating postherpetic neuralgia risk. This case report represents the pioneering application of serratus posterior superior intercostal plane block for postherpetic neuralgia, offering a promising avenue for relieving patients suffering from this condition.Öğe Postoperative Analgesic Efficacy of Clavipectoral Plane Block and Serratus Posterior Superior Intercostal Plane Block Combination in Clavicle Surgeries: A Report of 10 Cases(Lippincott Williams & Wilkins, 2024) Balci, Fatih; Tekcan, Muhammed Nail; Gundogdu, Oguz; Avci, OnurThis case series included 10 patients who underwent clavicular fracture surgery under general anesthesia. A novel analgesic approach combining 2 distinct nerve block techniques-serratus posterior superior intercostal plane block (SPSIPB) and clavipectoral plane block (CPPB)-was used for postoperative pain management. SPSIPB provided sensory blockade for the innervation of the clavicular skin, whereas CPPB targeted the clavipectoral fascia. The combination of SPSIPB and CPPB demonstrated variable efficacy in controlling postoperative pain. Future studies may explore potential improvements through dosage optimization, the use of adjuvants, or targeting higher anatomical levels.Öğe The effect of postoperative serratus anterior plane block on postoperative analgesia in patients undergoing breast surgery(Turkish Surgical Assoc, 2020) Aslan, Gokhan; Avci, Onur; Gundogdu, Oguz; Isbir, Ahmet Cemil; Kol, Iclal Ozdemir; Kaygusuz, Kenan; Gursoy, SinanObjective: This study aimed to evaluate the effect of serratus anterior plane block (SAP) on postoperative morphine consumption. We aimed to determine the differences between both similar blocks and evaluate the effect of the methods of application of this block on patients' postoperative pain scores and morphine consumption. Material and Methods: This study is a single-center, prospective and observational study performed with 40 volunteer patients with American Society of Anesthesiologists (ASA) I-III, who were 18-70 years of age, scheduled for breast surgery. A total of 40 patients who underwent general anesthesia were divided into two groups each with 20 patients. While SAP block was applied to the study group, no block was applied to the control group. SAP block was made by injecting a total of 40 ml of 0.25% bupivacaine between 2 muscles after the test dose was injected with saline. All patients were followed up for 12 hours postoperatively with patient-controlled analgesia (PCA) pump. Morphine consumption, visual analogue score (VAS) values and side effects were recorded at the postoperative 1st, 6th and 12th hours. Results: There was no significant difference between the two groups in terms of hemodynamic parameters and demographic data. Postoperative morphine consumption and postoperative analgesic requirement were significantly lower in the SAP block group (p< 0.001). Postoperative VAS values were significantly lower in the SAP block group (p< 0.001). No complication was observed related to the block. Conclusion: It was found that the SAP block reduced morphine consumption, significantly decreased VAS values, and reduced side effects due to opioids postoperatively.Öğe The effects of hyperventilation on seizure length and cerebral oxygenation during electroconvulsive therapy(Kare Publ, 2020) Gundogdu, Oguz; Avci, Onur; Gursoy, Sinan; Kaygusuz, Kenan; Kol, Iclal OzdemirOBJECTIVE: Previous studies have reported that hyperventilation prolongs seizure length. However, there is no clear consensus in clinical guidelines on how to perform hyperventilation during Electroconvulsive Therapy (ECT). The present study aims to investigate the effects of hyperventilation on seizure length and cerebral oxygenation. METHODS: Forty patients aged 18-65 and classified as ASA I-II, who would have their first ECT course were included in the study. Ethics committee approval was obtained and all patients' consent was taken. The consecutive patients were randomized into two groups as follows: group H (20 patients; target etCO(2): 25-30 mmHg) and group N (20 patients; target etCO(2) 35-40 mmHg). All patients were ventilated with a facial mask for two minutes and later were ventilated by a laryngeal mask (LMA) for one minute. Vital signs, peripheric oxygen saturation (SpO(2)), and regional oxygen saturation (rSO(2)) were measured before general anesthesia induction, on the 3rd minute of ventilation with an LMA (LMA(3)), on the 1st minute postictal (PI1), on the 5th (PI5), and 10th (PI10) minutes. The motor seizure duration, Richmond sedation-agitation scale, and the time needed to reach Aldrete Score 9 were also recorded. RESULTS: There was a significant difference between the groups when they were compared concerning seizure length and recovery time. However, when we compared the rSO(2) values that were measured at different times in group H, the difference between the measurements was statistically significant. When rSO(2) values in group H were compared in doubles, there were significant differences between measurements between the basal and LMA(3), basal and PI1, and the basal and PI5. When Richmond agitation scores in both groups are compared, there were no significant differences between the groups. CONCLUSION: This study found that seizure length was longer, and the recovery time was shorter in group H. There was a contribution of hyperventilation on cerebral oxygenation that was measured on the same person at different times, but cerebral oxygenation was not statistically different from patients that were normoventilated. More studies are required to form a consensus regarding how hyperventilation applies to ECT.Öğe The Relationship between Platelet/Lymphocyte and Neutrophil/Lymphocyte Ratios and Mortality in Intensive Care Patients with Crimean-congo Hemorrhagic Fever(Erciyes Univ Sch Medicine, 2020) Avci, Onur; Gundogdu, OguzObjective: This study aims to examine the platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) values in predicting mortality of Crimean-Congo Hemorrhagic Fever (CCHF) patients in an intensive care unit (ICU). Materials and Methods: This is a retrospective study, and 34 patients diagnosed with CCHF hospitalized in ICU between 1 January 2016-1 January 2020 were included in this study. Demographic data and PLR, NLR, mean platelet volume (MPV), red cell distribution width (RDW), c-reactive protein (CRP) values in their first blood samples taken in ICU were analyzed. Receiver operating characteristic (ROC) curve analyses for the estimation value of the parameters was carried out. The area under the curve (AUC), sensitivity and specificity were used to evaluate the performance of the diagnostic tests. Results: The mortality rate was 52% (18 exitus). The average length of ICU stay was 10.8 +/- 6.6 days. For the value of 8.40 FL for MPV, sensitivity was 83.3%, and specificity was 68.8%. The sensitivity was 88.9% and the specificity was 81.3% for the value of 13.15% of RDW. For NLR, the sensitivity was 83.3%; and the specificity was 87.5% for the value of 2.73. For PLR, the sensitivity was 81.3%, and the specificity was 100% for the cut-off value of 49.94. Conclusion: PLR and NLR can give the physician an idea about the mortality in patients with severe CCHF; however, studies with a larger number of patients are needed for full validity.Öğe Ultrasound-Guided Serratus Posterior Superior Intercostal Plane Block in Modified Radical Mastectomy Surgeries: A Case Series(Lippincott Williams & Wilkins, 2024) Balci, Fatih; Tekcan, Muhammed Nail; Gundogdu, Oguz; Avci, OnurEffective pain management is crucial for modified radical mastectomy (MRM) surgeries. The Serratus Posterior Superior Intercostal Plane Block (SPSIPB), introduced in 2023, shows promise for postoperative analgesia. This study was designed to demonstrate the analgesic efficacy of the SPSIPB in MRM surgeries. SPSIPB was administered to 7 patients who underwent MRM for postoperative analgesia. NRS scores of patients were <= 4 and total tramadol consumption was 0 mg in 3 of 7 patients. In conclusion, SPSIPB appears to be an effective, safe, and easily applicable option for analgesia.
