Serdar Yeşiltaş

Bezmiâlem Vakıf Üniversitesi

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İS

İsmail Sümer

Bezmiâlem Vakıf Üniversitesi

Kazım Karaaslan

Bezmiâlem Vakıf Üniversitesi

Meltem Türkay

Bezmiâlem Vakıf Üniversitesi

Hayrettin Daşkaya

Bezmiâlem Vakıf Üniversitesi

Harun Uysal

Bezmiâlem Vakıf Üniversitesi

Sinan Yılmaz

Atatürk University

Ayda Türköz

Bezmiâlem Vakıf Üniversitesi

MÇ

Muhittin Çalım

Bezmiâlem Vakıf Üniversitesi

Mustafa Sarp Kaya

Bezmiâlem Vakıf Üniversitesi

ÖP

Özge Pasin

Bezmiâlem Vakıf Üniversitesi

Cooperative Institutions

Türk Anesteziyoloji ve Reanimasyon Derneği

Sağlık Bilimleri Üniversitesi

Bezmiâlem Vakıf Üniversitesi

Ministry of Health

University of Health Science

Gazi University

State Hospital

University of Health Sciences

Sivas State Hospital

Haseki Eğitim ve Araştırma Hastanesi

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MuLBSTA skorunun şiddetli akut solunum sendromu koronavirüs 2019 pnömonili hospitalize hastalarda kritik klinik sonuçları öngörmedeki prediktif değerinin incelenmesi

Anadolu Kliniği Tıp Bilimleri Dergisi (2022)

Serdar Yeşiltaş Meliha Meric Koç Ayşe KARATAŞ Gülpınar TEPE Özge Pasin

Aim: Multilobar infiltration, lymphocytopenia, bacterial co-infection, smoking history, hypertension, and age>65 (MuLBSTA) score is a clinical prediction rule used to classify patients with viral pneumonia by expected mortality. We compared the predictive performance of MuLBSTA with PSI, CURB-65, and qSOFA for poor clinical outcomes in hospitalized severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) patients.Methods: A retrospective study was conducted on patients with SARS-CoV-2 who were hospitalized in a tertiary medical center between March 11, 2020, and May 31, 2020. 271 out of 900 patients who tested positive for SARS-CoV-2 were included in the study. The MuLBSTA, PSI, CURB-65, and qSOFA scores were used to assess thirty-day mortality, need for intensive care unit (ICU), mechanical ventilation (MV) requirement, and development of acute respiratory distress syndrome (ARDS) in all patients. Prognostic factors were also analyzed for thirty-day mortality.Results: Among all 271 hospitalized patients, 150 males (55.3%) were included. The mean age was 54.2±15.4 years. The 30-day mortality rate was 10.7%. Of the patients included in the study; 39 patients (14.3%) were admitted to the intensive care unit, 32 patients (11.8%) received mechanical ventilator support, and 23 patients (8.4%) were diagnosed with ARDS. In predicting mortality, the area under the curve (AUC) of the MuLBSTA, PSI, CURB-65 and qSOFA scores were 0.877 (95% CI 0,832 0,914), 0.853 (95% CI 0,806-0,893), 0.769 (95% CI 0,714-0,817) and 0.769 (95% CI 0,715-0,818), respectively. The MuLBSTA score showed a higher AUC value compared to other prediction scores. The MuLBSTA and PSI scores performed better than CURB-65 and qSOFA scores in determining patients’ need for ICU, MV requirement, and ARDS development.Conclusion: The MuLBSTA score is an efficient tool to predict poor clinical outcomes in hospitalized patients with SARS-CoV-2. Further studies are warranted to validate its use.

10.21673/anadoluklin.1132734

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Efficacy of Intravenous Ibuprofen and Paracetamol on Postoperative Pain and Tramadol Consumption After Arthroscopic Shoulder Surgery: A Prospective, Randomized, Double-blind Clinical Trial

Medeniyet Medical Journal (2023)

Muhittin Çalım Serdar Yeşiltaş Mustafa GUNAY İsmail Sümer Sedat Akbaş

Efficient pain management following arthroscopic shoulder surgery plays a crucial role in decreasing pain intensity, tramadol consumption, and related side effects. This study primarily aimed to examine the analgesic impact of intravenous (IV) ibuprofen and paracetamol on postoperative pain intensity. In addition, as secondary objectives, the study assesses tramadol consumption, determine the global satisfaction score (GSS), analyze hemodynamic parameters, and investigate tramadol-related side effects.In this study, we enrolled sixty-four patients who were scheduled to undergo arthroscopic shoulder surgery and met the inclusion criteria of having American Society of Anesthesiologists scores between 1 and 3 and falling within the age range of 18 to 85 years. All participants were managed using IV patient-controlled analgesia. These patients were then randomly assigned in a double-blind manner to two groups: one receiving paracetamol (n=32), and the other receiving ibuprofen (n=32). Demographic information, visual analog scale (VAS) and GSS data, hemodynamics, tramadol consumption, and tramadol-related side effects were recorded.There were no significant differences between the two groups regarding demographics, hemodynamics, GSS scores, and tramadol side effects (respiratory depression, pruritus, urinary retention, and nausea and vomiting). VAS scores of the two groups were similar at postoperative 1st, 6th, and 12th hours. However, group ibuprofen significantly reduced the VAS scores at the postoperative 24th hour (p=0.039). On the other hand, the two groups showed no significant differences in GSS scores. Compared with total tramadol consumption during the postoperative 24-hour period, ibuprofen significantly reduced tramadol consumption (p=0.003).The findings of this study indicate a significant reduction in both pain intensity and tramadol consumption when IV ibuprofen was administered 24 hours following arthroscopic shoulder surgery, in comparison with the use of IV paracetamol.Artroskopik omuz cerrahisi sonrası etkin ağrı yönetimi, ağrı yoğunluğunun, tramadol tüketiminin ve ilgili yan etkilerin azaltılmasında önemli bir rol oynamaktadır. Bu çalışmanın birincil amacı, intravenöz (İV) parasetamol ve ibuprofenin postoperatif ağrı şiddeti üzerindeki analjezik etkilerini karşılaştırmak, ikincil amacı ise tramadol tüketimi, global memnuniyet skoru (GMS), hemodinami ve tramadol ile ilgili yan etkileri incelemektir.Bu çalışmaya artroskopik omuz cerrahisi planlanan, Amerikan Anestezistler Derneği skoru 1-3 olan, yaşları 18-85 arasında olan 64 hasta dahil edildi. Tüm hastalarda İV hasta kontrollü analjezi kullandı. Hastalar rastgele ve çift-kör olarak iki gruba ayrıldı: Parasetamol (n=32) ve ibuprofen (n=32). Demografik bilgiler, vizüel analog skala (VAS) ve GMS, hemodinami, tramadol tüketimi ve buna bağlı yan etkiler kaydedildi.İki grup arasında demografik özellikler, hemodinami, GMS skorları ve tramadole bağlı yan etkiler (solunum depresyonu, kaşıntı, idrar retansiyonu ve bulantı-kusma) açısından anlamlı fark yoktu. Postoperatif 1., 6. ve 12. saatlerde iki grubun VAS skorları benzerdi. Ancak ibuprofen grubu postoperatif 24. saatte VAS skorlarını anlamlı olarak düşürdü (p=0,039). Öte yandan, iki grubun GMS skorlarında anlamlı bir fark yoktu. Postoperatif 24 saatlik dönemde toplam tramadol tüketimi ile karşılaştırıldığında ibuprofen grubu, tramadol tüketimini anlamlı olarak azalttı (p=0,003).Bu çalışma, artroskopik omuz cerrahisi sonrası 24 saatlik periyotta, İV parasetamole kıyasla İV ibuprofen ile ağrı şiddetinin ve tramadol tüketiminin önemli ölçüde azaldığını göstermiştir.

Ibuprofen

10.4274/mmj.galenos.2023.99975

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Ultrasound-guided erector spinae plane block in patients undergoing pediatric abdominal surgery: a randomized study

Ain-Shams Journal of Anaesthesiology (2022)

Parvin Pınar Serdar Yeşiltaş Meltem Türkay Kazım Karaaslan Ayda Türköz

Abstract Background Erector spinae plane block (ESPB) can provide effective analgesia in pediatric abdominal surgery . Additionally, when used as an analgesic method in abdominal surgery, ESPB may increase regional intra-abdominal tissue oxygen saturation (rSO 2 ) throughout the operation. However, the number of related studies conducted on pediatric patients is insufficient. Results Fifty-two patients undergoing lower abdominal surgery were allocated into two groups, the ESPB (E) and the control (C). Group E received general anesthesia plus unilateral ultrasound-guided ESPB, and group C received general anesthesia alone. Intraoperative fentanyl consumption, Face, Legs, Activity, Cry, Consolability (FLACC) score, time to first rescue analgesia and adverse events were recorded over the first 24 h postoperatively. The rSO 2 level was evaluated in both groups throughout the operation. The FLACC score was significantly lower in group E than in group C ( p <0.05). Four patients in group E required intraoperative fentanyl compared to 12 patients in group C ( p <0.05). The first rescue analgesic administration time was significantly longer in group E than in group C ( p <0.05). No significant difference in rSO 2 values was detected between the groups ( p >0.05). However, in group E, rSO 2 values were significantly increased after the block compared to the postinduction values. Conclusions ESPB provides effective perioperative analgesia in children undergoing low abdominal surgery. Although there was no significant difference in rSO 2 values between the groups, ESPB administration consistently increases rSO 2 over time. Trial registration The trial was registered at ClinicalTrials.gov before patient enrolment ( NCT03808129 -13.12.2018).

FLACC scale

10.1186/s42077-022-00246-x

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The Effect of Exogenous Human Albumin Administration on Acute Kidney Injury Development in Hypoalbuminemic Patients in the Intensive Care Unit

Bezmialem Science (2022)

Serdar Yeşiltaş Cumali GÜZEL İsmail Sümer Harun Uysal Hayrettin Daşkaya

Objective: Hypoalbuminemia is an independent risk factor for acute kidney injury (AKI) and mortality.The primary aim of our study was to investigate the effect of exogenous human albumin (EHA) administration on hypoalbuminemic patients in the intensive care unit (ICU) regarding the development of AKI.Our secondary aim was to compare the ICU admission duration and mortality rates of these patients.Methods: After receiving ethics committee approval, the researchers retrospectively screened database for 5,989 patients admitted to the adult ICU from 01.01.2014 to 01.06.2018.The demographic data, serum albumin and creatinine levels, ICU admission duration and mortality rates of patients were recorded.Stage 2-3 AKI was accepted based on the AKI network criteria, while hypoalbuminemia was accepted as serum albumin values below 3.5 g/dL.Patients not given EHA were assigned to group none human albumin (Group NHA), while patients given EHA were assigned to group human albumin (Group HA).The rate of AKI development, duration of stay in ICU and mortality rates were compared between the groups. Results:The mean age, AKI development rate, mortality rate and ICU admission duration in Group HA were statistically significantly higher than in Group NHA (p=0.0001,p=0.0001, p=0.0001, p=0.0001).There was no difference in terms of the gender distribution in the groups.The mean albumin value in Group HA was statistically significantly lower than Group NHA (p=0.0001).Amaç: Hipoalbüminemi, akut böbrek hasarı (ABH) ve mortalite için bağımsız bir risk faktörüdür.Çalışmamızın temel amacı, yoğun bakım ünitesinde (YBÜ) izlenen hipoalbüminemik hastalarda eksojen human albümin (EHA) uygulamasının ABH gelişimi üzerine etkisini araştırmaktı.İkincil amaçlarımız ise YBÜ'de kalış süresi ile mortalite oranlarını karşılaştırmaktı.

Hypoalbuminemia

Serum Albumin

Rifle

10.14235/bas.galenos.2021.6113

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Dental Treatment of Two Children with Niemann Pick Disease Type B Under General Anesthesia: Case Reports

Bezmialem Science (2019)

Mustafa Sarp Kaya Meltem Bakkal Serdar Yeşiltaş

Niemann-Pick disease (NPD) is an autosomal recessive lysosomal lipid storage disorder with accompanying symptoms including hepatosplenomegaly and thrombocytopenia.Delayed or extensive dental treatment may need to be delivered under general anesthesia and the management of such treatments in these children may require advanced medical support including intensive care (IC).Two children with NPD type B who underwent dental treatment with general anesthesia and their post-operative follow-ups requiring in IC are were presented.Patients with NPD may present with fragile blood clots in extracted tooth socket and should be subjected to strict bleeding control standards; especially the ones that may require further respiratory assistance since oral intubation is an invasive application to the oral surgical site.

10.14235/bas.galenos.2017.1872

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The Effect of Intraoperative Body Temperature on Postoperative Nausea and Vomiting in Pediatric Patients

Journal of PeriAnesthesia Nursing (2021)

İsmail Sümer Harun Uysal Serdar Yeşiltaş Meltem Türkay

10.1016/j.jopan.2021.04.012

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Comparison of serratus plane block alone and in combination with pectoral type 1 block for breast cancer surgery: a randomized controlled study.

PubMed (2021)

Serdar Yeşiltaş Ayda Türköz Muhittin Çalım Sinan Yılmaz Asım Esen

Concurrent application of ultrasound-guided pectoral type 1 (PECS I) and serratus plane block (SPB) is one of the most appropriate multimodal analgesic strategies for reducing acute post-mastectomy pain. The purpose of the present study was to compare the analgesic efficacy of SPB alone, or in combination with PECS I block for post-mastectomy pain following breast cancer surgery.Sixty participants undergoing breast cancer surgery were randomly assigned to two groups. After anesthesia induction, group S (n =30) received SPB alone, whereas the SPECS group (n =30) received a combination of PECS I and SPB. Pain scores at 0, 1, 2, 6, 12, 24 h postoperatively, intra-operative fentanyl consumption, postoperative time to first rescue analgesia, nausea, vomiting, patient satisfaction, and anesthesia-related complications were recorded.Pain scores in the SPECS group were significantly lower than group S throughout the follow-up period (p <0.001). A significant reduction in postoperative rescue morphine consumption (p =0.01, median difference 7 mg, 95 % confidence interval: 5.1-7.9 mg) and intraoperative fentanyl consumption (p =0.01) in the SPECS group compared with group S. Moreover, postoperative nausea and vomiting were lower, and patient satisfaction was higher in the SPECS group compared with that of the group S.These results suggest that SPB application and PECS I provide more effective and reliable perioperative analgesia and increase patient satisfaction in breast cancer surgery. HIPPOKRATIA 2021, 25 (1):8-14.NCT03899545.

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Investigation of the Prognostic Values of the Shock Index and Modified Shock Index in Predicting the Clinical Outcomes in Elderly Hospitalized Patients with Coronavirus Disease-2019

İstanbul medical journal (2023)

Serdar Yeşiltaş Saadet Öztop Mustafa Günay İsmail Sümer Sedat Akbaş

Shock index (SI) is a non-invasive, simple, and reproducible dynamic monitoring method.Allgöwer and Buri (9) introduced the SI in 1968 to measure the grade of hypovolemia in shocks due to hemorrhage and infections.The SI is a good predictor of mortality in different infectious conditions, exemplarily sepsis, and pneumonia (10-14).Additionally, the modified SI obtained by the ratio of the heart rate (HR) to the mean arterial pressure is a better indicator of prognosis than the SI in infectious diseases (15). Introduction:Advanced age is an independent risk factor for increased mortality in coronavirus disease-2019 (COVID-19).However, the best method for estimating mortality in elderly patients with COVID-19 is still under debate.We performed this study to assess the shock index (SI) and the modified shock index (MSI) for the abovementioned problem.Methods: A retrospective study was conducted including elderly cases (≥65 years) confirmed with COVID-19 who admitted to a tertiary university hospital between March-December 2020.The SI and MSI at the time of the emergency department visits were used to evaluate the intensive care unit admission, ventilator support, septic shock, and 30-day mortality in all patients.The receiver operating characteristic and area under the curve (AUC) were used to measure the overall ability of SI and MSI to predict clinical outcomes. Results:We recruited 334 consecutive COVID-19 patients with a mean age of 75.2±7.3and an almost equal gender distribution [170 males (50.9%)].In deceased and surviving patients, the SI was 0.66±0.16and 0.6±0.1 (p=0.014), while the MSI was 0.95±0.22 and 1.09±0.34(p=0.003),respectively.In predicting mortality, the AUC of the SI and MSI were 0.590 [95% confidence interval (CI): 0.535 to 0.643] and 0.608 (95% CI: 0.553 to 0.660), respectively.Conclusion: Increased SIs and MSIs are associated with 30-day mortality.SI and MSI can benefit the triage of elderly patients hospitalized for COVID-19.However, it was found that there is no single cut-off value of SI or MSI with optimum accuracy for predicting COVID-19-related clinical outcomes.

Coronavirus

2019-20 coronavirus outbreak

10.4274/imj.galenos.2023.44380

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The effectiveness of clavipectoral fascia plane block for analgesia after clavicle surgery: a report of five cases

Minerva Anestesiologica (2020)

Yunus Oktay Atalay Bahadır Çiftçi Mürsel Ekinci Serdar Yeşiltaş

10.23736/s0375-9393.20.14503-6

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Comparison of ultrasound-guided transversus abdominis plane block, quadratus lumborum block, and caudal epidural block for perioperative analgesia in pediatric lower abdominal surgery

TURKISH JOURNAL OF MEDICAL SCIENCES (2019)

Celal Bulut İPEK Deniz Kara Sinan Yılmaz Serdar Yeşiltaş Asım Esen

Despite different regional anesthesia techniques used to provide intraoperative and postoperative analgesia in pediatric patients, the analgesic effectiveness of peripheral nerve blockades with minimal side effect profiles have not yet been fully determined. We aimed to compare the efficacy of ultrasound-guided transversus abdominis plane (TAP) block, quadratus lumborum (QL) block, and caudal epidural block on perioperative analgesia in pediatric patients aged between 6 months and 14 years who underwent elective unilateral lower abdominal wall surgery.Ninety-four patients classified under the American Society of Anesthesiologists physical status classification system as ASA I or ASA II were randomly divided into 3 equal groups to perform TAP, QL or Caudal epidural block using 0.25% of bupivacaine solution (0.5 ml kg−1).Postoperative analgesic consumption was highest in the TAP block group (P < 0.05). In the QL block group, Pediatric Objective Pain Scale (POAS) scores were statistically significantly lower after 2 and 4 h (P < 0.05). The length of hospital stay was significantly longer in the caudal block group than the QL block group (P < 0.05).We suggest that analgesia with ultrasound-guided QL block should be considered as an option for perioperative analgesia in pediatric patients undergoing lower abdominal surgery if the expertise and equipment are available.

10.3906/sag-1812-59

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