Bu arastirmanin amaci, gecmiste uzun yillar idari ve mali acidan kamu muessesesi niteliginde hizmet veren, gunumuzdeyse bir vakif universitesine bagli Tip Fakultesi’nin Fizik Tedavi ve Rehabilitasyon (FTR) Anabilim Dali’na ait bakim ve tedavi servislerinin maliyet yapisi ve analizidir. Calismada, Vergi Usul Kanunu ve diger ilgili mevzuat geregince tutulan kayit ve raporlara dayali muhasebe verileri kullanilmistir. Bunlar, Microsoft Excel programi kullanilarak geleneksel yontemlerle cozumlendikten sonra, bilgisayar istatistik programinda Korelasyon (iliski) testi yapilmis, veri guvenligiyse Alfa testiyle yapilmistir. ‘Toplam maliyet’in yarisindan fazlasinin ‘isgucu gideri’nden olusmasina ragmen, bu iki degisken/gider arasinda anlamli bir iliski bulunamamistir.
Amac: Bu calismada, karaciger nakli vericilerinde torakal epidural ve paravertebral blogun postoperatif agri kontrolundeki etkinliklerinin karsilastirilmasi amaclandi.Gerec ve Yontemler: Calismaya karaciger vericisi olmayi ve agri kontrolu icin paravertebral veya epidural kateter yerlestirilmesini kabul eden, 18-60 yas arasi, ASA I-II, 50 hasta dâhil edildi. Olgular kapali zarf yontemi ile T6-8 duzeyinden paravertebral blok uygulanan olgular (Grup 1) ve epidural blok uygulanan olgular (Grup 2) olarak 2 gruba randomize edildi. Olgular operasyondan sonraki 24 saat boyunca, VAS, vital bulgular, sedasyon skorlari, hasta memnuniyet duzeyleri, kumulatif tuketilen lokal anestezik miktari, ek analjezik gereksinimi ve yan etkiler acisindan karsilastirildi. Bulgular: Kumulatif tuketilen lokalanestezik miktari 2. ve 4. saatte Grup 2’ye gore Grup 1’de daha fazlaydi (p
Postoperative cognitive dysfunction is a serious complication that may be associated with increased mortality. Living-donor liver transplant includes major surgery for the donor. The purpose of this study was to evaluate preoperative and postoperative cognitive function of liver donors in living-donor liver transplant.In 102 patients who had hepatectomy for liver transplant donation, preoperative and postoperative (1 week) neuropsychologic tests were performed including the Trail Making Test, the Stroop effect, score on the Beck Depression Inventory, and the mini-mental state examination.Liver transplant donors had significantly lower mean Trail Making A Test duration and greater mean Trail Making B Test error number after than before surgery. The mean Stroop effect reading durations (black and white reading; reading colored words) were significantly greater after than before surgery; the mean time difference between naming the colors of colored words minus reading colored words, and the error number, were smaller after than before surgery. The mean score on the Beck Depression Inventory and mini-mental state examination score were similar before and after surgery.Mild frontal lobe dysfunction may be present in liver donors at 1 week after surgery, and postoperative attention problems may be experienced by these patients.
Carotid endarterectomy (CEA) is an effective surgery which is applied in order to reduce the risk of stroke associated with severe stenosis of the carotid artery. Anesthesia management is important in these patients due to high incidence of cardiovascular disease and studies are in progress for ideal anesthesia management. In this study, we aimed to share our experience in carotis endarterectomy and evaluate the clinical outcomes and review retrospectively.
Patients informations were obtained from the patients and anesthesia records. Age, ASA physical status, Mallampati score (MP), anesthesia and surgery duration, ICU and discharge time, blood transfusion rate, anesthetic and analgesic drugs, invasive procedures, complications, smoking, stenosis side and ratio, comorbid conditions of patients and drugs were recorded. The mean age of patients was 67.19±1.07 (33-98). It was evaluated that 44 patients (61.2%) were ASA II, 28 patients (38.8%) were ASA III. It was recorded that mean duration of anesthesia was 226.25 ± 37.99 min, duration of surgery was 195.83±38 min, ICU stay was 2.45 ± 2.52 days and hospital stay time was 5.23 ± 2.77 days. 29 of patients (40.3%) were smokers and 7 of patients (9.7%) were identified as secondary smokers. The mortality rate was 6.9% (5 patients). Clinical experience and outcome data from our study are consistent with the literature. In CEA surgery, anesthetic technique that is safe enough to guide the evidence is not there yet. Experience of the anesthesiologist and the surgeon as surgical anesthetic management of CEA is an important point to be noted that the current developments in the patient's characteristics and monitoring.
