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Öğe Determination of anthropometric measurements that may be associated with difficult incubation in children(2022) Kutlucan, Leyla; Aygün, HakanAim: Difficult tracheal intubation is a fundamental cause of perioperative morbidity and mortality. The frequency of difficult intubation is thought to be higher in the pediatric age group due to the different anatomical and physiological structures, and it may not be easy to detect this beforehand. Anthropometric measurements were evaluated before the elective operation and the relationship of some parameters with difficult intubation. Material and Method: This prospective cross-sectional study was conducted on 90 pediatric patients aged 2-14 who underwent elective surgery under general anesthesia. All patients’ age, gender, height, weight, body surface area (BSA), and body mass index (BMI) records were recorded before the operation. Mallampati scoring, head and neck circumference, thyromental distance measurements, and head circumference/neck circumference ratio were performed. Cormack-Lehane (CL) scoring and endotracheal intubation were applied during direct laryngoscopy of the operated patients. Children with easy intubation (CL grade 1 and 2) group 1; children who underwent difficult intubation (CL grade 3 and 4) were defined as group 2. Results: There was no significant relationship between Groups I and II in terms of age, height and weight values. There was no significant relationship between the two groups with BSA and thyromental distance measurements. Mallampati scores were found to be grades 3 and 4 (3.3%) in three of the 90 patients, and CL scores of 3 and 4 (4.4%) in four patients. A significant correlation was found between Mallampati scoring and CL scoring. A statistically significant difference was found between the two groups regarding head/neck ratios and BMI. Conclusion: In our study, head circumference/neck circumference ratio and BMI were found to be helpful while predicting difficult intubation in children with normal physical characteristics, 2-14 years of age, who underwent elective surgery. Our findings can be supported by further studies that will be planned and include more patients.Öğe The effect of neutrophil lymphocyte ratio on mortality in patients followed in the intensive care unit with the diagnosis of ischemic stroke from the emergency department(2022) Aygün, Hakan; Şener, AslıThe goal of this study was to determine if the neutrophil-lymphocyte ratio (NLR) predicts mortality in patients hospitalized in the intensive care unit (ICU) with an ischemic stroke. Between January 1 and December 31, 2021, 116 patients admitted to our emergency department with the diagnosis of ischemic stroke and hospitalized in the 3rd level ICU unit were included in the study and divided into two groups: patients who died (Group 1: n=62) and patients who survived (Group 2: n=54). Patients’ age, gender, presence of chronic diseases, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and neutrophil count, lymphocyte count, and NLR were obtained by dividing these two numbers in the first complete blood count taken at the time of admission to the emergency department were collected and analyzed. While 54 (46.5%) patients were discharged from the ICU, 62 (53.4%) patients died. 60 (51.7%) of the patients were female. The average age of patients was 76.85±10.70. APACHE II score was found to be correlated with mortality (AUC 0.70, 95% CI (0.616-0.802) (p=0.01). When the APACHE II cut-off value was more than 13.5, it predicted mortality with 95% sensitivity and 85% specificity. The median NLR ratio of the patients was found to be 5.08 (0.38-35.16) in the survivors and 11.68 (1.38-113.00) in patients that died. NLR was lower in survivors (p=0.002). NLR may be a valuable marker in predicting mortality in stroke patients admitted to the ICU.Öğe Innovation in measuring obese patients' blood pressure: measurement with conical wrapping technique(Lippincott Williams & Wilkins, 2022) Şahan, Seda; Şahin, Sevil; Aygün, Hakan; Yıldız, AysegülIntroduction Accurate measurement of blood pressure (BP) is difficult in obese patients due to their upper arm shape and width. Errors made during BP measurement cause misdiagnosis or lead to wrong treatment. Method The data of this methodological study were collected from 40 patients who were 18 years old or above, with a BMI above 25 kg/m(2), and who were followed up with radial catheter arterial pressure in adult intensive care and postoperative care units between March and December 2020. Results In total 55% of the participants were male with a mean age of 63.9 years, mean height of 165.7 cm, mean weight of 85.2 kg and mean BMI of 31.0 +/- 2.1 kg/m(2). Intra-arterial BP (IABP) measurement values were found to be correlated with conical wrapping technique and cylindrical wrapping technique (P < 0.001). As a result, a statistically significance was found between conical SBP and intra-arterial SBP (r = 0.921; P < 0.05) and conical DBP and intra-arterial DBP (r = 0.902; P < 0.05) Conclusion It was determined that the SBP and DBP results of the conical wrapping technique were closer to the results obtained by IABP measurements. For this reason, it is more appropriate to measure BP with conical wrapping technique in clinically obese patients.Öğe Use of ultrasound guided single shot costotransverse block (intertransverse process) in breast cancer surgery: a prospective, randomized, assessor blinded, controlled clinical trial(Bmc, 2022) Aygün, Hakan; Kızıloğlu, İlker; Öztürk, Nilgün Kavrut; Öcal, Haydar; İnal, Abdullah; Kutlucan, Leyla; Gönüllü, EdipBackground: Ultrasound guided costotransverse block (CTB) is a relatively newperi-paravertebral block that has been described recently. It has been previously reported that CTB, administered with a single high-volume injection, provides effective analgesia in breast conserving surgery. In this study we evaluated the effect of CTB when used in breast cancer surgery. Methods: Seventy patients due to undergo breast cancer surgery were included in this blinded, prospective, randomized, efficiency study. Patients were randomized into two equal groups (CTB group and control group) using the closed envelope technique. All patients underwent general anesthesia. In addition to standard analgesia methods, patients in group CTB also received CTB block while the remaining (control group) did not. Numeric rating (pain) scores and opioid consumption was compared between the two groups. Results: Opioid consumption in all time frames and pain scores at 1st and 3rd hours only were found to be significantly lower in Group CTB when compared to the control group. Conclusions: Ultrasound guided CTB improves analgesia quality in breast cancer surgery.