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Öğe Effect of ultrasound-guided pericapsular nerve group (PENG) block on pain during patient positioning for central nervous blockade in hip surgery: a randomized controlled trial(Bmc, 2023) Aygun, Hakan; Tulgar, Serkan; Yigit, Yavuz; Tasdemir, Ayse; Kurt, Cengizhan; Genc, Caner; Bilgin, SezginBackground Most patients with hip fractures are elderly patients with comorbidities, and well-managed pain management is associated with positive postoperative outcomes. In recent years, new indications for regional anesthesia techniques have been defined, and they have found more place in clinical practice. Herein we investigate the effect of US-guided PENG block on positioning pain and compare that effect to intravenous opioid in patients undergoing surgery under spinal anesthesia for hip fractures. Additionally, we sought to investigate the effect of PENG block on pain scores, opioid intake, time to first analgesic requirement, and quality of recovery within the first 24 h following surgery. Methods In this study, patients were divided into the PENG (n = 42) and control group (n = 42) one hour prior to surgery. A team who was blinded to the assigned groups, collected and evaluated all data such as spinal anesthesia positioning pain, postoperative pain, opioid requirement. Results Patients that underwent PENG had statistically significantly lower NRS scores after interventions, immediately before positioning, at positioning and at end of spinal anesthesia. Pain scores during positioning for spinal anesthesia were statistically significantly lower in the PENG group than in the control group (p < 0.001). Total morphine use over the first 24 h was extremely statistically significantly lower in the PENG group (p < 0.001). Conclusions Positive outcomes of PENG block in patient positioning pain before spinal anesthesia, postoperative pain scores, and morphine consumption are consistent with similar studies. High patient satisfaction in patients who underwent PENG block contributes to the literature. Trial Registration ClinicalTrials.gov Identifier: NCT04871061Öğe Non-heparin-induced thrombocytopenia in patients after open-heart surgery(Sage Publications Ltd, 2022) Keles, Ercan; Bilen, Cagatay; Aygun, Hakan; Gencpinar, Tugra; Catalyurek, HudaiBackground Thrombocytopenia (platelet count below 150 x 10(3)/mu L) is a common finding after open-heart surgery and can lead to various complications, including patient death. This study aimed to determine the extent of non-heparin-induced thrombocytopenia in open-heart surgery and to highlight the associated factors. Materials and Methods In this cohort study, 842 patients who underwent valve and/or coronary bypass surgery over a 5-year period were retrospectively analyzed. After open-heart surgery, patients whose platelet count was less than 150 x 10(3)/mu L on a complete blood count 12 and 24 h after surgery were classified as thrombocytopenic. Three hundred twenty patients without thrombocytopenia and 21 patients with a high probability of heparin-induced thrombocytopenia were excluded from the study. Logistic regression analysis was used to assess the association of independent variables in moderate-severe thrombocytopenia: Age groups, sex, underlying disease, symptoms, type of surgery, pump time, pulsatile or non-pulsatile duration, degree of hypothermia, hemodilution, oxygenator type, use of an intra-aortic balloon, and erythrocyte transfusion counts were included in the analysis. Results A total of 501 patients were diagnosed as having non-heparin-induced thrombocytopenia, and 64.3% were male. Three hundred seventy-seven (75.2%) patients had mild thrombocytopenia and 124 (24.7%) had moderate-severe thrombocytopenia. The postoperative platelet count was significantly lower than the preoperative platelet count (213 x 10(3) vs.117 x 10(3)/mu L; p < 0.001). Moderate-severe thrombocytopenia was associated with age >= 80 years odds (OR = 9.026, 95% CI: [1.757-46.363]; p = 0.008), isolated valve surgery (OR = 3.090, 95% CI: [1.867-5.114]; p < 0.001), and valve surgery with coronary bypass (OR = 4.938, 95% CI: [1.638-14.889]; p = 0.005) compared to isolated coronary bypass, type of oxygenator (Nipro vital compared with Affinity OR = 11.097, 95% CI: [1.923-64.023]; p = 0.007), erythrocyte transfusion count (OR = 1.219, 95%CI: [1.046-1.420]; p = 0.011). Conclusion Age 80 years or older, surgical procedures including heart-valve surgery, and the number of red blood cell transfusions are associated with the risk of moderate-to-severe thrombocytopenia. This study provides a guide in terms of risk factors that may lead to moderate-to-severe thrombocytopenia after open-heart surgery. However, future multicentre prospective randomized studies may provide more detailed information on this subject.Öğe Resistive Warming Mattress, Forced-Air Warming System, or a Combination of the Two in the Prevention of Intraoperative Inadvertent Hypothermia: A Randomized Trial(Elsevier Science Inc, 2023) Alcan, Aliye Okgun; Aygun, Hakan; Kurt, CengizhanPurpose: To prevent intraoperative inadvertent hypothermia (IIH), resistive products and forced-air warming systems are often used simultaneously. There is insufficient evidence to show whether this application is clinically more effective than a single active warming device. The aim of this study is to compare the efficacy a single intraoperative active warming method with combined methods in IIH prevention.Design: A randomized, prospective, experimental study.Methods: This study was conducted between June and October 2021 in the operating room of a training and research hospital. The study sample consisted of 123 patients who underwent scheduled orthopedic surgery under spinal anesthesia, were young (18-64), and had an ASA risk score of I to III. The patients were divided into three groups preoperatively according to the stratified randomization technique. To prevent IIH, a resis-tive warming mattress was used in group 1; a forced-air warming system was used in group 2; and a combi-nation of the two methods were used in group 3. The body temperatures of the patients were measured and recorded every 15 minutes from admission to the operating room until the end of surgery.Findings: The mean intraoperative body temperature of the patients was 36.6 & PLUSMN;0.15 & DEG;C for group 1; 36.6 & PLUSMN;0.1 & DEG;C for Group 2 and 36.6 & PLUSMN; 0.15 & DEG;C for Group 3. There was no difference between the groups in terms of body tem-perature. The overall incidence of IIH was 8.1%; 9.8% in group 1, 9.8% in group 2 and 4.9% in group 3. There was no statistically significant difference between the groups in terms of IIH (p < .05).Conclusions: This study supports the efficacy of using resistive warming mattress and forced-air warming sys-tems in preventing IIH. The use of both methods together made no difference in terms of IIH development.& COPY; 2022 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.