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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 preoperative briefing on anxiety: A randomized study(Galenos Publishing House, 2022) Altaş, Ömer Faruk; Kutlucan, LeylaObjectives: Contrary to the standard information before the surgery, it was aimed to reveal the effect of detailed verbal information on the anxiety level of the patients. Materials and Methods: Eighty-four patients included in the study were randomized into 2 groups with 42 patients in each group. While detailed verbal information was given to the patients in group 1 before the surgery, standard information was given to the patients in group 2. Amsterdam Preoperative Anxiety and Knowledge scale (APAIS) questionnaire was applied to all patients for preoperative anesthesia and one hour before the operation, immediately after informing. Results: There was no significant difference between the two groups in terms of demographic data (p>0.005). Before the information, patients in group 1 had higher anxiety and desire for information scores than group 2 (p<0.001, p<0.001). In the within-group evaluation after the information, there was a significant improvement in each parameter in group 1 (p<0.001, p<0.001). While a significant increase in anxiety was detected in group 2 (p=0.02), there was no statistically significant change in the desire to obtain information (p=0.21). In the intergroup evaluation, no significant difference was found in any of the parameters after the information (p=0.86, p=0.40), while a statistically significant difference was found in the APAIS anxiety and APAIS desire to learn scores when the ? values ?were examined (p<0.001, p=0.007). Conclusion: In our study, we showed that detailed verbal information before the surgery reduced the patients’ anxiety and desire to obtain information. © 2022 by the International Society for Pelviperineology / Pelviperineology published by Galenos Publishing House.Öğe Investigating the effects of the COVID-19 pandemic on obstetric anesthesia and perioperative outcomes in cesarean section surgery(MediHealth Academy Yayıncılık, 2023) Kutlucan, Leyla; Altaş, Ömer Faruk; Şenoğlu, NimetAim: In the literature, studies comparing the preferred anesthesia methods and related parameters in obstetric anesthesia during the pandemic period with the pre-pandemic period are limited. I n this study, primarily in patients who gave birth by cesarean section before and during the COVID-19 (Coronavirus disease 19) pandemic; It was aimed to evaluate the anesthesia method, postoperative complications, length of hospital stay, clinical urgency of the patients and ASA (American Society of Anesthesiologists) scores. In addition, in patients who underwent cesarean section with positive and negative PCR (Polymerase Chain Reaction) tests during the COVID-19 pandemic; It was aimed to evaluate the anesthesia method, postoperative complications, hospital stay, clinical urgency of the cases and ASA scores. Material and Method: In this retrospective, single-center study, we noted down and compared types of cesarean section (elective or emergency), anesthesia techniques (spinal, spinal+epidural, or general anesthesia), and patients’ ages, ASA scores, PCR test results, postoperative complications (e.g., pneumonia, excessive postpartum bleeding), and lengths of hospital stay. Results: We carried out this study with the data of 2,406 women, 1,458 of whom gave birth before the pandemic. The findings revealed that the rate of developing complications, the length of hospital stay, the number of patients with an ASA score of 3 and above, and the use of spinal anesthesia significantly increased during the pandemic. Moreover, 182 women were COVID-19-positive among a total of 948 applicants during the pandemic. Although the ASA scores and complication rates were significantly higher among those with a positive PCR test result, the length of hospital stay was similar between the patients by their PCR test results. Conclusion: Our findings revealed a significant decrease in spinal + epidural anesthesia, which was frequently adopted before, in cases with cesarean section during the pandemic. Spinal anesthesia was mostly used alone. Despite increased complication rates in PCR-positive patients with higher ASA scores undergoing cesarean section, we concluded no significant change in the length of hospital stay. In cases of increased risk of infection and transmission (e.g., pandemic), neuraxial blocks may be preferred as an anesthesia technique to minimize the risk of infection in emergency obstetric operations. It should also be noted that the risk of developing postoperative complications always be high during pandemics.Öğe Red cell distribution width, eosinophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio can predict the development of infection and the number of antibiotics used in elderly patients undergoing revision total knee arthroplasty(2022) Kutlucan, Leyla; Yıldız, VahitIntroduction: We aimed to evaluate the relationship between complete blood parameters reported to be associated with inflammation and development of complications, length of hospital stays and the number of antibiotics used in elderly patients undergoing revision total knee arthroplasty (rTKA). Material and Method: Our retrospective study was conducted in a single center and included 72 older patients who underwent rTKA operations. We recorded patients’ firs day preoperative, first day postoperative and 45th day postoperative whole blood parameters. Results: It was found that the development of postoperative infection and the number of antibiotics used were higher in patients with low preoperative Hb values and high platelet-to-lymphocyte ratio (PLR) rates. In patients with high RDW value and high eosinophil-lymphocyte ratio (ELR) one day after surgery, both the development of infection (P=0.002, P=0.002) and the number of antibiotics used during follow-up were found to be significantly higher (P<0.001, P<0.001). When the laboratory parameters were evaluated 45 days after the operation, it was determined that the RDW (P=0.001, P=0.001) and ELR (P=0.039, P<0.001) elevations continued in the patients who developed infection and used multiple antibiotics. CRP and ESR values one day and 45 days after surgery were also found to be significantly associated with the development of infection and the use of multiple antibiotics. Conclusion: RDW, ELR and PLR parameters may be as important as CRP and ESR in predicting the development of infection and the number of antibiotics used in elderly patients undergoing rTKA.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.
