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    The Effect of Erector Spinae Plane Block on Laparoscopic Cholecystectomy Anesthesia: Analysis of Opioid Consumption, Sevoflurane Consumption, and Cost
    (MARY ANN LIEBERT, INC, 2020) Peker, Kevser; Akçaboy, Zeynep Nur; Aydin, Gülçin; Gencay, Işın; Şahin, Ahmet Tugrul; Koçak, Yahya Fatih; Peker, Seydi Ali
    Background: Erector spinae plane (ESP) block has been increasingly suggested for laparoscopic cholecystectomy (LC) as a part of multimodal analgesia in many studies. However, there is not any study that investigated the perioperative effects of ESP block on anesthetic agent consumption and cost of LC anesthesia. This is the first study that evaluates the effect of ESP block in terms of cost-effectiveness, intraoperative consumption of inhalation agents, and perioperative consumption of opioids. Materials and Methods: In this prospective observational study, 81 patients who underwent LC were included. Patients were divided into two groups: In Group ESP (n = 39) bilateral ultrasound-guided ESP block was performed in preoperative period and in Group non-ESP (n = 42) ESP block was not performed. After standard general anesthesia protocol, anesthesia was maintained with 2% sevoflurane in 50% air and 50% oxygen with controlled ventilation in both groups. All patients were monitored with electrocardiography, noninvasive blood pressure, pulse oximetry, end-tidal carbon dioxide, and bispectral index. The consumption of sevoflurane and opioids in the intraoperative and postoperative 24 hours was recorded. The costs of drugs were determined by multiplying total consumed amounts with unit prices. Results: The costs and the consumed amounts of remifentanyl, sevoflurane, and tramadol were significantly higher in non-ESP group in the perioperative period (respectively, P < .001, P = .01, and P < .001). Conclusions: ESP block for LC decreased the consumed amount and cost of inhaled agents and opioids in the perioperative period.
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    Öğe
    EŞ ZAMANLI PCT VE CRP İSTENEN TOPLUM KÖKENLİ PNÖMONİ VE KOAH ALEVLENMESİ OLAN HASTALARDA BU PARAMETRELERİN KORELASYONU VE MALİYET ETKİLİLİK AÇISINDAN DEĞERLENDİRİLMES
    (2019) Badem, Nermin Dindar; Peker, Seydi Ali; Kaygusuz, Sedat
    Amaç: Bakteriyel enfeksiyonlar önemli morbidite vemortalite nedenidir. Serum prokalsitonin ve C-reaktifprotein sistemik inflamasyon ve bakteriyel enfeksiyonlarıntanı, tedavi ve takibinde önemli belirteçlerdir. Buçalışmada nihai tanıları pnömoni ve/veya KOAHalevlenmesi olan hastalarda son zamanlarda enfeksiyontakibinde sıklıkla kullanılmaya başlanan prokalsitonin ileklasik belirteç olarak kullanılan C-reaktif protein düzeyleriarasındaki korelasyon araştırıldı. Ayrıca alt solunum yoluenfeksiyonu tanısı ya da yönetimi için C-reaktif proteininmi, prokalsitoninin mi maliyet etkililik açısından yararlıolduğunu saptamayı amaçladık.Gereç ve Yöntemler: Toplam 1948 hastadan elde edilmiş4712 örnekten eş zamanlı çalışılan prokalsitonin ve Creaktif protein sonuçları değerlendirildi. Örneklerden499’u (%10.6) KOAH alevlenmesi (Grup I), 1480’i(%31.4) pnömoni (Grup II) ve 2733 (%58)’i KOAHalevlenmesi ve pnömoni (Grup III) tanısı almış hastalarınörneklerinden oluşuyordu.Bulgular: C-reaktif protein ve prokalsitonin düzeyleriarasında pozitif güçlü korelasyon saptandı (rho=0.512,p<0.001). Yine prokalsitonin ve C-reaktif proteinarasındaki grup içi değerlendirmede Grup I, Grup II veGrup III’de pozitif güçlü korelasyon tespit edildi (sırasıylarho=0.539, p<0.001; rho=0.509, p<0.001; rho=0.511,p<0.001).Sonuç: Prokalsitoninin C-reaktif protein ile korelasyongösterdiği, enfeksiyonun ileri dönem takibinde yüksekmaliyetli prokalsitonin yerine C-reaktif protein ölçümününkullanılmasının uygun olacağı kanaatine varılmıştır
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    Öğe
    The Comparison of FLACC and OPS Scales in Differentiating Pain and Emergence Delirium in the Postoperative Period in Pediatric Patients
    (2020) Peker, Kevser; Peker, Seydi Ali
    Objective: Postoperative pain and pediatric emergence delirium (ED) are early-postoperative negative behaviours. However it is very difficult to diferentiate each other. The aim of the present study is to compare the utility of “Face, legs, Activity, Cry, Consolability” (FLACC) and Objective Pain Scale (OPS) in differentiating the pain and ED in the early postoperative period. Materials and Methods: This prospective study was conducted at a university hospital. Sixty one (61) children were included in this study. General anesthesia was provided for all children. The incidence of ED was evaluated with PAED scale, the incidence of pain was evaluated with both FLACC and OPS scales in the early postoperative period. Results: Only the number of children with delirium were 29 (47.5%), with pain were 10 (16.4%) and with both delirium and pain were 25 (40.9%). For FLACC, the area under the curve (AUC = 0.914, p = 0.02) at the 5th minute and the area under the curve value (AUC = 0.865, p < 0.001) at the 15th minute was high. Conclusions: The utility of FLACC is better than OPS in differentiating pain and emergence delirium in the postoperative period in pediatric patients. 
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    Öğe
    The effect of erector spinae plane block on cost of percutaneous nephrolithotomy surgery
    (2020) Peker, Kevser; Peker, Seydi Ali
    Aim: The analgesic effect of ESPB for percutaneous nephrolithotomy have been reported in a few study. However there is not any study yet in terms of the effect of ESPB on the cost of anesthesia. The aim of the study is to evaluate the effect of ESPB on sevoflurane and opioid consumption and cost for percutaneous nephrolithotomy. Material and Method: The patients who underwent percutaneous nephrolithotomy were divided into two groups as ESPB group (Group B; N, 30) and non-ESPB group (Group K; N, 31) whether ESPB was performed or not in this prospective observatioanl study. Total consumption of sevoflurane, remifentanyl and total consumption of tramadol was recorded. Total consumption of sevoflurane, remifentanil and tramadol was multiplied by the unit price of the drug (milliliter and milligram) for determining cost estimation. Results: The total amount of remifentanil, sevoflurane and tramadol consumption were significantly lower in the Group B (respectively; p=0.009, p=0.001, p<0.001). The total remifentanil, sevoflurane and tramadol costs were found to be statistically significantly lower in the Group B (respectively: p=0.006, p=0.001, p<0.001). Conclusion: The ESPB is a cost-effective procedure and contributes to the multimodal anesthesia.
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    Öğe
    The effect of preemptive retrolaminar block on lumbar spinal decompression surgery
    (Springer, 2024) Peker, Kevser; Aydin, Guelcin; Gencay, Isin; Saracoglu, Ayse Gizem; Sahin, Ahmet Tugrul; Ogden, Mustafa; Peker, Seydi Ali
    Purpose Spinal decompression surgery causes severe pain. Retrolaminar block (RLB) is block, which is done by infiltration of local anesthetic to block spinal nerves between the lamina and superior costotransversospinalis muscle. The primary aim of this study is to evaluate the effectiveness of RLB on postoperative analgesia in patients undergoing spinal surgery. Secondary aims are effects on additional anesthetic and analgesic consumption. Methods The sixty (60) patients who underwent lumbar spinal surgery between May 2020 and May 2021 under general anesthesia with or without applied preemptive RLB for postoperative analgesia were included in this prospective observational study. Group I received ultrasound-guided preemptive RLB. In Group II, no intervention was performed. Postoperative VAS scores were compared in groups as primary outcome, perioperative additional anesthetic and analgesic needs were compared as secondary outcome. Results There was a significant difference between the groups in favor of the RLB group in terms of postoperative VAS scores at rest [1.33 (0.33-3.509)] and movement [2.40 (1.20-4.00)] (p < 0.001). Perioperative sevoflurane consumption was significantly low in block group (p < 0.001). Postoperative tramadol consumption was lower in Group I compared with Group II [Group 1: 200 (100-300); Group 2: 37.5 (0-200); p < 0.001]. Conclusion Preemptive RLB may be used to reduce patients' pain in lumbar decompression surgery as well as to be part of a multimodal analgesia and anesthesia regimen to reduce anesthetic and analgesic drug consumption. Trial registration numberClinicalTrials.gov (No. NCT04209907). Conclusion Preemptive RLB may be used to reduce patients' pain in lumbar decompression surgery as well as to be part of a multimodal analgesia and anesthesia regimen to reduce anesthetic and analgesic drug consumption. Trial registration numberClinicalTrials.gov (No. NCT04209907).