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100 →- ArticleYayıncıda açık erişim2026Comparison of paravertebral, thoracolumbar interfascial plane, and retrolaminar blocks for postoperative analgesia in lumbar disc herniation surgery: A randomized controlled trial
Tas, Hakan Gokalp; Akyol, Fethi; Somunkiran, Mustafa
Background: – The goal of this prospective randomized controlled experiment was comparing the analgesic efficacy, opioid needs, and adverse effect profiles of paravertebral (PVB) block, thoracolumbar interfascial plane (TLIP) block, and retrolaminar (RLB) block in patients undergoing lumbar disc herniation surgery. Methods: – One hundred eighty-five adults (American Society of Anesthesiologists I–III) undergoing elective lumbar disc herniation surgery made up this single-center study. Among the exclusion criteria were coagulation problems, injection site infection, allergy to local anesthetics, and incapacity to provide informed consent. Patients were randomly assigned into 4 groups: control (systemic analgesia only), PVB, TLIP, and RLB (45 patients per group). An expert anesthesiologist supervised the ultrasonography during each block. The visual analog scale was used to measure postoperative pain at 0, 1, 2, 6, 12, and 24 hours after surgery. This was the primary outcome. Motor block incidence, rescue morphine consumption, and quality of recovery-40 scores at 24 hours were secondary objectives. Unfavorable incidents were noted. Analysis of variance and Kruskal–Wallis tests (P < .05) were used to examine the data. Results: – At every time point, the TLIP and RLB groups’ visual analog scale scores were significantly lower than those of the PVB and control groups (P < .001). The TLIP and RLB groups consumed considerably less rescue morphine (P < .001). The TLIP and RLB groups had the highest quality of recovery-40 scores (P < .001). The PVB group had the highest incidence of motor block (26.7%), whereas the RLB group had the lowest rate (8.9%). There were no significant adverse effects noted. Conclusion: – Compared to PVB and control group, TLIP and RLB provide better and longer postoperative analgesia, smaller opioid needs, and higher-quality recovery. Their importance in improved recovery regimens following lumbar disc herniation surgery is supported by their good safety profile.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2026Effect of adding a superficial parasternal intercostal plane block to the serratus anterior plane block on postoperative analgesic outcomes in breast cancer surgery: a prospective, randomized, double-blind trial
Akbulut, Fazil Ahmet; Kürşad, Hüsnü; Sözüak, Muhammed Emin; Ahiskalioglu, Ali
Background: Breast cancer surgery is frequently associated with moderate to severe postoperative pain. While the serratus anterior plane block (SAPB) provides effective anterolateral chest wall analgesia, it may inadequately cover the anterior intercostal nerve branches. This study aimed to determine whether adding a superficial parasternal intercostal plane block to SAPB improves postoperative opioid consumption, pain scores, and dermatomal sensory coverage. Methods: In this prospective, randomized, double-blind trial, 64 patients aged 18–65 years undergoing elective breast surgery were randomly allocated into two groups. Group S (n = 32) received a preoperative SAPB with 30 mL of 0·25% bupivacaine combined with a parasternal injection of 10 mL saline. Group S + P (n = 32) received a SAPB with 30 mL of 0·25% bupivacaine plus a parasternal block with 10 mL of 0·25% bupivacaine. All patients were managed with an identical multimodal postoperative analgesia protocol. The primary outcome was postoperative opioid consumption. Secondary outcomes included visual analogue scale (VAS) pain scores, dermatomal sensory analysis and side effects. Results: Baseline demographic characteristics and surgical variables were comparable between groups (p > 0·05). Sensory blockade of the T3, T4, and T5 dermatomes was significantly more frequent in the S + P group than in the S group (p < 0·05). However, postoperative VAS pain scores at rest and during movement, as well as total opioid consumption, were comparable between groups (p > 0·05). Conclusions: Although the addition of a superficial parasternal intercostal plane block to SAPB resulted in wider anterior chest wall dermatomal coverage, it did not confer additional benefit in terms of postoperative pain scores or opioid consumption under a multimodal analgesia regimen. These findings suggest that SAPB-based strategies, when combined with systemic analgesics, may provide sufficient postoperative analgesia in patients undergoing mastectomy.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2026Site amplification estimated from strong motion records at Türkiye strong-motion stations using spectral separation technique
Ozmen, O.T.; Yamanaka, H.; Arslan, H.I.; Beyhan, M.; Altiok, S.; Ozel, A.O.; Turkoglu, M.; Gokce, O.
This study presents a nationwide assessment of seismic site amplification across Türkiye, based on 7191 strong-motion records from 757 earthquakes recorded at 462 stations of the Türkiye National Strong Motion Network. Using a spectral separation technique, contributions of source, path, and local site conditions were separated within the 0.5–20 Hz frequency range. The results indicate spatially and frequency-dependent amplification patterns across the country. Low-frequency amplification within the 0.5–1.3 Hz band is primarily observed at sites situated in sedimentary surface settings in eastern and southwestern Türkiye, whereas amplification within the 8.0–20 Hz band appears more evident in parts of southern Türkiye, including Hatay. Site amplification factors were evaluated across four geological units and five site classes defined by the National Earthquake Hazards Reduction Program (NEHRP). Quaternary units and sites classified as Class E exhibit stronger low-frequency amplification, whereas Paleozoic units and Class C–D sites tend to show higher-frequency responses. A relationship between Vs30 (time-averaged shear-wave velocity in the upper 30 m) and amplification is observed, particularly within the 0.5–1.3 Hz frequency band. These findings contribute to understanding of local site effects and provide insights relevant to seismic hazard assessment, urban planning, and resilient structural design under local ground conditions in Türkiye.
RDL Kalıcı Kaydıİncele - ArticleYayıncıda açık erişim2026Ultrasound-Guided Transversalis Fascia Plane Block Versus Transversus Abdominis Plane Block for Postoperative Analgesia After Repeat Cesarean Delivery: A Prospective Observational Study
Ötügen, Taha Emre; Akyol, Fethi; Karataş, Talha; Ataş, Gamze; Taş, Hakan Gökalp; Kuyrukluyıldız, Ufuk
Background: Effective postoperative pain control after cesarean delivery is essential for facilitating early mobilization and reducing analgesic requirements. Ultrasound-guided fascial plane blocks, such as the transversus abdominis plane (TAP) and transversalis fascia plane (TFP) blocks, are increasingly used as components of multimodal analgesia; however, direct comparative data between these techniques remain limited. Methods: In this prospective observational study, 90 patients undergoing repeat cesarean deliveries under spinal anesthesia were administered either a bilateral ultrasound-guided transversus abdominis plane (TAP) block or a transversus fascia plane (TFP) block in accordance with standard clinical practice. The intensity of postoperative pain, assessed both at rest and during movement, was determined using VAS scores at 3, 6, 12, and 24 h after surgery. The time until first ambulation and additional postoperative analgesic consumption beyond the standardized baseline analgesic regimen over the first 24 postoperative hours were also evaluated. Results: The patients who were administered a TFP block had diminished postoperative pain levels, reduced additional postoperative analgesic requirements, and expedited mobilization relative to those administered a TAP block. The TFP group had considerably lower movement-related pain levels within the first 24 h following surgery. Opioid-related adverse effects were comparable between groups. Conclusions: After a repeat cesarean delivery, applying a TFP block was linked to better postoperative analgesia and fewer analgesic requirements than applying a TAP block. These findings suggest that TFP blocks may represent an effective component of multimodal analgesia in obstetric anesthesia.
RDL Kalıcı Kaydıİncele - ArticleYayıncıda açık erişim2026Impact of Injection Level on Analgesic Efficacy of Adductor Canal Block Following Total Knee Arthroplasty: A Prospective Observational Study
Karatas, Talha; Akyol, Fethi; Tas, Hakan Gokalp; Karakurt, Tulay Ceren Olmezturk; Aydin, Seyma Selin; Isik, Onur; Otugen, Taha Emre; Kuyrukluyildiz, Ufuk
Background/Objectives: Following total knee arthroplasty (TKA), adductor canal block (ACB) is usually used for postoperative analgesia; however, the optimal injection level is yet unclear. This study tried to determine how the injection level of the ACB had an impact on postoperative analgesic efficacy and functional results after total knee arthroplasty. Methods: A total of 108 patients undergoing unilateral total knee arthroplasty under spinal anesthesia were included in this prospective observational study and were categorized according to the level of ultrasound-guided adductor canal block performed (proximal [Group I], mid [Group II], or distal [Group III]). The visual analog scale (VAS) was used to measure postoperative pain at 1, 4, 8, 12, and 24 h. Additionally, functional pain throughout 24-h standardized static and dynamic tests was assessed. We noted 24-h opioid consumption, motor strength levels, and sensory and motor block features. Results: During each time point, the distal group’s VAS scores were considerably higher than those of the proximal and mid groups (e.g., 8th hour: 40.69 ± 10.50 vs. 26.94 ± 8.72 and 23.47 ± 7.64, p < 0.001), whereas there was no difference between the proximal and mid groups (p > 0.05). At 24 h, the distal group had significantly higher functional pain scores on all dynamic and static measures (p < 0.001). The proximal and mid groups had longer sensory block durations (5.38 ± 1.33 and 5.03 ± 1.29 h) than the distal group (2.95 ± 0.95 h, p < 0.001). While mid-level ACB maintained motor function, 13.9% of patients receiving proximal ACB experienced transient motor block. Conclusions: After TKA, injection level has a major impact on postoperative analgesia. Mid-level ACB supports the employment of multimodal analgesia techniques by offering the best possible compromise between efficient pain management and motor function maintenance.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2026Postoperative Complications of Percutaneous Tracheostomy in a Tertiary Anesthesia Intensive Care Unit: A 10-Year Retrospective Observational Study
Tas, Hakan Gokalp
Intensive care units (ICUs) frequently perform percutaneous tracheostomy (PDT) on patients who need continuous mechanical ventilation. Percutaneous dilatational tracheostomy has a number of postoperative complications that vary in intensity and time, although being less invasive than surgical tracheostomy. This retrospective observational study looked at complication rates in adult patients who had PDT in a tertiary anesthetic ICU between January 2015 and December 2024. Patients who spent <30 days in the hospital overall were not included. The mean age of the 647 patients who were included was 67.1 ± 17.1 years. A total of 139 patients (21.5%) experienced complications following surgery. Minor bleeding and subcutaneous emphysema were among the minor complications (12.2%). Pneumothorax, bleeding requiring transfusion, and deep tissue infection were among the major complications (10.5%). Life-threatening complications (2.3%) included tracheoesophageal and tracheoarterial fistulas. There were no documented deaths from the surgery. Early postoperative surveillance is crucial, as the majority of problems (89.9%) happened within 7 days of surgery. Patients who developed complications had prolonged ICU stays and more complex treatment requirements during hospitalization. The results highlight the necessity of systematic postoperative care and surveillance by confirming that, despite PDT’s general safety, considerable morbidity can occur. These findings back up upcoming multicenter research aimed at improving patient outcomes and complication management procedures.
RDL Kalıcı Kaydıİncele - ArticleYayıncıda açık erişim2025Incidental brain MRI findings in intensive care unit patients: a retrospective analysis
Aydin, Sonay; Taş, Necip Gökhan; Taş, Hakan Gökalp
Aims: Magnetic resonance imaging (MRI) frequently shows unexpected results unrelated to the presumed pathology. The aim of this study is to look into the frequency and type of incidental brain MRI findings in ICU patients. Methods: The Anesthesiology and Reanimation Intensive Care Unit at Erzincan Mengücek Gazi Training and Research Hospital was the setting for the retrospective observational study. A total of 5,145 ICU patients admitted between 2021 and 2023 were screened using the hospital information management system, eliminating those without a brain MRI. Incidental findings in brain MRI data were documented and divided into five categories: vascular (aneurysms, cavernomas, and other vascular structures), neoplastic (meningioma, pituitary mass, glioma, and other tumors), Chiari malformation, pineal cyst, and arachnoid cyst. Results: 1317 (25.6%) participants who received brain MRI were included in the study. Incidental MRI findings were detected in 366 patients (27.8%). The most common incidental discoveries were vascular anomalies (9.79%, primarily aneurysms and cavernomas), neoplastic lesions (8.81%, primarily meningiomas and pituitary masses), arachnoid cysts (2.89%), nonspecific plaques (2.81%), pineal cysts (2.66%), and Chiari malformations (0.84%). A large majority of these patients had clinically important findings that demanded additional clinical follow-up or evaluation; nevertheless, none required emergency surgical intervention. Patients with incidental findings had a mean age of 70.92±18.42 years (range 18-98). Conclusion: In conclusion, incidental MRI results are common in critically ill patients and have significant clinical consequences. Enhanced clinician awareness and consistent management practices are critical for improving patient care, reducing unnecessary interventions, and optimizing results. Future prospective studies are required to create tailored guidelines for this population.
RDL Kalıcı Kaydıİncele - ArticleYayıncıda açık erişim2025Early Detection of Lung Metastases in Breast Cancer Using YOLOv10 and Transfer Learning: A Diagnostic Accuracy Study
Taş, Hakan Gokalp; Taş, Mehmet Bilge Han; Yildiz, Eyyup; Aydin, Sonay
Background: This study used CT imaging analyzed with deep learning techniques to assess the diagnostic accuracy of lung metastasis detection in patients with breast cancer. The aim of the research was to create and verify a system for detecting malignant and metastatic lung lesions that uses YOLOv10 and transfer learning. Material/Methods: From January 2023 to 2024, CT scans of 16 patients with breast cancer who had confirmed lung metastases were gathered retrospectively from Erzincan Mengücek Gazi Training and Research Hospital. The YOLOv10 deep learning system was used to assess a labeled dataset of 1264 enhanced CT images. Results: A total of 1264 labeled images from 16 patients were included. With an accuracy of 96.4%, sensitivity of 94.1%, specificity of 97.1%, and precision of 90.3%, the ResNet-50 model performed best. The robustness of the model was shown by the remarkable area under the curve (AUC), which came in at 0.96. After dataset tuning, the GoogLeNet model’s accuracy was 97.3%. These results highlight our approach’s improved diagnostic capabilities over current approaches. Conclusions: This study shows how YOLOv10 and transfer learning can be used to improve the diagnostic precision of pulmonary metastases in patients with breast cancer. The model’s effectiveness is demonstrated by the excellent performance metrics attained, opening the door for its application in clinical situations. The suggested approach supports prompt and efficient treatment decisions by lowering radiologists; workload and improving the early diagnosis of metastatic lesions.
RDL Kalıcı Kaydıİncele - ArticleYayıncıda açık erişim2025Protective Effect of Probiotics on Cardiac Damage in Experimental Sepsis Model Induced by Lipopolysaccharide in Rats
Taş, Necip Gökhan; Aktaş, Osman; Taş, Hakan Gökalp; Zırh, Selim; Kurt, Nezahat; Uslu, Hakan
Background and Objective: Probiotics have been shown to be effective in controlling various adverse health conditions such as antibiotic-associated diarrhea, inflammatory bowel disease, obesity, and neurological diseases. However, to our knowledge, there is no research on the preventive effect of probiotics on heart damage caused by infections. This study examined the preventive benefits of probiotics against sepsis-related heart injury using a rat model caused by lipopolysaccharide (LPS). Materials and Methods: Four groups of twenty-four male Wistar albino rats, each with six rats, were set up. For 14 days, Group 1 (Sham Group) was given oral normal saline, intraperitoneal Escherichia coli O111-B4 lipopolysaccharide (LPS Group) was given to Group 2, and oral probiotics were given to Group 3 (Probiotic Group). Escherichia coli O111-B4 lipopolysaccharide was injected intraperitoneally after Group 4 (Probiotic + LPS) received oral probiotics containing Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12 (109 CFU/day). Blood samples were taken twenty-four hours following the administration of LPS. The animals were then euthanized by cervical dislocation, and samples of cardiac tissue were taken in order to assess any damage to the heart. The following serum values were measured: C-reactive protein (CRP), creatine kinase-myocardial band (CK-MB), cardiac troponin subunit I (cTn-I), tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6). The TNF-α, IL-1β, IL-6, glutathione (GSH), malondialdehyde (MDA), Total Oxidant Status (TOS), Total Antioxidant Status (TAS), Oxidative Stress Index (OSI), CRP, CK-MB, and cTn-I levels were assessed in tissue samples. Additionally, staining techniques were used to analyze histopathological alterations in tissues. Results: With the exception of serum IL-6 (p = 0.111), tissue and serum cytokine levels were considerably greater in the sepsis group (Group 2) than in the other groups (p < 0.05 to <0.001). The TAS, GSH, and SOD levels were significantly lower (p < 0.05 to <0.001) in septic rats, although the tissue levels of TOS, OSI, and MDA were significantly higher. With the exception of serum CRP in Group 3 (p = 0.328), the CK-MB, CRP, and cTn-I levels were considerably higher in Group 2 than in the other groups (p < 0.01 to <0.001). When compared to the other groups, histopathological examination showed significant alterations in the LPS group. Conclusions: Probiotics showed positive effects on oxidative stress markers and dramatically decreased sepsis-induced cardiac damage in the LPS-induced sepsis model. These results imply that probiotics could be used as a therapeutic approach to lessen the cardiac damage brought on by sepsis.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2024The Effect of Intra-abdominal Pressure on Heart Rate Variability and Hemodynamics During Laparoscopic Cholecystectomy: A Prospective Observational Study
Eren, Nurhan; Onk, Didem; Koç, Alparslan; Kuyrukluyildiz, Ufuk; Nalbant, Remziye Aysenur
Introduction This study aimed to evaluate hemodynamic changes using heart rate variability (HRV) measurements in diabetic and nondiabetic patients who will undergo laparoscopic cholecystectomy and to provide our preoperative measurements to guide us for better perioperative anesthesia management. Materials and methods The study included 143 patients aged 40 years and older who would undergo elective laparoscopic surgery, did not have any comorbidities other than diabetes mellitus (DM) type II, and were in the American Society of Anesthesiologists (ASA) class I -III risk group. Patients were divided into two groups: the control group (n = 77) and the DM group (n = 66). The preoperative glycated hemoglobin (HbA1C) level was measured. Peripheral oxygen saturation (SpO2) and hemodynamic parameters such as systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), and HRV parameters were measured preoperatively, perioperatively, and postoperatively. Intra-abdominal pressure (IAP) was administered at 10-12 mmHg. Results Even though SAP, DAP, MAP, and HR decreased with induction, they increased with insufflation, and an overall decrease was seen at the postoperative 24th hour for all parameters. When the groups were evaluated, no difference was observed except that the DAP was significantly lower in the DM group (p = 0.029) at insufflation and the HR was higher in the DM group at induction, and the difference was significant (p = 0.001). Preoperative HRV parameters were significantly lower in the DM group. According to the HRV parameters, although a decrease was observed after induction and insufflation, conversely, an increase was observed postoperatively. When the postoperative and preoperative values were compared, the standard deviation of the NN (R -R) intervals (SDNN), SDNN index, high frequency (HF), low frequency (LF), and LF/HF parameters were found to be significantly lower in the DM group than in the control group. Conclusion Diabetic patients are more sensitive to increased intra-abdominal pressure (IAP) in laparoscopic surgery, and the effects on cardiac autonomic functions can be determined by HRV measurements without clinically reflecting on hemodynamic data. Additionally, in diabetic patients with preoperative LF and/or HF values less than 100, we believe that careful follow-up in terms of autonomic neuropathy complications and anesthesia management should be done more meticulously in these patients.
RDL Kalıcı Kaydıİncele
Tam Kayıt
| Alan | Değer | Dil |
|---|---|---|
| dc.date.accessioned | 2026-10-20T15:26:02.430199382Z | |
| dc.date.available | 2026-10-20T15:26:02.430199382Z | |
| dc.identifier.uri | https://rdlopen.rawdatalibrary.net/r/ebyu/22859 | |
| dc.rights | info:eu-repo/semantics/openAccess | |
| dc.title | Anesteziyoloji ve Reanimasyon Anabilim Dalı | tr |
| dc.title | Department of Anesthesiology and Reanimation | en |
| dspace.entity.type | OrgUnit | |
| organization.identifier.code | tip-anestezi | |
| organization.unitType | department | |
| rdl.unit.alias | an(a)?esthes |