Tas, Hakan Gokalp; Subası, Faruk; Hayme, Serhat; Akkus, Mustafa; Kuyrukluyıldız, Ufuk

Background & objective: Perioperative anxiety affects 25-80% of all surgical patients. It has a negative impact on postoperative recovery, potentially increasing morbidity and mortality. The anxiolytic effects of music therapy are well recognized, but its cognitive implications are unknown. We examined the effects of 440 Hz and 432 Hz music therapy on pre-operative anxiety and cognitive functions in patients scheduled for surgery. Methodology: The study took place in the operating room of our hospital. Following ethical committee approval, the study was launched. It was a prospective observational study comprising 66 ASA I, II, and III patients, between the ages of 18 and 65, scheduled to undergo surgery. They were divided into three groups: Control Group (CG), music therapy at 440 Hz (MG440), and music therapy at 432 Hz (MG432). Music therapy was administered to MG440 and MG432, but not to CG. Patients took the Montreal Cognitive Assessment (MoCA) and the Beck Anxiety Scale (BAS). MoCA and BAS were assessed before surgery, one hour and at 24 hours following surgery. Results: In both groups, preoperative music therapy significantly reduced anxiety (P < 0.001). Anxiety levels following surgery were comparable in all groups. Postoperative one-hour cognitive performance in music therapy groups was lower than in controls (P < 0.001), but increased and became significantly higher than in the control group at 24 h (P < 0.001). There was no substantial difference between the 440 Hz and 432 Hz groups. Conclusions: Preoperative music therapy reduced anxiety; it initially lowered postoperative cognitive performance; nevertheless, within 24 hours, therapy groups had enhanced cognitive skills when compared to controls. Ethical committee approval: (Protocol No. 2023-01/2, Date: May 1, 2023). Abbreviations: BAS - Beck Anxiety Scale; MoCA - Montreal Cognitive Assessment

Kupeli, Like; Ozcan, Seckin; Bedir, Zehra; Karakurt, Ceren

With an ever increasing ratio of advanced age and cardiovascular disease in the population the anesthesiologists often come across patients for elective and emergency surgery, who are on one or multiple anticoagulants. Although the use of regional techniques is a preferred choice of anesthesia in suitable patients, some anesthesiologists prefer combing regional with general anesthesia and/or peripheral nerve blocks. Traditionally patients on anticoagulants have been opted out of regional or nerve block analgesia for fear of hematoma formation, but the recent upsurge in the use of ultrasound has increased the precision in the procedures and the confidence in the performers. This report describes the case of an old lady for lower limb surgery, who was on multiple anticoagulants, and she was successfully anesthetized using combined techniques.

Onk, Didem; Eken, Huseyin; Ayazoglu, Tulin Akarsu; Kupeli, Ilke; Kucuksu, Zafer; Alagol, Aysin

Anesthetic preparation before non-cardiac surgery deserves particular attention in patients with cardiac disease as these are prone to develop hemodynamic instability and myocardial ischemia. Risk of complications is not only related to individual patient characteristics, but also to surgery related factors. In this report we present our experience regarding anesthetic management of a patient with multiple comorbidities including advanced chronic obstructive pulmonary disease, severely impaired left ventricular systolic function and occluded bypass grafts. We chose thoracic epidural analgesia for his sub-xiphoid incisional hernia repair. The operative and postoperative course was uneventful.