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Öğe Clinical characteristics of patients who died within a year in a tertiary intensive care unit(2021) Mınıksar, Ökkeş Hakan; Toy, ErolAim: The aim of this study was to find out the clinical characteristics of patients who died within a year in the intensive care unit (ICU) and to find out the association of ICU admission albumin, lactate levels and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of these patients who died with ICU length of stay. Material and Method: The files of patients who died in the ICU (n:350) between January 2018 and December 2018 were examined retrospectively. The patients’ demographic data and their clinical characteristics, ICU admission types (surgery or medical medicine), the units they were admitted in, reasons for admission, comorbidities, admission albumin and lactate levels, APACHE II scores and ICU length of stay were recorded. The association of patients’ clinical characteristics with ICU length of stay and laboratory values was evaluated. Result: The patients’ mean age was 72.68±12.98 years, mean APACHE II score was 27.0±10.0, mean albumin value was 3.1±0.7 g/dL and mean lactate value was 4.1±3.3 mmol/L. It was found that albumin value was lower in patients admitted to ICU with mechanical ventilator (MV) need (p<0.001), and lactate value and APACHE II score were significantly higher in patients with post-cardiopulmonary resuscitation (p<0.001). Mean ICU length of stay was 28.24 ± 37.53 days. A weak positive correlation (r =0.172, p=0.001) was found between the patients’ length of stay and albumin, and a weak negative correlation was found with the lactat (r = 0.121, p=0.023) and APACHE II scores (r = 0.151, p=0.001). A weak negative correlation was found between the patients’ albumin and lactate (r =0.152, p=0.004), and APACHE II score (r =0.179, p=0.001), as well as a moderate positive correlation between lactate and APACHE II score. Conclusion: Significant association was found between hypoalbuminemia, hyperlactatemia and high APACHE II scores and ICU length of stay in patients who died in ICU. More comprehensive studies are needed to show the effects of this association on effective use of ICUs.Öğe Nasotracheal intubation for dental surgery: a comparison of direct laryngoscopy with mcgrath mac videolaryngoscopy(2021) Toy, Erol; Özkan, Ahmet Selim; Akbaş, Sedat; Sanli, Mukadder; Durmuş, MahmutAim: The purpose of our study was to compare the McGrath MAC videolaryngoscope (VL) with the Macintosh direct laryngoscope (DL) for the efficacy during nasotracheal intubation (NTI) in patients undergoing dental surgery. Material and Methods: In total, 70 American Society of Anesthesiologist physical status (ASA) I-II patients who underwent elective dental surgery requiring NTI were included in this study. The patients were divided to two groups based on intubation using McGrath MAC VL (n=35) and Macintosh DL (n=35). The patients were monitored via electrocardiography (ECG), noninvasive arterial pressure, and peripheral oxygen saturation (SpO2) after they were taken to the operating room. Preoxygenation was performed with face mask for at least 3 minutes with 100 % O2. In addition, 2 mg/kg propofol and 1 µg/kg fentanyl were administered for anesthesia induction, and 0,6 mg/kg rocuronium was administered for muscular relaxation. NTI was performed 3 minutes after rocuronium injection with a nasotracheal tube. Anesthesia was maintained with sevoflurane and 50% air in oxygen. Mean arterial pressure (MAP), heart rate (HR), SpO2 and end tidal-carbon dioxide (EtCO2) were recorded at baseline; after anesthesia induction; and 1st, 2nd, 3th and 5th minutes after intubation. Cormack-Lehane and Mallampati Scores (MPS), laryngeal compression, duration of intubation, using Magill forceps, ease of intubation, and the incidence of complications due to intubation were recorded. Results: The demographic characteristics of the groups were similar. Regarding the success of the intubation, no significant difference was detected between the McGrath MAC VL group and the Macintosh DL group (p >0,05). However, when intubation times were compared, a significant difference was noted between groups (p<0,05). The intubation time was reduced in the McGrath MAC VL group. No statistically significant difference was observed regarding MAP and HR values. Intubation using McGrath MAC VL was significantly easier than direct laryngoscopy (p<0,05). No difference in complications was observed (p>0,05). Conclusion: We compared the McGrath MAC VL with the Macintosh DL for NTI and found that intubation was applied in less time using McGrath MAC VL than Macintosh DL. Intubation was more easy with McGrath MAC VL than Macintosh DL. We believe that McGrath MAC VL can be preferred to DL for NTI.Öğe The relationship between preoperative anxiety level, abo blood types and birth outcomes in cesarean sections(2021) Miniksar, Ökkeş Hakan; Yıldız Miniksar, Dilşad; Toy, ErolObjective: There is a relationship between ABO blood groups, which are part of the genetic phenotype, and various psychiatric diseases. Our primer aim in this study is to examine the relationship between ABO blood groups and preoperative anxiety (POA) levels in patients undergoing elective cesarean section. The secondary aim is to determine the relationship between POA levels and birth outcomes in pregnant women. Material and Method: A total of 132 patients with different ABO blood groups who were scheduled for elective cesarean section under spinal anesthesia between August 2020 and July 2021 at the Medical Faculty Hospital were included in this prospective observational study. State Anxiety Inventory scores (SAI) were used to assess preoperative anxiety in groups A, B, AB, and O. Birth outcomes (fetal birth weight, birth sex and APGAR scores at the 1st and 5th minutes) were recorded. Results: There were 55 people (41.7%) in the A blood group, 43 people (32.6%) in the O blood group, 25 people (18.9%) in the B blood group, 9 people (6.8%) in the AB blood group. A total of 73/132 (55.3%) patients with SAI score >40 were identified. There was no significant difference in mean SAI scores in A, B, AB and O blood groups (p=0.531). Fetal birth weight was found to be lower in patients with high SAI scores (p=0.044). Conclusion: There was no relationship between ABO blood groups and preoperative anxiety and birth outcomes in elective cesarean sections under spinal anesthesia, but low fetal birth weight was found in pregnant women with high anxiety. More studies with larger sample sizes in the future are needed to confirm the results of our study.Öğe Spinal anaesthesia experience in a patient with progressive supranuclear palsy using mao-b inhibitor(2021) Toy, Erol; Kart, Kenan; Taşkın, DuyguProgressive supranuclear palsy (PSP) is a rare clinical syndrome characterized by postural instability and mild dementia. The classical clinical picture of PSP includes severe gait and balance disorder, general bradykinesia, frontal dementia, visual disorders, dysarthria and dysphagia. Aspiration pneumonia is the leading cause of death in advanced PSP. We aimed to present our experiences in a 72-year-old patient with PSP using MAO-B inhibitor as an update for anaesthesiologists. We recommend that it should be taken into consideration that patients with PSP have a high risk of aspiration due to dysphagia and use of various medical treatments with high drug interaction and regional anaesthesia should be preferred. At the same time, we recommend the careful use of opioids during general or regional anaesthesia if the drug cannot be discontinued in patients using MAO-B inhibitor.
