Sedation is one of the most common practices applied in the intensive care units (ICUs), and the management of sedation, analgesia and delirium is a quality measure in the ICUs. Several guidelines on sedation had been published, and many surveys investigated the practices of sedation in the ICUs, but knowledge on the sedation practices in Turkey is lacking. The aim of the present study was to provide baseline knowledge on the sedation practices and preferences of Turkish intensive care physicians and to establish some points to be improved. An electronic survey form consisting of 34 questions was generated and posted to email addresses. The survey included questions about demographics and practices on sedation, analgesia, neuromuscular blockage and delirium. Of 1700 email addresses, 429 (25.0%) were returned. Sedation was practised by 98.0% of the respondents, and mechanical ventilation was indicated as the primary indication (94.0%) for sedation. The presence of a written sedation protocol was 37.0%. For drug choices for sedation, midazolam was the most preferred agent (90.0%). With regard to pain questions, the most commonly used evaluation tool was Visual Analogue Scale (69.0%), and the most preferred drug was tramadol. Nearly half of the participants routinely evaluated delirium and used the confusion assessment method in the ICU. The results of this survey have indicated some areas to be improved, and a national guideline should be prepared taking pain, agitation and delirium in focus. ClinicalTrials.gov ID: NCT03488069.

Background: The use of inhaled isopropyl alcohol (IPA) has been proposed as a therapeutic intervention for the relief of nausea in various settings. The objective of this systematic review was to evaluate the existing evidence for the use of inhaled IPA in the management of nausea and vomiting. Methods: We performed a literature search on Medline, EMBASE, Web of Science, Scopus, CINAHL, PsycInfo, and Cochrane Library databases before November 2021. The following concepts were searched using subject headings and keywords as needed “aromatherapy,” “alcohol,” “ethylic alcohol,” “ethanol,” “isopropyl alcohol,” “emesis,” “chemotherapy-induced,” “pregnancy,” “hyperemesis gravidarum,” “motion sickness,” “emetics,” “antiemetics,” “inhalation,” and “inhale.” Searches were not limited to a specific language. The bibliographies of identified articles were also manually searched. Two authors independently assessed the included studies for risk of bias. Results: Thirteen randomized controlled trials out of 158 studies identified met the inclusion criteria, with a total of 1253 participants. Twelve studies were conducted in the postoperative anesthesia care unit and two studies were performed in the emergency department setting. Four studies were double blinded, one was single blind, and eight were open label. Three studies assessed the use of inhaled IPA for prevention, whereas 10 studies evaluated its use in the treatment of nausea and vomiting. Seven studies reported IPA to be more effective, four studies reported no difference, and two studies reported IPA to be ineffective. Participant satisfaction was high overall, regardless of intervention received. No adverse effects were reported. The overall quality of evidence was low. Conclusion: There is a lack of strong evidence to support the use of inhaled IPA in the management of nausea and vomiting. Additional trials are warranted to confirm this finding and to further explore the use of inhaled IPA in various populations and settings.

The aim of this study was to analyse the relationship between types of anaesthesia, patients' demographic variables, preoperative emotional states and the prevalence of postoperative pain. In this randomized prospective study, postoperative pain was assessed in 100 patients, who were ASA (American Society of Anaesthesiologist) I-II and between 18-65 years old, undergoing inguinal herniorrhaphy with either general or spinal anaesthesia. In addition, postoperative pain compared with patients' demographic properties and psychological conditions in each group was also considered. Acute pain was evaluated at 1, 2, 4, 6, 12 and 24th hours with the Numerical Rating Scale (NRS) and chronic neuropathic pain was at 1, 2 and 3rd months with Douleur Neuropathique 4 Questions (DN4). All patients were treated with the same analgesics after operation. Group spinal anaesthesia had lower acute pain at 1 and 2nd hours but they felt more severe pain at the 24th hour. Also patients' anxieties were correlated with acute and chronic postoperative pain. Ten patients complained about postoperative chronic pain after 3 months and there was no significant difference between groups. Spinal anaesthesia decreased acute pain intensity at the first postoperative hours. Patients with anxiety felt high pain levels and they had an increased chronic pain prevalence.

Objective: To assess chronic pain prevalence, health related quality of life (HRQOL), and factors associated with HRQOL in patients at least one year after total knee arthrosplasty (TKA).Study Design: Descriptive study.Place and Duration of Study: Sancaktepe Martyr Prof. Dr. Ilhan Varank Education and Training Hospital, between June 2019 and June 2021.Methodology: Patients, who had undergone elective TKA operation for the first time were included in the study. The identified patients were contacted by phone and asked to complete questionnaires including short form 12 version 2 (SF-12 v2) for HRQOL, having components, physical (PCS) and mental health score (MCS). Demographic and perioperative data were collected by reviewing the patients' medical records retrospectively.Results: Of the 122 selected patients, 105 (86%) patients accepted to take survey via telephone. According to MCS scores, all patients showed good mental health. Patients were classified according to their PCS; into low HRQOL (Group L, n=42) and high HRQOL (Group H, n=63). Six percent of patients had chronic pain and 60% had high HRQOL after TKA. Age, body mass index (BMI), and chronic obstructive pulmonary disease (COPD) were significantly higher in Group L. Postoperative numerical rating scale (NRS, p=0.007) and dolour neuropathic pain score (DN4, p=0.002) were significantly different between both groups.Conclusion: Older age, high BMI, COPD, postoperative chronic pain, and postoperative neuropathic pain were associated with HRQOL after TKA.