Objetivo: Evaluar el efecto del bloqueo del plano erector espinal (ESPB) como terapia de rescate en la sala de recuperación. Método: Este estud...

The Beach Chair Position (BCP) has many advantages such as less neurovascular injury and better intra-articular visualization, but it has also negative consequences, including hemodynamic instability. Although maintaining normal Mean Arterial Pressure (MAP) is important, fluid management is also a crucial concept for hemodynamic stability. The main objective of this study is whether preloading before positioning would be effective for less hemodynamic instability. This randomized, controlled study was conducted in a single center in the Istanbul University, Istanbul Faculty of Medicine. Forty-nine patients undergoing elective arthroscopic surgery in the BCP were recruited. In the study group, crystalloid fluid at 10...mL.kg^-1 of ideal body weight was administered intravenously 30...min before the BCP for preloading. The primary outcome measures were differences of hemodynamic variables as MAP, Stroke Volume (SV), Heart Rate (HR), and Cardiac Output (CO). The secondary outcome measures were Postoperative Nausea and Vomiting (PONV) rates in postoperative first day, surgical satisfaction scale, total ephedrine dose used during surgery, and total amount of fluid. The MAP, CO, and SV measurements of the study group were higher than those of the control group in the 5th minute after the BCP (respectively, p...=...0.001, p...=...0.016, p...=...0.01). The total amount of crystalloid and surgical satisfaction scales were higher in the study group (respectively, p...=...0.016, p...=...0.001). Total amount of colloid and ephedrine dose used in the intraoperative period, and PONV rates were lower in the study group (p...=...0.003, p...=...0.018, p...=...0.019, respectively). Consequently, preloading can be favorable approach to preserve hemodynamic stability.

Background/aim: The percentage change in the stroke volume index (SVI) due to the mini fluid challenge (MFC) (MFC-?SVI%) is used commonly in daily practice. However, up to 20% of patients remain in the gray zone of this variable. Thus, it was aimed to compare the MFC-?SVI% and the percentage change in the cardiac power index (CPI) due to the MFC (MFC-?CPI%) with the baseline values of the pulse pressure variation (PPV) and stroke volume variation (SVV) in terms of their abilities to predict fluid responsiveness. Materials and methods: The SVI, CPI, SVV, and PPV were recorded before 100 mL of isotonic saline was infused (MFC), after MFC was completed, and after an additional 400 mL of isotonic saline was infused to complete 500 mL of fluid loading (FL). Patients whose SVI increased more than 15% after the FL were defined as fluid responders. Results: Sixty-seven patients completed the study and 35 (52%) of them were responders.The areas under the receiver operating characteristics curves for the MFC-?SVI% and MFC-?CPI% (0.94; 95% CI: 0.86?0.99 and 0.89; 95% CI: 0.79?0.95, respectively) were significantly higher than those for the SVV and PPV (0.63; 95% CI: 0.50?0.75 and 0.55; 95% CI: 0.42?0.67, respectively) (p < 0.001 for all of the comparisons). The gray zone analysis revealed that the MFC-?SVI% values of 12 patients were in the gray zone. Of the 12, the MFC-?CPI% values of 7 patients were outside of the gray zone. Conclusion: Fluid responsiveness can be predicted more accurately using the MFC-?SVI% and MFC-?CPI% than using the SVV and PPV. Additionally, concomitant use of the MFC-?SVI% and MFC-?CPI% is recommended, as this approach diminishes the number of patients in the gray zone.

OBJECTIVE: Robotic surgery has been gaining attention because of the physical and metabolic morbidity of the conventional open technique. The systemic immune-inflammation index has emerged as a recent and more reliable biomarker. In our single-center retrospective cohort study, we investigate systemic immune-inflammation index in robotic gastrectomy in order to show the advantageous effect on the immune system, which we think is the first study in the literature.

Background: This study compares the analgesic effects and dermatomal blockade distributions of single and double injection bilateral thoracic paravertebral block (TPVB) techniques in patients undergoing reduction mammaplasty.Methods: After obtaining ethics committee approval, 60 patients scheduled for bilateral reduction mammaplasty were included in the study. Preoperatively, the patients received one of single (Group S: T3–T4) or double (Group D: T2–T3 & T4–T5) injection bilateral TPVBs using bupivacaine 0.375% 20 ml per side. All patients were operated under general anesthesia. The T3–T6 dermatomal blockade distributions on the midclavicular line were followed by pin-prick test for 30 min preoperatively and 48 h postoperatively. All patients received paracetamol 1 g when numeric rating scale (NRS) pain score was ≥ 4, and also tramadol 1 mg/kg when NRS was ≥ 4 again after 1 h. The primary endpoint was NRS pain scores at postoperative 12th h. The secondary endpoints were dermatomal blockade distributions and NRS scores through the postoperative first 48 h, time until first pain and the analgesic consumption on days 1 and 2.Results: Fifty-two patients completed the study. The NRS pain scores at 12th h were similar (right side: P = 0.100, left side: P = 0.096). The remaining NRS scores and other parameters were also comparable within the groups (P ≥ 0.05). Only single injection TPVB application time was shorter (P < 0.001).Conclusions: The single injection TPVB technique provided sufficient dermatomal distribution and analgesic efficacy with the advantages of being faster and less invasive.

Objective: The aim of this study is to evaluate the effect of erector spinae plane block (ESPB) as a rescue therapy in the recovery room. Materials and metho...