Quadratus lumborum block (QLB) and modified thoracoabdominal nerves block through perichondrial approach (m-TAPA) can be used for postoperative analgesia in laparoscopic cholecystectomies (LC). The aim of this study is to evaluate the analgesic efficacy of anterior QLB and m-TAPA during the first 24 hours postoperatively. This study was designed as a randomized, prospective, single-blinded trial. Preoperatively, patients were divided into two groups: Group QLB (n=55) and Group m-TAPA (n=53). The anterior QLB was applied to Group QLB, while the m-TAPA was applied to the other group. After the blocks were administered, the dermatome areas covered at the 20th and 30th minutes were evaluated using a cold test. Intraoperative remifentanil consumption was recorded, while Numerical Rating Scale scores at rest (rNRS) and during movement (dNRS), opioid consumption, time to first rescue analgesic use, and complications were evaluated during the first 24 postoperative hours. There was no statistically significant difference between the groups in terms of total analgesic consumption during the first 24 hours, rNRS and dNRS values at hours 1, 4, 8, 12, and 24, time to first rescue analgesic use, intraoperative remifentanil consumption and complications. When comparing dermatome involvement between the groups, it was observed that dermatome coverage in the m-TAPA group was mostly distributed in the T7-T10 dermatomes, while in the QLB group, it was mostly distributed in the T10-L1 dermatomes. We believe that both anterior QLB and m-TAPA can be used as part of opioid-free multimodal analgesia for postoperative analgesia during the first 24 hours in LC.

Aim: The coronavirus disease 2019 (COVID-19) pandemic has presented significant challenges to healthcare systems worldwide, impacting the mental health of healthcare workers. This study aimed to assess and compare anxiety levels among different categories of healthcare workers during the pandemic. Methods: A cross-sectional survey study was conducted with 180 healthcare workers categorized into four groups: COVID-19 negative healthcare workers (n=45), COVID-19 positive hospitalized and treated healthcare workers (n=45), COVID-19 positive healthcare workers treated at home (n=45), and COVID-19 negative healthcare workers who were off duty due to chronic illnesses (n=45). The Coronavirus Anxiety Scale (CAS) was used to measure anxiety levels. Results: COVID-19 negative healthcare workers reported relatively lower anxiety levels (mean CAS score = 1.29, SD = 1.829), with the majority experiencing minimal anxiety. COVID-19 positive hospitalized and treated healthcare workers had expressively higher anxiety levels (mean CAS score = 4.09, SD = 5.049), indicating substantial distress. COVID-19 positive healthcare workers treated at home demonstrated intermediate anxiety levels (mean CAS score = 3.09, SD = 3.014). COVID-19 negative healthcare workers with chronic illnesses showed higher anxiety levels compared to their non-chronically ill counterparts (mean CAS score = 2.02, SD = 2.19). Conclusion: This study highlights the diverse psychological impact of the COVID-19 pandemic on healthcare workers. COVID-19 positive hospitalized and treated healthcare workers experienced the highest levels of anxiety, followed by those treated at home. Even COVID-19 negative healthcare workers and those with chronic illnesses experienced notable anxiety. These findings emphasize the need for targeted interventions and support systems to address the mental health needs of healthcare workers effectively during and beyond the pandemic. Understanding and mitigating anxiety among healthcare workers are crucial for their well-being and the quality of patient care. Further research is warranted to explore additional factors influencing anxiety levels in this population.

Mortality prediction in critically ill patients is commonly performed with scoring systems such as SOFA and APACHE II. The arterial-to-end-tidal carbon dio

Background and Objectives: Postspinal hypotension (PSH) remains a common complication of cesarean delivery under spinal anesthesia. Simple prespinal predictors may assist in identifying patients at increased risk. This study evaluated the associations of shock index (SI), modified shock index (MSI), diastolic shock index (DSI), and right internal jugular vein collapsibility index (RJV-CI) with postspinal hypotension (PSH). Materials and Methods: This prospective observational study included term parturients undergoing elective cesarean delivery under spinal anesthesia. Prespinal SI, MSI, DSI, and RJV-CI were measured before intrathecal injection. PSH was defined as systolic arterial pressure <90 mmHg or a reduction of ≥30% from baseline within 15 min after intrathecal injection. Receiver operating characteristic (ROC) analyses were performed for individual predictors. Three logistic regression models combining RJV-CI with SI, MSI, or DSI were evaluated using bootstrap internal validation. Results: Of 80 enrolled patients, 76 were included in the final analysis; 36 (47.4%) developed PSH. SI, MSI, DSI, and RJV-CI were significantly higher in the PSH group than in the non-PSH group. The areas under the ROC curve (AUCs) were 0.757 for SI, 0.747 for MSI, 0.693 for DSI, and 0.709 for RJV-CI. In multivariable models, RJV-CI remained significantly associated with PSH after adjustment for the respective shock index. The model combining RJV-CI and SI showed the highest apparent AUC (0.790; 95% confidence interval, 0.688–0.886) and an optimism-corrected AUC of 0.775. The RJV-CI plus MSI model showed an optimism-corrected AUC of 0.774. Conclusions: Prespinal SI, MSI, DSI, and RJV-CI were associated with PSH in this cohort. Models combining RJV-CI with SI or MSI showed numerically higher discrimination than the individual predictors. The derived cutoff values should be considered exploratory and require external validation before routine clinical use.

In this retrospective research, it was aimed to evaluate predictive values of lactate-related ratios on mortality in intensive care units (ICUs) at multivariable level. A total of 4985 patients who were hospitalized in the Anesthesia Intensive Care Unit of Istanbul Gaziosmanpaşa SUAM between January 2015 and January 2025 were included in the study. Patients’ age, gender, body mass index, hospitalization diagnoses and chronic diseases, lactate, albumin, hemoglobin, potential of hydrogen (pH), HCO₃⁻, base excess, platelets, APACHE II score, and 28-day mortality values were obtained. Lactate albumin ratio (LAR), lactate hemoglobin ratio, lactate pH ratio, and lactate bicarbonate ratio of the patients were analyzed. Age, pH, and LAR parameter means were significantly higher in the non-survival group, whereas blood extracellular fluid mean was significantly higher in the survival group ( P < .05). Acute renal failure and ketoacidosis were more common in the non-survival group ( P < .05). Twenty-eight-day mortality was significantly correlated with age ( R = 0.077; P < .01), acute renal failure ( R = 0.030; P < .05), ketoacidosis ( R = 0.028; P < .05), albumin ( r = −0.117; P < .01), base excess in the extracellular fluid ( R = 0.032; P < .05), pH ( R = 0.036; P < .05), LAR (0.057; P < .01), and hospitalization duration ( R = 0.044; P < .01). Effects of age ( B = 0.020; P < .01), acute renal failure ( B = −0.648; P < .05), base excess in the extracellular fluid ( B = 0.024; P < .05), pH ( B = 1.753; P < .05), and LAR ( B = 4.893; P < .01) were statistically significant. Although the LAR parameter has a predictive value on 28-day mortality in ICU patients, this is not the case in acute renal failure patients. The LAR variable in acute renal failure patients may have different mechanism than in other ICU patients, and this mechanism may be misleading for LAR. Therefore, further predictive parameters are needed for ICU 28-day mortality in acute renal failure patients.