Background/Aims: There are studies with different results on improving effectiveness and patient comfort by increasing lumen disten tion through positioning during colonoscopy. In our study, we aimed to compare colonoscopy outcomes and post-procedural patient comfort in the left-lateral and right-lateral positions. Materials and Methods: A total of 231 patients who underwent screening colonoscopy were included. Patients were randomized to either the left-lateral or the right-lateral position. Patient age, sex, comorbidities, body mass index (BMI) values, times to reach the cecum, ileum intubation rates, total procedure times, and colonoscopy findings were compared. Pain and discomfort after the procedure were evaluated and compared with the visual analog scale (VAS) scores at 30 minutes, 6 hours, and 24 hours. Results: Colonoscopy was performed in the left-lateral position in 129 patients and in the right-lateral position in 102. The distributions of age, sex, comorbidities, and BMI values were similar in both groups. The time to reach the cecum and the total procedure time were similar in both groups. There were no significant differences in the findings detected by colonoscopy. There was no significant difference in the post-procedural VAS scores. Conclusion: This study failed to show a difference in colonoscopy outcomes and postprocedural discomfort between the left- and right lateral positions. Cite this article as: Ergin M, Yumuşak Ergin G, Kıvrakoğlu F, İbiş M. The effects of positioning during colonoscopy on effıcacy and post-procedure comfort. Turk J Gastroenterol. 2025;36(3):174-182.

Background/Objectives: Postoperative nausea and vomiting (PONV) is a common complication that may negatively affect patient comfort and recovery following procedures performed under sedation. Although gastrointestinal endoscopic procedures are widely performed, data on the incidence and risk factors of PONV after esophagogastroduodenoscopy (EGD) remain limited. This study aimed to determine the incidence of PONV following EGD under sedation and to identify factors associated with its development. Methods: This single-center retrospective study included adult patients who underwent elective EGD under sedation between June and November 2023. Demographic and clinical data, Apfel risk scores, sedative agents, procedure duration, and macroscopic endoscopic findings were obtained from electronic medical records. PONV was assessed based on documentation during the post-anesthesia care unit stay. Patients were categorized into PONV-positive and PONV-negative groups and compared using appropriate statistical tests. Results: A total of 152 patients were included, and PONV occurred in 13 patients (8.6%). Female sex (p = 0.020), higher body mass index (BMI) (p = 0.009), preoperative nausea or vomiting (p = 0.002), thyroid disease (p = 0.004), oral antidiabetic drug use (p = 0.003), and higher Apfel risk scores (p = 0.008) were significantly associated with PONV. Age, American Society of Anesthesiologists (ASA) score, procedure duration, sedative agents, and macroscopic endoscopic findings showed no significant association. Conclusions: PONV following EGD under sedation was relatively uncommon. Patient-related factors, particularly female sex, higher BMI, preoperative nausea, thyroid disease, oral antidiabetic drug use, and higher Apfel scores, were associated with increased risk.

Neurocysticercosis is the most common parasitic infection of the human central nervous system, caused by the larval stage of Taenia solium. Its clinical manifestations vary widely, ranging from asymptomatic cases to seizures, focal neurological deficits, and increased intracranial pressure. The postpartum period involves significant immunological, hormonal, and metabolic changes that may influence the onset, progression, or presentation of infectious diseases. This report presents a rare case of neurocysticercosis presenting as a subdural hematoma during the postpartum period. A twenty-one-year-old woman with no previous medical history was admitted thirty-five days after cesarean section due to severe headache and speech impairment. Cranial computed tomography revealed a left-sided subdural hematoma measuring fifteen millimeters in thickness, associated with a seven-millimeter midline shift. The patient underwent emergency craniotomy to evacuate the hematoma. Histopathological examination of the surgical specimen confirmed the presence of the larval form of Taenia solium, thereby establishing the diagnosis of neurocysticercosis. Following surgery, the patient experienced seizures, which required intensified antiepileptic medication. Antiparasitic treatment consisting of albendazole and corticosteroids was initiated. Further radiological evaluations, including cranial and spinal magnetic resonance imaging, did not identify any additional cystic lesions. The patient responded well to treatment and was discharged on hospital day twenty-three with mild speech impairment. At the one-month follow-up visit, her neurological examination was entirely normal. This case highlights an unusual presentation of neurocysticercosis in the postpartum period and underscores the importance of considering this diagnosis in patients presenting with seizures or subdural hematoma in endemic regions.

Background/Objectives: Colonoscopy, a common outpatient procedure requiring bowel preparation, can lead to dehydration and electrolyte disturbances. Sedation, while improving patient comfort, may exacerbate these effects and contribute to orthostatic hypotension (OH) and postural orthostatic tachycardia syndrome (POTS). This study aimed to determine the prevalence of OH and POTS following sedated colonoscopy and to identify associated risk factors. Methods: This prospective observational study included 76 adult patients (ASA I–III) who underwent colonoscopy with fentanyl–propofol sedation between August and November 2024. Blood pressure, heart rate, and orthostatic intolerance (OI) symptoms were assessed before and after mobilization. OH was defined as a systolic blood pressure decrease ≥20 mmHg or diastolic decrease ≥10 mmHg upon standing. POTS was defined as a heart rate increase ≥30 bpm or an absolute heart rate ≥ 120 bpm. Statistical analyses were performed using SPSS 29.0. Results: Post-procedural OH and/or POTS occurred in 18 patients (23.7%), and 14 patients (18.4%) reported OI symptoms such as dizziness, nausea, or blurred vision. Symptomatic patients were significantly younger than asymptomatic patients (42.7 ± 15.4 vs. 54 ± 13.9 years, p = 0.009), and symptoms were more frequent among females (p = 0.046). Preoperative diastolic blood pressure was significantly higher in patients who developed OH (p = 0.022), while other hemodynamic and demographic variables showed no significant associations. Conclusions: Orthostatic hypotension and postural tachycardia are relatively common after sedated colonoscopy. Younger age and female sex were identified as independent risk factors for OI symptoms, suggesting a possible role of autonomic variability. Routine post-procedure monitoring and assisted mobilization before discharge may improve patient safety and recovery outcomes.

Impact of Preoperative Anaemia on Blood Transfusion and Clinical Outcomes in Total Knee Arthroplasty: A Retrospective Observational Study - Turkish Journal of Anaesthesiology and Reanimation

Percutaneous endoscopic gastrostomy (PEG) is used in patients requiring long-term nutritional support and is more physiological than parenteral nutrition. Various minor and major complications may develop during the procedure. This study aimed to evaluate how the timing of the skin incision during the procedure affects complications. In 80 out of a total of 192 patients, a skin incision was made after lidocaine injection, and in 112 patients, a skin incision was made while the PEG tube was being pulled out of the stomach. Both groups were monitored for possible complications and compared using appropriate statistical methods. A total of 192 patients, 94 women and 98 men, were included in this study. The median age of the patients was 77 years. The most common indications for PEG were cerebrovascular disease, Alzheimer disease, and hypoxic encephalopathy. The most common complication was PEG tube dislocation. Other complications that developed included peristomal infection/cellulitis, bleeding, peristomal leak, PEG tube obstruction, and buried-bumper syndrome. Indications and comorbid conditions showed a similar distribution in both groups. No statistically significant differences were found in terms of complications between the groups. PEG is a very effective procedure with appropriate indications and preparation and has low rates of serious complications. There was no difference in terms of complications that may occur between making the incision after applying a local anesthetic to the skin and making it while the PEG tube was being removed from the stomach.