General anesthesia (GA) is the most commonly used anesthetic technique for spinal surgery. This study aimed to compare spinal anesthesia (SA) and GA in patients undergoing spinal surgery, in terms of perioperative outcome and cost effectiveness. The study included 80 patients with ASA (American Society of Anesthesiologists) physical status I-II. The patients were randomized to receive SA (n = 40) or GA (n = 40). Heart rate (HR), mean arterial blood pressure (MABP), blood loss, duration of surgery, duration of anesthesia, surgeon satisfaction, and duration in the post-anesthesia care unit (PACU) were recorded. Postoperative analgesic requirement, nausea and vomiting (PONV), perioperative hemodynamic variables, and anesthetic costs were determined. HR and MABP were significantly higher in the GA group than in the SA group at the end of surgery and at PACU admission. Duration of anesthesia, surgeon satisfaction, postoperative analgesic requirement, and anesthetic costs were significantly higher in the GA group. Mean blood loss was lower in the SA group than in the GA group, but the difference was not significant. Duration of surgery, duration in the PACU, perioperative hemodynamic variables, and complications were similar in both groups. SA could be considered a reliable alternative to GA in patients undergoing lumber spine surgery, as it is clinically as effective as GA, but more cost effective.

OBJECTIVE: Erector spinae plane block is an updated method than paravertebral block, possessing a lower risk of complications. This study aimed to compare erector spinae plane and paravertebral blocks to safely reach the most efficacious analgesia procedure in laparoscopic cholecystectomy cases.

PI stage on admission, discharge and treatment costs were recorded. Patients were grouped according to diagnoses, and PI localizations (sacrum, trochanter, ischium, and heel). The comparison was made of changes in wound stage in the groups. Results: PI was present in all 154 patients during hospitalization and in 94 (61%) on discharge. Full recovery was determined in 52/129 (40.3%) patients with PI in the sacrum, in 23/46 (50%) in the trochanter, in 22/40 (55.0%) in the heel, and in 10/12 (83.3%) in the ischium. Worsening PI stage was observed in 5 (3.9%) in the sacrum, in 1 in the trochanter and in 4 in the heel. Improvement in PI stage was seen in 96 (74.4%) in the sacrum, in 35 (3.9%) in the trochanter, in 27 (50.5%) in the heel, and in 10 (83.3%) in the ischium. Regardless of wound localization, the improvement was observed in 168 (74%) of 227 PI and worsening in 10 (4.4%). The group with no change in the PI stage had prolonged hospital stay and higher costs. The Karnovsky Performance Score and Glasgow Coma Score of fully recovered patients were determined to be higher, and no statistically significant difference was seen in respect of age. Conclusions: PC patients are prone to PI due to many chronic diseases. The localization of PI and infection are effective factors in the healing of ulcers. The treatment costs for PC patients is higher if they have a pressure ulcer. More comprehensive studies will be useful to clarify the economic and social dimensions of this issue....

Objective: This study aims to compare the effects of different inhalation anesthetics on oxidative status by measuring thiol-disulfide homeostasis in laparoscopic cholecystectomy surgeries. The effect of inhaler agents on thiol-disulfide homeostasis that shows the oxidative status in laparoscopic cholecystectomy is unknown. Materials and Methods: In this study, 71 patients planned to undergo laparoscopic cholecystectomy under general anesthesia were included. They were divided into two groups: desflurane (group D, n: 35) and sevoflurane (group S, n: 36). Blood samples were taken before induction (T1), at 30th minute of insufflation (T2) (30th min of ischemia), and at 30th min postdeflation (T3) (30th min of reperfusion). The native thiols (–SH) and total thiols (–SH+ –SS) were determined. The amounts of disulfide (–SS), disulfide/native thiol percent ratios (–SS/–SH), disulfide/total thiol percent ratios (–SS/–SH+–SS), and native thiol/total thiol percent ratios (–SH/–SH+ –SS) were calculated. Results: In the sevoflurane group, preoperative values and intraoperative 30th-minute SS–SH ratio were significantly reduced (p=0.017). In the desflurane group, intraoperative native thiol values and postdeflation levels significantly decreased compared to those in the preoperative values (p

Objective. The aim of this prospective, randomized study was to investigate the effects of low-flow sevoflurane anesthesia on the pulmonary functions in patients undergoing laparoscopic cholecystectomy.Methods. Sixty American Society of Anesthesiologists (ASA) physical status classes I and II patients scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomly allocated to two study groups: high-flow sevoflurane anesthesia group (Group H,n=30) and low-flow sevoflurane anesthesia group (Group L,n=30). The fresh gas flow rate was of 4 L/min in high-flow sevoflurane anesthesia group and 1 L/min in low-flow sevoflurane anesthesia group. Heart rate (HR), mean arterial blood pressure (MABP), peripheral oxygen saturation (SpO₂), and end-tidal carbon dioxide concentration (ETCO₂) were recorded. Pulmonary function tests were performed before and 2, 8, and 24 hours after surgery.Results. There was no significant difference between the two groups in terms of HR, MABP, SpO₂, and ETCO₂. Pulmonary function test results were similar in both groups at all measurement times.Conclusions. The effects of low-flow sevoflurane anesthesia on pulmonary functions are comparable to high-flow sevoflurane anesthesia in patients undergoing laparoscopic cholecystectomy.

Introduction: We aimed to define the characteristics of patients hospitalised in a palliative care unit and evaluate the role of palliative care services in the geriatric age group. The priorities and treatment approaches needed according to age groups were also evaluated. Materials and Methods: The records of patients aged 18 years and older who followed up with palliative care between 01/2020-12/2021 were reviewed retrospectively. Patients aged 18-64 were defined as “group-1”, patients aged 65-75 as “group-2”, patients aged 76-90 as “group-3”, and patients aged 91 and over as “group-4”. The patient’s age, sex, diagnosis, comorbidities, length of stay in the clinic, prognosis, pressure ulcers and immobilisation status were recorded and compared according to age groups. Results: A total of 560 patients were included. The mean age was 73.14±14.22 years, and 53.2% were women. 48.2% of patients were transferred to the palliative care unit from the intensive care unit. Groups-1, 2, 3, and 4 consisted of 139 (24.8%), 129 (23%), 254 (45.4%), and 38 (6.8%) patients, respectively. When patients were examined according to age group, there was a statistically significant difference between the groups in terms of sex, pressure ulcers, immobilisation, mean hospital stay in the palliative care, and prognosis (p=0.026, p≤.001, p=0.006, p≤.001, p≤.001). While 72% of patients were discharged from the palliative care unit, 28% died during admission. The prognosis was better in group-1 compared to other groups. Conclusion: Geriatric age and presence of chronic disease were the primary groups receiving palliative care. Access and integration of these patients to palliative care must be expanded. Keywords: Palliative Care; Geriatrics; Critical Care; Chronic Diseases; Health Services Accessibility.