Objective: This study aimed to determine preoperative anxiety levels, their associated factors, and the relationship between health literacy and preoperative anxiety in adult patients undergoing elective surgery. Materials and Methods: This descriptive cross-sectional study was conducted in a tertiary hospital between December 21, 2021, and June 20, 2022, and included 466 adult patients. Participants were administered the demographic data and basic health status form, Health Literacy Scale (HLS), and Beck Anxiety Inventory (BAI). Statistical significance was set at p < 0.05. Results: The participants’ mean BAI score was low to moderate (9.28± 10.85). The total HLS score was 105.89± 24.42. For the BAI, a negative correlation was found between the access to information sub-dimensions of the HLS and BAI (p=0.043, r=− 0.094). In addition, a negative correlation was detected between patients’ age and HLS and its sub-dimensions (p< 0.001, respectively [r=− 0.188, r=− 0.193, r=− 0.205, r=− 0.161]), and a positive correlation was observed among the HLS sub-dimensions (p< 0.001, respectively [r=0.873, r=0.057, r=0.966, r=0.915]). Higher HLS and sub-dimension averages were observed in single, high school, university graduates, and civil servant participants. In addition, higher BAI averages were detected in females, homemakers, urban residents, participants living only with their children, and those with additional diseases (respectively, p< 0.001, p< 0.001, p=0.007, p=0.0034, p< 0.01). Conclusion: As the level of health literacy increased, preoperative anxiety levels decreased. Preoperative assessment and education are fundamental to perioperative patient care, particularly in the surgical setting.

Objectives: Delayed gastric emptying create a risk of pulmonary aspiration during anesthesia. We aim to assess the antral cross-sectional area (CSA) and gastric volume using ultrasound techniques and to investigate the relationship between these variables and both the duration and regulation of type 2 diabetes mellitus (DM). Methods: Gastric volume was estimated by measuring the antral CSA in the supine and right lateral decubitus (RLD) positions in 80 patients. The antral content was qualitatively classified according to Perlas et al. (grades 0, 1, and 2), and gastric volume was computed using a previously described formula. The presence of solid content or > 1.5 mL/kg fluid in the stomach was classified as indicative of a full stomach. Results: The mean duration of diabetes among the subjects was 9.4 ± 3.7 years. The mean fasting duration was 10.2 ± 2.1 hours for solids and 2.5 ± 0.7 for liquids. Twelve of the 80 patients exhibited grade 2 stomach. Age (p = 0.005), Body mass index (p = 0.001), solid fasting duration (p = 0.027), and supine and RLD CSA (p < 0.001 for both) were significantly associated with full stomach. A history of ≥8 years of diabetes (p < 0.001) and peripheral neuropathy (p = 0.005) was identified as a risk factor for a full stomach. Conclusions: Despite adherence to standard fasting protocols, 15% of the type 2 DM patients were identified with a 'full stomach' condition. Preoperative ultrasound assessment of gastric contents in patients with type 2 DM, especially with long-standing diabetes (≥ 8 years) and with peripheral neuropathy is recommended. The findings of this study necessitate additional investigation to support the conceptualization of specific guidelines for diabetes to mitigate the risk of pulmonary aspiration.

Objectives: Epidural anesthesia, once considered a gold standard, has significant complications: hypotension, urinary retention, and catastrophic neurological damage in rare cases. While paravertebral analgesia can provide similar analgesic effectiveness to epidural analgesia, it is associated with fewer side effects. To compare the perioperative and postoperative effects of epidural (ED) and ultrasound-guided paravertebral block (PVB) applications in thoracotomy surgeries. Methods: Fifty-two patients underwent elective thoracotomy; Group 1 (ED, n = 23) and Group 2 (PVB, n = 29) were evaluated. A comparison of hemodynamic parameters and complications preoperatively and postoperatively, postoperative analgesia requirements, visual analog scale (VAS) pain scores within 24 hours at specified times, the amount of analgesic used, the time to mobilize, the time to discharge, and the VAS values measured at three months was made. Results: There was no difference between the study groups regarding demographic and ASA values, most comorbid chronic diseases, obesity, and smoking. The number of attempts, the postoperative 2nd hour VAS score, and the doses of paracetamol and tramadol used was significantly higher in Group 1 than in Group 2 (p = 0.002, p = 0.002, p = 0.012, and p = 0.022, respectively). There was no statistical difference between the groups in terms of postoperative 6, 12, 24 hours, and 3 months VAS scores, first mobilization and discharge, time to remove the thorax tube, intensive care (PACU) need, and perioperative and postoperative complications (p > 0.05). Conclusions: Ultrasound-guided PVB can be considered a safe and effective alternative to ED in thoracotomy surgery.

Aims: Kyphoplasty (KP) surgeries are commonly performed under local, general and regional anesthesia. The purpose of our study was to compare the perioperative and postoperative effects of ultrasound (USG) guided erector spinae plane blocks (ESPB) and paravertebral blocks (PVB) in patients with KP. Methods: Forty patients who underwent kyphoplasty were evaluated retrospective as Group 1 (ESPB, n=20) and Group 2 (PVB,n=20). Perioperative additional opioid, hemodynamic parameters, complications, postoperative analgesia requirement, pain with visual analog scale (VAS) at specified times, amount of analgesic used within 24 hours, first mobilization and discharge time, and complications were compared. Results: There was no difference between the study groups regarding demographic data, ASA, preoperative analgesic use, mean arterial pressure (MAP), heart rate (HR), SpO2, additional opioid requirement, perioperative complication rates, VAS and surgical level. A significant difference was observed between Group 1 and Group 2 regarding the VAS score and paracetamol dose at 6 hours postoperatively (p:0.023 and p:0.006, respectively). There was no statistical difference between the groups first mobilization and discharge time, postoperative complications, postoperative intensive care needs (PICU), and tramadol dose rates used (p>0.05). Conclusion: The USG-guided ESPB and PVB did not appear superior to one another in kyphoplasty procedures regarding 12 and 24-hour VAS scores, first mobilization and discharge time, postoperative complications, PICU needs and tramadol dose. The analgesic effect of ESPB in KP surgery was superior to that of PVB, 6hours postoperatively. Therefore, it is possible to consider them a safe and alternative method of anesthesia and analgesia.

Objective: Minimally invasive cardiac surgery (MICS) has gained increasing popularity due to reduced surgical trauma and enhanced recovery protocols. However, data focusing on anesthetic management and postoperative clinical outcomes, particularly from Turkiye, are limited. This study aimed to retrospectively evaluate anesthetic approaches and postoperative outcomes in patients undergoing minimally invasive cardiac surgery at a single tertiary center. Methods: This retrospective, exploratory observational study included adult patients who underwent minimally invasive cardiac surgery between January 1, 2020, and September 30, 2025 at our hospital. Demographic characteristics, perioperative anesthetic management, intraoperative variables, postoperative outcomes and complications were analyzed. Fascial plane block–based analgesia was compared with intravenous analgesia regarding extubation time, analgesic requirements, and length of hospital stay. Risk factors for postoperative complications were evaluated using univariate and multivariate logistic regression analyses. Results: A total of 33 patients were included in the analysis, with a mean age of 56.2±11.9 years; 75.8% were male. The most common procedures were minimally invasive coronary artery bypass grafting (42.4%) and aortic valve replacement (27.3%). Fascial plane blocks were applied in 66.7% of patients and were associated with reduced need for rescue analgesia (36.4% vs. 100%, P<0.001), earlier extubation (P=0.014), and shorter hospital stay (P=0.038), although considerable inter-patient variability was observed. Postoperative complications occurred in 42.4% of patients, with delirium (18.2%) and pneumonia (12.1%) being the most frequent. Diabetes mellitus, smoking, and prolonged cardiopulmonary bypass duration were associated with increased postoperative complication risk. In multivariate analysis, smoking remained an independent predictor of postoperative complications. Conclusion: In this exploratory single-center study, minimally invasive cardiac surgery was performed safely in appropriately selected patients. Fascial plane block–based analgesia was associated with improved postoperative recovery. These preliminary findings warrant validation in larger, prospective studies. Preoperative optimization may further enhance outcomes.