General anaesthesia,paediatric anaesthesia,preoperative anxiety,the modified Yale Preoperative Anxiety Scale

Background/Objectives: This study aimed to investigate the effects of explaining the perioperative process to pediatric patients scheduled for adenotonsillectomy using pictures on their anxiety levels. Methods: A prospective, randomized controlled trial was conducted, enrolling 58 patients. The patients were divided into two groups: Group 1 (n = 29), where the perioperative process was explained using pictures, and Group 2 (n = 29), the control group, where no pictures were used. Child anxiety was assessed using the modified Yale Preoperative Anxiety Scale Short Form (mYPAS-SF) at five observation time points before anesthesia induction. Parents’ anxiety was measured using the Visual Analog Scale for Anxiety. Results: Patients in Group 1 had significantly lower heart rates during induction and the intraoperative period compared to Group 2 (p = 0.031, p = 0.025, respectively). In terms of anxiety and RSAS scores, patients in Group 1 had significantly lower mYPAS-SF scores at time points t2, t3, t4, and t5 compared to Group 2 (t2: p = 0.001; t3–t5: p < 0.001). No significant difference was observed at t1 (p = 0.068). The mean RSAS scores were also significantly lower in Group 1 (p = 0.029). Parents’ anxiety was significantly lower in Group 1 at all three time points (t1: p = 0.017; t2: p = 0.006; t3: p = 0.036). Conclusions: Our study results demonstrate that illustrating the perioperative process to children undergoing adenotonsillectomy can significantly reduce preoperative anxiety and prevent awakening agitation. Given its ease of implementation, we believe that using visual aids to explain the perioperative process to pediatric patients can facilitate process management for patients, parents, and physicians.

Laparoscopic cholecystectomy (LC) is one of the most commonly performed minimally invasive surgical procedures. Postoperative pain may negatively affect patient satisfaction and recovery. External oblique intercostal plane block (EOIB) is proposed as a new regional anaesthesia technique to reduce this pain. The aim of this study was to investigate the effect of ultrasound-guided EOIB on postoperative pain scores, postoperative opioid consumption, intraoperative hemodynamic parameters, and patient satisfaction in patients undergoing LC. After approval of the ethics committee, 64 patients aged 18-65 years, in ASA I-II class, who underwent elective LC for cholelithiasis were included in the study. Patients were randomly allocated into two groups: the EOIB group and the control group. Visual analogue scale (VAS), heart rate, systolic-diastolic-mean arterial pressure, analgesic consumption, nausea-vomiting frequency and patient satisfaction parameters were recorded for 24 h postoperatively. VAS scores were significantly lower in favour of EOIB at all time points (p < 0.001). There was a significant difference over time and between groups. (p < 0.001) In addition, patient satisfaction was significantly higher in the EOIB group at 24 h (p < 0.001). EOIB improves pain control after LC, reduces the need for analgesics and significantly improves patient satisfaction. ClinicalTrials.gov, NCT06712498; registered 26 November 2024 (retrospectively registered).

Background: In cardiac surgery, intraoperative tranexamic acid (TXA) is commonly used and highly recommended approach for managing perioperative bleeding. Nevertheless, a standardized dose and administration protocol remains undefined. This study compares the efficacy of intraoperative triple-dose intravenous (IV) bolus TXA versus IV bolus followed by continuous IV infusion in preventing postoperative bleeding in patients undergoing isolated coronary artery bypass grafting (CABG). Methods: The study included 93 patients who underwent elective isolated CABG between August 14, 2023, and October 14, 2024. Patients received either triple-dose IV bolus TXA (Group 1, n = 53) or IV bolus followed by continuous IV infusion (Group 2, n = 40) during surgery. Results: Postoperative bleeding was lower in Group 1 at all assessed time points (1 h: 116 vs. 146 mL; 6 h: 253 vs. 332 mL; 24 h: 589 vs. 713 mL). However, a statistically significant difference was found only at 6 h ( p = 0.03), representing an approximately 24% relative reduction in bleeding volume compared with Group 2. No significant differences were observed in transfusion requirements (packed red blood cells p = 0.85; fresh frozen plasma p = 0.55). Three patients in Group 2 required reoperation due to bleeding ( p = 0.07), and one late mortality occurred in Group 2 ( p = 0.43). Conclusion: This study suggests that triple-dose IV bolus TXA administration may be both an effective and safe strategy for preventing postoperative bleeding in isolated CABG surgery. Trial registration: The study was registered at the Clinical Trial Registry (NCT05994989, August 8, 2023) on.

Amaç: Koroner arter baypas greft cerrahisi geçiren hastalarda uzamış ekstübasyon süreleri postoperatif komplikasyonlar, morbidite ve mortalite artışı, yoğun bakım ünitesi ve hastanede kalış sürelerinin uzaması ile ilişkilidir. Bu çalışmada, koroner arter baypas greft cerrahisi geçiren hastalarda ekstübasyon süresine etki eden faktörlerin belirlenmesi amaçlamıştır. Gereç ve Yöntemler: Bu retrospektif kesitsel çalışmaya elektif şartlarda izole koroner arter baypas greft cerrahisi uygulanmış olan 81 hasta dâhil edildi. Hastalar ekstübe edildikleri saate göre gruplandırıldı. Yoğun bakım ünitesinde 6 saatten önce ekstübe edilenler Grup 1'e (n=49); 6 saatten sonra ekstübe edilenler ise Grup 2'ye dâhil edildi (n=32). Bulgular: Grup 2'deki hastaların preoperatif hematokrit değerlerinin daha düşük (p=0,02); pre (p=0,02) ve postoperatif kan üre nitrojeni (p<0,001) ve postoperatif kreatinin (p=0,001) düzeylerinin ise Grup 1'e göre daha yüksek olduğu saptandı. Ayrıca intraoperatif ultrafiltrasyon ihtiyacı olanların (p=0,02) daha geç ekstübe olduğu ve Grup 2'deki hastalara postoperatif dönemde daha fazla eritrosit süspansiyonu (p<0,001) ve taze donmuş plazma (p=0,003) replasmanının yapıldığı saptandı. Son olarak Grup 2'deki hastaların yoğun bakım ünitesi (p=0,002) ve hastane kalış süreleri (p=0,056) daha uzun olarak saptandı. Sonuç: Koroner arter baypas greft cerrahisi geçiren hastalarda postoperatif ekstübasyon süresine etki edebilecek faktörlere dikkat edilmesi hastaların daha kısa sürede ekstübe edilmesine katkı sunacaktır. Bu da postoperatif morbidite ve mortalitenin azalması ve yoğun bakım ünitesi ile hastanede kalış sürelerinin kısalmasına katkı sunacaktır.

Aim: Postoperative bleeding is one of the most frequently encountered complications following coronary artery bypass grafting (CABG). This study aims to investigate preoperative and intraoperative risk factors affecting postoperative bleeding in CABG surgery. Methods: A total of 242 patients who underwent CABG between March 2019 and January 2023 were retrospectively analyzed. Based on postoperative bleeding volume, patients were classified into two groups: normal bleeding (Group N) and excessive bleeding (Group B). The groups were compared in terms of demographic, clinical, and perioperative variables. Results: Patients in Group B demonstrated significantly lower preoperative platelet counts (p=0.005), a lower prevalence of COPD (p=0.01), and longer anesthesia durations (p=0.033). Logistic regression analysis identified the absence of COPD (OR: 0.202; 95% CI: 0.054–0.759) and low platelet levels (OR: 0.995; 95% CI: 0.991–0.999) as independent predictors of excessive bleeding after CABG surgery. Conclusion: The findings indicate that reduced preoperative platelet count and the absence of COPD are significant risk factors for excessive bleeding following CABG. Moreover, these patients exhibited higher rates of postoperative complications and mortality.