Transversus abdominis plane (TAP) block has been shown to ameliorate postoperative pain after abdominal surgery. Postoperative pain-associated respiratory compromise has been the subject of several studies. Herein, we evaluate the effect of oblique subcostal TAP (OSTAP) block on postoperative pain and respiratory functions during the first 24 postoperative hours. In this double-blind, randomized study, 76 patients undergoing laparoscopic cholecystectomy were assigned to either the OSTAP group (n=38) or control group (n=38). Bilateral ultrasound-guided OSTAP blocks were performed with 20 ml 0.25% bupivacaine after induction of general anesthesia. Both the OSTAP and control groups were treated with paracetamol, tenoxicam, and tramadol as required for postoperative analgesia. Visual Analog Scale (VAS) pain scores (while moving and at rest), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR), arterial blood gas variables, and opioid consumption were assessed during first 24 h. VAS pain scores at rest and while moving were significantly lower in the OSTAP group on arrival to PACU and at 2 h postoperatively. The total postoperative tramadol requirement was significantly reduced at 0-2 h and 2-24 h in the OSTAP group. Postoperative deterioration in FEV1 and FVC was significantly less in the OSTAP group when compared to the control group (P<0.01 and P<0.05, respectively). There were no between-group differences in arterial blood gas variables. After laparoscopic cholecystectomy, OSTAP block can provide significant improvement in respiratory function and better pain relief with lower opioid requirement.

Background: This study was conducted to compare the efficacy and effects of dexmedetomidine and midazolam in preoperative sedation. Materials and Methods: A total of 125 patients in American Society of Anaesthesiologists (ASA) I-II were divided into three groups: Group I (n = 40) for controls, Group II (n = 40) for Dexmedetomidine (1 μg/kg), and group III was the midazolam group (n = 45). Group III was further divided into three subgroups according to the doses of midazolam: Group IIIA (n = 15) received 0.02 mg/kg, group IIIB (n = 15) received 0.04 mg/kg, and group IIIC (n = 15) received 0.06 mg/kg of midazolam. Drugs were infused over a 10-minute period with appropriate monitoring. Ramsay and visual analog scores, for sedation and anxiety, respectively, and mean arterial pressure, heart rate, and SpO ₂ measurement, including respiratory rates were recorded, every 5 minutes for 30 minutes following infusion. Results: There was marked sedation and a decrease in anxiety in groups II and IIIC (P < 0.01). Mean arterial pressure (MAP) and heart rate (HR) decreased significantly in group II (P < 0.01 and P < 0.05, respectively), but there was no associated hypotension (MAP <60 mm Hg) or bradycardia (HR <50 bpm) (P < 0.05). Respiratory rates and SpO ₂ values decreased in groups II, IIIA, IIIB, and IIIC. The differences in respiratory rates were not significant (P > 0.05); however, decrease in SpO ₂ was significant in group IIIC (P < 0.01). Conclusions: Dexmedetomidine was as effective as higher doses of midazolam in sedation. The hemodynamic and respiratory effects were minimal. Although dexmedetomidine caused significant decrease in the blood pressure and heart rate, it probably just normalized increased levels caused by preoperative stress.

Background: Hemorrhoidectomy is a common surgical procedure associated with significant postoperative pain. The conventional analgesic methods used for hemorrhoidectomy often have adverse effects and may not provide adequate pain relief. The sacral erector spinae plane block (ESPB) is a newly introduced technique that has shown promise in various surgical procedures. This prospective, randomized, controlled trial aimed to evaluate the analgesic effects of sacral ESPB following hemorrhoidectomy. Methods: Seventy patients undergoing hemorrhoidectomy were divided into 2 groups: the control group and the sacral ESPB group. Bilateral sacral ESPB was performed in the sacral ESPB group, whereas no intervention was performed in the control group. The numeric rating scale at rest and during the active period (mobilizing) was used as the primary outcome measure. Secondary outcome measures were the cumulative doses of tramadol, the number of patients who required rescue analgesia postoperatively, and quality of recovery-15 Turkish version patient recovery quality. Results: The sacral ESPB group had significantly low numeric rating scale scores at various time points (P < .05). More patients in the control group needed rescue analgesia during the postoperative period (P < .001). The dosages of tramadol consumption after the first 24 hours postoperatively were significantly lower in the sacral ESPB group compared with the control group (P < .001). Furthermore, quality of recovery-15 Turkish version scores were high in the sacral ESPB group (P < .001). Conclusion: The results suggest that sacral ESPB is an effective method for post-hemorrhoidectomy pain management, reducing the need for additional analgesics and improving patient recovery.

Amaç: Bu araştırmada üniversite ve devlet hastaneleri ile özel hastanelerde kullanılan bir dizi intra­venöz (İV) ve intramüsküler (İM) enjeksiyon bilgilendirilmiş onam formunun okunabilirlik düzeyini değerlendirmek amaçlanmıştır. Gereç ve Yöntemler: Toplam 90 (45 İV, 45 İM enjeksiyon) bilgilendirilmiş onam formu 45 hasta­neden temin edildi. Formlar Bezirci–Yılmaz tarafından geliştirilen bilgisayar yazılımına aktarıldı. Formlardaki hece sayısı, kelime sayısı, 4+ heceli kelime sayısı hesaplandı. Ardından her bir formun okunabilirlik değeri Ateşman ve Bezirci–Yılmaz formülleriyle hesaplandı. Üniversite, devlet ve özel hastane formlarının okunabilirlik değeri ortalamaları İV ve İM enjeksiyon formları için ayrı ayrı kar­şılaştırıldı. Bulgular: İM enjeksiyon onam formlarının ortalama hece sayısı, ortalama kelime sayısı, ortalama 4+ heceli kelime sayısı, ve de Ateşman ve Bezirci–Yılmaz okunabilirlik değerleri ortalamaları açı­sından hastaneler arasında istatistiksel açıdan anlamlı fark bulunamadı (sırasıyla p=0,73; p=0,73; p=0,57; p=0,56; p=0,92). İV enjeksiyon onam formlarının ortalama hece sayısı, ortalama kelime sayısı, ortalama 4+ heceli kelime sayısı, Ateşman ve Bezirci–Yılmaz okunabilirlik değerleri ortala­maları açısından da hastaneler arasında istatistiksel açıdan anlamlı fark yoktu (sırasıyla p=0,53; p=0,34; p=0,42; p=0,59; p=0,53). Tüm formların Ateşman okunabilirlik değeri ortalaması “orta güç­lükte”, Bezirci–Yılmaz okunabilirlik değeri ortalaması ise “ortaöğretim” seviyesinde bulundu. Tartışma ve Sonuç: Bu çalışmada hastanelerde kullanılan İV ve İM enjeksiyon bilgilendirilmiş onam formlarının okunabilirliğinin oldukça düşük olduğu ve bu formların toplumun geneli tarafın­dan kolayca okunabilecek biçimde revize edilmesi gerektiği tespit edilmiştir.