Person: ZENGİN, SENİYYE ÜLGEN
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ZENGİN
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SENİYYE ÜLGEN
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Publication Open Access The effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement in patients undergoing laparatomy(HINDAWI LTD, 2015) SARAÇOĞLU, AYTEN; Zengin, Senniye Ulgen; Saracoglu, Ayten; Eti, Zeynep; Umuroglu, Tumay; Gogus, Fevzi YilmazOBJECTIVES: To evaluate and compare the effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement, adverse effects, patients' satisfaction, mobilization, time to first defecation and time to discharge in patients undergoing laparotomy. Methods: Eighty patients (18 to 65 years of age) undergoing elective laparotomy were randomly divided into four groups (n=20 in each group): group C, placebo capsules and normal saline infusion perioperatively (control); group L, placebo capsules and lidocaine 1 mg/kg intravenous bolus dose followed by 2 mg/kg/h infusion until skin closure; group P, 150 mg oral pregabalin and normal saline infusion perioperatively; and group PL, 150 mg oral pregabalin and lidocaine 2 mg/kg/h infusion until skin closure. Hemodynamic parameters, visual analogue scale (VAS) scores, analgesic consumption, side effects, time to mobilization, time to first defecation, time to discharge and patients' satisfaction were recorded. Results: VAS scores of group L, group P and group PL were lower than group C (P<0.05). Morphine consumption of group P and group PL was lower than group C (P<0.05). Incidence of nausea in group C was higher than group L and group PL. Time to first defecation and mobilization were shorter in group L and group PL compared with group C (P<0.05). Conclusion: Preoperative oral pregabalin and perioperative intravenous lidocaine infusion decreased postoperative VAS scores. Preoperative oral pregabalin decreased morphine requirement and perioperative intravenous lidocaine infusion hastened gastrointestinal motility and mobilization, and decreased the incidence of nausea in patients undergoing laparotomy. Therefore, preoperative pregabalin with or without lidocaine provides superior pain relief in patients undergoing laparatomy.Publication Open Access Determining the factors affecting the development of perioperative complications according to aging stages(2022-06-01) ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN, MELİHA; ÇORMAN DİNÇER, PELİN; UMUROĞLU, TÜMAY; ORHON ERGÜN M., ZENGİN S. Ü., ÇORMAN DİNÇER P., UMUROĞLU T., AYKAÇ Z. Z.Objective: This study aimed to examine perioperative complication risks in elderly patients stratified by age. Method: Elderly patients (youngest-old, ages 65 to 74 years; middle-old, 75 to 84 years; and oldest-old, ≥85 years) and controls (20-30 years) who underwent surgical intervention under general anesthesia were included in this prospective observational study. Results: Two-hundred-sixty patients were included. Different age subgroups showed a different course in terms of perioperative complications. For any combined end-point of any perioperative complication, having a body mass index>28 [odds ratio (OR): 2.4; 95% confidence interval (CI): 1.2-4.6; p=0.012] and being on multi-pharmacy regimen at baseline (OR: 1.9; 95% CI: 1.1-3.5; p=0.029) emerged as significant independent predictors. In reference to controls, each elderly age group emerged as a significant independent predictor: youngestolds (OR: 4.9; 95% CI: 2.2-10.8; p<0.001); middle-olds (OR: 2.5; 95% CI: 1.1-5.4; p=0.025); oldest-olds, (OR: 5.6; 95% CI: 2.5-12.6; p<0.001). Conclusion: Elderly patients appear to have higher risk for intraoperative and postoperative complications when compared to the young patients, and each age group appears to have increased risk for different type of complications.Publication Open Access Targeted bleeding management guided by non-invasive haemoglobin measurement in surgical patients(2022-10-01) AKDAĞ, ŞÜKRİYE; ZENGİN, SENİYYE ÜLGEN; UMUROĞLU, TÜMAY; AYKAÇ, ZEYNEP ZUHAL; SARAÇOĞLU, AYTEN; AKDAĞ Ş., ZENGİN S. Ü. , Cakmak G., UMUROĞLU T., AYKAÇ Z. Z. , SARAÇOĞLU A.© 2022 College of Physicians and Surgeons Pakistan. All rights reserved.Objective: To assess blood transfusion decisions in blood losses using a continuous total haemoglobin (SpHb) and non-invasive haemoglobin (Hb) device. Study Design: Double-blinded randomised controlled trial. Place and Duration of Study: Marmara University Hospital, Istanbul, Turkey, from March 2018 to December 2019. Methodology: One hundred and twenty adult patients scheduled for elective major surgery and expected to experience a blood loss greater than 20% of their total blood volume were divided into two groups. These groups were compared for bleeding management with conventional blood gas sampling (Group Hb, the control group) according to Hb monitoring versus SpHb measurement (Group SpHb, the study group). Results: In the postoperative measurement, there were fewer red blood cells (RBC) in the SpHb group than in the Hb group (p=0.020). There was a greater change in the amount of RBC from the perioperative to the postoperative period in the SpHb group compared to the Hb group (p<0.001). Postoperative Hb levels of patients in the intensive care unit (ICU) were higher in the SpHb group than in the Hb group (p<0.05). Conclusion: SpHb can provide effective patient blood management in cases of major surgery. It does not cause a delay in the decision of blood transfusion during surgery.Publication Metadata only The Effects of Perioperative Factors on Early Postoperative Morbidity in Bariatric Surgery(2022) ORHON ERGÜN, MELİHA; Zengin, Seniyye Ulgen; Orhon Ergun, Meliha; Gunal, OmerPublication Open Access Pediatrik hastalarda postoperatif deliryum gelişmesi ile analjezi nosisepsiyon index değerleri arasındaki ilişkinin belirlenmesi(2022-01-01) ORHON ERGÜN, MELİHA; ÇORMAN DİNÇER, PELİN; UMUROĞLU, TÜMAY; ZENGİN, SENİYYE ÜLGEN; ÖZALTUN F., ZENGİN S. Ü., ORHON ERGÜN M., ÇORMAN DİNÇER P., UMUROĞLU T.Publication Open Access Comparative efficacy of finger versus forehead plethysmographic variability index monitoring in pediatric surgical patients(2022-10-01) FİDAN, SEYFULLAH; ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN, MELİHA; UMUROĞLU, TÜMAY; Fidan S., ZENGİN S. Ü. , ORHON ERGÜN M., UMUROĞLU T.Introduction The Plethysmographic Variability Index can be measured by both finger and forehead probes. Vasoconstriction may jeopardize the reliability of finger PVI measurements in pediatric patients undergoing surgery. However, forehead vasculature exhibits more marked resistance to alterations in the vasomotor tonus. Objective Our aim was to compare the Plethysmographic Variability Index measured via finger or forehead probes in mechanically ventilated pediatric surgery patients in terms of their ability to predict fluid responsiveness as well as to determine the best cut-off values for these two measurements. Materials and Methods A total of 50 pediatric patients undergoing minor elective surgery were included after provision of parental consent and ethics committee approval. Perfusion index measured at the finger or forehead and Plethysmographic Variability Index monitoring comprised the primary assessments. Hemodynamic parameters monitored included perfusion index, Plethysmographic Variability Index, and cardiac output. A >= 15% increase in cardiac output following passive leg raise maneuver was considered to show fluid responsiveness. Two groups were defined based on fluid responsiveness: Group R (responsive) and Group NR (non-responsive). Student\"s t-test, Mann-Whitney U test, DeLong test, and ROC were used for statistical analysis. Results The area under curve for finger and forehead Plethysmographic Variability Index prior to passive leg raise maneuver were 0.699 (p = .011) and 0.847 (p < .001), respectively. The sensitivity for finger and forehead measurements at a cut-off value of <= 14% was 92.9% and 96.4%, and 45.4% and 72.7%, respectively. Conclusion Although forehead and finger Plethysmographic Variability Index monitoring were similarly sensitive in predicting fluid responsiveness in pediatric surgical patients, the former method provided higher specificity. The best cut-off value for PVI measurements with forehead and finger probes was found to be 14%.Publication Metadata only Goal-Directed Fluid Management Using Plethysmographic Variability Index in Patients Undergoing Laparoscopic Bariatric Surgery(MARY ANN LIEBERT, INC) ORHON ERGÜN, MELİHA; Ergun, Meliha Orhon; Zengin, Seniyye Ulgen; Umuroglu, TumayBackground: Optimal intraoperative fluid management is essential in surgical patients, including individuals with obesity undergoing bariatric surgery. The objective of this study was to assess the feasibility of pleth variability index (PVI) for intraoperative goal-directed fluid management in comparison with standard approach, in patients with obesity undergoing laparoscopic bariatric surgery. Methods: A total of 60 patients with obesity who underwent elective laparoscopic bariatric surgery were included in this single-blind prospective randomized study. Patients were randomly assigned to the PVI group or control. Patients were monitored for PVI, heart rate, noninvasive mean blood pressure, and perfusion index. In addition, administered fluids, amount of bleeding, and renal function parameters were recorded. Results: The PVI group received higher amounts of crystalloids (3053 +/- 275 mL vs. 1703 +/- 349 mL, p < 0.001) and colloids (277 +/- 208 mL vs. 17 +/- 91 mL, p < 0.001) intraoperatively, and it had higher perioperative urine output. In addition, the PVI group had decreases in blood urinary nitrogen (BUN), lactate, and creatinine levels; however, controls had increased BUN, lactate, and creatinine. Conclusions: Findings of this study suggest that PVI may represent a useful noninvasive strategy for intraoperative goal-directed fluid management in patients with obesity undergoing laparoscopic bariatric surgery.Publication Metadata only Neutrophil gelatinase associated lipocalin in predicting postoperative acute kidney injury in elderly(SPRINGER LONDON LTD) ORHON ERGÜN, MELİHA; Orhon Ergun, Meliha; Zengin, Seniyye Ulgen; Mustafayeva, Aynur; Umuroglu, TumayBackground Elderly patients are at increased risk of developing acute kidney injury (AKI) following major surgery and rapid diagnosis is essential. Aim This study aimed to examine the potential utility of plasma neutrophil gelatinase associated lipocalin levels in early prediction of AKI in geriatric patients undergoing laparotomic oncological surgery. Methods This prospective single-center cohort study included 60 geriatric patients (>= 65 years of age) that underwent major oncologic surgery with laparotomy. Perioperative measurements of plasma creatinine, blood urinary nitrogen, plasma lactate, urine output, and neutrophil gelatinase associated lipocalin (NGAL) were made. Patients were followed for AKI development, which is the primary outcome measure, and predictive role of NGAL was investigated. Results At 48 h follow-up, AKI developed in 13 patients (21.7%). Significant differences in creatinine (p < 0.001), NGAL (p < 0.001), and urine output levels (p = 0.001) were evident over time between the two groups. High NGAL measurements at 6 and 24 h after surgery seem to be highly predictive of AKI development. At 6 h, a plasma NGAL level greater than 71.8 ng/mL has a sensitivity and specificity of 85% and 81% in predicting subsequent AKI development. Conclusions Plasma NGAL levels seem to represent an early and reliable marker for AKI in elderly patients undergoing laparotomic surgery with the potential to allow early diagnosis and prevent further renal deterioration. Further confirmatory studies are warranted. Trial registration The study was registered to ClinicalTrials.gov (number, NCT05030727). Implication statement Elderly patients are at increased risk of postoperative acute kidney injury (AKI). This study shows that plasma neutrophil gelatinase associated lipocalin is a helpful marker to predict AKI in elderly patients undergoing laparotomic major surgery, which will allow early diagnosis and prevent further renal deterioration in this vulnerable patient group.Publication Metadata only Pediatrik torakotomi vakasında erektor spina plan bloğu deneyimimiz(2022-10-25) ORHON ERGÜN, MELİHA; ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN M., GÜÇLÜ E., ZENGİN S. Ü.Publication Open Access Effect of the Recruitment Maneuver on Respiratory Mechanics in Laparoscopic Sleeve Gastrectomy Surgery(SPRINGER, 2020-07) ZENGİN, SENİYYE ÜLGEN; Sumer, Ismail; Topuz, Ufuk; Alver, Selcuk; Umutoglu, Tarik; Bakan, Mefkur; Zengin, Seniyye Ulgen; Coskun, Halil; Salihoglu, ZiyaPurpose LSG surgery is used for surgical treatment of morbid obesity. Obesity, anesthesia, and pneumoperitoneum cause reduced pulmoner functions and a tendency for atelectasis. The alveolar recruitment maneuver (RM) keeps airway pressure high, opening alveoli, and increasing arterial oxygenation. The aim of our study is to research the effect on respiratory mechanics and arterial blood gases of performing the RM in LSG surgery. Materials and Methods Sixty patients undergoing LSG surgery were divided into two groups (n = 30) Patients in group R had the RM performed 5 min after desufflation with 100% oxygen, 40 cmH(2)O pressure for 40 s. Group C had standard mechanical ventilation. Assessments of respiratory mechanics and arterial blood gases were made in the 10th min after induction (T1), 10th min after insufflation (T2), 5th min after desufflation (T3), and 15th min after desufflation (T4). Arterial blood gases were assessed in the 30th min (T5) in the postoperative recovery unit. Results In group R, values at T5, PaO2 were significantly high, while PaCO2 were significantly low compared with group C. Compliance in both groups reduced with pneumoperitoneum. At T4, the compliance in the recruitment group was higher. In both groups, there was an increase in PIP with pneumoperitoneum and after desufflation this was identified to reduce to levels before pneumoperitoneum. Conclusion Adding the RM to PEEP administration for morbidly obese patients undergoing LSG surgery is considered to be effective in improving respiratory mechanics and arterial blood gas values and can be used safely.
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