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 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 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.Publication Open Access Analgesic efficacy and opioid sparing effect of erector spinae planeblock in oncologic breast surgery: An observational study(2022-03-01) ORHON ERGÜN, MELİHA; UMUROĞLU, TÜMAY; ZENGİN, SENİYYE ÜLGEN; UĞURLU, MUSTAFA ÜMİT; ORHON ERGÜN M., ZENGİN S. Ü., mustafayeva a., UĞURLU M. Ü., UMUROĞLU T.Background/Aim: Erector spinae plane block (ESPB) is a fascial plane block technique suitable for perioperative analgesia. This study aimed to evaluate the value of ESPB performed under ultrasound guidance and with ANI (Analgesia Nociception Index) monitoring in terms of intraoperative opioid need and postoperative pain management, in patients undergoing oncological breast surgery. Methods: This prospective case-control study includes forty-two female breast cancer patients who underwent unilateral modified radical mastectomy with axillary lymph node dissection. Patients were allocated to receive (ESPB group) or not receive (controls) ultrasound guided ESPB before anesthesia induction based on patient preference, and the groups were compared in terms of total intraoperative opioid consumption (with the guidance of ANI) and postoperative pain. Visual analogue scores (VAS) were obtained during the 12-hour postoperative follow-up. Results: Total intraoperative remifentanil dose required was significantly lower in the ESPB group when compared to controls (361.9 (108.3) vs. 1560.0 (4), P<0.001). ESPB group had significantly lower visual analogue scores at all postoperative time points. None of the patients in the ESPB group but all controls required additional analgesia during the 12-hour postoperative follow-up period. Conclusion: Ultrasound guided ESPB together with ANI monitoring is an effective and relatively safe perioperative analgesia method in patients undergoing mastectomy. Together, they provide an effective postoperative analgesia and reduce intraoperative opioid use consumption. Further studies will shed more light on the role of ESPB in this setting.Publication Open Access The effects of perioperative factors on early postoperative morbidity in bariatric surgery(2022-04-01) ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN, MELİHA; GÜNAL, ÖMER; Zengin S. Ü., Orhon Ergün M., Günal Ö.Purpose This study aims to examine the predictive role of obesity-type-related indexes and perioperative intraabdominal pressure measurements for early postoperative complications following bariatric surgery. Materials and Methods Sixty-seven female patients with obesity who underwent bariatric surgery (laparoscopic sleeve gastrectomy or gastric bypass) were included in this study. Obesity-related indexes (BMI, waist/hip ratio, and waist/height ratio) were calculated using patient data. Intraoperative hemodynamic measurements and intraabdominal pressure measurements were done at the beginning and at the end of the operation. Intraabdominal pressure measurements were done using both bladder port and trocar port. Patients were followed for early postoperative complications. Results Among 67 patients included, 22 developed early postoperative complications (32.8%), mostly pulmonary (20.9%). Trans-trocar IAP measured at the beginning of the operation emerged as the single independent predictor of postoperative complications (OR, 40.3; p=0.002). Based on ROC analysis, AUC for predicting complications was 0.955 (p<0.01). Optimal cutof point (≥14.5 mmHg) was associated with 100% sensitivity and 82% specifcity. In addition, there were weak but signifcant positive correlations between trans-trocar IAP-beginning and BMI (r=0.443, p<0.001), waist/hip ratio (r=0.434, p<0.001), and waist/height ratio (r=0.539, p<0.001). Conclusion Findings of this study suggest that a high baseline intraabdominal pressure predicts a higher risk for early postoperative complications following bariatric surgery. This information would help improve patient care. Further large studies are warranted.Publication Open Access The Role of neutrophil gelatinase associated lipocalin as a predictive biomarker of acute kidney injury in patients undergoing major abdominal surgery(2022-06-01) ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN, MELİHA; mustafayeva a., ORHON ERGÜN M., ZENGİN S. Ü.Objective: The current study investigates the development of acute kidney injury (AKI) in patients undergoing major abdominal surgery via earlier determination of the rise in neutrophil gelatinase-associated lipocalin (pNGAL) compared to that in creatinine. Methods: In this prospective observational study, 60 patients aged between 18 and 65 undergoing major abdominal surgery were selected for the investigation after obtaining ethics committee approval. Patients who did not meet the age criteria, had liver and kidney failures, severe cardiac and respiratory distress, used angiotensin-converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs, developed postoperative respiratory failure, cardiogenic and septic shock, relapse in the 1st 24 h, and those who underwent emergency surgery were excluded from the study. Leukocyte and creatinine values (preoperatively and at 24 and 48 h postoperatively), pNGAL (at 0 h intraoperatively and 6 h and 24 h postoperatively), lactate values (at 0 h intraoperatively and 24 h and 48 h postoperatively), and urine output value (at 24 and 48 h postoperatively) were evaluated. Results: Of the 60 patients, 9 (15%) showed increased pNGAL values at 6 h postoperatively; however, increased creatinine values and decreased urine output values were observed at 48 h postoperatively. Thus, AKI development was detected at an early stage. The change in leukocyte and lactate values was not statistically significant. Conclusion: pNGAL was proven to be an early predictive biomarker of AKI in patients undergoing major abdominal surgery.Publication Open Access A Comparison of Pregabalin and Ketamine in Acute Pain Management After Laparoscopic Cholecystectomy(AVES, 2018-02-22) BİLGİLİ, BELİZ; Haliloglu, Murat; Bilgili, Beliz; Zengin, Seniyye Ulgen; Ozdemir, Mehtap; Yildirim, Ahmet; Bakan, NurtenObjective: Pregabalin and ketamine are popular analgesic adjuvants for improving perioperative pain management. We designated this double-blind, placebo controlled study to test and compare the preventive effects of pregabalin and ketamine on postoperative pain management after elective laparoscopic cholecystectomy. Methods: Seventy five patients (18 to 65 years of age) undergoing laparoscopic cholecystectomy were randomly assigned to one of the following 3 groups: control group (group C) received oral placebo capsule 1 h before surgery and bolus plus intravenous (iv) infusion of saline during surgery; ketamine group (group K) received oral placebo capsule 1 h before surgery and 0.3 mg kg(-1) iv bolus plus 0.05 mg kg(-1) h(-1) iv infusion of ketamine during the surgery; pregabalin group (group P) received oral pregabalin 150 mg 1 h before surgery and bolus plus iv infusion of saline during surgery. The anesthetic technique was standardized, total tramadol consumption, visual analog scale (VAS), incidence of postoperative nausea and vomiting (PONV), sedation score and complications related to the drugs used in the study were assessed in the postoperative 24 h period. Results: Postoperative total tramadol consumption were significantly lower in the pregabalin and ketamine group compared to the group C (p=0.001). Tramadol requirement was similar between pregabalin and ketamine groups. At 30 min postoperatively, VAS values were lower in the pregabalin and ketamine groups compared with group C (p=0.001). There was no difference between the three groups in the need for supplemental analgesia, incidence of PONV and sedation score >2. Discussion: Pregabalin and ketamine improved postoperative pain control and decreased analgesic consumption after laparoscopic cholecystectomy with a good safety profile without any changes in sedation level or PONV.