Person: UMUROĞLU, TÜMAY
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UMUROĞLU
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TÜMAY
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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 Topical and systemic analgesia versus caudal epidural and dorsal penile nerve block in relieving pain after pediatric circumcision(MARMARA UNIV, FAC MEDICINE, 2021-10-31) ZENGİN, SENİYYE ÜLGEN; Karatas, Ayse; Eti, E. Zeynep; Umuroglu, Tumay; Zengin, Seniyye Ulgen; Gogus, F. YilmazObjective: There is no consensus on the use of optimal analgesic method after pediatric circumcision, although, caudal block (CB), dorsal penile nerve block (DPNB), topical local anesthetic application and systemic analgesic administration are frequently used methods. In this study, we aimed to compare the postoperative analgesic effects and side effects, as well as parental satisfaction concerning these methods. Patients and Methods: Eighty children, aged 3-12 years, undergoing circumcision were randomized into four groups (n=20). Group Caudal Anesthesia (CA), Group Dorsal Penile Blok (DP), Group Topical Analgesia (TA), Group Systemic Analgesics (SA). The severity of pain was measured with NRS or CHEOPS scores. Time to awakening, first analgesic requirement, hospital discharge, side effects and parental satisfaction were recorded. Results: In groups CA and DP, pain scores during the first postoperative hour were lower than the pain scores of other groups and in group CA, the first analgesic requirement time was significantly longer compared to other groups (p<0.05). In the early postoperative hour, parental satisfaction was higher in group CA compared to other groups. Conclusion: In the early postoperative period, CB and DPNB reduce pain more effectively and provide more parental satisfaction than other applications, (in children who underwent) circumcision.