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GÜNAL, ÖMER

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Author: ZENGİN, SENİYYE ÜLGEN × Start date: 2020 ×

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Now showing 1 - 3 of 3
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    The Effects of Perioperative Factors on Early Postoperative Morbidity in Bariatric Surgery
    (2022) ORHON ERGÜN, MELİHA; Zengin, Seniyye Ulgen; Orhon Ergun, Meliha; Gunal, Omer
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    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.
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    Effect of Ultrasound-Guided Erector Spinae Plane Block on Postoperative Pain and Intraoperative Opioid Consumption in Bariatric Surgery
    (SPRINGER, 2021) ORHON ERGÜN, MELİHA; Zengin, Seniyye Ulgen; Ergun, Meliha Orhon; Gunal, Omer
    Background Bariatric surgery is often associated with moderate to severe pain. In patients with obesity, opioids have the potential to induce ventilatory impairment; thus, opioid use needs to be limited. This study aimed to compare the novel ultrasound-guided erector spinae plane block (ESPB) technique with controls in terms of intraoperative opioid consumption and postoperative pain control. Methods A total of 63 patients with morbid obesity who underwent laparoscopic bariatric surgery were included in this randomized study. Patients were randomly assigned to the bilateral erector spinae plane block (ESPB) group or the control group. To evaluate perioperative pain and to adjust opioid dose, analgesia nociception index (ANI) was monitored during surgery. Total opioid dose was recorded for each patient. In addition, pain was evaluated using visual analogue scale (VAS) scores for 24 h following the operation. Results Total intraoperative remifentanil dose was significantly lower in the ESPB group when compared to controls (1356.3 +/- 177.8 vs. 3273.3 +/- 961.9 mcg, p < 0.001). In the ESPB group, none of the patients required additional analgesia during follow-up. In contrast, all control patients required analgesia. ESPB group had significantly lower VAS scores at all postoperative time points (p < 0.001 for all). Conclusion Bilateral ultrasound-guided ESPB appears to be a simple and effective technique to improve perioperative pain control and reduce intraoperative opioid need in patients with morbid obesity undergoing bariatric surgery.