Person: ORHON ERGÜN, MELİHA
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ORHON ERGÜN
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MELİHA
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Publication Metadata only Anestezi pratiğinde simülasyon eğitiminin önemi(Akademisyen Yayınevi Kitabevi, 2022-03-01) ORHON ERGÜN, MELİHA; Orhon Ergün M.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 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 Metadata only Anestezide arteriyal dalga analizinin kullanımı(Akademisyen Yayınevi Kitabevi, 2022-03-01) ORHON ERGÜN, MELİHA; Orhon Ergün M., Mustafayeva A.Publication Open Access Awake Video-Assisted Thoracoscopic Surgery with Erector Spinae Plane Block(2022-08-01) ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN, MELİHA; LAÇİN, TUNÇ; ZENGİN S. Ü., Ergun M., LAÇİN T.Erector spinae plane block has been used for postoperative pain following thoracic surgery as an alternative to epidural block or adjunct to general anesthesia in thoracic procedures. However, its sole use during thoracoscopic surgery without general anesthesia is rare. Here, we report two cases in which erector spinae plane block was successfully used as the only anesthetic method during video-assisted thoracoscopy.Publication Open Access Effects of erector spinae plane block on postoperative pain and quality of recovery questionnaire scores in video-assisted thoracoscopic surgery: a randomized controlled study(2023-03-01) ORHON ERGÜN, MELİHA; ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN M., Ozturk E. G., ZENGİN S. Ü.Objectives: Opioid-free anesthesia with erector spinae plane block (ESPB) has the potential to decrease perioperative opioid need, thereby potentially reducing related complications. This study aimed to compare opioid-free anesthesia with ESPB and standard opioid-based balanced anesthesia in patients undergoing video-assisted thoracic surgery (VATS) in terms of postoperative opioid need (through patient control analgesia) as well as postoperative pain management, recovery quality, and opioid-related side effects. Methods: Seventy-four patients, ranging in age from 18 to 75 years, who underwent lobectomy with VATS were included in this randomized-controlled study. The opioid-free group had ESPB, and no opioid was used during anesthesia maintenance. The opioid group received standard anesthesia with opioid use. Postoperative morphine requirement, postoperative pain as measured by the visual analog scale (VAS), intraoperative vital parameters, recovery quality using the Quality of Recovery-40 (QoR-40) questionnaire, and opioid-related complications were compared between groups. Results: The opioid-free group received a significantly lower total dose of morphine during the first 24 postoperative hours through patient-controlled analgesia (PCA) when compared to the opioid group (7.3 +/- 3.4 vs. 21.7 +/- 7.9 mg, p<0.001). In addition, the opioid-free group had significantly better postoperative pain scores and QoR-40 scores (184.3 +/- 7.5 versus 171.2 +/- 6.4, p<0.001), shorter times to mobilization (5.5 +/- 0.8 versus 8.1 +/- 1.1 hours, p<0.001), and oral intake (5.8 +/- 0.6 versus 6.4 +/- 0.6 hours, p<0.001), as well as less frequent opioid-related side effects.Conclusion: The findings of this study suggest that opioid-free anesthesia with ESPB represents a promising option for patients undergoing lobectomy with VATS. It has the potential to decrease postoperative opioid need, improve postoperative pain management, and reduce opioid-related unwanted consequences.