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ARSLANTAŞ, MUSTAFA KEMAL

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ARSLANTAŞ

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MUSTAFA KEMAL

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2019 - 20202
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Subject: Bariatric surgery ×

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    Subcostal Transversus Abdominis Plane Block for Laparoscopic Sleeve Gastrectomy, Is It Worth the Time?
    (SPRINGER, 2019) CİNGİ, ASIM; Coskun, Muemin; Yardimci, Samet; Arslantas, Mustafa Kemal; Altun, Gulbin Tore; Uprak, Tevfik Kivilcim; Kara, Yalcin Burak; Cingi, Asim
    BackgroundObesity is a complex and multifactorial disease whose incidence has increased, making it a serious public health issue. Laparoscopic sleeve gastrectomy (LSG) is one of the most common surgical procedures that is chosen for bariatric surgery. Decreasing postoperative pain in these patients which will increase patients' compliance and quality of life will lead to better surgical results. This study aims to compare the effectiveness of trocar site infiltration versus bilateral subcostal transversus abdominis plane block (TAP) in controlling postoperative pain in patients.MethodsForty-five consecutive patients who have undergone LSG in xxx General Surgery Department have been enrolled in the study. Patients were divided into two groups according to the surgeon's choice. The first group underwent TAP block, while the second group underwent trocar site infiltration. Patients' pain was recorded via visual analogue scale (VAS) in postoperative periods.ResultsTwenty-nine female (69%) and 13 (31%) male patients were included in the study. Median age was 41 (18-58) and median BMI was 48 (41.1-68). When the VAS values were compared, in the TAPB group, 6th hour resting and coughing pain was statistically significantly less. Other VAS values measured while resting, coughing, and post-mobilization did not show significant differences. There were no significant differences between the groups' tramadol use.ConclusionsAfter LSG, TAP block and trocar site infiltration yield similar pain control. Due to the faster application and fewer side effects, we concluded that trocar site infiltration should be the intervention of choice in controlling postoperative pain in LSG.
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    The effects of pneumoperitoneum and patient position on the perfusion index and pleth variability index during laparoscopic bariatric surgery
    (MARMARA UNIV, FAC MEDICINE, 2020-03-31) ARSLANTAŞ, MUSTAFA KEMAL; Arslantas, Reyhan; Arslantas, Mustafa Kemal; Tore Altun, Gulbin; Corman Dincer, Pelin
    Objective: Limited data are available on the use of the perfusion index (PI) and the pleth variability index (PVI) during laparoscopic bariatric suigery. We investigated the effects of pneumoperitoneum and the reverse Trendelenburg position on these indices. Materials and Methods: PI, PVI, heart rate (HR), blood pressure, SpO(2) and ventilation parameters were recorded before anaesthesia induction (T0), 5 min after endotracheal intubation (T1), immediately before surgery, after the patient had been in the reverse Trendelenburg position for 5 min (T2), after inflating the abdomen with CO2 in reverse Trendelenburg (T3), after the abdomen had been deflated (T4) and 5 min after extubation (T5). Results: General anaesthesia induced an increase in the PI (P<.001), and a decrease in the PVI (P=.002). The PI and PVI values were not affected during T2 or T3. Pneumoperitoneum caused an increase in mean arterial pressure (MAP) and a decrease in HR. PVI and MAP decreased during 14, but the PI and IHR remained unchanged. PVI, HR and MAP increased during T5. Conclusion: Our data suggest that the reverse Trendelenburg position and pneumoperitoneum did not affect the PI or PVI values, whereas deflation decreased the PVI in morbidly obese patients under general anaesthesia.