In this study, we evaluated the hypothesis that preoperative bilateral infraoptic nerve (ION) and infratrochlear nerve (ITN) blocks under general anesthesia with sevoflurane and remifentanil reduced the incidence of emergence agitation (EA), pain scores, and the analgesic consumption after the septorhinoplasty. Patients and Methods: Our study was conducted as a prospective randomized, double-sided blind study. Fifty-two patients whose septorhinoplasty operation was planned under general anesthesia were included in the study. Patients were randomly distributed to either the ION and ITN blocks were performed. Group 1: Bilateral ION and ITN blocks were performed; Group 2: ION and ITN blocks were not performed. Duration of the surgery and anesthesia, Riker Sedation-Agitation Scale (RSAS) score, EA presence, duration of postoperative analgesia, numerical rating scale (NRS) scores, and cumulative dexketoprofen consumption were recorded. Results: The RSAS score, NRS score and cumulative dexketoprofen consumption of the patients in Group 1 were statistically significantly lower than the patients in Group 2 (p<0.05). It was also found that patients in Group 1 (n: 8/26) had less EA compared to patients in Group 2 (n: 16/26) and this difference was statistically significant (p: 0.026). Postoperative analgesia duration of patients in Group 1 was found to be statistically significantly higher than patients in Group 2 (p: <0.001). In addition, the number of patients given postoperative dexketoprofen in Group 1 (n: 8/26) was found to be statistically significantly lower than patients in Group 2 (n: 25/26). (p: <0.001). Conclusion: Bilateral ION and ITN blocks in septorhinoplasty operation is an effective, reliable and simple technique in the treatment of postoperative pain.

AIM:To compare the effect of ultrasound-guided modified thoracolumbar interfascial plane (TLIP) block versus local anesthetic infiltration on the wound site for post-operative analgesia in patients undergoing lumbar disc surgery with spinal anesthesia. MATERIAL and METHODS:This prospective and observationally planned study included 42 patients from the ages of 18 to 75 years, American Society of Anesthesiologists classes I-III, who underwent lumbar disc surgery. In Group L, bupivacaine infiltration was performed on the surgical incision line. In Group T, TLIP block was performed with ultrasound. In the postoperative period, visual analogue scale (VAS) values were also investigated and recorded on the 10 th day after discharge. Nausea, vomiting, and sedation score values and analgesic doses used by all patients in the postoperative period were recorded. RESULTS:During any of the postoperative follow-up hours, the VAS score was ≤ 3 (mild pain), and those who did not need tramadol were 80.9% (n=17) in Group T and 71.4% (n=15) in Group L. VAS scores at the 1 st , 4 th , and 8 th hours were statistically lower in Group L than those in Group T (p values: 0.011, 0.028, and 0.029). The average amounts of tramadol consumption per patient were determined as 19.04 mg ± 40.23 in Group T and 27.38 ± 44.65 mg in Group L in the first 24 hours postoperatively. There was no statistically significant difference between groups (p=0.519). CONCLUSION:In this study, it was determined that the modified TLIP block application performed for the purpose of post-operative analgesia in lumbar disc surgery was not superior to local anesthetic infiltration in terms of postoperative opioid consumption and VAS scores.

Objective: Prealbumin renamed transthyretin is a protein that is made in the liver and released in the blood and has been used as a beneficial nutritional indicator for long years. It aimed to investigate whether serum prealbumin level is a marker of mortality in patients hospitalized in the intensive care unit. Methods: This retrospective and single-center study was carried out at level 3 intensive care unit. Data were collected from hospital electronic records and patient file archives. Patient age, gender, acute physiologic and chronic health evaluation score, nutritional risk screening 2002, nutric score, neutr ophil -lymp hocyt e ratio, need for mechanical ventilation and duration, intensive care unit length of stay, comorbid conditions, the situation of nutrition support, causes of enteral feeding intolerance, the situation of protein and energy intake (7 days), laboratory parameters (included prealbumin (0 and 7 days)) at the time of admission to intensive care unit, and mortality status were recorded. Patients were divided into 2 groups as survivors and non-survivors, and the differences between the 2 groups were analyzed for all parameters. Results: Sixty-three (60%) were female of 105 patients who participated in this study. The mean age was 59 ± 23 years. The mortality rate was 48.6%. The length of stay in the intensive care unit was 30 ± 34 days. The median level of serum albumin (g/dL) on day 1 was 2.7 (2.3-3.2) and on day 7, it was 2.5 (2.1-2.8). The mean level of serum prealbumin (mg/dL) on day 1 was 13.8 ± 6.6 and on day 7, it was 12.5 ± 6.5. Prealbumin (on days 0 and 7) values were not different between survivors and non-survivors (for all P < .05). In the binary logistic regression analysis, age and albumin value (on day 7) were found to be independent risk factors for mortality (odds ratio: 1.038 (1.002-1.075), P = .036, odds ratio: 1.148 (1.021-1.290), P = .021), respectively. Conclusions: Prealbumin levels did not differ for critically ill patients with and without mortality.

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Objective: Modified Nutrition Risk in Critically Patients is a classification scale that has been widely used all over the world recently to determine the level and degree of nutritional risk in individuals treated in intensive care units. It was analyzed whether the length of stay in the intensive care units as different in individuals classified according to the Modified Nutrition Risk in Critically score level. Methods: In this retrospective study, which included 100 patients, the age and gender of the patients, the laboratory parameters at the time of first admission to the intensive care units, the prognostic indicators including the Acute Physiologic and Chronic Health Evaluation Score II, Sequential Organ Failure Assessment, and Modified Nutrition Risk in Critically scores calculated in the first day, the need for invasive mechanical ventilation, and if ventilated duration of invasive mechanical ventilation, intensive care units length of stay, comorbid conditions, and death rate were recorded. Results: Sixty (60%) patients were male. The median age was 66 (48-79) years. The patients with high Modified Nutrition Risk in Critically score were 26 (26%). Intensive care units length of stay was 19 (10-38) days. Acute Physiologic and Chronic Health Evaluation II score was 18 (11-24). Mortality rate was 39%. High Modified Nutrition Risk in Critically score group had higher Acute Physiologic and Chronic Health Evaluation II score, the necessity of invasive mechanical ventilation, length of stay in the critical care unit, and death rate as compared to low Modified Nutrition Risk in Critically score group (for all P > .05) and need of invasive mechanical ventilation and Modified Nutrition Risk in Critically score ≥ 5 were shown to have a remarkable influence on length of stay in the critical care unit. Conclusion: The need for invasive mechanical ventilation and Modified Nutrition Risk in Critically score ≥ 5 were shown to have remarkable influence on intensive care units length of stay.