Objectives. The aim of the study was to compare adductor canal block and femoral nerve block in the postoperative analgesia of patients undergoing elective arthroscopic knee surgery with respect to opioid use and Visual Analogue Scale (VAS), which is a unidimensional measurement of pain intensity. Methods. The study was designed and conducted prospectively between April 2016 and November 2016 in a tertiary care hospital but the results were evaluated retrospectively. Prior to the induction of general anesthesia for knee surgery, (the first) 20 consecutive patients underwent femoral nerve block, and (the second) 20 consecutive patients received adductor canal block. Patients receiving adductor canal block for analgesia were referred to as Group A and patients receiving femoral nerve block for analgesia were defined as Group F. Pain was evaluated using the VAS score.The results were compared statistically. Results. Both the femoral nerve block and adductor canal block groups showed similar results in terms of VAS and opioid use (p < 0.05). Conclusion. In the postoperative analgesia of patients undergoing elective arthroscopic knee surgery, no difference was found between adductor canal block and femoral nerve block in terms of opioid use and VAS scores.Eur Res J 2018

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Background and Aims: During the coronavirus disease 2019 (COVID-19) pandemic, health care workers are at a high risk of infection from aerosols. In this study, we compared the ease of using the aerosol box (AB) with the traditional method during internal jugular vein cannulation attempts (IJVCA). Methods: The study included 40 patients with COVID-19 who required central venous catheterisation during treatment in the ward. The patients were randomly allocated to one of the two protective equipment (PPE) groups and then randomly assigned to one of the five anaesthesiologists with at least 5 years of experience. Group P and A had both PPE and AB used, whereas Group P included patients where PPE was used alone. The physicians completed a survey after performing the procedure to evaluate the use of the AB. Results: The preparation for the procedure and procedure durations were observed to be statistically longer in Group P and A ( P = 0.002 and P = 0.001, respectively). The first attempt in Group P and A was unsuccessful in six patients, whereas the first attempt in Group P was unsuccessful in only two patients ( P = 0.235). Anaesthesiologists described difficulty with manipulation during the procedure, discomfort using the box, and resulting cognitive load increase in Group P and A. Conclusion: The IJVCA procedures were faster and easier and had greater satisfaction for physicians when the AB was not used. Also, the high complication rate, including carotid artery punctures and disruption of sterility and PPE, albeit not statistically significant, has clinical implications. Therefore, we do not recommend the use of ABs for IJVCA.

Amaç: Obezite cerrahisinde, epidural analjezi ve transversus abdominal plan (TAP) blok ile yapılan multimodal ağrı yönetimi postoperatif etkili bir analjezi sağlayarak, opioidlerin kullanım sıklığını azaltır ve opioid kullanımına bağlı oluşan yan etkileri en aza indirir. Fakat obez hastalarda hem epidural hem de TAP bloğunu uygulamak teknik olarak zordur, bazen imkansızdır. TAP bloğunun laparoskopik olarak yapılması bu teknik zorluğa bir çözüm olabilir. Bu çalışmada laparoskopik sleeve gastrektomide laparoskopik TAP bloğunun teknik başarısı ve etkinliği değerlendirildi. Yöntemler: Bu çalışma prospektif olarak randomize, çift kör ve plasebo kontrollü olarak dizayn edildi. Laparoskopik sleeve gastrektomi (LSG) uygulanan hastalarda iki taraflı petit ve subkostal alana 30 cc bupivakain (Grup M) veya salin (Grup S) TAP infiltrasyonu uygulandı. Çalışmaya 165 hasta dahil edildi. Tüm hastalara postoperatif hasta kontrollü analjezi cihazı uygulandı ve postoperatif 1. ve 8. saatlerde iv tenoxicam 20 mg IV uygulandı. Çalışmaya katılan bütün hastaların; analjezik gereksinimi, ortalama ağrı skoru, vital parametreleri ve bulantı, kusma durumları postoeratif 1., 6. ve 24. saatte objektif bir gözlemci tarafından kayıt edildi. Bulgular: Yaş, vücüt kitle indeksi, ortalama ameliyat süresi, cinsiyet açısından gruplar arasında fark saptanmadı (p>0,05). Görsel analog ölçeği skoru değerlendirildiğinde, kontrol grubunda (Grup S) 1., 6. ve 24. saatlerin ortalama puanları, Grup S'den istatistiksel olarak anlamlı derecede yüksek bulundu (p=0,009, p=0,002). Sonuç: Morbid obez hastalarda multimodal analjezi kullanılarak opioid ilişkili yan ekilerin azalması dikkat çekicidir. Bu çalışmada, LSG operasyonlarında laparoskopik TAP bloğun yüksek oranda başarı ile uygulanabileceği ve postoperatif opioid tüketimini azalttığı gösterilmiştir.