Amaç: Çalışmamızın amacı, yoğun bakım ünitesinde solunumu mekanik ventilasyon ile sağlanan hastalarda, toplam gastrik kalıntı hacim miktarları ve iki farklı gastrik kalıntı hacmi eşiği ile gastrointestinal komplikasyon gelişimi arasında ilişki olup olmadığının tespiti, ikinci hedefimiz ise farklı gastrik kalıntı hacimlerinin, ventilatör ilişkili durumlar üzerindeki etkilerini belirlemektir. Metod: Çalışmaya en az 3 gün enteral beslenme planlanan, 18 yaşın üzerindeki 70 adet yetişkin hasta dahil edildi. Birinci gruptaki 35 hastada gastrik kalıntı hacmi eşiği 250 ml, ikinci grupta ise 500 ml olarak belirlendi. İzlem süresi boyunca, belirlenen her iki gastrik kalıntı hacmi eşiğinden herhangi birini aşmamış olan hastaların, 72 saat boyunca kaydedilen gastrik kalıntı hacimlerinin toplam miktarı hesaplandı. Tüm hastaların yüksek gastrik kalıntı hacim oranları, hedef kaloriye ulaşma süreleri, ortalama mide kalıntı hacim miktarları, abdominal distansiyon, kusma, diyare, ventilatör ilişkili durum ve enfeksiyona bağlı ventilatör ilişkili komplikasyon oranları gözlendi. Bulgular: Çalışmamızın sonunda, iki grup arasında yüksek gastrik kalıntı hacim oranları, belirlenen eşik değerini aşan yüksek gastrik kalıntı hacim oranları arasına, anlamlı bir fark oluşmasına rağmen (p<0.05), her iki grup arasında abdominal distansiyon, kusma, diyare, ventilatör ilişkili durum ve enfeksiyona bağlı ventilatör ilişkili komplikasyon açısından anlamlı bir fark yoktu. (p >0.05) Sonuç: Bu sonuçlar, enteral yolla beslenen yoğun bakım hastalarında, gastrointestinal motiliteyi ölçmek ve komplikasyon oranını azaltmak için gastrik kalıntı hacim miktarlarının ölçülmesinin gerekli olmadığı düşündürmektedir.

Introduction: Femoral Nerve Block (FNB) and Adductor Canal Block (ACB) methods, which are regional analgesic techniques, are successfully used in postoperative pain control after total knee arthroplasty. This study aimed to compare adductor canal block method that was preoperatively used and femoral nerve block method in total knee arthroplasty (TKA) patients who underwent spinal anesthesia in terms of factors effecting patient satisfaction and determine whether these methods were equally effective or not. Methods: A total of 80 patients between the ages of 60 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were prospectively included in this randomized study. Patients (n = 40) who received FNB were called Group FNB and patients (n = 40) who received Adductor Canal Block were called Group ACB. Results: Although mean postoperative VAS values were lower in FNB group only in the first hour (p = 0.02) there was no significant difference between the groups in the third, fifth, seventh, ninth, 12th and 24th hours (p≥0.05). Although Bromage scores were lower in FNB group in the first, second, third, fourth and fifth hours there was no statistically significant difference between the groups (p≥0.05). When mobilization time, patient satisfaction level, time of first analgesia, intraoperative sedation need, and recovery time of sensorial block were compared no statistically significant difference was found (p≥0.05). Discussion: When ACB and FNB that are used for postoperative analgesia in patients who undergo total knee arthroplasty are compared in terms of factors affecting patient satisfaction it is observed that they result in the same level (non-inferiority) of patient satisfaction. Conclusion: We recommend the routine use of ACB method with FNB in total knee arthroplasty. More studies focusing especially on measuring patient satisfaction are needed.

BACKGROUND: The most important cause of mortality due to long bone fractures in the elderly patients are femoral fractures that require total hip arthroplasty (THA). THA surgeries may cause severe postoperative pain, long hospital stays, a need for transfusion and mortality. OBJECTIVE: Compare outcomes of spinal anesthesia (SA) versus combined sciatic nerve/lumbar plexus block (CSLPB). DESIGN: Retrospective cohort trıal. SETTING: University hospital in Turkey. PATIENTS AND METHODS: We selected patients from the electronic medical records by date of surgery (most recent first) and compared demographic and pre- and postoperative clinical characteristics including the amount of opioid use within the first 48 postoperative hours, 30-day mortality rates, length of hospital stay, intraoperative oxygen saturation (SpO 2 ) and mean arterial pressure (MAP) values, duration of the surgery, and blood transfusion need. MAIN OUTCOME MEASURE: Opioid use within the first 48 postoperative hours. SAMPLE SIZE: 204, 102 patients in each group with overall median (IQR) age of 82 (10.2) years. RESULTS: There was no significant difference between the groups in terms of the amount of opioid use within the postoperative 48 hours, 30-day mortality rates, intensive care need, duration of the surgery, blood transfusion need, and length of hospital stay. While the intraoperative SpO 2 value was lower in the CSLPB group ( P =.03), MAP values were lower in the SA group ( P =.046). Preoperative American Society of Anesthesiology score (ASA) scores ( P =.039) and the number of comorbidities were higher in the CSLPB group. CONCLUSION: We prefer CSLPB used with standardized sedation protocols for anesthesia in THA surgery in elderly patients. LIMITATIONS: Retrospective design and single-centered. CONFLICT OF INTEREST: None.

This study aims to investigate the validity and reliability of the FS-ICU 24 survey in the Turkish language, to evaluate the satisfaction of ICU patients' relatives, and to determine the factors affecting satisfaction. Materials and Methods: In this study, the Turkish version was prepared based on the FS-ICU 24 survey applied to the relatives of ICU patients (Anesthesiology, Internal Medicine, General Surgery and Neurosurgery) at the Erciyes University in the Faculty of Medicine between April 2015 and June 2015. The Turkish version was tested and proven to be reliable and valid. Relatives of patients that were hospitalized for at least 48 hours, who had visited the patient at least once, were included. In this study, 369 surveys were completed. Results: FS-ICU 24 survey was found reliable and valid in Turkish. Patients' relatives were unsatisfied with physical conditions, waiting room setting and frequency of communication with nurses the most. The relatives were highly satisfied with the skills and competency of ICU doctors/nurses, setting of the ICU, completeness of treatment provided. Among the intensive care unit departments, there were not any statistically significantly different satisfaction results (p>0.05). The satisfaction level was found to decrease with increasing education levels and increasing duration of hospitalization (p<0.05). The satisfaction in the group who knew the diagnosis was higher (p<0.05). Conclusion: Even though the general satisfaction level of the patients' relatives was high, satisfaction level can be increased by improving physical factors, such as the waiting room setting, and by training on the communication skills of all staff that have contact with the patients' relatives on communication skills.