To investigate the effects of low-flow anesthesia on hemodynamic parameters and recovery from anesthesia in obese individuals undergoing laparoscopic surgery. Methods: This randomized-controlled and prospective study included 44 obese patients who underwent laparoscopic sleeve gastrectomy operation. The patients were randomly allocated into 2 groups as low-flow and high-flow anesthesia. Further, the groups compared in terms of hemodynamic parameters, anesthesia recovery times, operation times, and arterial blood gas parameters. Results: The groups were similar with respect to demographic data. Heart rate, peripheral oxygen saturation, arterial blood pressure measurements, endtidal, and CO 2 , lactate levels measurements were similar Original Article in both groups during the entire procedure. There was also no statistically significant difference in terms of arterial blood gas parameters or anesthesia recovery periods. Conclusion: Low-flow anesthesia in laparoscopic obesity surgery seems to be safer compared to high-flow anesthesia in terms of the adequacy of tissue perfusion, depth of anesthesia, and postoperative recovery.
Objective: Inadequate pain management after laparoscopic cholecystectomy is an important problem that can lead to complications and negatively affect the patient’s recovery. Transversus abdominis plane block can contribute to postoperative analgesia in abdominal surgeries. The aim of this study is to investigate the effects of preoperative unilateral or bilateral transversus abdominis plane block on perioperative analgesia in patients underwent laparoscopic cholecystectomy and its contribution to patient comfort. Methods: A total of 75 patients were randomized into 3 groups as Group-1 (n=25) without unblocking, Group-2 (n=25) with unilateral block and Group-3 (n=25) with bilateral block. Block was applied to Group 2 and Group 3 under general anesthesia before surgery. Demographic characteristics of patients, intraoperative opioid consumption, postoperative 30 min, 2, 4, 8, 12 and 24 hours VAS rest-VAS cough scores, analgesic consumption in patient controlled analgesia, postoperative additional analgesic requirement, side effects, mobilization times and patient satisfaction were recorded. Results: The dose of remifentanil consumed intraoperatively was significantly lower in Group-3. VAS values were significantly different among the groups until the 12th hour postoperatively. The VAS rest and VAS cough values were lower in the Group 3. There was a significant difference among the groups in the patient-controlled analgesia devices when the bolus dose demand/given amounts and the total amount of drugs requested/consumed were compared. Total drug consumption was determined in the highest Group-1 and the lowest in Group-3. The satisfaction scores of the patients in group-3 were higher than the other groups. Conclusion: Our study showed that transversus abdominis plane block application in laparoscopic cholecystectomy surgeries contributed to decreased perioperative analgesic consumption and lower VAS scores up to 12 hours. Transversus abdominis plane block, which was performed with laparoscopic cholecystectomy in the preoperative period, has been shown to be an effective analgesic method.
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