Objectives Stroke is an important cause of mortality and morbidity in surgery. In the present study, we examined the cerebral oximetry values of patients with carotid artery stenosis who did not present surgical indications and those who did not present carotid artery stenosis in coronary artery bypass grafting (CABG) surgery by comparing their cerebral oximetry values with cerebrovascular disease (CVD). Methods Between January and May 2014, 40 patients who underwent isolated CABG were included in the study. Cerebral oximetry probes were placed prior to induction of anesthesia. Cerebral oximetry values were recorded before induction, in the pump (cardiopulmonary bypass) inlet period, in the post-clamp period, in the pump outlet period, and in the intensive care unit and neurological complications. Results There was no difference between the groups in terms of demographic data and routine follow-up parameters. Intraoperative surgical data and early postoperative results were similar in both groups. When comparing the groups, there were no statistically significant results in cerebral oximetry values and CVD development. Only one patient in group 2 had postoperative CVD and this patient was discharged from the hospital with right hemiplegia. Mean arterial pressure (MAP)levels were significantly higher in Group 2 ( P <0.05). Conclusion The follow-up of cerebral perfusion with a method like near-infrared spectroscopy (NIRS) will ensure that MAP is adjusted with interventions that will be made according to changes in NIRS. Thus, it will be possible to avoid unnecessary medication and flow-rate increase with cerebral oxygen saturation (rSO 2 ) follow-up.
The aim of this study was to measure the level of preoperative anxiety in patients scheduled for coronary artery bypass grafting (CABG) to assess the relationship between anxiety and postoperative symptoms. Materials and Methods. This descriptive study was conducted at a single university hospital from February to November 2021. Seventy-four CABG patients who completed the Anxiety Specific to Surgery Questionnaire, the Visual Analogue Scale, the Modified Borg Scale, the Rhodes Index of Nausea, Vomiting and Retching were included in the study. The data were analyzed by the mean, standard deviation, frequency distribution, Mann-Whitney U Test, and Spearman’s correlation analysis. Results. The average age of participants was 65.55 ± 8.35; 66.2% of them were males. The ASSQ total scores of female participants were significantly higher as compared to male participants (p < 0.05). There was a statistically significant positive relationship between the levels of anxiety in patients before CABG and the levels of postoperative pain and dyspnea severity (p < 0.05). Conclusions. Patients were found to experience predominantly moderate to severe anxiety before CABG, and increased dyspnea complaints and pain in the postoperative period. A coordinated, multidisciplinary approach to preoperative training of healthcare professionals may offer a promising way to provide more efficient and productive services.
Background and Aims. Tympanosclerosis (TS) is a scarring process that may occur during otitis media. Aortic stiffness (AS) is a significant predictor for the development of heart diseases due to its close relationship with atherosclerosis. Similar pathophysiological processes based on inflammation may explain both TS and AS formation. This study aimed to determine echocardiographically whether aortic elasticity is impaired in TS-detected patients and to correlate blood inflammatory parameters with TS and aortic elasticity. Methods. Ninety-eight participants diagnosed with chronic otitis media were enrolled in the study. TS-detected 42 participants were assigned to the study group, while 56 without TS constituted the control group. The two groups' demographic, clinical, echocardiographic, and laboratory characteristics were comparable. Results. Demographic, clinical, and laboratory parameter differences were insignificant. Hs-CRP, neutrophil-to-lymphocyte ratio, and systemic immune-inflammation index were significantly higher in the study group than in the control group (P=0.018, P=0.003, P=0.019, respectively). The study group had significantly lower aortic strain (11.80 ± 4.84 vs. 16.30 ± 3.91; P<0.001) and distensibility (5.23 ± 2.68 vs. 7.24 ± 2.89; P=0.001) values than the control group. The AS index was significantly higher in the study group than in the control group (4.81 ± 2.41 vs. 3.12 ± 1.02; P<0.001). Conclusion.In TS-detected patients, AS parameters were found to be impaired. Aortic elasticity parameters measured by echocardiography, a non-invasive and easily accessible method, may signify early cardiovascular involvement in TS-developed patients.
Background: Neurological complications of coronary artery bypass surgery are still the major causes of mortality and morbidity despite all advances in this field. Aims and Objectives: We investigated the effect of bispectral index (BIS) monitoring of the patient consciousness on the postoperative neurocognitive functions in our study. Materials and Methods: A total of 40 patients in the age range from 25 to 75 years were included in our study, who were electively operated for isolated coronary artery bypass grafting (CABG) surgery in the period from January 2014 to June 2014. The patients were assigned to two groups based on whether BIS monitoring was performed or not. The patients were consecutively allocated to either group when they were found eligible to be included based on the exclusion criteria. Administration of the anesthesia was monitored with BIS in the respective group (Group 1). All patient follow-up parameters were compared in both groups. Neurocognitive function tests (the clock drawing test and standardized mini mental test) were administered to the patients in the preoperative and postoperative period(1 st day and day before discharge). The results were compared. Results: There were no significant findings in the demographic features and the routine follow-up parameters between the two groups. The time of extubation, intensive care unit (ICU) follow-up parameters, and the length of stay in the ICU were not significantly different between the groups; however, the length of stay at the hospital was significantly longer in the group of patients, who were not monitored with BIS (p<0.05). The mean arterial blood pressure was statistically significantly higher in group 1 (BIS monitoring) at all phases of the operation and during the postoperative follow-ups. A significant acidosis was present in the arterial blood pressure tests of the patients in group 1 during their stay at the ICU. The Po2 values following cross-clamping and extubation were significantly higher in group 1. In the group monitored with BIS, the results of the neurocognitive tests, which were the clock drawing test and the standardized mini mental test, were both clinically and statistically superior (p<0.05). Conclusıons: BIS monitoring provides favorable contributions for the follow-up of the patients undergoing CABG surgery and it is helpful in estimating the consciousness state of the patients after the surgery.
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