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İnterskalen brakiyal pleksus blok uygulamalarında ultrason ve sinir stimülatörü tekniklerinin etkinliklerinin karşılaştırılmasıThe comparison of the effectiveness of the ultrasound and peripheral nerve stimulating techniques during interscalen block AbstractThere are potential advantages and disadvantages during ultrasonographic and peripheral nerve stimulating techniques in interscalen plexus blockade. In this study, we aimed to compare the sensory and motor blockade onset time and the duration of postoperative analgesic requirement during interscalen blockade performed with ultrasound and peripheral nerve stimulating techniques. Sixty patients in ASA (American Society of Anesthesiologysts) 1-2 groups were accepted in this prospective and double blind study for the shoulder surgery. Twenty-five ml 0.5% Levobupivacaine was administered to each patient group. The sensory blockade was evaluated with Pinprick test and the motor blockade was evaluated with the Bromage Scale. The duration of the sensorial and the motor blockade and the duration of postoperative first analgesic requirement were noted. The demographic data were similar between the groups. The onset time of sensorial and the motor blockades in group U was significantly shorter than in group S and the first analgesic requirement time in group U was significantly longer than in group S. During the interscalen blockade performed with ultrasound and peripheral nerve stimulator, it was observed that the sensorial and motor blockade was developed faster and the duration of first analgesic requirement was longer with ultrasound technique. Furthermore, it was determined that postoperative patient comfort score was more satisfied by ultrasound technique.

Objective: This study aims to compare the effectiveness of non-invasive pressure of transcutaneous CO 2 (PtcCO 2 ) and O 2 (PtcO 2 ) analyzers versus conventional blood gas sampling in patients with sepsis and septic shock. Materials and Methods: Sepsis patients without a need for inotrope support (sepsis) were prospectively enrolled to group 1 (n=50), whereas group 2 (n=50) was composed of patients needing inotropes (septic shock). Demographic data, laboratory tests, Acute Physiology and Chronic Health Evaluation-II (APACHE-II) and Sequential Organ Failure Assessment (SOFA) scores, standard monitoring data, data of blood gas analysis (pH, PaCO 2 , PaO 2 , and SaO 2 ), and transcutaneous CO 2 and O 2 were collected at the first, second, third, and fourth hours. Results: No significant difference was noted between the groups in terms of demographic parameters, baseline white blood cell, hematocrit, baseline heart rate, central venous pressure, respiratory rate, and positive end-expiratory pressure values. Group 2 had significantly higher serum urea and creatinine levels and lower albumin levels and mean arterial pressure, whereas group 1 had significantly lower APACHE-II and SOFA scores and peak inspiratory pressure and FiO 2 . No significant difference was noted between the PtcCO 2 and PaCO 2 values in group 1, whereas the PtcCO 2 values of group 2 were significantly lower than PaCO 2 . PtcO 2 and PaO 2 values were significantly lower in group 1, whereas PtcO 2 vs PaO 2 values were significantly lower in group 2. A strong correlation was noted between arterial and transcutaneous CO 2 and O 2 values in both the groups. Conclusion: PtcCO 2 assessment may be an alternative method in patients with sepsis but not in septic shock. PtcO 2 measurement may not be a reliable method for patients with sepsis and septic shock. Keywords: Sepsis, septic shock, ICU, transcutaneous CO 2 , transcutaneous O 2 , arterial blood gas analysis ÖZ Amaç: Sepsisli ve septik şoklu hastalarda non-invaziv transkutanöz parsiyel CO 2 (PtcCO 2 ) ve O 2 (PtcO 2 ) basıncı analizörlerininin etkinliğini geleneksel kan arter kan gazı analizi ile karşılaştırmayı amaçladık. Gereç ve Yöntem: Sepsis 3 tanı kriterlerine göre "sepsis" tanısı alan hastalar grup 1'e (n=50), "septik şok" tanısı alan hastalar grup 2'ye (n=50) ayrıldı. Demografik veriler, laboratuvar testleri, Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi-II (APACHE-II) ve Ardışık Organ Yetersizliği Değerlendirme (SOFA) skorları, 1., 2., 3., ve 4. saatlerdeki standart monitorizasyon verileri, kan gazı analizi verileri (pH, PaCO 2 , PaO 2 , SaO 2 ) ve transkutanöz CO 2 ve O 2 değerleri kaydedildi. Bulgular: Gruplar arasında demografik parametreler, başlangıç beyaz küre, hematokrit, kalp hızı, santral venöz basınç, solunum sayısı ve pozitif ekspirasyon-sonu basınç değerleri açısından anlamlı bir fark bulunamadı. Grup 2'de serum üre ve kreatinin seviyeleri belirgin olarak yüksekken, albümin seviyeleri, ortalama arteriyel basınç daha düşüktü. APACHE-II ve SOFA skorları, tepe inspiratuar basınç ve...