BackgroundThe Quality of Recovery-40 questionnaire (QoR-40) is a self-rated questionnaire used to assess the postoperative recovery quality and health status of patients in the early stages following surgery; however, there is no Turkish version of the QoR-40. The aim of this study was to assess the reliability, validity, and responsiveness of the Turkish version of the QoR-40 (QoR-40 T).MethodsAfter the approval of the ethics committee, a total of 137 patients completed the questionnaire during the preoperative period, on the third day, and one month after surgery. The quality of life was evaluated by using a health-related quality of life questionnaire (Short-Form Health Survey-36; SF-36) on the third day and one month after surgery. Reliability, feasibility, and validity were assessed to validate the QoR-40 T.ResultsThe Cronbach’s alpha of the global QoR-40 T on the third day after surgery was 0.936. A positive moderate correlation was obtained between the physical comfort, emotional state, physical independence, and pain dimensions of the QoR-40 T and the physical component summary, mental health, physical functioning, and bodily pain subscales of the SF-36 on the third day after surgery, respectively (physical comfort - physical component summary, ρ = 0.292, p = 0.001; emotional state - mental health, ρ = 0.252, p = 0.003; physical independence - physical functioning, ρ = 0.340, p < 0.01; pain - bodily pain, ρ = 0.381, p < 0.01). The standardized responsive mean of the total QoR-40 T was 0.62.ConclusionsThe QoR-40 T showed satisfactory reliability and validity in evaluating the quality of recovery after surgery in the Turkish population.

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The aim of this study was to investigate the effect of the bispectral index (BIS) guided depth of anesthesia to inhibition of the oculocardiac reflex (OCR) during pediatric strabismus surgery. Patients between the ages of 3 and 16 years who were scheduled for elective strabismus surgery were randomly assigned to two groups. In Group 1 (n: 32), the BIS values of the patients were maintained at <50; in Group 2 (n: 28), the BIS values of the patients were maintained at levels greater than or equal to 50 with 4-7 % desflurane in a 50 % O-air mixture by titrating the concentration during the surgery. The heart rates, presence of dysrhythmia, anticholinergic drug usage and the type of the operated extra ocular muscle were recorded. The incidence of OCR was 25 % in Groups 1 and 64.3 % in Group 2, (p < 0.05). Moreover, the incidence of OCR in group 2 was higher in medial rectus (MR) traction (78.9 %) than in lateral rectus (LR) traction (33.3 %) (p = 0.035), with no significant difference in Group 1 between MR (21.1 %) and LR (26.7 %) tractions (p = 0.83). We found that the lower BIS values are associated with the lower incidence of OCR in pediatric patients undergoing strabismus surgery. And our findings confirmed that the deeper anesthesia has a protective effect against the OCR.

BackgroundThe optimal position for surgery is one in which the patient is provided the best possible surgical intervention and put at minimum risk. Different surgical positions may cause changes in tissue perfusion. This study investigates the relationship between surgical patient positions and perfusion index.MethodsA sample of 61 healthy individuals with no peripheral circulatory disorders, chronic diseases, or anemia was included in this study. Participants held six different positions: supine, prone, 45-degree sitting-supine, 45-degree supine with legs lifted, Trendelenburg (45-degrees head down), and reverse Trendelenburg (45-degrees head up). Perfusion index values were then measured and recorded after individuals held their positions for five minutes.ResultsParticipants’ perfusion index values were affected by different body positions (p < 0.05). Perfusion index was lowest in the sitting position (4.5 ± 2.5) and highest in individuals with Trendelenburg position (7.8 ± 3.8).ConclusionDifferent body positions can cause changes in tissue perfusion. This should be considered in patient follow-up along with the perfusion index.

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Evaluation of mean platelet volume and its ratio over platelet count in children with obstructive sleep apnea syndromeTıkayıcı uyku apne sendromu olan çocuklarda ortalama trombosit hacmi ve ortalama trombosit hacminin trombosit sayısına oranının değerlendirilmesi ABSTRACTObjectives: This study aims to determine the association between obstructive sleep apnea syndrome (OSAS) caused by adenotonsillar hypertrophy and mean platelet volume (MPV) and MPV/platelet count ratio in children, and to evaluate the impact of adenotonsillectomy on these two parameters. Patients and Methods:This prospective study consisted of 73 child patients (38 boys, 35 girls; mean age 8.6±3.3 years, range 2 to 17 years) with chronic adenotonsillar hypertrophy who applied to Gaziosmanpaşa University Faculty of Medicine, Ear, Nose and Throat policlinics due to witnessed apnea and snoring in January 2011 and January 2013. Also, 56 age and sex matched pediatric patients (28 boys, 26 girls; mean age 8.0±3.2 years; range 3 to 13 years) who admitted to our clinic due to reasons besides OSAS were included in the study as control group. Preoperative and postoperative third month hemoglobin, white blood cell, thrombocyte count, and MPV values of the patients were recorded. Results:Although ratio of MPV/platelet count was higher in patient group than in control group, the difference was not statistically significant. Mean platelet volume level was 7.68±1.07 fL in patient group and 7.21±0.84 fL in control group. Preoperative MPV level in patient group was significantly higher than that in control group (p<0.05). A statistically significant decrease was detected in postoperative third month MPV level and platelet count compared with preoperative MPV and platelet count (7.68±1.07 fL and 7.17±0.97 fL, respectively; p<0.05). Conclusion:High MPV and MPV/platelet count in children with adenotonsillar hypertrophy may be an important risk factor for cardiopulmonary and cerebrovascular morbidities which may develop both in childhood and in adulthood. Adenotonsillectomy may reduce this risk significantly.Keywords: Adenotonsillectomy; mean platelet volume; pediatric obstructive sleep apnea. ÖZAmaç: Bu çalışmada çocuklarda adenotonsiller hipertrofinin neden olduğu tıkayıcı uyku apne sendromu (TUAS) ile ortalama trombosit hacmi (OTH) ve OTH/trombosit sayısı oranı arasındaki ilişki belirlendi ve adenotonsillektominin bu iki parametre üzerindeki etkisi değerlendirildi. Hastalar ve Yöntemler: Bu prospektif çalışmaya Ocak 2011 -Ocak 2013 tarihleri arasında Gaziosmanpaşa Üniversitesi Tıp Fakültesi HastanesiKulak Burun Boğaz Polikliniği'ne tanıklı apne ve horlama nedeni ile başvuran, kronik adenotonsiller hipertrofisi olan 73 çocuk hasta (38 erkek, 35 kız; ort. yaş 8.6±3.3 yıl; dağılım 2-17 yıl) dahil edildi. Ayrıca kliniğimize TUAS dışı nedenlerle başvuran, yaş ve cinsiyet uyumlu 56 çocuk hasta (28 erkek, 26 kız; ort. yaş 8.0±3.2 yıl; dağılım 3-13 yıl) kontrol grubu olarak çalışmaya alındı. Hastaların ameliyat öncesinde ve ameliyat sonrası üçüncü ayda hemoglobin, beyaz...

Objective: Postoperative cognitive dysfunction (POCD) is common after anaesthesia in elderly patients. However, it may appear in patients of all ages. The main pathogenesis of cognitive dysfunction remains unclear, although there is some evidence that brain inflammation may alter cognitive abilities. In the present study, we aim to evaluate short-term and long-term effects of dexamethasone on cognitive dysfunction induced by sevoflurane anaesthesia in adult rats.Methods: Seven-month-old 30 male Wistar albino rats were randomised into three groups: sevoflurane group (exposure to sevoflurane), sevoflurane + dexamethasone group (exposure to sevoflurane and dexamethasone injection), and control group (exposure to 100% oxygen). Spatial learning and short-term (7 days after exposure) and long-term (30 days after exposure) memory were evaluated using Morris water maze test.Results: Sevoflurane induced significant deficit in spatial learning and short-term and long-term memory in adult rats. Dexamethasone-treated animals exposed to sevoflurane had equivalent performance as control animals in training and probe trials. Conclusion:Sevoflurane may impair spatial learning and short-term and long-term memories in adult rats. The co-administration of dexamethasone and sevoflurane may ameliorate short-term and long-term cognitive dysfunctions induced by sevoflurane in adult rats. Keywords: Sevoflurane, dexamethasone, cognitive disordersAmaç: Postoperatif kognitif disfonksiyon (POKD) yaşlı hastalarda anestezi sonrası sık olmaktadır. Ancak POKD tüm yaşlarda da görü-lebilmektedir. Kognitif disfonksiyonun temel patogenezi tam olarak bilinmemekle birlikte beyin inflamasyonunun bilişsel yetenekleri değiştirebildiğine dair bazı kanıtlar bulunmaktadır. Bu çalışmada, erişkin farelerde sevofluran anestezisi ile oluşturulmuş kognitif disfonksiyon üzerine deksametazonun erken ve geç dönem etkilerini araştırmayı amaçladık.Yöntemler: Yedi aylık 30 erkek wistar albino rat üç gruba ayrıldı; grup sevofluran (sevofluran anestezisine maruziyet), grup sevofluran+deksametazon (sevofluran anestezisiyle birlikte deksametazon enjeksiyonuna maruziyet) ve grup kontrol (%100 oksijene maruziyet). Uzaysal öğrenme, erken (maruziyetten 7 gün sonra) ve geç (maruziyetten 30 gün sonra) dönem hafıza Morris su labirenti testi ile değerlendirildi. Bulgular: Sevofluran anestezisi erişkin ratlarda uzaysal öğrenme, erken ve geç dönem hafıza üzerinde anlamlı derecede olumsuz etki oluşturdu. Deksametazon ile tedavi edilmiş ratlar ise eğitim ve araş-tırma testlerinde kontrol grubuna benzer bir performans gösterdi.Sonuç: Sevofluran erişkin ratlarda uzaysal öğrenmeyi, erken ve geç dönem hafızayı olumsuz etkileyebilir. Sevofluran anestezisi ile birlikte deksametazon uygulanması erişkin ratlarda sevofluran ile oluş-turulmuş erken ve geç dönem kognitif disfonksiyonu iyileştirebilir.Anahtar sözcükler: Sevofluran, deksametazon, biliş bozuklukları Abstract / Öz

There was a positive correlation between venipuncture pain and PCS score. Consequently, the venipuncture pain score could be useful in informing practitioners about a patient's pain considerations.