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.

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

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Background The interscalene brachial plexus block (ISBB) is an effective procedure for minimizing postoperative opioid consumption and pain following arthroscopic shoulder surgery. The ultrasound (US)‐guided supraclavicular brachial plexus block (SCBB) seems to be an alternative technique for arthroscopic shoulder surgery. However, evidence is lacking regarding the impact of SCBB on postoperative pain management and recovery after arthroscopic shoulder surgery. The aim of this study was to compare the effects of SCBB with ISBB in terms of postoperative pain and quality of recovery after arthroscopic shoulder surgery. Methods A total of 62 adult patients scheduled for arthroscopic shoulder surgery under general anesthesia were randomized into 2 groups to receive either ISBB (IB group, n = 31) or SCBB (SB group, n = 29) with 20 mL of 0.25% bupivacaine under US guidance. Assessments included postoperative pain scores, additional analgesic requirement, timing of the first analgesic requirement, Quality of Recovery‐40 (QoR‐40) scores, block characteristics, and side effects. Results No significant differences were found between the 2 groups for pain scores (P = 0.34), timing of first analgesic requirement (P = 0.30), additional analgesic requirement (P = 0.34), or QoR‐40 scores (P = 0.13). The block characteristics regarding procedure time (P = 0.95), block failure, and onset time of sensory blockade (P = 0.33) were similar. Horner's syndrome occurred in 8 patients in the IB group and 1 patient in the SB group (P = 0.015). Conclusions This study showed that US‐guided SCBB is as effective as ISBB in reducing postoperative pain and improving the quality of recovery for arthroscopic shoulder surgery.

ÖZET Amaç: Bu çalışma doğuma hazırlık eğitiminin, gebelerin depresyon riskleri ve prenatal bağlanma düzeylerine etkisini belirlemek amacıyla yapıldı. Gereç ve Yöntem: Tek grup ön test-son test tasarımlı yarı deneysel olarak planlanan çalışma, bir kamu hastanesinin doğuma hazırlık sınıfına başvuran 44 gebe ile yürütüldü. Verilerin toplanmasında Gebe Tanıtım Formu, Prenatal Bağlanma Envanteri (PBE), Beck Depresyon Envanteri (BDE) kullanıldı. Veriler araştırmacı tarafından karşılıklı görüşme yöntemi ile toplandı. Bulgular: Çalışmaya katılan kadınların yaş ortalaması 26,29±4,34, gebelik haftasının 30,47±3,00 ve gebelikte izlem sayısının 8,06±2,33 olduğu belirlendi. Gebelerin doğuma hazırlık sınıfına katılmadan önce BDE puan ortalaması 14,77±7,40, PBE puan ortalamasının 59,90±12,40 olduğu, eğitim sonrası ise BDE puan ortalaması 8,06±5,26 iken, PBE puan ortalamasının 71,88±8,25 olduğu belirlendi. Gebeliği planlı, çekirdek aile tipi olan ve çalışan kadınlarda prenatal bağlanmanın yüksek olduğu, multipar kadınlarda ise depresyon riskinin düşük olduğu saptandı. Sonuç: Doğuma hazırlık eğitiminin gebelerin depresyon riskini azalttığı ve anne-bebek bağlanma düzeyini artırdığı belirlendi. Anahtar Kelimeler: prenatal bağlanma, doğuma hazırlık eğitimi, depresyon, gebelik ABSTRACTObjective: This study is conducted to specify the effects of birth preperation training on the depression risk of pregnant women and their prenatal attachment levels. Material and Methods:This semi-experimental designed single group pretest-posttest study was conducted with 44 pregnant women attending the prenatal preparatory class of a public hospital. In the data collection process of the study, Pregnancy Presentation Form, Prenatal Attachment Inventory (PBI), Beck Depression Inventory (BDI) were used . The data were collected through interview method by the researchers. Results:The mean for the age of the participants is 26,29±4,34, for the mean of the participants gestational week is 30,47±3,00, for the gestational observation number is 8,06±2,33. The average BDI score before participating in the birth preparation class is is 14.77 ± 7,40, the mean PBI score is 59,90 ± 12,40. The mean BDI score of the participants after participating in the birth preparation class is 8.06 ± 5.26. The mean PBI score is 71,88 ± 8.25. Prenatal attachment was found high in women who were planned pregnant, nuclear family and working women and the risk of depression was found low in multiparous women. Conclusion:It has been observed that birth preperation training decreases the depression risk of the pregnant women and increased the level of mother-baby attachment.