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    Efficacy of bilateral ultrasonography-guided transversus abdominis plane block after laparoscopic sleeve gastrectomy: Prospective, randomized, controlled study
    (TULPAR Academic Publishing, 2023) Alver, Selçuk; Umutoğlu, Tarık; Sümer, İsmail; Ülgen Zengin, Senniye; Topuz, Ufuk; Bakan, Mefkur; İdin, Kadir; Bozkurt, Süleyman; Salihoğlu, Ziya
    Aim: Transversus Abdominis Plan (TAP) block is an interfascial plane block, commonly used as an analgesic technique in abdominal surgeries. The aim of this study is to investigate the postoperative analgesic efficacy of bilateral ultrasonography (US) guided TAP block in patients scheduled for laparoscopic sleeve gastrectomy. Method: In this randomized prospective study; 48 patients, 18-65 years, ASA I-II, morbidly obese (BMI>35), underwent laparoscopic sleeve gastrectomy were included. The patients randomized into two groups: TAP block Group (group TAP) and Control Group (group C). At the end of the operation, bilateral TAP block were performed to 24 patients in Group TAP with a total 40 ml of local solution. 20 ml of local solution was injected into the trocar incision lines of all patients. Patient-controlled analgesia was administered to all patients at a dose of 5 mg/ml tramadol. Tramadol consumption, visual analogue scores (VAS) and the need of rescue analgesia (paracetamol) of the patients at postoperative first 24th hours were recorded. Results: There is no statistical difference in terms of demographic data. Total tramadol consumption and VAS were significantly higher in the Group C (p<0.01). No complications were found in either group. Conclusions: US-guided TAP block provides effective analgesia in patients underwent laparoscopic sleeve gastrectomy surgery
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    Prospective evaluation of remifentanil-propofol mixture for total intravenous anesthesia: A randomized controlled study
    (Spandidos Publications, 2021) Bakan, Mefkur; Umutoğlu, Tarık; Topuz, Ufuk; Yılmaz Güler, Emine; Uysal, Harun; Öztürk, Erdoğan
    Application of total intravenous anesthesia (TIVA) may be considered as unpractical when compared with inhalational anesthesia. Although it is mostly not recommended, mixing intravenous agents is popular in clinical practice. The aim of the present study was to investigate the suitability of using remifentanil-propofol mixture (MIXTIVA) for TIVA. Adult patients with an American Society of Anesthesiologists grade of I-II scheduled for elective thyroidectomy were randomly allocated to 3 groups (n=32 for each) to receive TIVA with remifentanil and propofol infusions separately (control group, Group I) or with MIXTIVA infusion that contained remifentanil/propofol at a proportion of 2/1,000 or 3/1,000 (remifentanil concentration, 20 or 30 mu g/ml in 1% propofol in Group II or Group III, respectively). The extubation time (the primary outcome of the study), the orientation time and number of patients in whom intraoperative hypotension, hypertension or bradycardia episodes were encountered during anesthesia were comparable among the groups. The mean remifentanil infusion rate in Group III was significantly higher than that in the other groups. The mean propofol infusion rates and mean bispectral index (BIS) scores during anesthesia were comparable among groups. Hypotension accompanied with a high BIS was encountered in one patient in Group III. In conclusion, compared to the standard TIVA technique using separate drug infusions, MIXTIVA infusion used for thyroidectomies did not result in any statistically significant difference in recovery and clinical outcomes. This technique may be considered as a practical implementation for busy ambulatory centers performing general anesthesia.