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    Comparison of ultrasound-guided lumbar erector spinae plane block and transmuscular quadratus lumborum block for postoperative analgesia in hip and proximal femur surgery: A prospective randomized feasibility study
    (National Center for Biotechnology Information Search database, 2018) Tulgar, Serkan; Köse, Halil Cihan; Selvi, Onur; Şentürk, Özgür; Thomas, David Terence; Ermiş, Mehmet Nurullah; Özer, Zeliha
    Study Objective: Lumbar Erector spinae Plane block (L?ESPB) is a modification of a recently described block. Both L?ESPB and Transmuscular Quadratus Lumborum block (QLB?T) have been reported to provide effective postoperative analgesia in hip and proximal femur surgery. Herein, we compare the effectiveness of L?ESPB and QLB?T in providing postoperative analgesia in patients undergoing hip and femur operations. Design: Double?blinded, prospective, randomized, feasibility study. Setting: Tertiary university hospital, postoperative recovery room and ward. Methodology: A total of 72 patients (American Society of Anesthesiology physical status classification II?III) were recruited. After exclusion, 60 patients were allocated to three equal groups (control, L?ESB and QLB?t). Interventions: Standard multimodal analgesia was performed in the control group while L?ESPB or QLB?T was performed in the block groups. Measurements: Pain intensity between groups was compared using Numeric Rating Scores. Furthermore, tramadol consumption and additional rescue analgesic requirement was measured. Results: There was no difference between demographic data or type of surgery. While there was no difference in Numeric Rating Scale (NRS) score at any hour between the block groups; NRS scores at the 1st, 3rd and 6th h, tramadol consumption during the first 12 h and total tramadol consumption, the number of patient required rescue analgesic in 24 h were significantly higher in the control group compared to both block groups. Conclusion: While L?ESPB and QLB?T have similar effect, they improve analgesia quality in patients undergoing hip and proximal femoral surgery when compared to standard intravenous analgesia regimen.
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    How does the Exponential Increase in Rocuronium Dose Effect the Train of Four Parameters in Rats Reversed with Sugammadex? An Animal Model
    (Galenos Publ House, 2023) Köse, Halil Cihan; Kose, Selin Güven; Aydın, Serdar Onur; Kuzucuoğlu, Tamer; Tasargol, Omer; Tulgar, Serkan
    BACKGROUND/AIMS: Sugammadex is a gamma cyclodextrin structured agent used for reversing the effect of steroidal neuromuscular blocking (NMB) agents. The first aim of this study was to evaluate the dose of rocuronium required to re-establish NMB when administered 2 min after its reversal with sugammadex in rats. Also, to monitor the onset times and durations of NMB achieved by variable doses of rocuronium after reversal with sugammadex.MATERIALS AND METHODS: Thirty-five Sprague-Dawley rats were randomly divided into groups including control and four experimental groups. The control group was designed to determine the onset time and duration of NMB induced by 1.2 mg/kg rocuronium. In the control group, no sugammadex was applied. In the experimental groups, rocuronium (1.2 mg/kg) was reversed with sugammadex (4 mg/kg). Subsequently, experimental groups were administered various doses of rocuronium. Groups were named according to the rocuronium dose administered (group 2.4, group 3.6, group 4.8 and group 6.0). Rats in all groups were monitored with train of four.RESULTS: In group 2.4, rocuronium did not ensure NMB. In group 3.6, NMB occurredin only 3 rats. All rats in groups 4.8 and 6.0 achieved complete NMB. There was no statistically significant difference in the onset time of NMB in 4.8 and 6.0 groups (p<0.05). The mean duration of NMB in the experimental groups was significantly shorter than that in the control group (p<0.01).CONCLUSION: Sufficient muscle relaxation and intubation conditions could be achieved with 3.6 mg/kg, 4.8 mg/kg, and 6.0 mg/kg doses of rocuronium as short as 2 min after sugammadex.