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Yayın The effect of smoking on neutrophil/lymphocyte and platelet/lymphocyte ratio and platelet indices: a retrospective study(VERDUCI PUBLISHER, 2016) Tulgar, Y. K.; Cakar, S.; Tulgar, S.; Dalkilic, O.; Cakiroglu, B.; Uyanik, B. S.OBJECTIVE: Smoking commonly leads to death. Although the neutrophil/lymphocyte Ratio, platelet/lymphocyte ratio and platelet indices have been shown to be important for the diagnosis, prognosis and severity of some diseases, the smoking status of patients in these studies has not been well defined. In this study, we compared ratios derived from complete blood count and platelet indices to smoking status and length in smokers and non-smokers. PATIENTS AND METHODS: The data of healthy males and females aged between 18-60 years who presented to our institute for a routine checkup were collected, and subjects were divided in two groups-smokers and non-smokers. The presence of medical history or laboratory results which could affect inflammatory response, formed our exclusion criteria. All complete blood count results were noted and persons' smoking habits were calculated as pack/years. RESULTS: White blood cell, neutrophil, basophil and eosinophil counts; mean corpuscular volume, red cell distribution width and neutrophil/lymphocyte ratio were significantly higher in smokers when compared to non-smokers (p<0.05). When smokers were grouped according to smoking habits; positive linear correlations were detected between pack/year and Neutrophil/lymphocyte ratio and also pack/year and plateletcrit in smokers (p<0.05). CONCLUSIONS: Neutrophil/lymphocyte ratio increases in correlation with pack/year while platelet/lymphocyte ratio is not affected and platelet distribution width is increased in smokers. If smokers are not excluded from studies evaluating neutrophil/lymphocyte ratio and platelet distribution width, the relationship between smoking status as well as pack/year must be determined and reported.Yayın Evaluation of ultrasound-guided bilateral low thoracic erector spinae plane block for postoperative analgesia in cesarean delivery patients: a prospective, randomized, controlled clinical trial(Elsevier Editora Ltda, 2022) Aygun, H.; Ozturk, N.K.; Ugur, M.; Aydin, Y.; Celik, G.I.; Thomas, D.T.; Tulgar, S.Background: Erector spinae plane block (ESPB) is a recently described block. In many reports, ESPB has been reported to provide effective postoperative analgesia in patients undergoing cesarean delivery (CD). Herein, we compared the effectiveness of ESPB and control group in postoperative analgesia in patients undergoing CD under spinal anesthesia. Methods: This assessor-blinded, prospective, randomized, efficiency study was conducted in the postoperative recovery room and ward at a tertiary university hospital. Eighty-six patients ASA II–III were recruited. Following exclusion, 80 patients were randomized into two equal groups (block and control group). Standard multimodal analgesia was performed in the control group while ESPB block was performed in the intervention (ESPB) group. Opioid consumption was measured and pain intensity between groups was compared using Numeric Rating Scores (NRS). Results: NRS was lower in Group ESPB at 3rd and 6th hours. There was no difference between NRS scores at other hours. Opioid consumption was lower in Group ESPB. Conclusion: When added to multimodal analgesia, bilateral ultrasound guided low thoracic ESPB leads to improve the quality of analgesia in the first 24 hours in patients undergoing CD. © 2021 Sociedade Brasileira de AnestesiologiaYayın Lumbar erector spinae plane block: A miracle or self-persuasion?(BMJ Publishing Group, 2021) Tulgar, S.; Ahiskalioglu, A.; Aydin, M.E.; Jadon, A.; Forero, M.; Gürkan, Y.[No abstract available]Yayın Ultrasound guided erector spinae plane block as a cause of unintended motor block(ELSEVIER SCIENCE BV, 2018) Selvi, O.; Tulgar, S.Erector spinae plane block (ESPB) as postoperative analgesia method has been successfully carried out in several surgical interventions. Postoperative pain treatment for cesarean section is considered one of the important challenges for anesthesiologists due to the risk of chronic pain development and even pospartum depression. Regional anesthesia techniques were effectively used to prevent the pain together with multimodal analgesia regimes in cesarean section. Formerly, successful erector spinae plane block was documented as postoperative analgesia treatment for cesarean section; however, no motor weakness was recorded as a side effect. In this case report, we present an unexpected motor weakness as a side effect of the erector spinae plane block after cesarean delivery operation in a 29 year old patient. To our knowledge, this is the first report of motor weakness related to the ESPB. (C) 2018 Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica del Dolor. Published by Elsevier Espana, S.L.U. All rights reserved.Yayın Use of quips survey for the assessment of quality in postoperative pain management(Anestezi Dergisi, 2016) Ozütemiz, M.; Selvi, O.; Tulgar, S.; Özer, Z.Objective: Although there are guidelines and advanced pain management techniques, quality of postoperative pain management can not still be measured with a standard method considering safety issues. Many factors like nausea, vomiting, functional disability and immobility have an effect on the achivement of postoperative pain therapy. QUIPS is a survey which takes all these factors into account. In this study we tried to evaluate the quality of postoperative pain management by using QUIPS. Method: This study was conducted on 400 volunteers who were planned for surgical operation between 07.2014 - 01.2015 at Maltepe University Medical Faculty Hospital. QUIPS was applied to these patients the day after the surgery Results: Fifty-four percent (n:216) of the patients were women and 46% (n:184) of them were men. These patients were asked about their pain level in questions 3 and 4. The highest scores for pain were recorded in neurosurgery and orthopedics. In the fifth question patients were asked to answer whether they had immobility problems due to pain and the highest scores were in neurosurgery patients (p<0.01). The most satisfied patients with their pain theraphy were in ENT group. Conclusion: The fact that focusing on only pain revealing therapies are not adequate while approaching towards postoperative pain was the main motivation in preaparation of QUIPS. Beacuse of this fact QUIPS can be used as a useful tool to evaluate pain, pain related symptoms and quality of postoperative pain management.
