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    End-tidal carbon dioxide levels under surgical drapes during local eye surgery: Retrospective study
    (Kuwait Medical Assoc, 2022) Yorulmaz, Ilknur Suidiye; Esbah, Ali Umit; Ozlu, Onur; Teberik, Kuddusi; Sozer, Muhammet Uzeyir; Kaya, Murat
    Objectives: To investigate the end tidal carbon dioxide pressure values in order to determine carbon dioxide accumulation under surgical drapes and it's hemodynamic effects based on anesthetic and surgical records in eye surgeries under local anesthesia Design: Retrospective study Setting: Department of Anesthesiology and Reanimation, Duzce Medical Faculty, Duzce, Turkey Subject: The data were collected from anesthetic records of patients (n=42) who were followed with noninvasive capnography in the operating room at Duzce University Hospital during the period of January 2016 to December 2016. Systolic, diastolic and mean arterial pressure, operation time, heart rate, ST segment analysis, ETCO2 pressure, pulse oximetry values were recorded. Time periods were determined as: after the anesthesia and before drape closure (baseline level), at 10th, 15th, 20th, 45th of the surgery and 5 minutes after drape removal. Intervention: Non-interventional Main outcome measure: Carbon dioxide accumulation under drapes and it's hemodynamic effects in eye surgeries under local anesthesia. Results: The comparisons were made with basal status and time periods statistically. No differences were found between mean arterial pressures, heart rates, arrhythmias and pulse oximetry values of patients between time periods. We observed significant differences for ETCO2 levels between basal and the other time periods, except when the drapes were removed (P=0.001). Conclusion: Routine monitorisation of ETCO2 with noninvasive capnography provides early detection of CO2 accumulation and CO2 rich air breathing during ophthalmic surgery.
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    Intensive Care Practice during COVID-19 Pandemia in Duzce University
    (Duzce Univ, 2020) Akbas, Turkay; Esbah, Ali Umit
    Nearly 5% of patients with COVID-19 need intensive care unit (ICU) admission due to the severity of disease progress. These patients generally have pneumonia induced acute respiratory disease syndrome (ARDS) and mostly need invasive mechanic ventilation. ARDS is a specific disease state that needs a long and complex treatment period. Since critical patients with COVID-19 have high viral loads and require a long therapy period, the risk of disease transmission from patients to medical staffs is high. Therefore, healthcare personnel should wear personal protective equipment (gloves, respirators, full bodysuits, bonnet, safety glasses, and full shield in the case of contact with airway) during the invasive procedures and therapies. In this article, we wanted to share our own experience of caring for critically ill patients with COVID-19-pandemia.
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    Type and Level of Anxiety Affects the Perception of Pain During Bone Marrow Biopsy
    (Duzce Univ, 2021) Onec, Birgul; Onec, Kursad; Esbah, Ali Umit; Esbah, Onur
    Objective: Bone marrow aspiration and biopsy (BMAB) is an essential tool for diagnosis of hematological disorders. The most frequent complaint after BMAB is pain but the severity of this pain is described very different among patients. We investigated factors predicting this pain focusing on the role of state and trait anxiety. Methods: One hundred and ten adult patients undergoing BMAB, were informed adequately and assessed with The State-Trait Anxiety Inventory (STAI) before the procedure. In this Likert-type inventory, State Anxiety Scale evaluates the current state of anxiety, asking how respondents feel at that moment. The Trait Anxiety Scale evaluates relatively stable aspects of anxiety proneness, including general states of confidence, calmness, and security. After the biopsy, pain was measured with visual analog scale. Results: Most of the patients (71.8%) described mild pain but moderate to severe pain were significantly more frequent in both high state and trait anxiety groups. Pain severity had a positive but weak correlation with trait anxiety but not with state anxiety. The described pain level was associated with older age but was not with indication of biopsy, performance status, comorbidities or previous BMAB experiences. Conclusions: Results of our study made us thought that a good communication with the patient and talking about possible outcomes days before procedure might play a role reducing his or her anxiety but because age and trait anxiety cannot be changed by using fast acting anxiolytic drugs, advantage of premedication with anxiolytics in order of reducing pain, would be limited.