Person: AKESEN, SELCAN
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AKESEN
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SELCAN
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Publication High-dose short-course oral corticosteroid protocol for treatment of primary frozen shoulder: A retrospective cohort study(Sage Publications Ltd, 2021-07-01) Atıcı, Teoman; Ermutlu, Cenk; Akesen, Selcan; Özyalçın, Ali; ATICI, TEOMAN; ERMUTLU, CENK; AKESEN, SELCAN; ÖZYALÇIN, ALİ; Uludağ Üniversitesi/Tıp Fakültesi/Travmatoloji Anabilim Dalı; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Yoğun Bakım Bölümü; 0000-0002-3396-3407; AEQ-5464-2022; A-5095-2018; ELR-9087-2022; FPA-5997-2022Objective To evaluate the effect of high-dose prednisolone on the functional outcome of patients with early-stage primary frozen shoulder. Methods Eighteen patients treated with oral prednisolone at an initial dose of 1 mg/kg/day for primary frozen shoulder were retrospectively evaluated. The patients' range of motion, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant-Murley score, American Shoulder and Elbow Surgeons (ASES) score, and visual analog scale score were recorded at baseline and at 4 weeks and 6 months after treatment. Results Rapid recovery of shoulder motion was noted at 4 weeks with the exception of abduction, which was maintained at 6 months. Significant improvement in pain perception and the Constant-Murley score was evident at 4 weeks and extended to 6 months. The DASH and ASES scores did not show significant improvement in the first 4 weeks but were significantly improved at 6 months. Conclusion High-dose oral prednisolone treatment provides rapid symptom resolution that persists long after drug discontinuation. The early treatment period is characterized by marked reduction in pain and rapid recovery of shoulder motion. Improvements in functional outcomes and disability indices tend to be more subtle in the early period but significantly improve during late treatment.Publication Evaluation of titanium release from titanium alloy implants in patients with spinal instrumentation(Sage Publications Ltd, 2021-01-01) Ulusaloğlu, Armağan Can; Atıcı, Teoman; Ermutlu, Cenk; Akesen, Selcan; ATICI, TEOMAN; ERMUTLU, CENK; AKESEN, SELCAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Yoğun Bakım Anabilim Dalı; 0000-0002-3396-3407; AEQ-5464-2022; A-5095-2018; ELR-9087-2022ObjectiveThis study was performed to investigate the baseline serum titanium levels in patients with short-segment titanium alloy posterior instrumentation and to assess patient-, implant-, and surgery-related factors that might affect the serum titanium level.MethodTwo groups of patients were included in the study. The study group comprised 39 patients who had undergone short-segment posterior instrumentation from January 2013 to June 2016. The control group comprised 11 randomly selected patients who presented to the outpatient clinic with no history of orthopedic surgery. The serum titanium levels and inter-group differences were analyzed.ResultsThe mean serum titanium level was significantly higher in the study group than in the control group. No significant difference was observed between patients with different etiologies, implants used for fusion, numbers of instrumented segments, or postoperative durations.ConclusionThe serum titanium levels of patients with posterior lumbar spinal instrumentation are significantly higher than those of the normal population even after achievement of solid fusion. These levels are not affected by the use of transverse connectors, the use of cages, the operated segments, or the duration of implants.Publication Which frequency is better for pediatric shock wave lithotripsy? Intermediate or low: A prospective randomized study(Springer, 2021-04-22) Kaygısız, Onur; Çiçek, Mehmet Çağatay; Mert, Ahmet; Akesen, Selcan; Sarandöl, Emre; Kılıçarslan, Hakan; KAYGISIZ, ONUR; ÇİÇEK, MEHMET ÇAĞATAY; AKESEN, SELCAN; SARANDÖL, EMRE; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0002-9790-7295; 0000-0002-0471-5404; 0000-0003-4236-3646; 0000-0002-2593-7196; L-9439-2019; HGM-5995-2022; ELR-9087-2022; DXM-3644-2022; FGY-3115-2022Purpose Shock wave lithotripsy (SWL) is the first option in the treatment of pediatric kidney stones; however, optimal frequency is still uncertain. The aim of this study was to compare low frequency [60 shocks per minute (SWs/min)] and intermediate frequency [90 SWs/min] in terms of lithotripsy success, complications, cardiac arrhythmia, anesthesia time, secondary procedures, and efficiency quotient (EQ) in children. Methods Seventy-eight consecutive children who received SWL for radiopaque renal stones between July 2016 and January 2020 were randomly divided into two groups: Group 60 (SWL frequency: 60 SWs/min) and Group 90 (SWL frequency: 90 SWs/min). After exclusion (remaining 71 children), Group 60 (n = 38) and Group 90 (n = 33) were compared using univariate analysis. Results The median age of children (37 girls, 34 boys) was 5 (1-16) years. Patient demographics and stone features were similar between the groups. Success rate after the last SWL session was 81.6% (n = 31) for Group 60 and 87.9% (n = 29) for Group 90 (p = 0.527). Stone-free rate after the first, second, and third sessions was 42.1%, 18.4%, and 21.1% for Group 60 and 48.5%, 27.3%, and 12.1% for Group 90, respectively. Additional treatment rate was similar between the groups. In Group 60, the EQ was 57.83, and it was 64.07 in Group 90. Median total anesthesia time was significantly longer in Group 60 (74.5 min) than in Group 90 (32 min; p < 0.001). Conclusion Intermediate frequency and low-frequency pediatric SWL have similar success rates; however, intermediate-frequency SWL has a shorter anesthesia time.Publication Comparison of efficacy between the genicular nerve block and the popliteal artery and the capsule of the posterior knee (IPACK) block for total knee replacement surgery: A prospective randomized controlled study(Türkiye Ortopedi Travmatoloji, 2021-03-01) Akesen, Selcan; Akesen, Burak; Atıcı, Teoman; Gurbet, Alp; Ermutlu, Cenk; Özyalçın, Ali; AKESEN, SELCAN; AKESEN, BURAK; ATICI, TEOMAN; GURBET, ALP; ERMUTLU, CENK; ÖZYALÇIN, ALİ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı; 0000-0002-3396-3407; 0000-0002-6503-8232; JHR-5447-2023; AEQ-5464-2022; ELR-9087-2022; AAH-9833-2021; A-5095-2018; A-7994-2018Objective: The aim of this study was to compare the efficacy of popliteal artery and the capsule of the posterior knee (IPACK) block and genicular nerve block on postoperative pain scores, the need for rescue analgesics, range of motion (ROM), walking distance, and perioperative monitorization variables in patients undergoing total knee replacement (TKR) surgery.Methods: Sixty American Society of Anesthesiologists (ASA) physical status I-III patients were enrolled in this study and then were randomly assigned into three groups: the IPACK block group (17 female, 3 male; mean age=67.5 +/- 1.4 years), genicular nerve block (16 female, 4 male; mean age=68 +/- 1.76 years), and the control group (13 female, 7 male; mean age=63 +/- 1.67years). All the patients underwent TKR under spinal anesthesia. The visual analog scale (VAS) score, mobility, pre- and intra-operative monitorization of systolic and diastolic holding area, non-invasive blood pressure, heart rate, and SPO 2 were compared between the groups.Results: Patients in the IPACK and genicular block groups had a significantly lower visual analogous scale (VAS) at postoperative 4 hours (p<0.01), 8h (p<0.01), 12h (p<0.01), and 24h (p<0.05). VAS score was significantly lower in the genicular block group at the postoperative 4h (5.5 +/- 0.55) and 8h (5.0 +/- 0.53) in the mobile state compared to the IPACK (8.0 +/- 0.47 and 8.0 +/- 0.43, respectively) and the control group (9.5 +/- 0.20; 10 +/- 0.28, respectively) (p<0.01). The use of patient-controlled-analgesia (PCA) devices and button push count for analgesics demand were significantly lower in the genicular block group on the immediate postoperative period (p<0.01 at the postoperative 0 to 4 h). The total consumption of morphine equivalents on the postoperative day 0 was significantly lower in the genicular block group (p<0.01, and p<0.001 for IPACK and control groups, respectively). The degree of flexion was significantly higher in the genicular block group at the postoperative 12h compared to the IPACK and the control group (p<0.001). The length of hospital stay was significantly lower in the genicular block group compared to the IPACK and the control group (p<0.05 for both variables).Conclusion: IPACK and genicular blocks both are effective in improving patient comfort during and after TKR surgery and reducing the potential need for systemic analgesic and opioids. The genicular block seems to be a promising technique that can offer improved pain management in the immediate and early postoperative period without adverse effects on systemic and motor variables.Publication Comparison of intra- and postoperative effectiveness of erector spinae plane block and patient controlled analgesia in patients undergoing coronary artery bypass grafting surgery(E-century Publishing Corp, 2022-01-01) Ogur, Lale; Akesen, Selcan; Goren, Suna; Kan, Irem Iris; Mogol, Elif Basagan; Gurbet, Alp; Akesen, Selcan; AKESEN, SELCAN; Goren, Suna; GÖREN, SUNA; Kan, Irem Iris; KAN, İREM İRİS; Mogol, Elif Basagan; MOĞOL, ELİF; Gurbet, Alp; GURBET, ALP; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimason Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisihi Anabilim Dalı.; 0000-0002-6503-8232; A-7994-2018The aim of our study was to compare bilateral erector spinae plane block (ESPB) efficacy on pain management with patient controlled analgesia (PCA) during the perioperative period in patients scheduled for coronary artery bypass grafting (CABG). After ethics committee approval (2019-7/31 dated 09.04.2019) from the Bursa Uludag University Medical Trials Ethics Committee, (https://uludag.edu.tr/buuetikkurulu) ASA 50 patients aged between 18-80 years were included. They were randomly divided into two groups, ESPB (n=25) and control (n=25). In the preoperative period, bilateral ESPB with ultrasonography was applied to both groups with 0.25% bupivacaine (0.5 ml/kg) + dexamethasone (8 mg) or saline, respectively. PCA prepared with morphine was given to all patients postoperatively. Perioperative opioid use, extubation times, coughing/resting Visual Analog Scale (VAS) scores, duration for first PCA bolus dose requirement, rescue analgesia needs, mobilization times, and opioid side effects were evaluated. In the ESPB group, compared to the control group, intraoperative fentanyl consumption was lower (P=0.001). During the postoperative period; extubation time was shorter, the need for initial PCA was much later, morphine consumption and need for rescue analgesia was less (P=0.001; P<0.001; P<0.001; P=0.009, respectively). The postoperative VAS scores were lower for each measurement period (P<0.05). Opioid-related side effects were more common in the control group (P=0.040). First mobilization time in ESPB group was earlier (P<0.001). As a result, ESPB has a significant analgesic effect in CABG patients. It was concluded that bilateral ESPB reduces opioid requirement compared to intravenous morphine PCA alone and provides better pain management and more comfortable recovery.Publication The effect of combined pulsed radiofrequency treatment to dorsal root ganglion with transforaminal epidural steroid injection on pain(Kare Publ, 2021-01-10) Çalışkan, Duygu Karaköse; Akesen, Selcan; Türker, Yunus Gürkan; Gurbet, Alp; AKESEN, SELCAN; TÜRKER, YUNUS GÜRKAN; GURBET, ALP; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; 0000-0002-3019-581X; 0000-0002-6503-8232; 0000-0002-9518-541X; AAI-6642-2021; A-7994-2018; ELR-9087-2022Objectives: We aimed to compare the treatment response with simultaneous application of transforaminal epidural steroid injection (TESI) and pulsed radiofrequency (PRF) to the lumbar dorsal root ganglion (DRG) with TESI in patients with chronic lumbar radicular pain.Methods: A total of 129 patients were enrolled. TESI was performed to 67 patients and TESI+DRG-PRF was performed to 62 patients. Demographic data, surgical records, and medications, side, and level of the procedure were recorded. Patients were evaluated on the pre-operative and post-operative 10th day, 1st and 3rd month follow-up visits, and visual analog scale (VAS, 0-10) scores, and patients' satisfaction assessment on the 3rd month follow-up were collected. A successful therapeutic response was defined as a 50% or more reduction in VAS scores.Results: In both groups, post-operative VAS scores were significantly lower than the pre-operative levels (p<0.001). VAS scores in the TESI+DRG-PRF group were significantly lower than the TESI group at all follow-up periods (p<0.001). Reduction ratios in VAS scores were significantly higher in the TESI+DRG-PRF group in all follow-up visits (p<-0.001). Satisfaction levels were significantly higher in the TESI+DRG-PRF group (p<0.01).Conclusion: According to our study, TESI provides short-moderate pain relief in patients with chronic lumbar radicular pain. A simultaneous application of PRF in the same session with TESI should be considered as an option to improve the treatment response.Publication Retrospective investigation of difficult airway cases encountered in Bursa Uludağ University Medical Faculty operating room(AVES, 2023-04) Alemdar, Didem; Akesen, Selcan; Bilgin, Hülya; AKESEN, SELCAN; BİLGİN, HÜLYA; Uludağ Üniverstesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı; 0000-0001-7332-5568; ELR-9087-2022; R-8285-2017Objective: Ensuring airway patency and proper management of ventilation by anticipating difficulties that can occur in airway control are vital in prevent-ing anaesthesia-related complications. We aimed to determine the role of preoperative assessment findings in difficult airway management.Methods: In this study, critical incident records of difficult airway patients between 2010 and 2020 in the operat-ing room of Bursa Uludag. University Medical Faculty were retrospectively analysed. A total of 613 patients, whose records were fully accessible, were grouped as paediatric (under 18 years old) and adult (18 years and over).Results: The success rate for maintaining an airway in all patients was 98.7%. Pathological situations which cause difficult airways were head and neck region malignancies in adult patients and congenital syndromes in pae-diatric patients. Anatomical reasons that cause difficult airway were anterior larynx (31.1%) and short muscular neck (29.7%) in adult patients and small chin (38.0%) in paediatric patients. A significant statistical relationship was found between difficult mask ventilation and increased body mass index, male gender, modified Mallampati class 3-4, and thyromental distance <6 cm (P =.001, P <.001, P <.001, and P <.001, respec-tively). The correlation of Cormack-Lehane grading with modified Mallampati classification, upper lip bite test, and mouth opening distance was statistically significant (P <.001, P <.001, and P <.001, respectively).Conclusion: In male patients with increased body mass index, modified Mallampati test class of 3-4 and thyromental distance of <6 cm should suggest the possibility of difficult mask ventilation. In modified Mallampati classification and upper lip bite tests, the possibility of difficult laryngoscopy should be considered as class increases and mouth opening distance becomes shorter. Preoperative assessment, including a good history taken from the patient and a complete physical examination, is crucial to provide solutions for difficult airway management.