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    The effect of early tranexamic acid administration on hemoglobin levels after unstablepelvic fracture: An experimental study in rats
    (2021) Kaya, Yasin Emre; Arikan, Emre; Özturan, Kutay Engin; Değirmenci, Erdem; Ayanoğlu, Tacettin; Yis, Özgür Mehmet
    Aim: To investigate the effect of early systemic tranexamic acid (TRA) administration on hemoglobin (Hb)levels in rats with pelvic fracture. Method: In our study, 30 Wistar Albino rats were randomly divided into 3 groups in equal numbers and theirhemoglobin levels were measured by taking blood samples from each. No trauma was applied to the first groupand it was taken as the main control group of the study. Closed bilateral unstable pelvic fractures were createdin all rats in groups 2 and 3. Fracture creation time is considered as minute 0. 10 minutes after the fracture was formed, TRA was given to the 1st group, TRA to the 2nd group and saline solution to the 3rd groupsystemically. Hemoglobin levels were measured by taking blood samples from all rats at 30th minute and 24thhour. The initial Hb values obtained were normalized to 100 and the percentages of 30th minute and 24th hourvalues were calculated. The initial, 30th minute and 24th hour values of all groups were compared statisticallywith each other. The 30th minute and 24th hour values were compared statistically between the groups. Results: No death was observed within 24 hours in all three groups. When the first Hb values of each groupare normalized to 100, the mean Hb percentages were calculated in the first group as 99.54 and 99.84 at 30minutes and 24 hour, respectively; 92.95 and 87.73 in the second group; and 87.95 and 73.16 in the third group.When these values obtained were compared statistically within the groups (initial, 30th minute, 24th hour Hb percentages), there was no significant difference between the initial, 30th minute and 24th hour values in group1. However, a statistically significant difference was found between the initial, 30th minute and 24th hourvalues in group 2 and 3 (p<0.01). In the comparison between the groups, a statistically significant differencewas found between group 1-2, group 1-3 and group 2-3 between both 30th minute and 24th hour values(p<0.01). Conclusion: In rats with bilateral unstable pelvic fractures due to blunt pelvis trauma, early administration ofTRA after trauma significantly reduced the first 24-hour decrease in Hb value. Our study supports the earlyand prehospital use of TRA in traumas that are predicted to progress with acute bleeding, such as unstablepelvic fractures.
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    Lymphocyte-to-Monocyte Ratio is a Good Marker of Adhesive Capsulitis in Rotator Cuff Tears
    (2023) Çelik, Ilhan; Çelik, Hümeyra; Ayanoğlu, Tacettin; Arikan, Emre; Kayiş, Seyit Ali
    Purpose: The aim of the study is to evaluate the prediction of adhe - sive capsulitis in the preoperative period of rotator cuff tear (RCT) by neutrophil-lymphocyte (NLR), platelet-lymphocyte (PLR), neutro- phil-monocyte (NMR), lymphocyte-monocyte (LMR) ratios. Methods: This study was designed as a retrospective case-control study. After ethical approval, preoperative hemogram and biochemis- try data of 128 patients who were operated on for RCT were collect- ed from the archive of hospitale. Among the patients who underwent arthroscopy due to RCT, those with signs of adhesive capsulitis in the intraoperative period were included in the RCT+Adhesive capsulitis group. Age, blood glucose, CRP, sedimentation, white blood cell, neu- trophil, monocytes, lymphocytes, platelets, fasting blood glucose, he- moglobin and hematocrit values, and NLR, PLR, NMR, and LMR ratios were compared between healthy control and RCT+Adhesive capsulitis. Logistic regression analysis of the ratios was also performed. Results: A total of 64 healthy RCT (group 1) and 64 patients with RCT+Adhesive capsulitis (group 2) were included in the study. Fasting blood glucose, lymphocyte, CRP values, and NMR and LMR were found to be higher in patients with adhesive capsulitis (p<0.05); and mono - cyte, NLR and PLR were found to be lower in group 2 compared to group 1 (p<0.05). According to ROC analysis, it was revealed that LMR was the best predictor of adhesive capsulitis in RCT. Conclusion: It has been demonstrated that the inflammation rate LMR obtained from the hemogram, which is an easy, low-cost, and repro- ducible method, is a variable that predicts adhesive capsulitis in RCT.
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    PCA-pump for analgesia following pediatric scoliosis surgery: bolus administration with/without basal infusion
    (Springer, 2024) Isik, Cengiz; Demirhan, Abdullah; Ayanoglu, Tacettin; Arikan, Emre
    Objectives The aim of this study is to compare the use of two different opioid delivery systems (bolus PCA with/without basal infusion) to control postoperative pain and evaluate the side effect profile in pediatric patients undergoing scoliosis surgery. Patients and methods 38 patients who underwent posterior spinal fusion for adolescent idiopathic scoliosis were included in the study. Patients were randomly divided into 2 groups by the computer. Patients who received only bolus PCA were named Group 1, and patients who received bolus PCA with basal infusion were named Group 2.Morphine consumption, postoperative pain assessmentduring rest, movement and coughing with numeric rating scale (NRS) and the Wong -Baker pain scale, heart rate and average blood pressure, sedation levels withRamsey sedation scale and side effects such as nausea, vomiting, itching, desaturation, and urinary retention were recorded. Results Total mean morphine consumption (mg) was 32.7 +/- 9.7 in Group 1 and 43.4 +/- 9.1 in Group 2. The mean morphine consumption (mg) at 12-24 hours and 0-48 hours in Group 1 was statistically lower than Group 2 (p = 0.001). There was no significant difference between the groups in terms of median NRS scores (p = 0.55). There was no statistically significant difference in the evaluation of the groups in terms of Wong-Baker pain scale. Wong-Baker pain scale is p:0.66 at the 2nd hour, p:0.951 at the 12th hour and p:0.467 at the 24th hour.There was no statistically significant difference in Ramsay Sedation Scale evaluation between groups during each follow-up time (p > 0.05). The Ramsay Sedation Scale was p: 0.94 at the 2nd hour, p:1.0 at the 12th hour, and p:1.0 at the 24th hour. The duration of vomiting between 0-2 h, 2-24 h and 0-48 h was higher in Group 2 (p = 0.001, p = 0.024, p = 0.001). Conclusion The two administration settings of morphine sulphate by PCA pump have shown to be equally effective in the treatment of postoperative pain following PSF. In addition, PCA with basal infusion administration causes more opioid consumption and more systemic side effects. Therefore, the use of only bolus PCA in pediatric scoliosis surgery should be encouraged. Level of evidenceLevel II, Randomized Controlled Trial.