Alper Ozbakkaloglu

The Turkish Validity and Reliability of the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms Scales:

The aim of the study was to test Turkish validity and reliability of Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) in patients with chronic venous insufficiency (CVI). A total of 118 patients with CVI hospitalized in 3 different hospitals were enrolled in this study. VEINES-QoL/Sym, translated to Turkish with a standard methodology, was applied to the patients and was evaluated for acceptability, reliability, validity, and responsiveness. Cronbach α (including if item deleted) values were used for the reliability analysis. Construct and criterion validity approaches were used for validity analysis. Cronbach α values are .86 for the VEINES-QOL and .81 for the VEINES-Sym. No problematic items were observed for the scale. The VEINES-QoL/Sym was significantly sensitive to clinical, etiology, anatomy, and pathophysiology (CEAP) classification, indicating good criterion validity. Significant correlation was found between scores of SF-36 and VEINESQoL (r = .43-.66). Turkish version of the VEINES-QOL/Sym was found reliable and valid for Turkish patients with CVI.

The Efficacy of Femoral Block and Unilateral Spinal Anaesthesia on Analgesia, Haemodynamics and Mobilization in Patients undergoing Endovenous Ablation in the Lower Extremity.

OBJECTIVE This study aimed to investigate the efficacy of femoral block and unilateral spinal anaesthesia on analgesia, haemodynamics and mobilization during endovenous ablation in patients with lower extremity venous insufficiency. METHODS Forty patients of ASA physical status I and II, with ages ranging between 30 and 45 years, and who were scheduled for endovenous laser ablation for varicose veins were prospectively enrolled in this study. Patients were randomized into a unilateral spinal anaesthesia group (group HS, n=20) or a femoral block group (group F, n=20). Group HS received 7.5-10 mg of heavy bupivacaine for unilateral spinal anaesthesia, while group F received 100 mg prilocaine for femoral block with ultrasound guidance. The level of motor blockage (Bromage score), visual pain score, mean heart rate and mean arterial pressures were recorded at postoperative 0, 1, 2, 3d and 6 h, respectively. RESULTS Perioperative visual pain score values in both groups were <4. None of the groups required an additional analgesic agent. Bromage scores were significantly lower in group F than in group HS during the postoperative period (p<0.01). Motor function returned to normal in all patients at 3 h in group F and at 6 h in group HS. Postoperative mean heart rate and arterial pressure did not differ between the groups (p>0.05). CONCLUSION In patients with lower extremity venous insufficiency who were undergoing endovenous laser ablation, an ultrasound-guided femoral block provided similar analgesia with that of unilateral spinal anaesthesia. In group F, the duration of anaesthesia and mobilization time was shorter.

Bentall Operation in a Patient With Severe Hemophilia A and Marfan Syndrome by Use of a Biologic Composite Graft

We describe a patient with severe hemophilia A and Marfan syndrome who underwent an elective Bentall operation. Because of the severe hemophilia, anticoagulation could not be given postoperatively; thus, a biologic Valsalva conduit graft was used. During the procedure, factor VIII was given as a bolus dose just before incision, then by continous infusion intraoperatively to maintain the factor VIII activity level between 200% and 300%. Minimal postoperative bleeding occurred. The infusion was continued postoperatively at a lower dose until all chest tubes, pacing wires, and invasive catheters were removed. The patient was discharged on postoperative day 7 without adverse events.

Thromboelastogram reduces blood use by inspecting coagulation in heart surgery

Objective Blood transfusion after coronary artery bypass surgery is carried out according to general coagulation tests and blood counts. Our aim was to determine the effects of rotational thromboelastography results on the amount of blood products used in the intraoperative and postoperative periods in coronary artery bypass patients. Methods Our study included 164 patients who underwent coronary artery bypass. A control group was formed from 82 patients picked from hospital records, who had elective coronary artery bypass before the introduction of rotational thromboelastography in our clinic. Blood transfusion was performed in this group according to conventional laboratory data. The study group comprised 82 patients who had elective coronary artery bypass after the introduction of rotational thromboelastography. Blood transfusion was performed in the study group according to rotational thromboelastogram results. The amounts of blood products used in the 2 groups were compared. Results There were statistically significant decreases in the intraoperative and postoperative amounts of packed red blood cells (p = 0.012 and p = 0.006) and postoperative whole blood (p = 0.013) used in the study group compared to the control group. Postoperative bleeding was also significantly reduced (p = 0.001) in the study group. Conclusion Blood transfusion is an important issue after coronary artery bypass, and because of the decreased amount of blood products used, a rotational thromboelastography-based blood transfusion algorithm should be applied in patients undergoing coronary artery bypass.