Browsing by Author "Güneş, H.Y."

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Intraoperative Repair of Pilot Balloon Inflation Line Damage: A Practical Solution to Tube Replacement
(Yuzuncu Yil Universitesi Tip Fakultesi, 2025) Güneş, H.Y.; Aydın, A.
Intraoperative damage to the pilot balloon inflation line of an endotracheal tube (ETT) can result in cuff deflation, leading to ineffective ventilation and increased aspiration risk. This case report describes a practical repair technique that allowed continued saf e ventilation without tube replacement. A 70-year-old woman underwent elective coronary artery bypass grafting. During central venous catheter placement, the anesthesia machine displayed low etCO₂ and ventilator failure alarms. Diminished bilateral breath sounds were noted, and the pilot balloon was found severed. As the patient's hemodynamics remained stable, a 20G intravenous catheter steel needle t ip was inserted directly into the inflation line, carefully positioned to avoid further damage. The cuff was reinflated using a syringe, and appropriate pressure was maintained with a three-way stopcock and cuff manometer. The air leak resolved, and surgery proceeded without requiring tube exchange. Pilot balloon damage can be safely managed intraoperatively using readily available equipment. This practical approach may serve as a valuable alternative to endotracheal tube replacement, especially in cases involving a difficult airw ay. Familiarity with such repair methods can enhance airway safety during surgery.
Retrospective Evaluation of Anesthesia Methods in Pediatric Orthopedic Surgery: A Single-Center Study of 1468 Patients
(Yuzuncu Yil Universitesi Tip Fakultesi, 2025) Keleş, M.Ş.; Kurt, N.; Yüzkat, N.; Soyalp, C.; Keskin, M.E.; Güneş, H.Y.
Introduction: This study aimed to evaluate the distribution of anesthesia methods and complication rates in pediatric patients aged 0–18 years who underwent orthopedic surgery at the Department of Anesthesiology and Reanimation, Van Yuzuncu Yil University Facult y of Medicine, between 2019 and 2021. Materials and Methods: The study was designed as a retrospective, cross-sectional, and descriptive study. A total of 1468 pediatric patients aged 0–18 years classified as ASA I–II who underwent orthopedic surgery were included. Patient data including age, sex, type of surgery, anesthesia method applied, and anesthesia-related complications were recorded and analyzed. Results: Of the 1468 patients included in the study, general anesthesia was administered to 70.8%, peripheral nerve blocks to 16%, and spinal anesthesia to 12.6%. A significant increase was observed in the rates of general and spinal anesthesia in 2021, while the rate of peripheral nerve blocks decreased. The most common complication was tachycardia, observed at a rate of 3.5% in 2019. Complication rates decreased significantly in subsequent years. Conclusion: General anesthesia remains the most preferred method in pediatric orthopedic surgeries. However, regional anesthesia techniques are increasingly used and demonstrate safety. These findings suggest that regional techniq ues can be effectively and widely applied in pediatric populations with appropriate patient selection. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Ultrasound-Guided Erector Spinae Plane Block Versus Intravenous Patient-Controlled Analgesia in Percutaneous Nephrolithotomy
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Kaçar, C.; Güneş, H.Y.; Keskin, M.E.
Intravenous patient-controlled analgesia is frequently used to optimize postoperative analgesia in many surgeries. In recently, ultrasound-guided erector spinae plane block has begun to be widely used. Does ease of application, fewer complications and providing effective analgesia with a single injection make it more advantageous in postoperative pain management? The aim of this study is to compare the postoperative analgesic efficacy of the ultrasound-guided erector spinae plane block with that of the intravenous patient-controlled analgesia in percutaneous nephrolithotomy surgery. Sixty participants selected for elective percutaneous nephrolithotomy were included in this study. The patients were randomized into two groups using a closed-envelope method. An ultrasound-guided erector spinae plane block was applied with 20 mL of the local anesthetic mixture at the T-7 level in group erector spinae plane block. In the PCA group a loading dose of 50 mg tramadol was administered 10 minutes before extubation. Following the extubation, patient-controlled analgesia was initiated with a 20 mg bolus, a 30minute lockout period, with a 4hour tramadol limit of 200 mg, and a basal infusion rate of 5 mg/hour. Demographic data and ASA scores of the groups were similar. In the erector spinae plane block group, VAS scores, and analgesic requirement were significantly lower, and patient satisfaction were higher in the first 6hours postoperatively. However, in the PCA group, VAS score and analgesic requirement were lower than group ESP at the 12th hour postoperatively. Erector spinae plane block block and iv PCA are effective in PNL surgery. We believe that the erector spinae plane block performed under USG guidance is more effective and advantageous in the first 6 hours. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.