Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Jan 2020
Randomized Controlled TrialThe effects of early femoral nerve block intervention on preoperative pain management and incidence of postoperative delirium geriatric patients undergoing trochanteric femur fracture surgery: A randomized controlled trial.
Hip fracture is a common clinical problem which causes severe pain in geriatric patients. However, severe pain following fracture may bring on mental disorders and delirium. A neuroinflammatory response with IL-6 and IL-8 has been shown to be associated with the pathophysiology of delirium. In this study, our primary hypothesis is that preoperative femoral nerve block (FNB) intervention in geriatric patients will more effectively attenuate pain following trochanteric femur fracture than the preoperative paracetamol application. Our secondary hypothesis is that interleukin levels (IL-6, IL-8) in cerebrospinal fluid (CSF) will be lower in the femoral nerve block group than the paracetamol group. Our tertiary hypothesis is that the incidence of postoperative delirium will be lower in the femoral nerve block group. ⋯ The femoral nerve block was more effective in preoperative pain management of trochanteric femur fracture and preventing pain during regional anesthesia application. The mean IL-8 level was lower in the femoral nerve block group when compared to the paracetamol group. There is no difference in the postoperative delirium incidence between groups.
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Ulus Travma Acil Cer · Jan 2020
ReviewUpper extremity replantation results in our series and review of replantation indications.
Upper extremity amputations are usually not life-threatening, but they negatively affect the life quality of the victim. In addition to the functional disabilities of upper extremity amputation, disfigurements frequently cause psychological and social debilitations. ⋯ Despite the availability of prostheses, cadaveric upper extremity replantations, replantation of the native extremity is still the most appropriate treatment for amputated cases. However, surgeons should realize that the ultimate goal is not merely to save the viability of the extremity through replantation, but rather to preserve the life quality by improving the function.
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Ulus Travma Acil Cer · Jan 2020
Randomized Controlled Trial Comparative StudyComparison of epidural analgesia combined with general anesthesia and general anesthesia for postoperative cognitive dysfunction in elderly patients.
Cognitive dysfunction in the early postoperative course is common for the elderly population. Anesthetic management may affect postoperative cognitive decline. Effective analgesia, early recovery and modulation of the stress response are advantages of neuraxial blocks. This study aims to compare the effects of general anesthesia and the combination of general anesthesia with epidural analgesia for postoperative cognitive dysfunction (POCD). We hypothesized that neuraxial block combined with general anesthesia (GA) would have a favorable influence on POCD prevention. ⋯ General anesthesia and epidural analgesia combined with general anesthesia resulted in similar POCD in elderly patients undergoing abdominal surgery. However, in combined anesthesia group memory, language skills and visuospatial functions appeared to be better preserved. Effective pain control might contribute to preventing cognitive decline in some domains.
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Ulus Travma Acil Cer · Jan 2020
Comparative StudyLong-term comparative study of internal fixation with Kirschner wires or cannulated screws for displaced medial epicondyle fractures of the humerus in children: A 10-year follow-up of 42 cases.
The rationale behind the decision-making on which type of fixation to use in displaced medial epicondyle fractures is not well elucidated. This study aims to compare the long-term clinical and radiographic outcomes of internal fixation with either Kirschner wires (K-wires) or cannulated screws in children with displaced medial epicondyle fractures. ⋯ Two smooth K-wires for younger children and screw fixation for children near skeletal maturity may provide favorable clinical and radiological outcomes at long-term follow-up, with low morbidity and radiographic deformity.
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Ulus Travma Acil Cer · Jan 2020
Factors affecting mortality in patients with traumatic diaphragmatic injury: An analysis of 92 cases.
This study aims to investigate the factors associated with mortality in patients with traumatic diaphragmatic rupture (TDR). ⋯ Other organs are frequently involved in cases of TDR, and mortality increased significantly in cases with associated liver injury. An ISS of ≥24 was determined to be an independent risk factor associated with mortality. Since the main determinant of mortality was the presence or absence of additional organ injuries, it is important that this should be taken into consideration in these patients.