Researcher:
Erçelen, Ömür

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Ömür

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Erçelen

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Erçelen, Ömür

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2017 - 201922020 - 20228

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    Can postoperative pain be prevented in bariatric surgery? efficacy and usability of fascial plane blocks: a retrospective clinical study
    (Springer, 2022) Coşarcan, Sami Kaan; Doğan, Alper Tunga; Yavuz, Yunus; Erçelen, Ömür; Other; Faculty Member; School of Medicine; School of Medicine; N/A; 12305
    Background: Providing analgesia after bariatric surgery might be challenging due to a high prevalence of obstructive sleep apnea syndrome and the increased sensitivity to respiratory depression triggered by opioid overuse after surgery. Various combination methods with paracetamol, nonsteroidal anti-inflammatory drugs (NSAIDs), and other pain medications such as ketamine or gabapentin have been suggested for reduction of the opioid usage. Regional anesthetic techniques represent a valuable option as they improve patient comfort while reducing opioid-related side effects. In this study, we have evaluated the adjuvant benefits of these various techniques in reduction of the postoperative pain in bariatric surgery. Methods: After the approval of the IRB Ethics Committee, the records of the patients who had laparoscopic bariatric surgery between January 2019 and December 2021 were reviewed retrospectively. Results: Records of 120 patients who underwent laparoscopic bariatric surgery between January 2019 and December 2021 were reviewed. In total, 113 patients with full documentation were included in this study. Among these, 74 patients were administered regional analgesia. The main regional analgesia techniques were transversus abdominis plane and rectus sheath block. The pain scores of those receiving regional analgesia were statistically low. The opioid consumption after transversus abdominis plane and rectus sheath block was significantly lower than that of others. External oblique intercostal block alone provides a postoperative opioid consumption similar to those of transversus abdominis plane and rectus sheath block. Conclusion: The use of fascial plane blocks in bariatric surgery significantly reduces opioid consumption. Transversus abdominis plane and rectus sheath block combination and external oblique intercostal block seem to be the most effective options.
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    Ultrasound-guided bilateral erector spinae plane block versus tumescent anesthesia for postoperative analgesia in patients undergoing reduction mammoplasty: a randomized controlled study
    (Springer, 2019) N/A; N/A; Oğuz, Bahadır Hakan; Gürkan, Yavuz; Ağcaoğlu, Orhan; Erçelen, Ömür; Other; Faculty Member; Faculty Member; Faculty Member; N/A; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; 154129; 175476; 12305
    PurposeThe aim of this prospective, randomized, double-blind study was to compare the tumescent anesthesia method and erector spinae block with respect to postoperative analgesia consumption, pain scores and patient satisfaction, in patients receiving breast reduction surgery under general anesthesia. MethodsThe study included 44 females, aged 20-65years, who were to undergo breast reduction surgery, without adjunctive liposuction on the breast. Using the closed envelope method, the patients were randomly separated into two groups to receive tumescent anesthesia or erector spinae block (ESB). Patients in the ESB group received the block before general anesthesia by a single anesthetist (G.o.).ResultsThe 24-h tramadol consumption with PCA, which was the primary outcome of the study, was determined to be statistically significantly less in the ESB group (p<0.001). The NRS scores were compared at 30min postoperatively and then at 1, 2, 4, 6, 12 and 24h. At all the measured time points, the pain scores of the ESB group were statistically significantly lower (p<0.001). Additional analgesia was required by one patient in the ESB group and by seven patients in the tumescent group and was applied as 1g paracetamol. The requirement for additional analgesia was statistically significantly lower in the ESB group (p<0.024). Patient satisfaction was statistically significantly better in the ESB group (p<0.001).ConclusionsAccording to the results of this study, bilateral ESB performed under ultrasound guidance in breast reduction surgery was more effective than tumescent anesthesia concerning postoperative analgesia consumption and pain scores. ESB could be an appropriate, effective and safe postoperative analgesia method for patients undergoing reduction mammoplasty surgery.Level of Evidence IIThis journal requires that authors assign a level of evidence to each article
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    Analgesic effect of dual injection technique for the erector spinae plane block in beating heart coronary by-pass surgeries
    (Cureus Inc, 2021) Cosarcan, Sami Kaan; Dogan, Alper Tunga; N/A; Gürkan, Yavuz; Erçelen, Ömür; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 154129; 12305
    Introduction Various regional anesthesia techniques such as thoracic epidural, thoracic paravertebral block, erector spinae plane block (ESPB), parasternal intercostal blocks are used in cardiac surgery for postoperative analgesia. In our study, we investigated the analgesic efficacy of the dual injection technique of ESPB in beating heart coronary bypass surgeries. Methods The records of patients with coronary artery bypass (CABG) surgery in the beating heart at the VKV American Hospital between January and December 2019 were retrospectively analyzed. The data of 30 patients who met the criteria to be included in the study were analyzed. Whether any opioid use is required for maintenance of anesthesia it is recorded. The pain scores of the patients are recorded by the intensive care team and cardiovascular service nurses for the first 48 hours. Results The absence of secondary responses to pain in all surgical periods, including skin incision and sternotomy, and low number of rating scale (NRS) scores in the postoperative 0- to 24-hour period show that the technique we developed can produce effective analgesia. After the 24th postoperative hour, the patients were followed up in the cardiovascular service and there was no opioid use between 24- to 48-hour period. Conclusion Our approach, in which the local anesthetic is applied by approaching the superior costa-transverse ligament (SCTL) in the ESPB, provides an effective analgesia in coronary artery bypass surgeries in the beating heart. The main purpose of our new approach is to increase the amount of local anesthetic in the paravertebral area. We recommend using our modified technique for effective analgesia after CABG surgeries.
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    The minimum effective analgesic volume of 0.5% bupivacaine for ultrasound-guided anterior suprascapular nerve block
    (Cureus Inc, 2022) Cosarcan, Sami Kaan; Dogan, Alper T.; Koyuncu, Ozgur; N/A; Gürkan, Yavuz; Erçelen, Ömür; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 154129; 12305
    Objective: The interscalene brachial plexus block (ISBB) constitutes the gold standard for analgesia after shoulder procedures. Ipsilateral phrenic nerve block remains the most common adverse effect after ISBB. Alternative nerve blocks are performed in shoulder surgery in order to prevent hemi-diaphragmatic paralysis (HDP). The purpose of the present study was to investigate the minimum effective local anesthetic volume of 0.5% bupivacaine for postoperative analgesia with an anterior suprascapular nerve block (ASSB). The secondary aim was to investigate diaphragm functions with the local anesthetic doses used while conducting effective volume research. Method: This prospective observational study was conducted at the American Hospital of Istanbul, Turkey, from March to July 2022. The initial injected volume of 0.5% bupivacaine was 10 ml. Our clinical experience indicates that this yields a complete sensory block of the anterior suprascapular nerve. In accordance with the up-and-down method, the volume of 0.5% bupivacaine used for a particular patient was determined by the outcome of the preceding block, which represented block success. In case of effective ASSB being achieved, the volume of 0.5% bupivacaine to be administered to the next patient was lowered by 1 ml. In case of block failure, however, the volume of 0.5% bupivacaine to be applied in the subsequent case was increased by 1 ml. Ipsilateral hemi-diaphragmatic movement measurements were taken before (baseline) and 30 minutes after the block. General anesthesia was induced 60 minutes after the completion of the block performance by means of a standardized protocol. Results: Sixty-seven patients were included in the study. The ED50 and ED95 calculated for anterior suprascapular nerve block using probit transformation and logistic regression analysis were 2.646 (95% CI, 0.877-2.890) and 3.043 ml (95% CI, 2.771-4.065), respectively. When complete paralysis was defined as 75% or above, partial paralysis as 25-50%, and no paralysis as 25% or less, volumes of 6 ml or lower appeared to cause no paralysis for the anterior suprascapular nerve block. Conclusion: We, therefore, recommend using a volume of 6 ml or less in order to achieve diaphragm-sparing features for anterior suprascapular nerve blocks.
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    Bilateral rhomboid block may provide complete pain relief following bilateral breast surgery
    (Elsevier Science Inc, 2021) N/A; N/A; N/A; N/A; N/A; N/A; N/A; Gürkan, Yavuz; Manici, Mete; Salgın, Belitsu; Dilege, Ece; Ağcaoğlu, Orhan; Tatar, Sedat; Erçelen, Ömür; Faculty Member; Faculty Member; Researcher; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 154129; 113502; 327625; 218050; 175476; N/A; 12305
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    Targeted modification of erector spinae plane block
    (Wiley, 2020) Coşarcan, Sami Kaan; Doğan, Alper Tunga; N/A; Gürkan, Yavuz; Erçelen, Ömür; Faculty Member; Faculty Member; School of Medicine; School of Medicine; Koç University Hospital; 154129; 12305
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    Erector spinae plane block for peroral endoscopic myotomy analgesia in pediatric patients
    (Bmj Publishing Group, 2020) N/A; N/A; Özkalaycı, Özlem; Çetin, Seçil; Yenigün, Yılmaz; Karakaya, Muhammet Ahmet; Gürkan, Yavuz; Erçelen, Ömür; Doctor; Doctor; Doctor; Doctor; Faculty Member; Faculty Member; N/A; N/A; N/A; N/A; School of Medicine; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; 154129; 12305
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    Intravenous port catheter implantation: retrospective study in single center experience
    (Anestezi Dergisi, 2022) N/A; N/A; N/A; N/A; N/A; N/A; Darçın, Kamil; İşgüzar, Agah; Coşarcan, Sami Kaan; Manici, Mete; Küçükerdem, Osman Barış; Erçelen, Ömür; Teaching Faculty; Doctor; Doctor; Faculty Member; Researcher; Faculty Member; School of Medicine; N/A; N/A; School of Medicine; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; 203217; N/A; N/A; 113502; 327616; 12305
    Objective: Totally implantable venous access ports (TIVAPs) are widely preferred for oncology patients who need chemotherapy. Although peripheral cannula or catheter in a large vein may help chemotherapy treatment; some complications such as vascular irritation, thrombosis may interrupt the treatment. To avoid this interruption, TIVAPs are usually preferred. The aim of the study was to evaluate device related complications and safety with anesthesia team implanted TIVAPs. Methods: This retrospective study was conducted on patients who underwent procedure for implantation of TIVAPs in our hospital between the dates of January 2017 - December 2020. The demographic data, vascular access side, complications seen related to TIVAPs insertion procedure, the number of removed catheters, reasons of removal of catheters were recorded. Results: During this study period 700 TIVAPs procedure have been performed in our clinic. While 646 patients (92.3%) had right sided TIVAPs, 678 patients (96.8%) had TIVAPs inserted to subclavian vein. When the most common cancer seen in this patient group was colorectal cancer, hepatobiliary tract cancer group came second. Total number of removed catheters for some reasons was 107 which is 15.2% of all patients. When the causes for catheter removal were examined, it was discovered that although systemic infection was the most common reason (47 patients, or 6.7%), the number of patients with positive culture from the port was extremely rare (19 patients) (2.71%). Conclusion: We think that when TIVAPs are inserted under ultrasound guidance and fluoroscopy control in the operating room, the incidence of complications will be relatively low. Especially in cancer patients, TIVAPs can be inserted and used safely with high patient comfort. © 2022 Anestezi Dergisi. All rights reserved./ Öz: Amaç: Tamamen implante edilebilir venöz erişim portları (TIEVEP), kemoterapiye ihtiyaç duyan onkoloji hastaları için yaygın olarak tercih edilmektedir. Büyük periferik kanül veya kateterler kemoterapi tedavisini kolaylaştırsa da damar yolu irritasyonu ve tromboz gibi bazı komplikasyonlar tedaviyi kesintiye uğratabilir. Bu kesintiyi engellemek için genellikle TIEVEP’ler tercih edilir. Bu çalışmanın amacı anestezi ekibi tarafından yerleştirilen TIEVEP’lerin cihaz ile ilişkili komplikasyonlarını ve güvenliğini araştırmaktır. Yöntem: Bu retrospektif çalışma, Ocak 2017 - Aralık 2020 tarihleri arasında hastanemizde TIEVEP implantasyonu yapılan hastalar üzerinde yapılmıştır. Demografik veriler, kateter takılan taraf, görülen komplikasyonlar, çıkarılan TIEVEP sayısı, çıkarma nedenleri kaydedilmiştir Bulgular: Bu çalışma süresince kliniğimizde 700 TIEVEP takılmıştır. Altı yüz kırk altı hastada (%92,3) sağ TIEVEP varken, 678 hastada (%96,8) TIEVEP subklavyen vene yerleştirilmiştir. Bu hasta grubunda en sık görülen kanser kolorektal kanser iken, hepatobiliyer sistem kanseri grubu ikinci sırada yer aldı. Yüz yedi olguda (%15,2) çeşitli nedenlerle kateter çıkarılmıştır. Kateter çıkarılma nedenleri araştırıldığında her ne kadar 47 hasta (%6,7) ile en sık neden sistemik enfeksiyonsa da, TIEVEP’den alınan örneklerde kültür pozitif olan hasta sayısının 19 (%2,71) olduğu görülmüştür. Sonuç: Tamamen implante edilebilir venöz erişim portlarının ameliyathanede ultrason rehberliğinde ve floroskopi kontrolünde yerleştirilmesi durumunda komplikasyon insidansının oldukça düşük olacağını düşünüyoruz. Özellikle kanser hastalarına TIEVEP’ler yüksek hasta konforuyla güvenle yerleştirilebilir ve kullanılabilir.
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    Single level bilateral ESPB provides effective analgesia for both lower and upper laparoscopic abdominal surgeries
    (Elsevier Science Inc, 2020) Karakaya, Arif; N/A; N/A; N/A; N/A; N/A; Ünlükaplan, Aytekin; Darçın, Kamil; Çetin, Seçil; Gürkan, Yavuz; Erçelen, Ömür; Doctor; Teaching Faculty; Doctor; Faculty Member; Faculty Member; Koç University Hospital; School of Medicine; Koç University Hospital; School of Medicine; School of Medicine; N/A; 203217; N/A; 154129; 12305
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    PublicationOpen Access
    A rehabilitation protocol for patients with lumbar degenerative disc disease treated with posterior transpedicular dynamic stabilization
    (Turkish Neurosurgical Society, 2017) Ataker, Yaprak; Çerezci, Önder; Canbulat, Nazan; Öktenoğlu, Bekir Tunç; Sasani, Mehdi; Erçelen, Ömür; Süzer, Süleyman Tuncer; Özer, Ali Fahir; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Koç University Hospital; 58534; N/A; N/A; N/A; 221691; 1022
    AIM: To evaluate the efficacy of the rehabilitation protocol on patients with lumbar degenerative disc disease after posterior transpedicular dynamic stabilization (PTDS) surgery. MATERIAL and METHODS: Patients (n=50) with single level lumbar degenerative disc disease were recruited for this study. Patients had PTDS surgery with hinged screws. A rehabilitation program was applied for all patients. Phase 1 was the preoperative evaluation phase. Phase 2 (active rest phase) was the first 6 weeks after surgery. During phase 3 (minimal movement phase, 6-12 weeks) pelvic tilt exercises initiated. In phase 4 (dynamic phase, 3-6 months) dynamic lumbar stabilization exercises were started. Phase 5 (return to sports phase) began after the 6th month. The primary outcome criteria were the Visual Analogue Pain Score (VAS) and the Oswestry Disability Index (ODI). Patients were evaluated preoperatively, postoperative 3rd, 12th and 24th months. RESULTS: The mean preoperative VAS and ODI scores were 7.52±0.97 and 60.96±8.74, respectively. During the 3rd month, VAS and ODI scores decreased to 2.62±1.05 and 26.2±7.93, respectively. VAS and ODI scores continued to decrease during the 12th month after surgery to 1.4±0.81 and 13.72±6.68, respectively. At the last follow-up (mean 34.1 months) the VAS and ODI scores were found to be 0.68±0.62 and 7.88±3.32, respectively. (p=0.0001). CONCLUSION: The protocol was designed for a postoperative rehabilitation program after PTDS surgery for patients with lumbar degenerative disc disease. The good outcomes are the result of a combination of very careful and restrictive patient selection, surgical technique, and the presented rehabilitation program.