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Öğe Comparison of Macintosh, McCoy and C-MAC D-Blade video laryngoscope intubation by prehospital emergency health workers: a simulation study(Springer-Verlag Italia Srl, 2017) Yildirim, Ahmet; Kiraz, Hasan A.; Agaoglu, Ibrahim; Akdur, OkhanThe aim of the this study is to evaluate the intubation success rates of emergency medical technicians using a Macintosh laryngoscope (ML), McCoy laryngoscope (MCL), and C MAC D-Blade (CMDB) video laryngoscope on manikin models with immobilized cervical spines. This randomized crossover study included 40 EMTs with at least 2 years' active service in ambulances. All participating technicians completed intubations in three scenarios-a normal airway model, a rigid cervical collar model, and a manual in-line cervical stabilization model-with three different laryngoscopes. The scenario and laryngoscope model were determined randomly. We recorded the scenario, laryngoscope method, intubation time in seconds, tooth pressure, and intubation on a previously prepared study form. We performed Friedman tests to determine whether there is a significant change in the intubation success rate, duration of tracheal intubation, tooth pressure, and visual analog scale scores due to violations of parametric test assumptions. We performed the Wilcoxon test to determine the significance of pairwise differences for multiple comparisons. An overall 5 % type I error level was used to infer statistical significance. We considered a p value of less than 0.05 statistically significant. The CMDB and MCL success rates were significantly higher than the ML rates in all scenario models (p < 0.05). The CMDB intubation duration was significantly shorter when compared with ML and MCL in all models. CMDB and MCL may provide an easier, faster intubation by prehospital emergency health care workers in patients with immobilized cervical spines.Öğe Experimental Esophagitis Model Preventing Tracheal Aspiration(Wroclaw Medical Univ, 2015) Kiraz, Hasan A.; Erbas, Mesut; Kucuk, Adem; Topaloglu, Naci; Erdem, Havva; Sahin, Hasan; Toman, HuseyinBackground. Corrosive esophagitis injuries are a serious clinical problem with many agents used for diagnosis and treatment. Experimental esophagus burn models use a method described mainly in studies by Gehanno and Guedon, and modified by Liu and Richardson. Objectives. The aim of this study was to describe a new esophagitis model that prevents tracheal aspiration. Material and Methods. In this study we used 16 Wistar albino rats weighing between 220-240 g. The experimental animals were randomly divided into two groups: the model group (group M, n: 8) and control group (group C, n: 8). The necessary anesthesia was administered. Passing through a median laparotomy incision, the abdomen was entered and in group M and C the esophagus was freed and held by a suture at the gastroesophageal junction. After this procedure, about 1 cm proximal to the gastroesophageal junction, the esophagus was suspended by a suture. The esophagus segment between the two sutures was exposed to 0.1 mL 10% NaOH in group M and 0.1 mL saline in group C for 20 s. Ten days later all experimental animals were sacrificed and their esophagus removed. After dying with hematoxylin and eosine trichrome, the histopathological evaluation results for the rats in all groups were investigated with a light microscope. Results. Histopathological examination indicated submucosal collagen increase, damage to muscularis mucosa and tunica muscularis and collagen deposition. In the model group, the rats had high neutrophils and tissue damage accompanied by necrosis. In the control group, the rats had minimal or no tissue damage and fibrosis was not observed. Conclusions. Our procedure is relatively less invasive and easy to apply with corrosive esophagitis only in the required region, and at the same time treatment medications can be easily administered.Öğe The analgesic efficacy of ultrasound-guided transversus abdominis plane block on postoperative pain and morphine consumption in varicocelectomy(Saudi Med J, 2016) Omur, Dilek; Oguzalp, Huseyin; Kiraz, Hasan A.; Ekin, Serpil; Alan, Cabir; Ersay, Ahmet R.; Hanci, VolkanObjectives: To evaluate the analgesic effect of transversus abdominis plane (TAP) block administered before varicocele surgery. Methods: This study was completed at the Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey, between January 2011 and April 2013. In a prospective, double blind, randomized, placebo controlled clinical study, 40 male patients scheduled for elective varicocele operations were randomized to group T (treatment group) or group C (controls). After receiving general anesthesia, group T received a TAP block using 20 mL 0.25% bupivacaine on the operation side, whereas group C received a control block using 20 mL 0.9% Sodium chloride. During the first 24 hours after surgery, the patient pain was evaluated using the visual analogue scale (VAS) at rest and while coughing. Postoperative patient controlled analgesia morphine consumption, VAS scores, and side effects were recorded. Results: Of 34 patients, Group T (n=18) had significantly lower VAS pain scores than Group C (n=16) both at rest and while coughing. The total morphine consumed was lower (7.7 +/- 4.0) versus 21.6 +/- 12.4 mg, p<0.001) in the 24 hours after surgery. Conclusion: As part of a multimodal analgesic regime after varicocelectomy surgery, morphine consumption and VAS pain scores were significantly lower among those receiving 20 mL 0.25% bupivacaine administered for a TAP block than among controls.