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Meço BC, Akyol C, Yılmaz AA, Şahintürk H, Kuzu MA, Kuzu MA. Does Pre-procedural Anxiety Affect the Consumption of Sedatives During Colonoscopy? Turk J Anaesthesiol Reanim 2023; 51:49-54. [PMID: 36847319 PMCID: PMC10081101 DOI: 10.5152/tjar.2022.22130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Anxiety is an unpleasant emotional stat with systemic effects. The anxiety level of the patients may increase the requirements for sedation during colonoscopy. The aim of the study was to evaluate the effect of pre-procedural anxiety on the dose of propofol. METHODS After ethical approval and informed consent, a total of 75 patients undergoing colonoscopy were enrolled in the study. Patients were informed about the procedure and the anxiety levels were assessed. The level of sedation was defined as a Bispectral Index (BIS) of 60 and was achieved by target-controlled infusion of propofol. Patients' characteristics, hemodynamic profiles, anxiety levels, the propofol dosage and complications were recorded. The procedure duration, difficulty score for colonoscopy assessed by the surgeon, and the patient's and surgeon's satisfaction with sedation instrument scores were recorded. RESULTS A total of 66 patients were studied.Demographic and procedural data were similar among groups. The anxiety scores were not correlated with the total propofol dosage, hemodynamic parameters, the time needed to reach a BIS value of 60, surgeon and patient satisfaction and the time needed to regain consciousness. No complications were observed. CONCLUSION In patients receiving deep sedation for elective colonoscopies, the pre-procedural anxiety level is not related to sedative requirement, post-procedural recovery, or surgeon and patient satisfaction.
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Affiliation(s)
- Başak Ceyda Meço
- Department of Anaesthesiology and Intensive Care, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Cihangir Akyol
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ali Abbas Yılmaz
- Department of Anaesthesiology and Intensive Care, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Helin Şahintürk
- Department of Anaesthesiology and Intensive Care, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Ayhan Kuzu
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
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Karakaya MF, Er E, Kırımker O, Gümüşsoy M, Bodakçi E, Özercan M, Doğanay Erdoğan B, Gökcan H, Koloğlu M, Karayalçın K, Yurdaydın C, Tüzüner A, Haznedaroğlu S, Çınar K, Özkan H, Idilman R, Idilman R. Management of Biliary Complications in Liver Transplant Recipients with Duct-To-Duct Anastomosis: A Single-Center Experience. Turk J Gastroenterol 2023; 34:177-181. [PMID: 36843302 PMCID: PMC10081117 DOI: 10.5152/tjg.2023.22724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND The aims of this study were to investigate biliary complications in liver transplant recipients with choledochocholedocho stomy anastomosis, to identify the risk factors for the development of such complications, and to evaluate the success of endoscopic approaches in liver transplant recipients. METHODS Between January 2013 and May 2021, a total of 238 patients with liver diseases underwent liver transplantation: 174 recipients undergoing choledochocholedochostomy anastomosis were included in the analysis. RESULTS Their median age was 54.0 years. The median posttransplant follow-up period was 29 months. Hepatitis B virus infection (33%) was the most common indication for liver transplantation. Most patients (87%) received living donor liver transplantation. The overall prevalence of posttransplant biliary complications was 31%. Anastomotic biliary strictures were the most common biliary complications (72%), followed by biliary leakage (13%). The median time between endoscopic retrograde cholangiography and liver transplantation was 4 months, with a mean of 3 ± 1.6 sessions. Endoscopic retrograde cholangiography-guided drainage and balloon dilation with or without stent placement was the most common treatment modalities for recipients with biliary strictures. The overall success rate of endoscopic treatment modalities was 83.3%, with 65% of the recipients exhibiting complete biochemical and endoscopic responses. The response did not differ significantly between living donor liver transplantation and cadaveric donor liver transplant recipients (P > .05). Three recipients required revision surgery for biliary complication repair. Six patients died due to biliary sepsis. CONCLUSION Biliary stricture and leakages were the most common biliary complications after liver transplantation. Endoscopic treatment was successful in most recipients.
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Affiliation(s)
| | - Erdem Er
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Onur Kırımker
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mesut Gümüşsoy
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emin Bodakçi
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mubin Özercan
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | - Hale Gökcan
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meltem Koloğlu
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Kaan Karayalçın
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Cihan Yurdaydın
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Acar Tüzüner
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Selçuk Haznedaroğlu
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Kubilay Çınar
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Hasan Özkan
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
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