Yunus Atalay
@medipol.edu.tr
Department of Anesthesia/yoatalay@medipol.edu.tr
Istanbul Medipol University
RESEARCH, TEACHING, or OTHER INTERESTS
Anesthesiology and Pain Medicine
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Yunus Oktay Atalay, Bahadir Ciftci, Bahar Tekin, Gamze Ansen, Bayram Ufuk Sakul, Mehmet Akif Cacan, Ibrahim Azboy, Bilge Yilmaz, and Haci Ahmet Alici
Ovid Technologies (Wolters Kluwer Health)
The study aimed to evaluate the effectiveness of deep subgluteal block (DSGB) for pain relief after posterolateral-approached total hip replacement. The cadaver study and observational case series assessed the spread and outcomes of ultrasound-guided DSGB. Results showed low postoperative pain scores, minimal opioid requirements, and no complications related to DSGB. Anatomical dissection revealed effective spread of the injected substance. These findings suggest that DSGB could be a promising regional analgesic technique for postoperative pain management after posterolateral-approached total hip replacement.
Hande GUNGOR and Yunus O. ATALAY
Edizioni Minerva Medica
Yunus O. ATALAY, Bahar TEKIN, Gamze ANSEN, Hande GUNGOR, Bayram U. SAKUL, and Haci A. ALICI
Edizioni Minerva Medica
Furkan Kapukaya, Mursel Ekinci, Bahadir Ciftci, Yunus Oktay Atalay, Birzat Emre Gölboyu, Ersin Kuyucu, and Yavuz Demiraran
Springer Science and Business Media LLC
Abstract Background Interscalene brachial plexus block (ISB) is the gold standard method used for postoperative analgesia after arthroscopic shoulder surgery. Ultrasound guided erector spinae plane block (ESPB) is an interfascial plane block. The aim of this study is to compare the analgesic efficacy of ESPB and ISB after shoulder arthroscopy. The primary outcome is the comparison of the perioperative and postoperative opioid consumptions. Methods Sixty patients with ASA score I-II planned for arthroscopic shoulder surgery were included in the study. ESPB was planned in Group ESPB (n = 30), and ISB was planned in Group ISB (n = 30). Intravenous fentanyl patient-controlled analgesia was administered to both groups in the postoperative period. Intraoperative and postoperative opioid and analgesic consumption of both groups, side effects and complications related to opioid use, postoperative pain scores and rescue analgesic use were recorded in the first 48 h postoperatively. Results Pain scores were significantly higher in the ESPB group in the first 4 h postoperatively than in the ISB group (p < 0.05). The total fentanyl consumption and number of patients using rescue analgesics in the postoperative period were significantly higher in the ESPB group (p < 0.05). The incidence of nausea in the postoperative period was significantly higher in the ESPB group (p < 0.05). Conclusions In our study, it was seen that ISB provided more effective analgesia management compared to ESPB in patients underwent shoulder arthroscopy surgery.
Tumay Uludag Yanaral, Pelin Karaaslan, Hande Gungor, Yunus Oktay Atalay, and Joseph Drew Tobias
Galenos Yayinevi
Bahadir Ciftci, Mursel Ekinci, Birzat Emre Gölboyu, Furkan Kapukaya, Yunus Oktay Atalay, Ersin Kuyucu, and Yavuz Demiraran
Oxford University Press (OUP)
Mursel Ekinci, Bahadir Ciftci, Yavuz Demiraran, Erkan Cem Celik, Murat Yayik, Burak Omur, Ersin Kuyucu, and Yunus Oktay Atalay
The Korean Society of Anesthesiologists
Background: Adductor canal block (ACB) provides effective analgesia after arthroscopic knee surgery. However, there is insufficient data regarding whether ACB should be performed before or after inflation of a thigh tourniquet. We aimed to investigate the efficacy of ACB performed before and after placement of a thigh tourniquet and evaluate associated quadriceps motor weakness.Methods: ACB was performed before tourniquet inflation in the PreT group, and it was performed after inflation in the PostT group. In the PO group, ACB was performed at the end of surgery after deflation of the tourniquet.Results: There were no statistically significant differences between the groups in terms of demographic data. There was no statistically significant difference among the three groups in terms of total postoperative opioid consumption (P = 0.513). Patient satisfaction and the amount of rescue analgesia administered were also not significantly different between the groups. There was no significant difference in terms of static and dynamic visual analog scale scores between the groups (for 24 h: P = 0.306 and P = 0.271, respectively). The incidence of motor block was higher in the PreT group (eight patients) than in the PostT group (no patients) and the PO group (one patient) (P = 0.005).Conclusions: Using a tourniquet before or after ACB did not result in differences in terms of analgesia quality; however, applying a tourniquet immediately after ACB may lead to quadriceps weakness.
Bahadir Çiftçi, Mursel Ekinci, and Yunus Oktay Atalay
The Korean Society of Anesthesiologists
tions such as thoracic procedures and myofascial pain [1,2]. It may be performed for open thoracotomy [3]; however, more information is needed for other thoracic procedures. Video-assisted thoracic surgery (VATS) has the advantage of reduced pain over open thoracotomy. However, patients may still experience moderate to severe pain after VATS [4]. Herein, we report the use of RIB in three patients for analgesia management after VATS. Written informed consent for the procedure and future publication was obtained from the patients. Patient 1 was a 45-year-old male with 170 cm height and 75 kg weight. He was diagnosed with lung carcinoma of the right lung. He had no additional comorbidities and was American Society of Anesthesiologists physical status (ASA PS) classification I. Patient 2 was a 53-year-old male with 165 cm height and 72 kg weight. He was diagnosed with left lung carcinoma, had no additional comorbidities, and was ASA PS classification I. Patient 3 was a 58-year-old male who was 178 cm tall and weighed 86 kg. He was diagnosed with right lung carcinoma, had no additional comorbidities, and was ASA PS classification I. All of three patients’ blood tests were within normal ranges and vital signs were stable. The patients underwent thoracoscopic surgery lasting 130, 125, and 110 minutes, respectively for the patient 1, 2, and 3 with no complications during the surgery. After RIB, the patients were extubated. After observing sufficient spontaneous respiration, they were transferred to the intensive care unit (ICU) for further monitoring. Intravenous (IV) ibuprofen (400 mg), dosed at every 8 hours postoperatively was administered for postoperative pain control. The visual analogue score (VAS) was evaluated at 1, 6, 12, and 24 hours. For patient 1, the static and dynamic (on deep breathing) VAS scores were 0/1, 1/2, 0/2, and 1/1, respectively. The patient needed no additional analgesic drugs. After 24 hours, the patient was transferred to the thoracic surgery ward. After 36 hours, the chest drain was removed. On the 4th day after surgery, the patient was discharged. For patient 2, the static and dynamic VAS scores were 1/2, 2/3, 1/3, and 0/1, respectively. He needed no additional analgesic drugs. After 24 hours, he was transferred to the ward. After 48 hours, the chest drain was removed. On the 5th day after surgery, the patient was discharged. For patient 3, the static and dynamic VAS scores were 0/2, 1/2, 1/1, and 0/1, respectively. He needed no additional analgesic drugs. After 24 hours, he transferred to the ward. After 36 hours, the chest drain was removed. On the 3rd postoperative day, he was discharged. All patients underwent unilateral thoracoscopic lobectomy due to lung carcinoma. A Received: September 28, 2020 Revised: October 6, 2020 (1st); October 21, 2020 (2nd); November 2, 2020 (3rd); November 5, 2020 (4th) Accepted: November 11, 2020
Bahadir Ciftci, Mursel Ekinci, Pelin Basim, Erkan Cem Celik, Ismail Cem Tukac, Mahmut Zenciroglu, and Yunus Oktay Atalay
Wiley
Although breast‐conserving surgery‐axillary dissection (BCS‐AD) is a minimally invasive surgery, patients may suffer from moderate‐to‐severe pain. Several regional techniques can be used for pain control. The type II pectoral nerve block (PECS II) and the rhomboid intercostal block (RIB) are interfascial plane blocks that have been reported to provide effective analgesia after breast surgery. This study aims to compare the analgesic efficacy of the PECS II block and the RIB after breast surgery.
Bahadir Ciftci, Mursel Ekinci, Birzat Emre Gölboyu, Furkan Kapukaya, Yunus Oktay Atalay, Ersin Kuyucu, and Yavuz Demiraran
Oxford University Press (OUP)
Abstract Objective Moderate to severe pain may occur following arthroscopic shoulder surgery. An erector spinae plane block (ESPB) may be used for painful conditions of the shoulder. The primary hypothesis of this trial is that ultrasound-guided ESPB would provide effective analgesia by reducing opioid consumption. The secondary hypothesis is that ESPB would result in low pain scores and reduce the use of rescue analgesia. Design Randomized prospective double-blind study. Setting Academic university hospital. Subjects Sixty patients aged between 18 and 65 years designated as American Society of Anesthesiologists (ASA) class I or II who underwent unilateral arthroscopic shoulder surgery under general anesthesia were included in the study. Methods Patients were equally divided into two groups—either the ESPB group (n=30) or the sham block group (n=30). ESPB was performed with 30 mL 0.25% bupivacaine at the T2 level in the ESPB group and sham block with 30 mL saline at the T2 level in the sham block group. Twenty minutes before the end of the operation, 100 mg tramadol was administered intravenously to the patients. Intravenous ibuprofen 400 mg 3 × 1 was ordered for the patients during the postoperative period. A patient control analgesia device including a dose of 10 µg/mL fentanyl was connected to the patients. Results There were no statistical differences between groups in terms of demographical data. Postoperative fentanyl consumption was significantly lower in the ESPB group than in the sham block group (96.66 µg ±105.57 µg and 230 µg ±247.17 µg, respectively) (P=0.009). The need for rescue analgesia was significantly lower in the ESPB group than in the sham block group (26.66 mg ±35.43 mg and 48.5 mg ±35.45 mg, respectively) (P=0.020). Overall, the visual analog scale scores were significantly lower in the ESPB group than in the sham block group. Conclusions ESPB may provide effective analgesia treatment following arthroscopic shoulder surgery.
Bahadir Ciftci, , Cem Erdogan, Deniz Kizilaslan, Mursel Ekinci, Oktay Olmuscelik, Yunus Oktay Atalay, , , ,et al.
AVES Publishing Co.
Patients infected with severe acute respiratory syndrome corona virus 2 may have mild symptoms such as fever and cough in the early stage of this disease and these symptoms may deteriorate to acute respiratory distress syndrome, multiple-organ failure, and death in the late phase.1 It has been reported that the cytokine levels increase and damage the tissues.2 As some agents used to decrease cytokine levels such as intravenous immunoglobulin and selective cytokine blockade (eg, anakinra or tocilizumab) may cause adverse events (infections, allergic reactions, and changes in blood pressure), there is a need of alternative treatment methods.3 Herein, we present our coupled plasma filtration adsorption (CPFA) (a detoxification system combining a plasma adsorption circuit) with a continuous renal replacement therapy (CRRT) experiences to treat 2 patients with coronavirus disease (COVID-19) in our tertiary university hospital intensive care unit (ICU).
Tumay Uludag Yanaral, Pelin Karaaslan, Emine Uzunoglu, Yunus Oktay Atalay, and Joseph Drew Tobias
Informa UK Limited
Background Kartagener syndrome (KS) is a rare genetic disorder consisting of the triad of situs inversus, chronic sinusitis, and bronchiectasis. Although there are previous reports regarding the anaesthetic considerations in KS, none have included liver transplantation. Case Presentation An 11-year-old boy with a diagnosis of KS underwent liver transplantation due to extrahepatic biliary atresia. Previous diagnostic imaging confirmed situs inversus and the absence of an inferior vena cava. The patient’s peak airway pressure intermittently increased intraoperatively from 15 to 30 cm H2O due to increased pulmonary secretions, which required frequent suctioning of the endotracheal tube. Intraoperative volume resuscitation included 200 mL of 5% albumin, 5 units of erythrocyte suspension and 3 units of fresh frozen plasma. Intermittently, a norepinephrine infusion was required to maintain the MAP. Coagulation function was monitoring using the thromboelastogram to guide the use of blood products including fresh frozen plasma. At the end of the surgery, the patient was transferred to the intensive care unit. He was discharged from the intensive care unit on postoperative day 5, and from the hospital on postoperative day 28. He continues to do well with normal liver function 23 months after surgery. Conclusion Despite the risk of pulmonary related to airway secretions and exacerbation of hemodynamic instability related to anatomical variations in the inferior vena cava anatomy, KS patients can be safely anesthetized with careful planning and attention of the disease process, even for complex surgical procedures such as liver transplantation.
Yunus O. Atalay, Bahadir Ciftci, Mursel Ekinci, and Serdar Yesiltas
Edizioni Minerva Medica
Mursel Ekinci, Bahadir Ciftci, and Yunus O. Atalay
Edizioni Minerva Medica
Bahadir Ciftci, Mursel Ekinci, Erkan Cem Celik, Ismail Cem Tukac, Yusuf Bayrak, and Yunus Oktay Atalay
Elsevier BV
OBJECTIVES
Investigate whether an ultrasound-guided erector spinae plane block (ESPB) can be used to manage postoperative pain in video-assisted thoracic surgery (VATS) patients.
DESIGN
Prospective, randomized study.
SETTING
Single institution, academic university hospital.
PARTICIPANTS
Adult patients who underwent VATS under general anesthesia between September 2018 and March 2019.
INTERVENTIONS
This study was an interventional study.
MEASUREMENTS AND MAIN RESULTS
A total of 60 patients were randomly assigned into 2 groups (n = 30 per group): an ESPB group and a control group. In the ESPB group, a single-shot ultrasound-guided ESPB was administered preoperatively. The control group received no such intervention. All of the patients received intravenous patient-controlled postoperative analgesia, and they were assessed using visual analogue scale (VAS) scores, opioid consumption, and adverse events. There were no statistically significant intergroup differences with respect to the age, sex, weight, American Society of Anesthesiologists status, anesthesia duration, and surgery length (p > 0.05 for each). The opioid consumption at 1, 2, 4, 8, 16, and 24 hours and the active and passive VAS scores at 0, 2, 4, 8, 16, and 24 hours were statistically lower in the ESPB group at all of the time periods when compared with the control group (p < 0.05). In the control group, the nausea and itching rates were higher, but there were no intergroup differences in terms of other adverse effects.
CONCLUSIONS
A preemptive single-shot ESPB may provide effective analgesia management after VATS.
Bahadır Çiftçi, Mürsel Ekinci, Erkan Cem Çelik, Ismail Cem Tukac, Birzat Emre Gölboyu, Mehmet Zeki Gunluoglu, and Yunus Oktay Atalay
BULUS Design and Printing Services Company
Bahadır Çiftçi
Kare Publishing
OBJECTIVES
Pain management is an important issue following lumbar spinal surgery. Wound infiltration is a technique that a local anesthetic solution is infiltrated into the tissues around the surgical area. Previous studies reported that US-guided modified thoracolumbar interfacial plane (mTLIP) block after lumbar spinal surgery provided effective analgesia. In this study, we aimed to compare the analgesic efficacy of the US-guided mTLIP block and wound infiltration following lumbar disc surgery.
METHODS
60 patients aged 18-65 years, ASA classification I-II, and scheduled for lumbar disc surgery under general anesthesia were included in the study. US-guided mTLIP block was performed via the lateral approach in group T (n=30), and wound infiltration was performed in group W (n=30). Opioid consumption, postoperative pain scores and adverse effects of opioids, such as allergic reactions, nausea, and vomiting, were recorded.
RESULTS
Opioid consumption and the use of rescue analgesia were significantly lower in group T in all the postoperative periods (1, 2, 4, 8, 16, and 24 h) (p<0.05). The VAS scores for pain during mobility and while at rest were significantly lower in group T than those in group W 8 h after the surgery (p<0.05). The incidences of nausea, vomiting, and itching in group W were higher than the incidences in group T.
CONCLUSION
The mTLIP block provides effective analgesia for the first 24 h following lumbar disc surgery, and it may be an alternative to wound infiltration for pain management.
Y.O. Atalay, E. Mursel, B. Ciftci, and G. Iptec
Elsevier BV
ismail cem tukaç
Kare Publishing
Nonobstetric operations are sometimes necessary during pregnancy, with an estimated incidence of about 2% among pregnant women. In recent years, laparoscopic procedures have been preferred for abdominal surgery in pregnancy, as these are well tolerated by both the mother and fetus during all trimesters of pregnancy.[1, 2] Postoperative pain management is important for pregnant patients undergoing a nonobstetric procedure, as pain may increase the risk of premature labor. For pain management during pregnancy, paracetamol is the drug of choice, and nonsteroidal anti-inflammatory drugs should be avoided. Regional blockade techniques are preferred, as they reduce the risk of opioidinduced hypoventilation.[3] Among regional block techniques, ultrasound (US)-guided erector spinae plane block (ESPB) is a novel interfacial plan block, which was first described by Forero et al. in 2016 as a treatment for thoracic neuropathic pain.[4] There are a number of case reports in the literature on the analgesic effect of ESPB after laparoscopic surgeries. [5] To our knowledge, this is the first report of ESPB performed for a pregnant patient as postoperative rescue analgesia. Written informed consent was obtained from the patient for this report.
Cengiz Kaya, Yunus O. Atalay, Bilge C. Meydan, Yasemin B. Ustun, Ersin Koksal, and Sultan Caliskan
Elsevier BV
Yasemin Burcu Ustun, Cengiz Kaya, Ersin Koksal, Yunus Atalay, Ziya Yilmaz, Aysun Caglar Torun, Ilhan Karabicak, Abdurrahman Aksoy, and Murat Yarim
International College of Surgeons
Objective: Hepatic ischemia and reperfusion (IR) injury is the most important cause of cellular death and hepatic dysfunction following liver transplantation and resection. Our aim in this study is to reveal the early stage effects of thyroid hormone levels on hepatic IR injury that effectively act on cellular homeostasis. Methods: Forty-six male Wistar albino rats were divided into 6 groups as follows: euthyroid-sham (n = 8), euthyroid with IR injury (n = 8), hyperthyroid-sham (n = 7), hyperthyroid with IR injury (n = 7), hypothyroid-sham (n = 8), and hypothyroid with IR injury (n = 8). After 90 minutes of partial hepatic ischemia, 90 minutes of reperfusion was applied. Liver tissue malondialdehyde (MDA) levels, catalase (CAT), glutathion peroxidase, and superoxide dismutase (SOD) enzyme activities were measured. Hepatic tissue was immunohistochemically analyzed. Results: MDA levels of liver tissue were analyzed, and hepatic MDA levels in the hyper-IR group were found to be significantly lower (P = 0.002) than those of the hypo-IR and euthyroid-IR groups. Serum CAT levels did not differ between control groups, whereas CAT values in the hyper-IR group were detected to be significantly lower than in the euthyroid-IR and hypothyroid-IR groups (P = 0.003). However, levels of SOD and glutathione peroxidase (GPX) were not affected by the functional state of the thyroid. No statistically significant difference was seen in the results of the histopathologic evaluation and immunohistochemical staining of the liver tissue. Conclusion: The administration of thyroid hormone within a short time before IR injury may have protective effects.
JosephDrew Tobias, YunusOktay Atalay, AhmetVeysel Polat, ElifOzyazici Ozkan, Leman Tomak, and Canan Aygun
Medknow
Background: Naso/Orogastric tube (NOGT) misplacement can lead to significant complications. Therefore, the assessment of tube position is essential to ensure patient safety. Although radiography is considered the gold standard for determining NOGT location, new methods may be helpful in reducing repetitive radiation exposure, especially for neonates. In this study, we sought to investigate if bedside ultrasonography (BUSG) can be used to verify NOGT placement in neonatal intensive care patients. Materials and Methods: Infants requiring NOGT placement were enrolled. After insertion of the NOGT, the location was first identified using BUSG and then confirmed using abdominal radiography for comparison. Results: The study cohort included 51 infants with an average gestational age of 34 ± 4.9 weeks. BUSG determined the NOGT location correctly with a sensitivity of 92.2%. The location of the NOGT could not be determined by BUSG in four neonates (7.8%). In one infant, the NOGT was positioned in the esophagus, as determined both by BUSG and radiography. Conclusion: BUSG is a promising diagnostic tool for determining NOGT location in neonates, thereby eliminating the need for abdominal radiography.
Ersin Köksal, Cengiz Kaya, Yunus Oktay Atalay, Yasemin Burcu Üstün, Uğur Adıgüzel, Sezgin Bilgin, Ender Çam, and Kağan Karabulut
Galenos Yayinevi
Received: 27.07.2017 Accepted: 28.11.2017 1Ondokuz Mayıs University Medicine Faculty Anesthesiology And Reanimation Department, Samsun, Turkey 2Ondokuz Mayıs University Medicine Faculty Radiology Department,outpatient Anesthesia Service, Samsun, Turkey 3Ondokuz Mayıs University Medicine Faculty General Surgery Department, Samsun, Turkey Yazışma adresi: Ersin Köksal, Ondokuz Mayıs University Medicine Faculty Anesthesiology And Reanimation Department, Samsun, Turkey e-mail: drekoksal@yahoo.com GİRİŞ
Ayşegül İdil Soylu, Sümeyra Arıkan Cortcu, Fatih Uzunkaya, Yunus Oktay Atalay, Tumay Bekçi, Levent Güngör, and Ümit Belet
SAGE Publications
Objectives Platelet-to-lymphocyte ratio is a novel biomarker, recently shown to be correlated with atherosclerotic inflammation. This study investigated the role of platelet-to-lymphocyte ratio in patients with carotid artery stenosis and stroke. Methods Patients, who underwent carotid angiography with Multiple Detector Computed Tomography Angiography at our hospital, were retrospectively screened. Patients enrolled were divided into three groups based on the platelet-to-lymphocyte ratio. Patients with a platelet-to-lymphocyte ratio value between 55.0 and 106.71 were assigned to Group I, patients with a platelet-to-lymphocyte ratio value between 106.79 and 160.61 were assigned to Group II and patients with a platelet-to-lymphocyte ratio value between 162.96 and 619.61 were assigned to Group III. The carotid arterial stenosis calculated was classified as per the criteria of North American Symptomatic Carotid Endarterectomy Trial. Results One hundred fifty patients were included in our trial (mean age 61.9 ± 13.1 with 104 males). The rate of carotid arterial stenosis was detected to be higher in patients with a high platelet-to-lymphocyte ratio value (p = 0.010). Additionally, the platelet-to-lymphocyte ratio was positively correlated with the carotid arterial stenosis percentage (r = 0.250, p = 0.002). In the multi-variate regression analysis, platelet-to-lymphocyte ratio was detected to be an independent variable with respect to stroke (odd’s ratio = 1.012, confidence interval = 1.001–1.024, p = 0.031). Conclusions Increased platelet-to-lymphocyte ratio could be a simple and practical marker of the clinical course in patients with carotid arterial stenosis.