Anesthesiologist Perspectives On Regional Analgesia İn The Treatment Of Postoperatif Pain; A National Survey Study

INTRODUCTION: In recent years, anesthesiologists have used Postoperative pain management more frequently due to its effects on early mobilization and discharge. In this study, we aimed to investigate the factors affecting anesthetists' preference for regional techniques and especially plane blocks in postoperative analgesia. METHODS: Anesthesiologists were asked to answer a survey consisting of 20 questions electronically. Two hundred fifteen physicians fully replied to our survey digitally. The answers given to our survey, which consisted of questions to determine whether the demographic characteristics of the participants, the institution they work for, their working conditions, and the training they received impacted their preferences, were evaluated. RESULTS: It has been determined that the participants' professional background, age, whether they have received USG training, and their titles affected their analgesia preferences.The plane block application rate was 61.4% higher in those who received USG training significantly (P = 0.003). 88.4% of the physicians said they used opioids, 84.2% used nonsteroidal anti-inflammatory drugs (NSAIDs), and 82.3% used regional analgesia methods. They also pointed out that they mostly applied lumbar epidural block procedure among the regional block methods,.(88.8%). The limiting reasons for using regional analgesia were 49% intensity, 6.8% the risk of complications. DISCUSSION AND CONCLUSION: Opioids, NSAIDs, and regional methods were commonly used for postoperative analgesia. An epidural block is the most preferred method among the regional methods. Age, professional years, whether they have received USG training, their titles, intensity, and physical factors also determine analgesia preferences

The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye

Background:Vaccines against coronavirus disease-19 (COVID-19) have been effective in preventing symptomatic diseases, hospitalizations, and intensive care unit (ICU) admissions. However, data regarding the effectiveness of COVID-19 vaccines in reducing mortality among critically ill patients with COVID-19 remains unclear.Aims:To determine the vaccination status and investigate the impact of the COVID-19 vaccine on the 28-day mortality in critically ill patients with COVID-19.Study Design:Multicenter prospective observational clinical study.Methods:This study was conducted in 60 hospitals with ICUs managing critically ill patients with COVID-19. Patients aged ≥ 18 years with confirmed COVID-19 who were admitted to the ICU were included. The present study had two phases. The first phase was designed as a one-day point prevalence study, and demographic and clinical findings were evaluated. In the second phase, the 28-day mortality was evaluated.Results:As of August 11, 2021, 921 patients were enrolled in the study. The mean age of the patients was 65.42 ± 16.74 years, and 48.6% (n = 448) were female. Among the critically ill patients with COVID-19, 52.6% (n = 484) were unvaccinated, 7.7% (n = 71) were incompletely vaccinated, and 39.8% (n = 366) were fully vaccinated. A subgroup analysis of 817 patients who were unvaccinated (n = 484) or who had received two doses of the CoronaVac vaccine (n = 333) was performed. The 28-day mortality rate was 56.8% (n = 275) and 57.4% (n = 191) in the unvaccinated and two-dose CoronaVac groups, respectively. The 28-day mortality was associated with age, hypertension, the number of comorbidities, type of respiratory support, and APACHE II and sequential organ failure assessment scores (p < 0.05). The odds ratio for the 28-day mortality among those who had received two doses of CoronaVac was 0.591 (95% confidence interval: 0.413-0.848) (p = 0.004).Conclusion:Vaccination with at least two doses of CoronaVac within six months significantly decreased mortality in vaccinated patients than in unvaccinated patients