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2015’in EN’leri Anestezi’de 2015’de Neler Oldu En Popüler Konular Gündemdekiler Gündemden Düşenler Dr. Volkan Hancı.

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... konulu sunumlar: "2015’in EN’leri Anestezi’de 2015’de Neler Oldu En Popüler Konular Gündemdekiler Gündemden Düşenler Dr. Volkan Hancı."— Sunum transkripti:

1 2015’in EN’leri Anestezi’de 2015’de Neler Oldu En Popüler Konular Gündemdekiler Gündemden Düşenler Dr. Volkan Hancı

2 Yeniliğe Doğru Her gün bir yerden göçmek Ne iyi Her gün bir yere Konmak ne güzel Bulanmadan, donmadan Akmak ne hoş Dünle beraber Gitti cancağızım Ne kadar söz varsa Düne ait Şimdi yeni şeyler Söylemek lazım

3 Sunum Planı Amaç Bilgilerin derlenmesi En popüler konular listesi Yayın örnekleri Gündemdekiler listesi Gündemden düşenler listesi Sonuçlar

4 Anestezi’de 2015’de Neler Oldu En Popüler Konular Populer ? Kaynak Web of science En çok atıf yapılan En çok yayın yapılan Arama yılı: 2015 Pub-med En çok yayın yapılan Arama yılı: 2015

5 AMAÇ ‘’Gündemdekiler’’ kavramının tanımlanması yılında hangi konular gündemi oluşturmaktadır? ’de hangi konularda daha fazla makale yayınlanmıştır? 3. Gündeme yeni giren ilaçlar nelerdir? 4. Rehberlerdeki değişiklikler nedir?

6 AMAÇ ‘’Gündemden Düşenler’’ kavramının tanımlanması 1. Geçen yıl gündemde olan konulardan hangileri 2015’de popülerliğini yitirmiştir? ’de hangi konularda daha az makale yayınlanmıştır?

7 Bilgilerin Derlenmesi 1 - Web of science Advance Search SU Anest* Yıl: yayın

8 Bilgilerin derlenmesi-2 ‘’Medline’’ taraması: Anahtar sözcük: Anesthesiology Limits Activated: Humans, Male, Female, Clinical Trial, Letter, Meta-Analysis, Practice Guideline, Randomized Controlled Trial, Review, Case Reports, Guideline, English, Publication Date from 2015 Ana başlık ve terimler: 53 adet Örnek: Postspinal headache Tek akciğer ventilasyonu TARK 2014 / TARK 2015 sunumları

9 Bilgilerin derlenmesi-3 Uluslararası dergiler Anesthesiology Anesth Analg Br J Anaesth J Clin Anesth Eur J Anaesth Ulusal dergiler TARD Dergisi Anestezi Dergisi T. K. Anesteziyoloji ve Reanimasyon Dergisi 1. Web sitesindeki ‘’En popüler yayınlar’’ listelerinin incelenmesi sayılarının içerik listelerinin incelenmesi

10 EN POPULER KONULAR

11 2015 yılı yayınları – Atıf

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14 Kronik ağrı için opioid kullanan olguların ¼’ünde opioid «hatalı kullanım» paterni mevcut Hatalı kullanım; «eksik-az kullanım», «organize olmayan kullanım», «yersiz kullanım (anksiyete, kısa stresler için kullanım)», «beraberinde alkol veya yasa dışı maddeler ile kullanım (örn marijuana), «yüksek miktarda kullanım».

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16 Yıllardır direkt laringoskopi trakeal entübasyon için anestezistin elindeki tek metottu – Glidescope Günümüzde, günlük pratiğin ne kadarı videolaringoskopi ? Obez olguarda videolaringoskopinin ilk seçenek olmasını öneren yayınlar mevcut Güç entübasyon algoritmasında yer almıştır İzleyen soru şu olacaktır: Neden tüm entübasyonlarda kullanmıyoruz? Dijital hava yolu parmak izi & Maliyet

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23 ERAS Preoperatif ERAS elementleri Operasyon öncesi riskin değerlendirilmesi Cerrahi öncesi skorlama sistemleri Kardiak risk skorlaması Fonsyonel kapasitenin değerlendirilmesi Dinamik testler CPET AKI-RIFLE Operasyon öncesi sağlık durumunun optimalize edilmesi Sigara kesilmesi, Preop aneminin düzeltilmesi, Kardiovasküler riskin azaltılması, Kronik hastalıkların optimalize edilmesi Preanestezik değerlendirme Preoperatif beslenmenin optimalize edilmesi Preoperatif açlık süresi ve karbonhidratlı yükleme (obes ve diabetik olgularda zayıf öneri)

24 ERAS İntraoperatif ERAS elementleri Postoperatif bulantı ve kusmanın önlenmesi ve tedavisi Standart anestezi protokolleri ve Anestezi derinliği monitörizasyonu Kas gevşetici kullanımı Laparaskopik cerrahide operasyon koşullarını düzeltmek için derin nöromuskuler bloğa karşı görüş bildirilmiş Nöromuskuler fonksyonlar monitörizasyonu: güçlü öneri Nöromuskuler blokajın geri döndürülmesi: güçlü öneri Oksijen FiO2 normal oksijenasyonun sağlanması için titre edilmeli, hiperoksiden kaçınılmalı %100 oksijen preoksijenasyon için veya hipoksinn giderilmesinde kısa süreli kullanılmalı İntraoperatif hipotermiden kaçınılmalı ve aktif ısıtma gereçleri kullanılmalı Cerrahi teknik Nazogastrik tüp İntraoperatif glisemik kontrol: Preoperatif hemodinamik yönetim: Hedefe yönelik sıvı tedavisi Ağrı tedavisi: multimodal ağrı tedavisi Erken mobilizasyon

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27 “Medical home” Healthcare reform Coordinated care and reduce healthcare costs. Patient-centered, Comprehensive, Team-based, Coordinated, Accessible, Focused on quality and safety.

28 Perioperative Surgical Home

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30 Geçmiş hayvan deneylerinde, gelişmekte olan hayvan beyinlerinde anestezi ile ilişkili nörotoksisite ile ilişkili sonuçlar elde edilmişti. Ancak insan çalışmalarının sonuçları kısıtlıdır. Bu review gelişmekte olan beyin üzerine anesteziklerin nörotoksik etkilerini sadece insan çalışmaları perspektifi ile incelemektedir. Şimdiye dek insan çalışmalarından elde edilen sonuçlar tek kısa bir anestezinin masum olduğunu göstermektedir. Ancak tekrarlayan anesteziler ile ilişkili durum farklıdır. Şu ana dek elimizdeki veriler güncel klinik pratiğimizi değiştirmeyi gerektirmemektedir

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38 2015 yılında en çok atıf alan geçmiş 10 yıla ait yazılar

39 Ağrı Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment By: Breivik, H; Collett, B; Ventafridda, V; et al. EUROPEAN JOURNAL OF PAIN Volume: 10 Issue: 4 Pages: Published: MAY 2006 Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment Central sensitization: Implications for the diagnosis and treatment of pain By: Woolf, Clifford J. PAIN Volume: 152 Issue: 3 Supplement: 1 Pages: S2-S15 Published: MAR 2011 Central sensitization: Implications for the diagnosis and treatment of pain The evidence for pharmacological treatment of neuropathic pain By: Finnerup, Nanna Brix; Sindrup, Soren Hein; Jensen, Troels Staehelin PAIN Volume: 150 Issue: 3 Pages: Published: SEP 2010 The evidence for pharmacological treatment of neuropathic pain Glia and pain: Is chronic pain a gliopathy? By: Ji, Ru-Rong; Berta, Temugin; Nedergaard, Maiken PAIN Volume: 154 Supplement: 1 Pages: S10-S28 Published: DEC 2013 Glia and pain: Is chronic pain a gliopathy? A new definition of neuropathic pain By: Jensen, Troels S.; Baron, Ralf; Haanpaa, Maija; et al. PAIN Volume: 152 Issue: 10 Pages: Published: OCT 2011 A new definition of neuropathic pain The epidemiology of chronic pain in children and adolescents revisited: A systematic review By: King, Sara; Chambers, Christine T.; Huguet, Anna; et al. PAIN Volume: 152 Issue: 12 Pages: Published: DEC 2011The epidemiology of chronic pain in children and adolescents revisited: A systematic review Fear-Avoidance Model of Chronic Pain The Next Generation By: Crombez, Geert; Eccleston, Christopher; Van Damme, Stefaan; et al. CLINICAL JOURNAL OF PAIN Volume: 28 Issue: 6 Pages: Published: JUL-AUG 2012 Fear-Avoidance Model of Chronic Pain The Next Generation A systematic literature review of 10 years of research on sex/gender and experimental pain perception - Part 1: Are there really differences between women and men? By: Racine, Melanie; Tousignant-Laflamme, Yannick; Kloda, Lorie A.; et al. PAIN Volume: 153 Issue: 3 Pages: Published: MAR 2012 A systematic literature review of 10 years of research on sex/gender and experimental pain perception - Part 1: Are there really differences between women and men? Practice Guidelines for Acute Pain Management in the Perioperative Setting An Updated Report by the American Society of Anesthesiologists Task Force on Acute Pain Management By: Ashburn, Michael A.; Caplan, Robert A.; Carr, Daniel B.; et al. Group Author(s): Amer Soc Anesthesiologists ANESTHESIOLOGY Volume: 116 Issue: 2 Pages: Published: FEB 2012 Practice Guidelines for Acute Pain Management in the Perioperative Setting An Updated Report by the American Society of Anesthesiologists Task Force on Acute Pain Management

40 Hava Yolu Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia By: Cook, T. M.; Woodall, N.; Frerk, C. Group Author(s): Fourth Natl Audit Project BRITISH JOURNAL OF ANAESTHESIA Volume: 106 Issue: 5 Pages: Published: MAY 2011 Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia STOP questionnaire - A tool to screen patients for obstructive sleep apnea By: Chung, Frances; Yegneswaran, Balaji; Liao, Pu; et al. ANESTHESIOLOGY Volume: 108 Issue: 5 Pages: Published: MAY 2008STOP questionnaire - A tool to screen patients for obstructive sleep apnea

41 Çeşitli Klavuzlar Management of severe perioperative bleeding Guidelines from the European Society of Anaesthesiology By: Kozek-Langenecker, Sibylle A.; Afshari, Arash; Albaladejo, Pierre; et al.EUROPEAN JOURNAL OF ANAESTHESIOLOGY Volume: 30 Issue: 6 Pages: Published: JUN 2013 Management of severe perioperative bleeding Guidelines from the European Society of Anaesthesiology Consensus Guidelines for the Management of Postoperative Nausea and Vomiting By: Gan, Tong J.; Diemunsch, Pierre; Habib, Ashraf S.; et al. ANESTHESIA AND ANALGESIA Volume: 118 Issue: 1 Pages: Published: JAN 2014 Consensus Guidelines for the Management of Postoperative Nausea and Vomiting Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures An Updated Report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters By: Apfelbaum, Jeffrey L.; Caplan, Robert A.; Connis, Richard T.; et al. Group Author(s): Amer Soc Anesthesiologists ANESTHESIOLOGY Volume: 114 Issue: 3 Pages: Published: MAR 2011 Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures An Updated Report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition) By: Horlocker, Terese T.; Wedel, Denise J.; Rowlingson, John C.; et al. REGIONAL ANESTHESIA AND PAIN MEDICINE Volume: 35 Issue: 1 Pages: Published: JAN-FEB 2010 Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition)

42 Opioidler Opioid-induced hyperalgesia - A qualitative systematic review By: Angst, MS; Clark, JDANESTHESIOLOGY Volume: 104 Issue: 3 Pages: Published: MAR 2006 Opioid-induced hyperalgesia - A qualitative systematic review Opioid Epidemic in the United States By: Manchikanti, Laxmaiah; Helm, Standiford, II; Fellows, Bert; et al. PAIN PHYSICIAN Volume: 15 Issue: 3 Special Issue: SI Supplement: S Pages: ES9-ES38 Published: JUL 2012 Opioid Epidemic in the United States Remifentanil-induced postoperative hyperalgesia and its prevention with small-dose ketamine By: Joly, V; Richebe, P; Guignard, B; et al. ANESTHESIOLOGY Volume: 103 Issue: 1 Pages: Published: JUL 2005 Remifentanil-induced postoperative hyperalgesia and its prevention with small-dose ketamine

43 Monitörizasyon – Hasta Güvenliği A Critical Review of the Ability of Continuous Cardiac Output Monitors to Measure Trends in Cardiac Output By: Critchley, Lester A.; Lee, Anna; Ho, Anthony M. - H.ANESTHESIA AND ANALGESIA Volume: 111 Issue: 5 Pages: Published: NOV 2010 A Critical Review of the Ability of Continuous Cardiac Output Monitors to Measure Trends in Cardiac Output Relationship between Intraoperative Mean Arterial Pressure and Clinical Outcomes after Noncardiac Surgery: Toward an Empirical Definition of Hypotension By: Walsh, Michael; Devereaux, Philip J.; Garg, Amit X.; et al.ANESTHESIOLOGY Volume: 119 Issue: 3 Pages: Published: SEP 2013 Relationship between Intraoperative Mean Arterial Pressure and Clinical Outcomes after Noncardiac Surgery: Toward an Empirical Definition of Hypotension Myocardial Injury after Noncardiac Surgery A Large, International, Prospective Cohort Study Establishing Diagnostic Criteria, Characteristics, Predictors, and 30-day Outcomes By: Botto, Fernando; Alonso-Coello, Pablo; Chan, Matthew T. V.; et al.Group Author(s): Vasc Events Noncardiac Surg Patien; Vasc Events Noncardiac Surg Patien ANESTHESIOLOGY Volume: 120 Issue: 3 Pages: Published: MAR 2014 Myocardial Injury after Noncardiac Surgery A Large, International, Prospective Cohort Study Establishing Diagnostic Criteria, Characteristics, Predictors, and 30-day Outcomes Anesthetic management and one-year mortality after noncardiac surgery By: Monk, TG; Saini, V; Weldon, BC; et al. ANESTHESIA AND ANALGESIA Volume: 100 Issue: 1 Pages: 4-10 Published: JAN 2005 Anesthetic management and one-year mortality after noncardiac surgery

44 Hipotermi- Mekanik Ventilasyon - Sepsis Outcome, timing and adverse events in therapeutic hypothermia after out- of-hospital cardiac arrest By: Nielsen, N.; Hovdenes, J.; Nilsson, F.; et al.Group Author(s): Hypothermia Network ACTA ANAESTHESIOLOGICA SCANDINAVICA Volume: 53 Issue: 7 Pages: Published: AUG 2009 Outcome, timing and adverse events in therapeutic hypothermia after out- of-hospital cardiac arrest Protective Mechanical Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function By: Severgnini, Paolo; Selmo, Gabriele; Lanza, Christian; et al. ANESTHESIOLOGY Volume: 118 Issue: 6 Pages: Published: JUN 2013 Protective Mechanical Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function Oxidative stress and mitochondrial dysfunction in sepsis By: Galley, H. F. BRITISH JOURNAL OF ANAESTHESIA Volume: 107 Issue: 1 Pages: Published: JUL 2011 Oxidative stress and mitochondrial dysfunction in sepsis

45 Anestezi ve Kanser Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis? By: Exadaktylos, Aristomenis K.; Buggy, Donal J.; Moriarty, Denis C.; et al.ANESTHESIOLOGY Volume: 105 Issue: 4 Pages: Published: OCT 2006 Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis? Anesthetic technique for radical prostatectomy surgery affects cancer recurrence - A retrospective analysis By: Biki, Barbara; Mascha, Edward; Moriarty, Denis C.; et al.ANESTHESIOLOGY Volume: 109 Issue: 2 Pages: Published: AUG 2008 Anesthetic technique for radical prostatectomy surgery affects cancer recurrence - A retrospective analysis

46 Diğer Early Exposure to Anesthesia and Learning Disabilities in a Population-based Birth Cohort By: Wilder, Robert T.; Flick, Randall P.; Sprung, Juraj; et al. Conference: Annual Meeting of the American-Society-of-Anesthesiologists Location: Orlando, FL Date: OCT 18-22, 2008 Sponsor(s): Amer Soc Anesthesiologists ANESTHESIOLOGY Volume: 110 Issue: 4 Pages: Published: APR 2009 Early Exposure to Anesthesia and Learning Disabilities in a Population-based Birth Cohort Point-of-Care Testing A Prospective, Randomized Clinical Trial of Efficacy in Coagulopathic Cardiac Surgery Patients By: Weber, Christian Friedrich; Goerlinger, Klaus; Meininger, Dirk; et al. ANESTHESIOLOGY Volume: 117 Issue: 3 Pages: Published: SEP 2012 Point-of-Care Testing A Prospective, Randomized Clinical Trial of Efficacy in Coagulopathic Cardiac Surgery Patients Effect of Perioperative Systemic alpha 2 Agonists on Postoperative Morphine Consumption and Pain Intensity Systematic Review and Meta-analysis of Randomized Controlled Trials By: Blaudszun, Gregoire; Lysakowski, Christopher; Elia, Nadia; et al. ANESTHESIOLOGY Volume: 116 Issue: 6 Pages: Published: JUN 2012 Effect of Perioperative Systemic alpha 2 Agonists on Postoperative Morphine Consumption and Pain Intensity Systematic Review and Meta-analysis of Randomized Controlled Trials

47 GÜNDEMDEKİ KONULAR

48 ERAS

49 Ultrason

50 Deksmedetomidin

51 Sugammadeks

52 Remifentanil

53 Propofol

54 Güç Havayolu

55 Bireysel Kan Yönetimi - Patient Blood Management

56 Anestezide Hasta Güvenliği

57 Pediatrik Havayolu

58 Tek akciğer ventilasyonu

59 Kapnografi

60 Palyatif Bakım

61 Obstetrik anestezi

62 Nöromonitörizasyon

63 Hipotermi

64 Perkutan trakeostomi

65 Magnezyum

66 Transamin

67 YENİ GÜNDEME GİRENLER

68 Remimazolam

69 Phaxan™ Alphaxalone &7-sulfobutylether β- cyclodextrin

70 Neosaksitoksin

71 Calabadion

72 Tapentadol

73 Fospropofol

74 Cebranopadol

75 Gündemdeki Uyarılar

76 GÜNDEMDEKİ KLAVUZLAR

77 DAS 2015

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79 Anesthesiology.Anesthesiology Dec 11. [Epub ahead of print] Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration: An Updated Report by the American Society of Anesthesiologists Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine.

80 Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations - Part I. Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations - Part I. Nelson G, Altman AD, Nick A, Meyer LA, Ramirez PT, Achtari C, Antrobus J, Huang J, Scott M, Wijk L, Acheson N, Ljungqvist O, Dowdy SC.

81 Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. [No authors listed] Anesthesiology Nov 18. [Epub ahead of print] No abstract available.

82 Guidelines to the Practice of Anesthesia - Revised Edition Guidelines to the Practice of Anesthesia - Revised Edition Merchant R, Chartrand D, Dain S, Dobson G, Kurrek MM, Lagacé A, Stacey S, Thiessen B, Chow L, Sullivan P. Can J Anaesth Nov 17. [Epub ahead of print]

83 European Resuscitation Council and European Society of Intensive Care Medicine Guidelines for Post-resuscitation Care 2015: Section 5 of the European Resuscitation Council Guidelines for Resuscitation European Resuscitation Council and European Society of Intensive Care Medicine Guidelines for Post-resuscitation Care 2015: Section 5 of the European Resuscitation Council Guidelines for Resuscitation Nolan JP, Soar J, Cariou A, Cronberg T, Moulaert VR, Deakin CD, Bottiger BW, Friberg H, Sunde K, Sandroni C. Resuscitation Oct;95: doi: /j.resuscitation No abstract available.

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85 European Malignant Hyperthermia Group guidelines for investigation of malignant hyperthermia susceptibility. European Malignant Hyperthermia Group guidelines for investigation of malignant hyperthermia susceptibility. Hopkins PM, Rüffert H, Snoeck MM, Girard T, Glahn KP, Ellis FR, Müller CR, Urwyler A; European Malignant Hyperthermia Group. Br J Anaesth Oct;115(4): doi: /bja/aev225. Epub 2015 Jul 18

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87 Peri-operative management of the obese surgical patient 2015: Association of Anaesthetists of Great Britain and Ireland Society for Obesity and Bariatric Anaesthesia. Peri-operative management of the obese surgical patient 2015: Association of Anaesthetists of Great Britain and Ireland Society for Obesity and Bariatric Anaesthesia. Members of the Working Party:, Nightingale CE, Margarson MP, Shearer E, Redman JW, Lucas DN, Cousins JM, Fox WT, Kennedy NJ, Venn PJ, Skues M, Gabbott D, Misra U, Pandit JJ, Popat MT, Griffiths R. Anaesthesia Jul;70(7): doi: /anae Epub 2015 May 7.

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89 GÜNDEMDEKİ ARAÇLAR

90 Philips Lumify | Ultrasound Imaging

91 High-Flow Oxygen Through Nasal Cannula in Acute Hypoxemic Respiratory Failure Frat J-P, Thille AW, Mercat A, et al; for the FLORALI Study Group and the REVA Network. Akut Hipoksemik Solunum Yetmezliğinde Nazal Kanül Aracılığıyla Yüksek Akımlı Oksijen Uygulaması NEJM 2015;372:

92 GÜNDEMDEN DÜŞENLER

93 Serebral Oksimetri

94 BIS

95 Dural Ponksyon Sonrası Başağrısı

96 HEAS

97 Xenon

98 Azot Protoksit

99 Neostigmin

100 Kronik postoperatif ağrı

101 Postop Boğaz ağrısı

102 Trakeal ekstübasyon

103 Krikoid Bası

104 Kaflı tüp – Kafsız tüp kullanımı

105 Preoperatif değerlendirme

106 Plazma katekolaminleri ve anestezi

107 Sonuçlar Anesteziyolojide gündemin belirlenmesinde impakt faktörü yüksek yayın organları ve ekonomik kaygılar önemli rol oynamaktadır. Gündemden düştüğü düşünülenler hala klinik pratiğimizde yaygın olarak kullanılabilmektedir. Global ekonomik kriz bazı gündemden düşenleri yeniden gündeme getirebilir. Yılda bir kez yapılacak bu tür bir tarama çalışma ve tez konusu bulunmasında çok yararlı olabilir.

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