The effect of patient positions on perfusion index.

BACKGROUND: The optimal position for surgery is one in which the patient is provided the best possible surgical intervention and put at minimum risk. Different surgical positions may cause changes in tissue perfusion. This study investigates the relationship between surgical patient positions and perfusion index. METHODS: A sample of 61 healthy individuals with no peripheral circulatory disorders, chronic diseases, or anemia was included in this study. Participants held six different positions: supine, prone, 45-degree sitting-supine, 45-degree supine with legs lifted, Trendelenburg (45-degrees head down), and reverse Trendelenburg (45-degrees head up). Perfusion index values were then measured and recorded after individuals held their positions for five minutes. RESULTS: Participants' perfusion index values were affected by different body positions (p < 0.05). Perfusion index was lowest in the sitting position (4.5 ± 2.5) and highest in individuals with Trendelenburg position (7.8 ± 3.8). CONCLUSION: Different body positions can cause changes in tissue perfusion. This should be considered in patient follow-up along with the perfusion index.

The relationship between myocardial bridge and frontal QRS-T angle.

Aim: Although Myocardial bridge (MB) is known as a benign condition, it has been demonstrated to be associated with cardiac arrhythmias and poor outcomes. Frontal QRS-T angle (fQRSTa) is a novel indicator of repolarization and depolarization heterogeneity. Last studies indicated that associated with fQRSTa and adverse cardiac events. No study evaluated the relationship between fQRSTa and MB. In the present study, we aimed to investigate the relationship between MB and fQRSTa. Methods: This study included 91 patients with normal coronary arteries and 89 patients with MB. Coronary angiography was performed in all patients due to ischemia findings on treadmill exercise test or myocardial scintigraphy.2-lead surface electrocardiograms (ECGs) of all patients were evaluated. QT interval, fQRSTa, QTc interval were measured from surface ECGs. Results: Baseline clinical, echocardiographic and laboratory parameters were similar between MB and control group. However, when compared to control group, patients with MB had importantly raised fQRSTa [27 (20-41) vs. 23 (12-37) p = 0.007]. In correlation analysis, fQRSTa was positively correlated with MB length (r = 0.411, p < 0.001). Linear regression analysis showed that MB length was the just considerable predictor of fQRSTa (ß = 0.247, p = 0.041). Conclusions: The fQRSTa is a novel electrocardiographic marker that can be easily obtained from surface ECG. We have shown for the first time that MB length is a significant predictor of fQRSTa.

Associations between postoperative analgesic consumption and distress tolerance, anxiety, depression, and pain catastrophizing: a prospective observational study.

BACKGROUND: Patients' postoperative treatment might be affected by their psychological state. The study aimed to evaluate the effects of anxiety, coping ability (stress tolerance), depression, and pain catastrophizing on analgesic consumption in patients scheduled for sleeve gastrectomy. METHODS: This prospective observational study consisted of 72 patients. The Distress Tolerance Scale (DTS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS) were completed in the preoperative period. In the postoperative period, pain intensity, as measured with the Visual Analogue Scale (VAS), and morphine consumption (mg) were evaluated after 2, 6, 8, and 24 hours. Total morphine consumption was recorded. RESULTS: The results revealed a strong negative correlation between distress tolerance and postoperative total morphine consumption (r = -0.702, p < 0.001). There was a strong positive correlation between total morphine consumption and pain catastrophizing (r = 0.801, p < 0.001). A moderate positive correlation was observed between total morphine consumption and anxiety and between total morphine consumption and depression (r = 0.511, p < 0.001; r = 0.556, p < 0.001, respectively). Linear regression revealed that distress tolerance, anxiety, depression, and pain catastrophizing are predictors of postoperative morphine consumption (ß = 0.597, p < 0.001; ß = 0.207, p = 0.036; ß = 0.140, p = 0.208; ß = 0.624, p < 0.001, respectively). CONCLUSIONS: Distress tolerance, anxiety, depression, and pain catastrophizing can be predictive of postoperative analgesic consumption. In the estimation of postoperative analgesic consumption, distress tolerance, as well as anxiety, depression, and pain catastrophizing, were found to be important predictors.