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Yayın Anesthesiologists' Perspective on the Use of Artificial Intelligence in Ultrasound-Guided Regional Anaesthesia in Terms of Medical Ethics and Medical Education: A Survey Study(Aves, 2023) Koçer Tulgar, Yasemin; Tulgar, Serkan; Kose, Selin Güven; Kose, Halil Cihan; Nasirlier, Gülten Cevik; Dogan, Meltem; Thomas, David TerenceObjective: Controversy exists around the world as experts disagree on what artificial intelligence will imply for humanity in the future. Medical experts are starting to share perspectives on artificial intelligence with ethical and legal concerns appearing to prevail. The purpose of this study was to determine how anesthesiology and reanimation specialists in Turkey perceive the use of artificial intelligence in ultrasound-guided regional anesthetic applications in terms of medical ethics and education, as well as their perspectives on potential ethical issues.Materials and Methods: This descriptive and cross-sectional survey was conducted across Turkey between July 1 and August 31. Data were collected through an online questionnaire distributed by national associations and social media platforms. The questionnaire included questions about the descriptive features of the participants and the possible ethical problems that may be encountered in the use of artificial intelligence in regional anesthesia and 20 statements that were requested to be evaluated.Results: The average age of the 285 anesthesiologists who took part in the study was 42.00 & PLUSMN; 7.51, 144 of them were male, the average years spent in the field was 10.95 & PLUSMN; 7.15 years, 59.3% were involved in resident training, and 74.7% habitually used ultrasound guidance regional anesthetic applications. Of the participants, 80% thought artificial intelligence would benefit patients, 86.7% thought it would benefit resident training, 81.4% thought it would benefit post-graduate medical education, and 80.7% thought it would decrease complications in practice. There will be no ethical issues if sonographic data are captured anonymously, according to 78.25%, while 67% are concerned about who will be held accountable for inaccuracies.Conclusion: The majority of anesthetists believe that using artificial intelligence in regional anesthetic applications will decrease complications. Although ethical concerns about privacy and data governance are low, participants do have ethical worries about accountability for errors.Yayın Comparison of Effects of Separate and Combined Sugammadex and Lipid Emulsion Administration on Hemodynamic Parameters and Survival in a Rat Model of Verapamil Toxicity(INT SCIENTIFIC LITERATURE, INC, 2016) Tulgar, Serkan; Kose, Halil Cihan; Piroglu, Isilay Demir; Karakilic, Evvah; Ates, Nagihan Gozde; Demir, Ahmet; Gergerli, Ruken; Guven, Selin; Piroglu, Mustafa DevrimBackground: Toxicity of calcium channel blockers leads to high patient mortality and there is no effective antidote. The benefit of using 20% lipid emulsion and sugammadex has been reported. The present study measured the effect of sugammadex and 20% lipid emulsion on hemodynamics and survival in a rat model of verapamil toxicity. Material/Methods: In this single-blinded randomized control study, rats were separated into 4 groups of 7 rats each: Sugammadex (S), Sugammadex plus 20% lipid emulsion (SL), 20% lipid emulsion (L), and control (C). Heart rates and mean arterial pressures were monitored and noted each minute until death. Results: Average time to death was 21.0 +/- 9.57 minutes for group C, 35.57 +/- 10.61 minutes for group S, 37.14 +/- 16.6 minutes for group L and 49.86 +/- 27.56 minutes for group SL. Time to death was significantly longer in other groups than in the control group (p<0.05). Conclusions: Verapamil overdose is has a comparatively high mortality rate and there is no effective antidote. Treatment generally involves gastric decontamination and symptomatic treatment to counteract the drug's negative effects. In animal studies sugammadex and lipid emulsion had a positive effect on survival in patients with calcium channel blocker toxicity. Sugammadex and intralipid increased survival in a rat model of verapamil toxicity. The combination of both drugs may decrease cardiotoxicity. Sugammadex alone or combined with 20% lipid emulsion reduce the need for inotropic agents. The mechanism requires clarification with larger studies.Yayın Deep supraspinatus muscle plane block: A novel ultrasound-guided technique for the blockade of suprascapular nerve branches(Elsevier Science Inc, 2021) Köse, Selin Güven; Kose, Halil Cihan; Tulgar, Serkan; Akkaya, Taylan[Abstract Not Available]Yayın Evaluation of ultrasound-guided adductor canal block with two different concentration of bupivacaine in arthroscopic knee surgery: A feasibility study(Wiley, 2021) Kose, Selin Güven; Kose, Halil Cihan; Arslan, Gülten; Cevik, Banu Eler; Tulgar, SerkanStudy Objective The application of regional anaesthesia techniques as a component of multimodal analgesia in knee arthroscopic surgeries increases the quality of postoperative analgesia. Adductor canal block (ACB) is an effective motor sparing analgesia technique used in knee surgeries. This study aimed to evaluate the efficacy of ACB using two different concentrations of local anaesthetic in terms of analgesic requirements and pain density in patients undergoing knee arthroscopy. Design Prospective, randomised, controlled. Setting Tertiary hospital. Patients A total of 60 patients (ASA I-II) were evaluated in three groups, with 20 patients in each group. Interventions Standardised postoperative analgesia was performed in all groups. In addition, ultrasound-guided ACB (same volume/two different concentrations of bupivacaine: 0.25% vs 0.16%) was applied to the experimental groups. Measurements Tramadol consumption, rescue analgesic requirement and Numeric Rating Scores (NRS). Main Results Tramadol requirement in the first 24 hours was significantly higher in the control group (209.5 +/- 23.27 mg) (P < .001), and there was no difference between the experimental groups (63 +/- 42.06 mg vs 80.5 +/- 36.63 mg). Although the mean NRS scores in the first three hours were higher in the control group when compared with both block groups, it was similar in all groups in the following measurements. Conclusion In arthroscopic knee surgery, ACB interventions with 0.25% and 0.16% concentrations of bupivacaine were similar in terms of postoperative analgesic efficacy, and they increased the quality of multimodal analgesics when compared with the control group.Yayın Lumbar versus thoracic erector spinae plane block: Similar nomenclature, different mechanism of action(ELSEVIER SCIENCE INC, 2018) Kose, Halil Cihan; Kose, Selin Guven; Thomas, David Terence…Yayın Peripheral Block Education and Level of Competency: A Survey of Turkish Anesthesiologists(Aves, 2020) Selvi, Onur; Tulgar, Serkan; Şentürk, Özgur; Tas, Zafer; Kose, Halil Cihan; Topcu, Deniz İlhan; Özer, ZelihaBACKGROUND/AIMS Presently, in Turkey, there is no work being conducted on the period of regional anesthesia education, and there are no statistics available on the frequency with the administration of basic extremity blocks. The present survey was conducted on anesthesia doctors throughout Turkey to explore the personal knowledge and competency of the participants. Simultaneously, this survey aimed to evaluate the information sources for regional anesthesia training in Turkey. MATERIAL and METHODS The present study surveyed 377 anesthesia doctors in March 2017 through a questionnaire formulated on the Delphi platform. The voluntary participants were recruited from professional organizations, hospital portals, and Turkey's anesthesia departments. Descriptive analyses were conducted for statistical evaluation. RESULTS Of the total participants, 3.2% were professors, 3.2% were associate professor doctors, 7.4% were assistant professors, 64.5% were specialist doctors, and 21.8% were residents. In the segment concerning skill and information level self-evaluation for blocks, the most commonly performed act was infraclavicular block (26.8%). With regard to their information source, 40% of the participants chose from my colleagues for upper extremity blocks. The specialist training was the least popular information source for ultrasound-guided interscalene block, while the digital visual information sources were often consulted for the same. CONCLUSION Various sources have been identified as the source of information as much as the specialty training, more so in some blocks. A significant majority of the participants avoided block applications. In the future, it would be useful to collect data on a more comprehensive national scale to overcome the limitations of the present issue.Yayın Radiological evaluation and unexpected sensorial block in a patient undergoing ultrasound-guided deep supraspinatus muscle plane block(Elsevier Science Inc, 2021) Köse, Selin Güven; Kose, Halil Cihan; Tulgar, Serkan; Thomas, David Terence; Akkaya, Taylan[Abstract Not Available]
