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    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 Terence
    Objective: 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.
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    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, Serkan
    Study 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.
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    How does the Exponential Increase in Rocuronium Dose Effect the Train of Four Parameters in Rats Reversed with Sugammadex? An Animal Model
    (Galenos Publ House, 2023) Köse, Halil Cihan; Kose, Selin Güven; Aydın, Serdar Onur; Kuzucuoğlu, Tamer; Tasargol, Omer; Tulgar, Serkan
    BACKGROUND/AIMS: Sugammadex is a gamma cyclodextrin structured agent used for reversing the effect of steroidal neuromuscular blocking (NMB) agents. The first aim of this study was to evaluate the dose of rocuronium required to re-establish NMB when administered 2 min after its reversal with sugammadex in rats. Also, to monitor the onset times and durations of NMB achieved by variable doses of rocuronium after reversal with sugammadex.MATERIALS AND METHODS: Thirty-five Sprague-Dawley rats were randomly divided into groups including control and four experimental groups. The control group was designed to determine the onset time and duration of NMB induced by 1.2 mg/kg rocuronium. In the control group, no sugammadex was applied. In the experimental groups, rocuronium (1.2 mg/kg) was reversed with sugammadex (4 mg/kg). Subsequently, experimental groups were administered various doses of rocuronium. Groups were named according to the rocuronium dose administered (group 2.4, group 3.6, group 4.8 and group 6.0). Rats in all groups were monitored with train of four.RESULTS: In group 2.4, rocuronium did not ensure NMB. In group 3.6, NMB occurredin only 3 rats. All rats in groups 4.8 and 6.0 achieved complete NMB. There was no statistically significant difference in the onset time of NMB in 4.8 and 6.0 groups (p<0.05). The mean duration of NMB in the experimental groups was significantly shorter than that in the control group (p<0.01).CONCLUSION: Sufficient muscle relaxation and intubation conditions could be achieved with 3.6 mg/kg, 4.8 mg/kg, and 6.0 mg/kg doses of rocuronium as short as 2 min after sugammadex.