Person: AKESEN, BURAK
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AKESEN
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BURAK
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Publication Comparison of efficacy between the genicular nerve block and the popliteal artery and the capsule of the posterior knee (IPACK) block for total knee replacement surgery: A prospective randomized controlled study(Türkiye Ortopedi Travmatoloji, 2021-03-01) Akesen, Selcan; Akesen, Burak; Atıcı, Teoman; Gurbet, Alp; Ermutlu, Cenk; Özyalçın, Ali; AKESEN, SELCAN; AKESEN, BURAK; ATICI, TEOMAN; GURBET, ALP; ERMUTLU, CENK; ÖZYALÇIN, ALİ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı; 0000-0002-3396-3407; 0000-0002-6503-8232; JHR-5447-2023; AEQ-5464-2022; ELR-9087-2022; AAH-9833-2021; A-5095-2018; A-7994-2018Objective: The aim of this study was to compare the efficacy of popliteal artery and the capsule of the posterior knee (IPACK) block and genicular nerve block on postoperative pain scores, the need for rescue analgesics, range of motion (ROM), walking distance, and perioperative monitorization variables in patients undergoing total knee replacement (TKR) surgery.Methods: Sixty American Society of Anesthesiologists (ASA) physical status I-III patients were enrolled in this study and then were randomly assigned into three groups: the IPACK block group (17 female, 3 male; mean age=67.5 +/- 1.4 years), genicular nerve block (16 female, 4 male; mean age=68 +/- 1.76 years), and the control group (13 female, 7 male; mean age=63 +/- 1.67years). All the patients underwent TKR under spinal anesthesia. The visual analog scale (VAS) score, mobility, pre- and intra-operative monitorization of systolic and diastolic holding area, non-invasive blood pressure, heart rate, and SPO 2 were compared between the groups.Results: Patients in the IPACK and genicular block groups had a significantly lower visual analogous scale (VAS) at postoperative 4 hours (p<0.01), 8h (p<0.01), 12h (p<0.01), and 24h (p<0.05). VAS score was significantly lower in the genicular block group at the postoperative 4h (5.5 +/- 0.55) and 8h (5.0 +/- 0.53) in the mobile state compared to the IPACK (8.0 +/- 0.47 and 8.0 +/- 0.43, respectively) and the control group (9.5 +/- 0.20; 10 +/- 0.28, respectively) (p<0.01). The use of patient-controlled-analgesia (PCA) devices and button push count for analgesics demand were significantly lower in the genicular block group on the immediate postoperative period (p<0.01 at the postoperative 0 to 4 h). The total consumption of morphine equivalents on the postoperative day 0 was significantly lower in the genicular block group (p<0.01, and p<0.001 for IPACK and control groups, respectively). The degree of flexion was significantly higher in the genicular block group at the postoperative 12h compared to the IPACK and the control group (p<0.001). The length of hospital stay was significantly lower in the genicular block group compared to the IPACK and the control group (p<0.05 for both variables).Conclusion: IPACK and genicular blocks both are effective in improving patient comfort during and after TKR surgery and reducing the potential need for systemic analgesic and opioids. The genicular block seems to be a promising technique that can offer improved pain management in the immediate and early postoperative period without adverse effects on systemic and motor variables.Publication Riluzole is effective on spinal decompression for treating acute spinal injury when compared with methylprednisolone and the combination of two drugs: In vivo rat model(Sage Publications Ltd, 2023-02-22) Önder, Çiğdem; Önder, Cem; ÖNDER, CEM; Akesen, Selcan; AKESEN, SELCAN; Akesen, Burak; AKESEN, BURAK; Yumusak, Ezgi; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmotoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-7773-3419; HKW-7185-2023Study Design Randomized controlled animal experiment. Objectives To determine and compare the efficacy of riluzole, MPS and the combination of two drugs in a rat model with acute spinal trauma, electrophysiologically and histopathologically. Methods 59 rats were divided into 4 groups as control, riluzole (6 mg/kg, every 12 hours for 7 days), MPS (30 mg/kg, 2nd and 4th hours after injury) and riluzole + MPS. Spinal trauma was created and the subjects were followed for 7 days. Electrophysiological recordings were made via neuromonitoring. The subjects were sacrificed and histopathological examination was made. Results For the amplitude values, mean alteration in the period from the spinal cord injury to the end of the 7th day is 15.89 +/- 20.00%, 210.93 +/- 199.44%, 24.75% +/- 10.13% increase and 18.91 +/- 30.01% decrease for the control, riluzole, riluzole + MPS and MPS groups, respectively. Although the riluzole treatment group produced the greatest increase in amplitude, it was observed that no treatment provided a significant improvement compared to the control group, in terms of latency and amplitude. It was observed that there was significantly less cavitation area in the riluzole treatment group compared to the control group (P = .020). (P < .05). Conclusions Electrophysiologically, no treatment was found to provide significant improvement. Histopathologically, it was observed that riluzole provided significant neural tissue protection.Publication Traumatic lumbosacral spondyloptosis: A case report and review of the literature(Georg Thieme Verlag Kg, 2014-02-01) Mutlu, Muren; Kara, Kürşat; Aydınlı, Ufuk; Akesen, Burak; AKESEN, BURAK; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; AAH-9833-2021Study Design Case report and review of the literature.Objective To report a case of traumatic L5-S1 spondyloptosis and review the literature.Method A 28-year-old man presented with severe low back pain, numbness at the soles of feet, and bowel and bladder dysfunction. Two days before admission, a tree trunk fell on his back while he was seated. A two-stage posterior-anterior procedure was performed. At the first stage, posterior decompression, reduction, and fusion with instrumentation were performed. At the second stage, which was performed 6 days after the first stage, the patient underwent anterior lumbar interbody fusion. The patient received physical therapy 1 week after the second stage.Results The patient's numbness improved immediately after the first posterior surgery. His fecal and urinary incontinence improved 6 months after discharge. He has been pain-free for a year and has returned to work.Conclusion A PubMed search was performed using the following keywords: lumbosacral spondyloptosis, lumbosacral dislocation, and L5-S1 traumatic dislocation. The search returned only nine reported cases of traumatic spondyloptosis. Traumatic spondyloptosis at the lumbosacral junction is a rare ailment that should be suspected in cases of high, direct, and posterior impact on the low lumbar area, and surgical treatment should be the standard choice of care.Publication Comparing the trajectory accuracy of pedicle screws placed with a free-hand technique and a three-dimensional computed tomography-assisted navigation system in spine surgery: A retrospective study(İstanbul Üniversitesi, 2023-02-28) Çetiner, Eyyup; Akesen, Selcan; Bilgin, Yücel; Önder, Cem; Güler, Saltuk Buğra; Akesen, Burak; AKESEN, SELCAN; BİLGİN, YÜCEL; Güler, Saltuk Buğra; AKESEN, BURAK; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; ELR-9087-2022; IAI-7796-2023; ADT-9515-2022; AAH-9833-2021Objective: We evaluated a free-hand technique and a three-di-mensional computerized tomography (3D-CT)-assisted naviga-tion technique, which are pedicle screw placement techniques used in spinal surgery, regarding screw placement and reliability.Material and Method: A total of 1664 screws in 73 patients with spinal deformities who underwent spinal instrumentation using pedicle screws were evaluated in this study. Forty patients were in the free-hand technique group, and 33 patients were in the 3D-CT-assisted navigation technique group. The placement and reliability of pedicle screws in all patients were evaluated using the Gertzbein-Robbins classification using CT images taken in the postoperative period.Result: There were no significant differences found regarding age, body mass index (BMI), sex (female or male), or deformity (scoliosis or kyphosis) (p>0.05). When the pedicle screws were evaluated in terms of transverse penetration, the 3D-CT-assisted navigation technique was determined Grade A (89.6%), as was the free-hand technique (76.5%), but the 3D-CT-assisted navi-gation technique was statistically more reliable (p<0.001). When the pedicle screws were evaluated in terms of anterior penetra-tion, both the 3D-CT-assisted navigation technique (92.5%) and the free-hand technique (82.9%) were determined Grade A, but the 3D-CT-assisted navigation technique was statistically more reliable (p<0.001).Conclusion: According to our studys results, the 3D-CT-assist-ed navigation technique is more reliable than the free-hand technique in surgeries involving spine deformities for pedicle screw insertion.Publication Bilateral bi-level erector spinae plane blocks in scoliosis surgery: A retrospective comparative study(Türk Ortopedi Travmatoloji, 2022-09-01) Akesen, Selcan; Güler, Saltuk Buğra; Akesen, Burak; AKESEN, SELCAN; GÜLER, ABDULKERİM SALTUKBUĞRA; AKESEN, BURAK; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı; 0000-0002-9518-541X; 0000-0002-4324-4844; 0000-0002-8679-6008; ADT-9515-2022; AAH-9833-2021; ELR-9087-2022Objective: This study aimed to compare the effect of the ultrasound (US) guided erector spinae plane block (ESPB) on pain scores, opioid requirement, patient satisfaction, and the length of hospital stay with standard analgesia methods following scoliosis surgery.Methods: Twenty-seven patients (17 females, 10 males; mean age = 15.59 +/- 3.24 years) who underwent scoliosis surgery with preoperative bilateral bilevel US- guided ESPB were the sample group, and the remaining 30 patients (20 females, 10 males; mean age = 15.57 +/- 2.75 years) without ESPB were the control group. Bilateral bilevel injection ESPB was performed at two levels (T4 and T10). Postoperative pain scores, morphine consumption, patient satisfaction scores, and the number of patients requiring rescue analgesia were recorded. A visual analog scale (VAS) was used to score postoperative pain.Results: VAS at rest and when mobile, as well as postoperative cumulative morphine consumption in the first postoperative 24 h, was significantly lower in the ESPB group. Thirteen patients in the control group but no in the ESPB group required rescue analgesics in the postoperative period. Both the time to the requirement of the initial dose of PCA and patient satisfaction scores were significantly higher in the ESPB group (P < 0.001 for both).Conclusion: Given the need for improved recovery of the patients, ESPB seems to be an essential analgesic technique that may reduce both opioid consumption and the severity of the pain, thus increasing the satisfaction of the patients and decreasing the length of hospital stay.