Epinay-sur-seine, France

Comparison of Spinal Anesthesia and Erector Spinae Plane Block in Critically Adult Patients Undergoing Femur Surgery

Different anesthesia methods, including general and regional anesthesia, are used in operating rooms in daily practice. When general anesthesia is performed, the patient is rendered entirely unconscious by using intravenous and/or inhalation anesthetics, total sensory loss develops, and the patient's ventilation is provided by a mechanical ventilator. Regional anesthesia applications consist of blockage of nerve conduction by applying local anesthetics from different body parts without causing loss of consciousness. By using neuraxial anesthesia techniques - such as spinal anesthesia, epidural anesthesia, and caudal block - medulla spinalis-related neuronal blocking can be performed. Another regional anesthesia method whose use has expanded considerably in recent years is peripheral nerve blocks. This anesthesia method injects local anesthetic by targeting a specific plexus, nerve, or facia without any central nervous system blockage. An essential part of intraoperative anesthesia management is planning analgesia for postoperative pain. It is aimed to provide analgesia with intravenous analgesics, central neuraxial blocks, or peripheral nerve blocks. Ensuring postoperative pain management has great importance in clinical practice because pain is associated with the patient's superficial breathing, prolonged immobilization, and noncompliant patients. Therefore, it is related to the development of atelectasis in the postoperative period and/or hypoxia-hypercarbia caused by inadequate gas exchange. In this situation where the patient cannot provide adequate respiration, the need for noninvasive mechanical ventilation may develop in the ward or intensive care unit where the patient is followed, closer clinical follow-up will be required, and the patient's hospitalization period will be prolonged. For this reason, it is one of the primary responsibilities to prefer anesthetic methods that help to provide optimal postoperative pain management. Femoral fracture cases are primarily encountered in elderly patients with multiple comorbidities. Postoperative follow-up of these highly mortal fractures is often provided in intensive care units. In Turkish society, with an increasing elderly population, the long hospitalization periods of this patient group in the intensive care unit and their subsequent follow-up in the ward until they are discharged bring high healthcare costs. It has been shown in various studies in the literature that the anesthetic method is related to the length of hospitalization. Therefore, the clinical practices of anesthesiologists who frequently work with elderly patients in the operating room and intensive care are essential. The clinician chooses the method of anesthesia, taking into account the type of operation, contraindications of the patient's clinical condition, pain management, postoperative follow-up conditions, and patient request. In critically ill patients with femoral fractures, the surgical procedure is successfully performed under general anesthesia, spinal anesthesia, or lumbar erector spinae plane (ESP) block. There are studies in which erector spinae plane (ESP) block applied from the lumbar region has been used as a primary anesthetic method that allows surgery in patients with femoral fractures. In this study, the investigators aimed to compare the regional anesthetic methods (not including general anesthesia) -spinal anesthesia, erector spinae plane (ESP) block- which are in routine practice in critically ill adult patients operated for femur fracture in terms of intraoperative and postoperative hemodynamics and clinical course, postoperative intensive care unit stay and hospitalization durations, pain scores, postoperative morbidity, and mortality.

19G FNB Needle Vs 22G FNB Needle for EUS-Guided Liver Biopsy

The Effect of the Use of Jigsaw Technique on Nursing Students' Critical Article Reviews and Students' Opinions on the Technique- Quasi-Experimental Study

Studies have proven that the Jigsaw learning method, one of the innovative learning methods, is an effective educational learning tool for nursing students. For nursing education to be sufficient to provide students with the modern roles required by the profession, students must actively learn instead of a memorized undergraduate education. -Training programs should enable them to participate in the teaching process. One of these programs is cooperative learning methods. The jigsaw learning technique creates a contemporary learning model by creating a positive learning environment, individualizing students and developing a sense of responsibility. No scientific literature has been found regarding the effect of the Jigsaw learning method on teaching critical article reading skills in nursing research courses in nursing education. It is assumed that the data obtained in this study will contribute to the effect of critical article reading training given using the Jigsaw technique, one of the cooperative learning techniques in nursing education, on students' critical article reviews and opinions about the technique. Aim: The purpose of the study is to determine the effect of using the Jigsaw technique on nursing students' critical article reviews and the student's opinions about the technique. Method: This is a randomized-controlled experimental study. The study will be carried out in the Spring Semester of the 2023-2024 Academic Year, with the students who attend the Research in Nursing Course at the Nursing Department of the Faculty of Health Sciences of Düzce University. The universe is the students taking the Research in Nursing course (191 people). To obtain a statistically significant difference with a 5% significance level, 80% power, and an effect size of 0.50, a total of 144 individuals will be randomly selected, with the number of people in the experimental and control groups being 2:1. A coin toss will be used to determine the experimental and control groups, and students will be randomly assigned to the groups. Data accumulation methods: In the study, descriptive features form, critical thinking disposition scale, Kolb's Learning Style Inventory, Self Directed Learning Skills Scales and Jigsaw Opinion Scale will be used as data Pre-tests will be administered to the students in the control group and individual homework will be given to the students. They will be provided to analyze articles under the supervision of the researcher. Post-tests will be applied. Students in the experimental group will be administered a pre-test. Students will be heterogeneously divided into eight groups according to their academic grade point average. The groups will consist of 7 people. Each student will be responsible for one of the 7 article sections. These sections are: 1) Title - Abstract 2) Introduction 3) Method 4) Results 5) Discussion 6) Conclusion and Recommendations 7) Limitations - Resources. Within the group, it will be determined which member will be responsible for which article section. collection tools.

Exclusive Enteral Nutrition in Patients With Ileocaecal Crohn's Disease