Agri-The Journal of the Turkish Society of Algology最新文献

Objectives: Headache is one of the most common health problems, and it severely reduces the quality of life. The present study examines the efficacy of greater occipital nerve (GON) block in patients monitored for primary headaches.

Methods: The present study includes 53 patients monitored by the headache outpatient clinic from March 2017 to June 2018, evaluates them for headache type, attack duration, attack frequency, severity of pain, and analgesic intake and compares the initial values with the follow-up values at months 1, 3, and 6.

Results: The study group comprises 36 episodic migraine cases, 12 tension-type headache (TTH) cases, 4 chronic migraine cases, and 1 cluster headache case. In migraine group, VAS scores, attack durations, and the mean value of monthly number of attacks and analgesics taken significantly decrease compared to initial values at the end of the 6-month follow-up period. In TTH group, VAS scores, attack durations, and the mean value of monthly number of attacks and analgesics taken significantly decrease compared to initial values at the end of the 3-month follow-up period. Since only 2 of 12 patients completed the 6-month follow-up, although there was a decrease in the 6-month data, it was found to be statistically insignificant.

Conclusion: Repetitive GON block is an effective treatment method for migraine and TTH.

We aimed to inform transient neurological symptoms after spinal anesthesia and to review postpartum neurological deficits of regional anesthesia. A previously healthy 25-year-old primigravid woman underwent an elective cesarean section. Hypotension and bradycardia were not observed during the operation. On the 25th day postpartum, the patient suffered from numbness and weakness at the lower extremity. On neurological assessment, the muscle strengths in the gastrocnemius and quadriceps bilaterally were 2/5 (+) and 3/5 (+), respectively. The muscle strength at foot dorsiflexion and plantar flexion were 2/5 (+) bilaterally. The patient was unable to walk on toes and walked on heels, and the lower extremities were hypoesthetic. The patellar and the Achilles tendon reflexes were bilaterally negative. No pathological findings could be detected on lumbosacral magnetic resonance imaging (MRI). Electromyography revealed a mixed type of polyneuropathy. The symptoms relieved partially at the end of the 2nd month and regressed completely at the end of the 3rd month. To prevention of irreversible postpartum permanent neurologic deficits, the diagnosis should be made using a detailed neurologic examination along with MRI or computed tomography.

Objectives: The aim of this study is to determine the factors that may be related to the headache experienced by health-care professionals in the coronavirus disease 2019 (COVID-19) pandemic.

Methods: The target population of the study consisted of the health-care professionals working in the COVID-19 pandemic. The questionnaire form consisted of 40 questions. The demographic information of the participants, the presence of contact with the COVID-19 patient, they used which personal protective equipment (PPE) and how often, the effect of the pandemic process on the lifestyle, the presence of visual defects, the effect of the pandemic process on water consumption, the presence of old or de novo headaches, the factors that may affect this headache, and the factors that reduce the pain were questioned in the survey.

Results: A total of 177 health-care professionals participated in the study. About 93.8% of the participants use masks daily for more than 4 h. About 62.7% of the participants stated that their water consumption increased on the days when they used PPE. About 72.3% of the participants reported disruption in sleep patterns, 83.1% of them reported increase in their stress and anxiety. About 65.5% of the participants experienced headaches during the pandemic process. They reported that the most likely causes of headache were excessive sweating and difficulty in breathing due to the use of PPE.

Conclusion: During the pandemic, a substantial portion of health-care professionals experiences headaches. Besides the physical difficulties caused by the use of PPE, the stress caused by the pandemic process should not be ignored.

In the current paper, we aim to emphasize the pivotal role of the specialist headache nurse whose scope of work is clearly defined and detailed in western medical practice within tertiary care.

Cervicogenic headache (CEH) is a headache arising from cervical nociceptive structures such as facet joints, disci intervertebrales, muscles and ligaments. Myofascial trigger points (TrPs) are common factors in patients with CEH and contribute to the pain and disability. In this report, we present two patients with CEH who had TrPs in their upper trapezius muscles. Each patient received an ultrasound-guided interfascial block of the trapezius muscle. Case 1 A 79-year-old female patient presented with a complaint of headache due to trigger point in her upper trapezius muscle. Her Numerical Rating Scale (NRS) score for pain intensity was 10. We performed an ultrasound-guided interfascial block of the trapezius muscle. Her NRS score at 30 minutes after the procedure was 2. The patient was pain free during the two months follow-up period. Case 2 A 55-year-old female patient presented with a complaint of headache due to trigger point in her upper trapezius muscle. Her Numerical Rating Scale (NRS) score for pain intensity was 8. We performed an ultrasound-guided interfascial block of the trapezius muscle. Her NRS score at 30 minutes after procedure was 3. The patient was pain free during the two weeks follow-up period. The structure of the fascia can ease diffusion of an injected anaesthetic during diagnostic and therapeutic blocks, and interfascial injections are becoming more common. We suggest that this treatment may produce positive effects for patients with CEH caused by trigger points.

The term post-dural puncture headache (PDPH) refers to a common complication that occurs after accidental dural puncture. One of the diagnostic symptoms of PDPH is a postural headache, which worsens dramatically while sitting or standing and is relieved mostly by lying down. This symptom is caused by a cerebrospinal fluid (CSF) leak, leading to decreased CSF pressure or low CSF volume, which provokes a shift of intracranial contents and traction on pain-sensitive structures in the upright position. PDPH is commonly a self-limited condition and remits spontaneously within 2 weeks, or becomes less severe after surgical intervention to seal the leak with autologous epidural blood patch (EBP). Although recurrence of spontaneous intracranial hypotension following an EBP is not rare, spontaneously late recurrence of PDPH has been rarely reported. The purpose of this paper is to discuss this case with late recurrence of PDPH after 10 months following EBP.

Objectives: This research was conducted to determine low back pain in nurses and their methods of coping with low back pain.

Methods: This descriptive, cross-sectional study was performed with 356 nurses in three university hospitals in the province of Istanbul in April-August 2016. Percentage calculations and Chi-square tests were used in statistical analyses.

Results: The mean age of the nurses in the study was 28.70±5.92, 25.3% were working in intensive care, 46.6% worked 41-48 h a week, and 55.6% stood for 5-8 h within a 24 h period. Low back pain was moderate in 75.8% of participants, and low back pains sometimes affected work efficiency in 43.3% (n=154). In terms of coping, the great majority of participants did not visit a physician, but used analgesics, avoided wearing high-heeled shoes, and slept in hard beds. Statistical significance (p<0.05) was observed between participants' age groups, the unit where they worked, type of duty, the amount of time spent standing, and the amount of time standing in the same position and low back pain.

Conclusion: Based on the results obtained, nurses experienced a moderate level of low back pain, and we think that experiencing low back pain is a continuous risk for nurses because of their lengthy hours of work and time spent standing, and that their working hours should, therefore, be adjusted and that correct body mechanics should be included during in-service training.

Objectives: We aimed to compare the treatment response with simultaneous application of transforaminal epidural steroid injection (TESI) and pulsed radiofrequency (PRF) to the lumbar dorsal root ganglion (DRG) with TESI in patients with chronic lumbar radicular pain.

Methods: A total of 129 patients were enrolled. TESI was performed to 67 patients and TESI+DRG-PRF was performed to 62 patients. Demographic data, surgical records, and medications, side, and level of the procedure were recorded. Patients were evaluated on the pre-operative and post-operative 10th day, 1st and 3rd month follow-up visits, and visual analog scale (VAS, 0-10) scores, and patients' satisfaction assessment on the 3rd month follow-up were collected. A successful therapeutic response was defined as a 50% or more reduction in VAS scores.

Results: In both groups, post-operative VAS scores were significantly lower than the pre-operative levels (p<0.001). VAS scores in the TESI+DRG-PRF group were significantly lower than the TESI group at all follow-up periods (p˂0.001). Reduction ratios in VAS scores were significantly higher in the TESI+DRG-PRF group in all follow-up visits (p˂-0.001). Satisfaction levels were significantly higher in the TESI+DRG-PRF group (p˂0.01).

Conclusion: According to our study, TESI provides short-moderate pain relief in patients with chronic lumbar radicular pain. A simultaneous application of PRF in the same session with TESI should be considered as an option to improve the treatment response.

Epidural anesthesia and thoracic paravertebral blocks have been the mainstay of regional anesthesia for thoracic surgery for many years. Following introduction of ultrasound use during regional anesthesia practices, new blocks named interfascial plane blocks have been introduced into clinical practice. Although interfascial plane blocks fail to provide surgical anesthesia their contribution to providing analgesia is clinically important. In this review we mention the most commonly accepted blocks namely pectoral blocks, serratus anterior plane block, erector spinae plane block and rhomboid blocks.