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

Herpes zoster (HZ) is a segmental vesicular eruption, pain, and sensorial symptoms. Segmental motor weakness can rarely be seen as a complication of HZ. Here, we present two cases of motor paresis associated with HZ, case 1 was L2 and L3 segmental motor paresis with femoral neuropathy and case 2 was L5 and S1 segmental motor paresis with sensorial ganglion involvement. In both cases after electrotherapy, exercise program, and medication for pain, there were no motor weakness and pain. Zoster motor paresis is a rare complication that responds to treatment and physicians should be careful about its presence in clinical follow-up.

Objectives: Trigeminal neuralgia is a paroxysmal and shock-like pain in the trigeminal nerve area. Various treatment options have been used for trigeminal neuralgia such as medical treatment, interventional procedures, and surgical operations. Pulsed radiofrequency (PRF) is a minimally invasive percutaneous technique which seems to be safer and easier to perform. This retrospective study aims to evaluate the analgesic effect, duration of efficacy, and side effects of PRF procedures in the peripheral branches of the trigeminal nerve.

Methods: The data of the patients with trigeminal neuralgia who were followed up in our hospital's algology clinic from 2016 to 2018 were reviewed retrospectively. Patients aged between 18 and 70 who did not respond to medical treatment or could not use medication due to side effects were treated with PRF procedure for peripheral branches of trigeminal nerve that was selected for this study. Demographic profile, clinical presentation, pain intensity, duration of efficacy, and complications were evaluated from their files.

Results: Twenty-one patients who underwent ultrasonography guided PRF procedures were included the study. Mean visual analog scale value of the patients was found to have decreased from 9.25±0.63 to 1.55±0.88 at the end of the 1st month (p<0.001). The painless period for the patients lasted up to 12 (9-21) months and no complications occurred.

Conclusion: PRF procedure seems to be an effective and safe method in patients who respond to block of the peripheral branches of the trigeminal nerve.

Objectives: The aim of this case-control study was to evaluate the physical activity levels of patients with fibromyalgia syndrome (FMS) and to assess a possible relation between physical activity and FMS characteristics.

Methods: Seventy patients with FMS and 50 age-gender-matched controls were included. Pain was evaluated using the visual analog scale. The Fibromyalgia Impact Questionnaire (FIQ) scoring system was used for the evaluation of the impact of FMS. Furthermore, for assessing the physical activity in our participants, we used the International Physical Activity Questionnaire (IPAQ). The Mann-Whitney U and Pearson's correlation tests were used for group comparisons and correlation analyses.

Results: The patients presented significantly less transportation-related, recreational, and total physical activity levels, besides reporting significantly less time spent walking and less time spent in vigorous activities than controls (p<0.05). Furthermore, there was a negative correlation between pain and the scores of self-reported moderate or vigorous physical activity (r=-0.41, p<0.01) in patients. However, we could not find any correlation between FIQ and IPAQ scores.

Conclusion: Patients with FMS are physically less active than healthy individuals. This reduced activity seems to be associated with pain, but not with the impact of the disease. In the management of the patient with FMS, considering the patient's physical activity behavior negatively affected by pain may contribute to holistic approach to the patients.

We herein present a 40-year-old female physician who was diagnosed with idiopathic intracranial hypertension (IIH) 4 years ago. In the last years, the patient was in remission without any medications. Since the onset of COVID-19 pandemic, she has been stressfully working in the high-risk area, therefore using personal protective equipment (N95 mask, protective clothing, goggles, and protective cap) during the day for extended periods. Her headaches recurred and the patient was diagnosed with a relapse of IIH; acetazolamide and afterward topiramate were initiated, with diet treatment. Symptomatic metabolic acidosis, which is otherwise a rare side effect of the IIH treatment and not seen in her first attack even with higher doses, developed during the follow-up, presenting with shortness of breath and chest tightening. The emerging problems of IIH diagnosis and management during the COVID-19 pandemic will be discussed.

vObjectives: The aim of this study is to determine the incidence and characteristics of pain in adults in Türkiye.

Methods: This cross-sectional study was carried out with 1391 participants in 28 provinces spread across seven demographic regions of Türkiye, between February 1 and March 31, 2021. The data were collected through the introductory and pain assessment information form prepared by the researchers and the online Google forms. SPSS 25.0 statistical program was used for data analysis.

Results: As a result of the analysis of the data obtained, it was found that the average age of the participants included in the study was 40.83±7.78 years, education level was 70.4% at most, and 80.9% was female at most. It was determined that 58.1% lived in the Marmara region and 41.8% lived in Istanbul, and 41.2% were private sector employees. It was determined that the pain prevalence of adults in Türkiye was 80.84% and 79.07% of them had pain in the last year. It was determined that the region with the most pain was the head and neck region with 37.88%.

Conclusion: According to the results of the research, the prevalence of adult pain is quite high in Türkiye. Despite the high prevalence of pain, the rate of preference for drug therapy to relieve pain is low and the preference for non-drug treatment methods is high.

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The successful use of the erector spinae plane block (ESPB) has been reported for post-operative analgesia in numerous operations due to the widespread use of local anesthetic (LA) and the blocking of the dorsal and ventral rami. ESPB has also been effective for easing lumbar back pain caused by lumbar disc herniation through a high-volume LA application to the lumbar area. While high-volume LA administration increases the effectiveness of the block, it can also cause unexpected side effects due to its coverage area. In the literature, only one study has reported on the development of motor weakness following ESPB application, in a case in which the block was performed at the thoracic level. In the present study, a 67-year-old female patient with lower back and leg pain resulting from lumbar disc herniation developed a bilateral motor block following lumbar ESPB. This is the second report of this type of case in the literature.

In this article, a cosmetic complication case secondary to bilateral supraorbital and supratrochlear nerve block with low dose local anesthetic and dexamethasone combination is presented.

Objectives: In our study, we aimed to retrospectively evaluate patients who were given particulate and non-particulate steroids for transforaminal epidural steroid injection due to non-operated chronic low back pain with radicular symptoms in terms of the change in pain and the change in functional capacity before the procedure.

Methods: This study was carried out by examining the files of 130 patients, underwent an interventional procedure. Records of patients pertaining to age, gender, location of pain, Visual Analog Scale, Patient Global Impression of Change, and Oswestry Disability Index Scale (ODI) before the interventional procedure and at the 1st and 3rd months after the procedure were recorded using the hospital automation system and patient follow-up forms.

Results: The functional capacity of the patients was evaluated, and in the comparison of the ODI score before the procedure, at the 1st month, and at the 3rd month, a statistically significant difference was found in the particulate steroid group compared to the non-particulate group at the 1st and 3rd months. When evaluated using the Generalized Linear Models, a statistically significant difference was found in both groups (p=0.039), and the ODI score was approximately 2,951 units lower in patients who were treated with particulate steroids than those who were treated with non-particulate steroids at each measurement time.

Conclusion: In our study, it has been demonstrated that particulate steroids are superior to non-particulate steroids in improving functional capacity in the early period, and non-particulate steroids are advantageous in the long term.

Objectives: The aim of this study was to investigate the effects of portable infrared Pupillometer, Critical Care Pain Observation Scale (CPOT), and vital sign changes during painful procedures on patients with mechanical ventilators in the intensive care unit (ICU), and comparing the efficacy of these methods to detect the presence of pain.

Methods: In 50 patients who could not verbally state pain, admitted to Necmettin Erbakan University Meram Faculty of Medicine ICU, aged 18-75 years, and connected to a mechanical ventilator, vital sign changes, CPOT scale assessments, and pain evaluation with a portable infrared pupillometer were performed during endotracheal aspiration and position changes, which are defined as painful stimuli.

Results: Data were collected from 50 patients with a mean age of 57.4±17.9 years and 48% of males. The systolic, diastolic, and mean arterial pressure and heart rate values, CPOT scores, and pupillometric measurements of the patients increased significantly at the time of aspiration and change of position (p<0.05). Neurological pupil index scores showed a significant decrease at the time of painful stimulation (p<0.05).

Conclusion: It was found that pupil diameter changes evaluated using a portable infrared pupillometric measuring device can be used effectively and reliably in pain assessment in patients who are treated in the ICU, supported by mechanical ventilation and who cannot communicate verbally.