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

Objectives: The aim of this study was to investigate the effectiveness duration of the peripheral blocks applied with high concentration local anesthetic and steroid in trigeminal neuralgia.

Methods: The data of 48 patients (nine patients received medical treatment and 39 patients underwent interventional procedure for peripheral block and Gasser ganglion radiofrequency thermocoagulation [RFT]) were analyzed retrospectively. The medications used by patients, pre-operative and post-operative visual analog scale scores who underwent interventional procedures, and duration for effectiveness of the procedure were evaluated with 36 months follow-up.

Results: Forty-eight patients (32 females and 16 males) who were treated with primary and secondary etiologies were evaluated. Three patients V1, 12 patients V2, 25 patients V3, and eight patients V2+V3 trigeminal nerve branches described appropriate clinical symptoms. Only peripheral block was applied to 31 patients and Gasser ganglion RFT was applied to eight patients after peripheral block. In 24 patients who underwent peripheral block, pain severity reduction was ≥50%, mean effectiveness duration of peripheral block was 7.5 months. The eight patients undergoing Gasser ganglion RFT had ≥50% pain intensity reduction, mean effectiveness duration of Gasser ganglion RFT was 22.7 months (p=0.002). While one patient had hypoesthesia in the palate after RFT, no serious side effects were recorded.

Conclusion: The duration of pain control for peripheral branch blocks in trigeminal neuralgia is not as long as RFT, but it is a relatively less invasive and less complicated interventional technique with good efficacy duration due to neurotoxicity of the used high concentrated local anesthetic.

Objectives: This study aims to define and compare sensory phenotypes in cervical radiculopathy patients exhibiting neuropathic pain (NP) components with healthy volunteers using clinical examination and quantitative sensory test (QST) findings. Another aim of the study is to show whether symptomatic components of the pain detect questionnaire (PDQ) are correlated with the QST findings, which may help clinicians indicate patients with sensory abnormalities without the use of specialized tests.

Methods: Fifty-seven participants were included in the study, including patients with NP (n=20) and healthy volunteers (n=37). After obtaining the sociodemographic and clinical data of the participants, the PDQ was performed in patients with pain followed by QST analysis in all participants.

Results: Analyses between painful and non-painful extremities yielded no differences in all groups for QST (p>0.05). Sensory thresholds were found to be higher in the NP group compared to healthy volunteers, and the pain threshold test was found to be lower (p<0.05) in the intergroup analyses. The changes described were found in both painful and non-painful limbs. Pain with slight pressure was found to be correlated with the lower heat pain threshold values (R=-0.602, p=0.005).

Conclusion: Patients with NP were found to have lower thresholds for pain and higher sensory thresholds when compared to healthy volunteers. Moreover, pain with pressure component in PDQ was found to be associated with hyperalgesia in QST.

Objectives: This study aims to the development of nursing students' attitudes scale toward pain assessment and establish its validity and reliability.

Methods: This was a methodological study conducted in the 2017-2018 academic year. The sample consisted of 300 nursing students attending at the Department of Nursing of Gazi and Selçuk Universities. First, a 51-item draft was developed based on a literature review and interviews with 25 students. Five experts were consulted for content validity. The items were revised, and six items were removed based on their feedback. The 45-item final version was applied to participants. Afterward, exploratory and confirmatory factor analyses were performed to determine the scale structure. Test-retest reliability was determined on 190 participants selected randomly from the sample.

Results: A 51-item draft was developed based on a literature review and interviews. Five experts were consulted for content validity, and six items were removed based on their feedback. The rotated principal component analysis revealed 15 items loaded on two factors. The total scale had internal consistency reliability (Cronbach's alpha; α) of 0.918 and test-retest reliability of 0.738.

Conclusion: Factor analyses showed that the scale had satisfactory construct validity and a two-factor structure. All α values were higher than 0.70, indicating that the scale had a satisfactory level of reliability. All in all, it is a valid and reliable scale that can be used to measure nursing students' attitudes toward pain assessment.

After the brachial plexus blocks, local anesthetics do not diffuse under the clavicle and can spread to the epidural space with a cephalic tendency. We aimed to show how the local anesthetic spread will be according to the integrity of the clavicle by adding contrast agent to the peripheral blocks. We observed that the barrier created by the clavicle at the neck-shoulder junction disappeared in fracture >2 cm and the drug distribution showed a caudal transition. We think that the type and degree of clavicle fracture changes the drug diffusion and affects the success of the block.

Objectives: Shoulder pain is one of the most common musculoskeletal pain syndromes. Interventional treatments can be applied to patients who do not respond to conservative therapies. Intra-articular steroid injection and suprascapular nerve block are both short-acting and may sometimes be clinically inadequate. In this study, the answer to the question of whether pulse radiofrequency application to the suprascapular nerve provides additional benefit was investigated.

Methods: Patients who had shoulder pain and were injected between October 2016 and April 2018 were evaluated retrospectively. Totally 160 patients who underwent shoulder injections were included in the study. Patients were divided into two groups: 114 patients who underwent shoulder intra-articular steroid injection and suprascapular nerve block, as Group 1 and 46 patients who underwent pulse radiofrequency to the suprascapular nerve, in addition to shoulder intra-articular steroid injection and suprascapular nerve block, as Group 2.

Results: There was no statistical difference between the groups in pre-intervention numerical rating scale (NRS) scores. One month after the intervention, NRS scores of Group 2 were significantly lower than Group 1. In both groups, 1 month after the intervention NRS scores were significantly lower than pre-intervention. The duration of pain relief for Group 2 was longer than Group 1. The satisfaction percentages of patients for Group 2 were higher than Group 1.

Conclusion: In addition to glenohumeral intra-articular steroid injection and suprascapular nerve block, pulse radiofrequency application to the suprascapular nerve provides additional benefits in terms of NRS scores, duration of pain relief, and patient satisfaction.

The superior cluneal nerve (SCN) is a sensory nerve known to be originated from the dorsal rami of the lower thoracic and lumbar nerve roots. One of the overlooked causes of low back pain (LBP) is the SCN Entrapment Neuropathy (SCNEN). SCNEN may also be associated with SCN stretching due to lumbar movement and the poor body posture through an increase in the paravertebral muscle tonus. A 59-year-old female patient presented with chronic LBP localized on the right iliac crest and radiating to the right buttock, groin, and leg. She had increased lumbar lordosis and anterior pelvic tilt. She had a tender point over the right iliac crest, and the pain was radiating to the buttock and posterolateral thigh (Tinel sign +). She was diagnosed with lower crossed syndrome and SCNEN, and a therapeutic nerve block was performed. Clinicians should consider SCNEN as a possible diagnosis of LBP.

Objectives: Psychiatric disorders including somatization impact pain severity and chronicity. This study aimed to determine sleep quality and the presence of psychiatric disorders in patients with chronic lateral epicondylitis (LE) and to investigate the effect of these comorbidities on pain levels.

Methods: This study included 46 patients diagnosed with chronic LE and 46 healthy controls. Visual analog scale (VAS) was used for the assessment of pain intensity. The prevalence of depression and other psychological factors was examined using Beck Depression Inventory (BDI) and the Symptom Checklist-90-Revised test (SCL-90-R). Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality.

Results: The mean BDI (p<0.001), all subdivisions of SCL-90-R including somatization (p<0.001), and the mean global PSQI scores (p=0.002) were found to be significantly higher in patients with chronic LE than those in the control group. The presence of depression according to BDI was 41.3% in the patient group. About 60.8% of the patients had somatization and 71.7% had poor sleep quality. VAS scores were significantly higher in the patients with depression, somatization, and low sleep quality indicating a low positive linear relationship (r=0.357, r=0.360, and r=0.463, respectively, and all p<0.05).

Conclusion: Psychiatric disorders and poor sleep quality are frequently observed in patients with chronic LE. These comorbidities negatively affect pain levels and may be linked to pain chronicity. Therefore, the potential coexistence of psychiatric disorders should be kept in mind when determining the treatment protocols for patients with chronic LE and adjunctive treatment should be given if necessary.

Objectives: This study aims to determine the validity and reliability of the full cup test (FCT), evaluating the pain severity in patients with chronic low back pain.

Methods: A total of 100 patients (70 women and 30 men) aged over 18 years with mechanical low back pain were enrolled in the study. Demographic and clinical characteristics were recorded. Pain severity was evaluated using the visual analog scale (VAS) and FCT, the functional state was assessed by the Oswestry Disability Index (ODI), and the quality of life was assessed using the Nottingham Health Profile (NHP). FCT was performed on the 1st day by two independent observers (G1 and G2) and 3 days after the first application, patients were readministered the FCT by G1.

Results: The mean age of participants was 56.04±12.33 years and mean body mass index was 27.7±4.3 kg/m². The reliability of the FCT and intraclass correlation coefficient (ICC) was found to be 0.989 for intrarater compliance, ICC was found to be 0.984 for inter-rater compliance, and Cronbach's alpha reliability coefficient was α=0.994. External construct validity of the scale was confirmed with expected correlations with all subgroups of NHP except for social isolation, VAS and ODI (p<0.01).

Conclusion: This study concludes that the FCT provides a reliable and valid instrument for measuring pain severity and loss of the function in patients with chronic mechanical back pain. We consider that FCT is a simple and easy test in patients with low education and advanced age.

Peripheral neuropathy secondary to entrapment of the nerves is not an uncommon etiology. Nerve entrapment is a common occurrence following trauma or surgery and poses significant diagnostic challenge. Entrapment neuropathy (EN) may not respond to standard neuropathic medication and may need invasive treatment. Pulsed radiofrequency (PRF) application is a recent modality and is gaining popularity for many EN as it does not cause neural ablation unlike conventional radiofrequency ablation. In this report, we present a case of young patient who presented with severe lower lateral leg pain in whom superficial peroneal nerve (SPN) EN was suspected and diagnostic SPN injection under ultrasound guidance confirmed the diagnosis. He subsequently underwent PRF neuromodulation and experienced long-lasting pain relief.