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

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.

Objectives: Patients suffer notable levels of pain after lumbar spine surgery. The primary objective of this randomized clinical trial is to investigate the efficacy of erector spinae plane block (ESPB) on 24-h post-operative pain score of patients undergoing lumbar spine surgery. Cumulative opioid consumption and intraoperative bleeding were assessed as well.

Methods: Adult patient candidates for elective lumbar spine surgery were randomly assigned to case (ESPB) and control (no ESPB) groups. The block was performed under ultrasound guidance in prone position after induction of general anesthesia. Both groups received the same anesthesia medication and technique. Post-operative pain score, number of patients requiring rescue analgesia (meperidine), total amount of post-operative rescue analgesic demand in the first 24 h, and intraoperative bleeding were recorded. To compare pain score variable in time span, the ANOVA repeated measure test was used. All the statistical tests were two tailed and p<0.05 considered as statistically significant.

Results: In all time intervals, pain score in case group was significantly lower than control group. In case group, eight patients demanded rescue analgesic (40%) which was significantly lower than that in control group (15 patients [75%]) (p=0.025). Total amount of meperidine consumption was 57.50±45.95 in control group and 22.50±32.34 in case group (p=0.01) which was higher in control group and statistically significant.

Conclusion: ESPB reduces post-operative pain score and opioid consumption, while it does not affect intraoperative bleeding in lumbar spine surgery.

High-energy chest wall traumas usually lead to multiple rib fractures associated with high morbidity and mortality. Pulmonary morbidity in patients with multiple rib fractures results from the impaired gas exchange from the pulmonary contusion areas and compromised breathing mechanics as a result of severe pain. Thus, analgesia plays a key role in the management of rib fractures. Erector spinae plane (ESP) block is a newly described technique and it has come into use in emergency departments for posterior rib fractures. ESP blocks can be administered in patients under anticoagulant therapy in the intensive care unit because the relevant area is located relatively superficial and far from the major vascular structures. In this report, anecdotal records of three patients with multiple rib fractures who had real benefits from ESP blocks are presented. This report highlights the bilateral extent of the sensory block after unilateral injection, the effect of ESP blocks on weaning from mechanical ventila-tion, and dramatic improvement in arterial blood gases analysis following ESP catheter insertion.