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

Regional anesthesia practices are important because they have the advantages, for example, the patient's awareness is open, spontaneous breathing continues, airway reflexes are preserved, analgesia continues in the post-operative period, and the patient has early mobilization. Local anesthetic at high doses and volumes are used in brachial plexus blocks with nerve stimulator. However, due to the development in ultrasound (US) technology and the increase in image quality, reduced dose of limited anesthesia, and because of its advantages such as vascular and reduced risk of pleural puncture, it has become increasingly widespread. Through US, it is possible to monitor the nerves and anatomical structures, to follow the needle, and to reduce the dose by monitoring the distribution of the local anesthetic given. Organ and tissue losses and tissue infections due to multiple exothermic burns, especially after burns, require multiple surgical procedures. While taking these patients to surgery, anesthesiologists may have difficulty in many stages. For this purpose, they prefer regional anesthesia for less complications. In our study, we aimed to present a low-dose bilateral supraclavicular, infraclavicular, and axillary block with US-guided paraplegic high-risk trauma in a patient with bilateral wounds, forearms, wrists, and wounds caused by burns.

The objectives of the study were to explore the short-term efficacy of radiofrequency thermocoagulation for the treatment of classic trigeminal neuralgia (TGN). A retrospective analysis of 58 patients with classical TGN treated with radiofrequency thermocoagulation at our institution between 2016 and 2019, including 23 men and 35 women. The mean age of all patients was 62.1±10.9 years, the duration of the disease ranged from 2 months to 360 months, and the mean duration of the disease was 80.1±77.9 months. Patients were divided into three groups, V2, V3, and V2+V3, according to the site of symptom presenta-tion. Treatment effectiveness was evaluated by observing patients' before surgery, after surgery, and 1-year after surgery visual pain simulation (VAS) scores. The clinical efficacy was evaluated by calculating the percentage of patients whose net improve-ment in VAS scores of the three groups of patients V2, V3, and V2+V3 reached the minimal clinically important differences MCID value of TGN. Patients' after surgery VAS scores and 1-year after surgery VAS scores all showed meaningful improvement (p<0.001) compared with pre-operative VAS scores, and after surgery VAS scores showed meaningful change (p<0.05) com-pared with 1-year after surgery VAS scores. About 84.62%, 95.45%, and 86.96% of patients in V2, V3, and V2+V3 groups showed net improvement in after surgery VAS scores to MCID values, and 69.2%, 86.4%, and 74.0% of patients in 1-year after surgery VAS scores showed net improvement to MCID values, respectively. The early efficacy of radiofrequency thermocoagulation for classic TGN is significant, but patients have a tendency to have recurrence of pain symptoms 1 year after surgery.

Objectives: Epidural injections have been used for many years in the treatment of chronic pain in patients with chronic backleg pain and chronic neck-arm pain. We aimed to compare the efficacy of lumbar and cervical epidural steroid injections on pain palliation, duration of pain relief and patient satisfaction.

Methods: This is a Retrospective, observational single-center study. A total of 159 patients (96 females, 63 males) who were performed epidural steroid injections in cervical and lumbar regions were included in the study. The patients were divided into two groups as lumbar epidural steroid injection 'Group 1' and cervical epidural steroid injection 'Group 2'. We retrospectively evaluated the patients for numerical rating scale (NRS) prior and after the injection, the duration of the pain relief, whether any complication occured related to injection and patient satisfaction.

Results: 130 patients in Group 1 and 29 patients in Group 2 were evaluated. Median NRS before the procedure: 8 in Group 1, 7 in Group 2 and median NRS after the procedure: 3 in Group 1, 4 in group 2. Patient satisfaction with the procedure 56.15% in Group 1 and 48.62% in Group 2. Mean duration of pain relief 7.23 months in Group 1 and 8.17 months in Group 2. There were no statistically significant difference in the evaluated parameters between the two groups.

Conclusion: It was observed that the pain relief, duration of pain relief and patient satisfaction were similar for cervical and lumbar epidural steroid injections.

Objectives: We aimed to compare the intraoperative and post-operative analgesic activities of the preventive applied serratus anterior plane (SAP) block and infiltration block in patients undergoing video-assisted thoracoscopic surgery (VATS).

Methods: The study was carried out in 60 patients aged between 18 and 80 who were eligible for elective VATS, with the American Society of Anesthesiologists classification I-II, following ethical committee approval and written informed consent form. Patients were divided into two groups as SAP (group serratus anterior plane block [SAPB]) and group infiltration block after routine monitoring and general anesthesia induction by recording demographic data after randomization. Hemodynamic data of all patients were recorded before, after induction and within intraoperative 30 min period. Patient controlled analgesia (PCA) prepared with morphine was applied to all patients postoperatively. Intraoperative hemodynamic data and opioid consumption of patients, resting time, and coughing visual analog scale, time to first PCA dose, post-operative opioid consumption, rescue analgesic requirement, mobilization times, opioid side effects, and patient and surgical team's satisfaction were evaluated.

Results: Intraoperative hemodynamic data and opioid consumption were similar between the two groups. Post-operative pain scores (0 and 30 min, 1, 2, 4, 8, and 12 h) were lower in the SAPB group (p<0.005) and time to use the first PCA (p=0.002) was longer in the SAPB group. Post-operative PCA and rescue analgesic requirement were lower in the SAPB group (p=0.002, p=0.00). It was found that the first mobilization time was shorter in the SAPB group (p=0.003), and opioid-related side effects were similar in both groups (p=0.067). Patient and surgical team satisfaction was high in the SAPB group (p=0.004, p=0.000).

Conclusion: As a result, more effective post-operative analgesia was provided with preventively SAPB, compared to infiltration block in patients undergoing VATS.

Objectives: Evaluation of low back pain (LBP) requires a condition specific disability questionnaire along with pain and satisfaction measure such as self-assessment pain scales. Dallas Pain Questionnaire (DPQ) is a 16-item visual analog scale, developed for evaluating patient's cognitions about the percentage that chronic pain affects four aspects of the subject's lives. It's easy to understand; can be answered in 3-5 min and can be scored in <1 min. This reliability and validation study offers health-care providers an opportunity to utilize this distinct questionnaire in Turkish population with back pain. The objectives are translation of Dallas questionnaire from English to Turkish language and to perform validation and reliability study.

Methods: A total of 102 patients (79 women and 23 men) with mean age of 50.2 years and LBP for at least 3 months answered DPQ along with five other previously translated and validated questionnaires in Turkish language. Fifty-nine of these patients participated retest reliability after 7 days. Internal consistency and test-retest analyzes were conducted to determine the reliability and convergent validity was evaluated for the validation study.

Results: The questionnaire was noted to have high internal consistency. The test-retest analysis revealed an excellent correlation (ICC=0.969). Pearson correlation coefficient shows that all subscales (sections) of DPQ are significant and comparable with each of the other questionnaires included in this study proving that it has sufficient convergent validity (p<0.001).

Conclusion: The Turkish version of DPQ is content, valid, and reliable. DPQ is sensitive to use in patients with LBP.

Objectives: Central blocks such as caudal, spinal, and sacral epidural are frequently used in pediatric inguinal surgeries. Furthermore, peripheral blocks have been used and successful results have been obtained in pediatric inguinal surgeries. In this study, we aimed to compare the intraoperative and postoperative analgesic efficacy of the ilioinguinal/iliohypogastric (IL/IH) block under general anesthesia with the sacral epidural block.

Methods: This study was carried out in Gazi University Faculty of Medicine, Department of Anesthesiology and Reanimation, after obtaining permission from the Ethics Committee of Gazi University Faculty of Medicine and the Central Ethics Committee of the General Directorate of Pharmaceuticals and Pharmacy of the Turkish Ministry of Health, numbered B.10.0.İEG.011.00.01. Sixty patients in the American Society of Anesthesiologists I-II group between the ages of 1 and 8 years who will undergo elective unilateral inguinal hernia operation under general anesthesia were randomly divided into two groups. Group S (n=30) sacral epidural block and group I (n=30) IL/IH nerve block were planned.

Results: Hemodynamic values were found to be statistically significantly lower than control values in both groups. The minimum alveolar concentration values for sevoflurane were statistically significantly lower values in both groups at all surgery periods. In terms of additional analgesic requirement, the group I was found to be statistically significantly lower than the group s at the 8th-12th h. When the first analgesic intake hours were examined, no significant difference was found between the two groups.

Conclusion: In our study, group I and group S analgesic efficacy was found to be similar.

Erector Spina plane (ESP) block; It is a new and simple interfacial area block applied with ultrasonography. ESP is gaining popularity in abdominal and thorax surgery due to its adequate postoperative analgesia, easy administration, and low complication rate. In this case, the postoperative analgesic efficacy of bilateral ESP block performed under the guidance of ultrasonography in a myasthenic patient undergoing thymectomy surgery presented. ESB may be a good option in myasthenic patients in terms of reducing opioid need after thymectomy surgery and preventing possible postoperative complications.

Objectives: In this study, we aimed to compare the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) values of patients with axial spondyloarthritis (ax-SpA) with and without coccydynia.

Methods: We included 42 cases between the ages of 18 to 65 that were admitted to our clinic between August 1, 2019 and April 20, 2020 with the diagnosis of ax-SpA. The first group consisted of 13 patients with coccydynia and the second group consisted of 29 patients without coccydynia. Besides the demographic data Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP), Bath Ankylosing Spondylitis Functional Index (BASFI), and MASES values of the patients were recorded.

Results: We found that 13 (29.5%) of 42 patients with ax-SpA had coccydynia. While the rate of female patients in the coccydynia group was 46.15%, in the group without coccydynia, this rate was 31.03%. The mean of MASES, ASDAS-CRP, and BASFI values of the coccydynia group was statistically significantly higher than the group without coccydynia. We found that the BASFI was the most effective factor affecting the presence of coccydynia.

Conclusion: Our study supports the increased prevalence of coccydynia in patients with ax-SpA. In this study, we found that the presence of coccydynia may be associated with hypomobility rather than enthesitis.

Lateral epicondylitis is the most common elbow problem in adults. Corticosteroid injection for the treatment of lateral epicondylitis is a frequently used method of conservative management. A 43-year-old woman was referred to our clinic with a 6-month history of pain along the lateral side of her right and left elbow. She had been treated with 20 mg Triamsinolon heksasetonit to the right and left elbow for lateral epicondylitis with the resistance of pain After 3 weeks of the injection, the pain was completely relieved. The patient was able to move easily her elbow within normal limit. Examination also revealed depigmentation of the skin and atrophy of subcutaneous fat over the lateral epicondyle of both elbows. In the treatment of lateral epicondylitis, corticosteroid injection can be used for alternative conservative treatment. Depigmentation or subcutaneous tissue atrophy may occur inappropriate technique or excessive cortisone dose.