Amaç: Tek başına veya birlikte sistemik olarak verilen tramadol ve gabapentinin farelerde akut ağrıda muhtemel antinosiseptif etklerini araştırmaktır.
Gereç ve Yöntem: Hayvan Etik Komitesinin onayı sonrası; 96 BALB/c albino dişi fare 12 gruba ayrıldı: (I) enjeksiyon yapılmaksızın kontrol grubu, (II) salin uygulanan kontrol grubu, (III)-(IV) tramadol 10 mg/kg veya 30 mg/kg uygulanan gruplar, (V)-(VIII) gabapentinin sırasıyla 30, 100, 200, 300 mg/kg uygulandığı gruplar idi. Tramadol ve gabapentinin olası etkileşimlerinin araştırıldığı gruplarda farelere tramadol+gabapentinin dört farklı dozları uygulandı; (30+30, 30+100, 30+200 ve 30+300 mg/kg) (sırasıyla, Grup IX-XII). Farelerin her 10 gram ağırlığı için intraperitoneal olarak 0.1 mL ilaç uygulandı. Enjeksiyondan 30 dakika sonra tail-flick ve hot plate testleri gerçekleştirildi.
Bulgular: On ve 30 mg/kg tramadol tail-flick ve hot plate testlerinde doz bağımlı antinosiseptif etki oluşturdu. Gabapentin 300 mg/kg dışındaki dozlarda tail-flick testinde antinosiseptif etki oluşturmazken, hot plate testinde doz bağımlı antinosiseptif etki oluşturdu.
Her iki testte de tramadol ve gabapentin birlikte kullanıldıklarında, tek başlarına kullanılmalarına oranla daha fazla antinosiseptif etki oluşturdu, fakat sadece 30mg/kg tramadol+300mg/kg gabapentin birlikte kullanıldığında her iki testte de anlamlı antinosiseptif etki saptandı (p<0.05).
Sonuç: Gabapentin ve tramadol birlikte kullanıldıklarında, tail-flick ve hot-plate testlerinde gabapentin 300 mg/kg dozu dışında additif antinosiseptif etki oluşturmadı. Tail-flick testi sonuçlarına göre tramadol, gabapentinden daha iyi antinosiseptif etki oluşturdu.

Objective: Postoperative pain after laparoscopic surgery is less intense than after laparotomy and patients may benefit from an intraperitoneal injection of local anesthetic and opioids. We aimed to compare intraperitoneal 0.75% ropivacaine with 0.75% ropivacaine plus meperidine for postoperative analgesia in patients undergoing gynecologic laparoscopy.
Material and Methods: At the end of gynecologic laparoscopy, in a double–blind, randomized manner, one of the following injections was given intraperitoneally. Patients were allocated into three groups: patients in R Group (n= 18) were given 0.75% ropivacaine 3 mg/kg in 200 mL saline; patients in RM Group (n= 17) were given meperidine 50 mg plus 0.75% ropivacaine 3 mg/kg in 200 mL saline; patients in C Group (n= 18) were given 200 mL saline through the trocars. All patients were given diclofenac sodium when they had pain (VAS ³ 3) and 1 mg/kg meperidine i.v. was also given when pain persisted.
Results: The pain scores and analgesic requirements during the first postoperative hour were significantly lower in the RM Group than those in the R and C Groups. Beyond that time, the pain scores were similar in all groups and there were no differences in total analgesic requirement in 24 h between groups. The three groups were comparable for shoulder pain and side effects.
Conclusion: The intraperitoneal infiltration of 0.75% ropivacaine plus meperidine reduced pain scores and analgesic requirement during the first one hour after gynecologic laparoscopy compared with the intraperitoneal infiltration of ropivacaine or saline.

Purpose: Pain treatment in laparoscopic cholecystectomy, which is performed in increasing numbers as an ambulatory procedure, is an important issue.Although laparoscopic cholecystectomy is regarded as an ambulatory procedure, patients are often hospitalized due to pain and this increases opioid consumption and side effects caused by opioids. This study aims at evaluating the efficacy of adding dexketoprofen trometamol to tramadol with patient controlled analgesia in post-laparoscopic cholecystectomy pain treatment.
Method: 40 patients in ASA I-II risk groups aged between 18-65 years were enrolled in the study and were randomized using closed envelope method. In Group TD 600 mg tramadol and 100 mg dexketoprofen trometamol, in Group T 600 mg tramadol was added to 100 ml 0.9% normal saline for PCA. 8 mg lornoxicam iv was given if VAS >40 in the postoperative period.
Results: There was no statistically significant difference in terms of adverse effects (hypotension, bradycardia, sedation) but in Group T 4 patients complained of nausea and 3 complained of vomiting. Opioid consumption was lower and patient satisfaction was higher in group TD.
Conclusion: This study has shown that adding dexketoprofen trometamol to tramadol in patient controlled analgesia following laparoscopic cholecystectomy lowers VAS scores, increases patient satisfaction and decreases opioid consumption.

This study was conducted to determine women’s about attitudes child’s teeth, abdomen and ear ache. Those who had lived in Antalya that 6 number primary health care center between March-May 2004 were enrolled in the study. As data collecting tools. A questionnaire prepared by the authors. This study was determined that 29.2 % of the mothers carried out mixture who had prepared at home to child’s abdomen and foot base; 30.3 % were to put breast milk childs’ ear; 38.9 % were placed aspirin, salt and salts of lemon to childs’ teeth ache.
The majority of the women make a wrong practices child that teeth, abdomen and ear ache. This traditional practice effecting factors were the women’s educational status and age. The results of the study that education about child care, common health problems and incorrect applications shoud be given to women by nurse.

Objective: This study looks into the efficacy and safety of the transforaminal lumbar epidural steroid injection (TLESI) applied to patients with radiculopathy due to lumbar disk herniation.
Methods: The patients’ files which were applied TLESI, were retrospectively scanned. Patients who did not respond to one-month conservative treatment and who were detected to have bulging or protruding lumbar disk herniation as a result of imaging methods were included in the study. All applications were performed with C-arm fluoroscopy under local anesthesia by outpatient method. In all cases, a mix of 80 mg triamsinolone and 0.25% bupivacaine, was transforaminally injected to the anterior epidural area. Initial VAS pain scores were compared with the values of the 1, 3 and 6th months after the application. Patient satisfaction was determined through scoring. Furthermore, early and late term complications were collected for evaluation.
Results: A total of 222 patients were administered TLESI 460 times (average: 2.1, repeat interval: 1-6 times). The applications were carried out most frequently at the levels of L4-L5 and L5-S1. While the initial VAS score average was 8.2±0.7, after TLESI, it was 5.0±1.6, 4.8±1.5 and 5.1±1.5 in the 1, 3 and 6th months, respectively. 63.9% of the patients (n=142) defined the treatment as ‘good and excellent’. No major complications were experienced and the overall minor complication rate was 11.1%.
Conclusion: It was seen that TLESI was an efficient and safe method in the short and medium term.

The aim of this study was to compare the sharp and blunt needles in order to determine the incidence of complications during transforaminal anterior epidural steroid injections.
In this retrospective study, 185 cases that undergo transforaminal epidural steroid injection with sharp or blunt needles were evaluated between June 2004 and December 2008. Patients age, sex, diagnosis, needle type (sharp or blunt), volume of local anesthetic and steroid injected, complications (paresthesia, dural puncture, bleeding, paralysis, intravascular penetration, headache, local back pain, temporary motor loss in lower extremities) was recorded.
3 cases in blunt needle group and 8 cases in sharp needle group showed paresthesia during the procedure. The difference was not found to be significant among the groups. Vascular penetration was observed in 2 cases in blunt and 13 cases in sharp needle group and the difference between groups was statistically significant (p<0.001). Dural punction and headache incidence were not significant when the two groups are compared. The local back pain at the injection site had a higher incidence in the blunt needle group.
When using the blunt needles, vascular penetration and paresthesia were less during transforaminal epidural steroid injections. Therefore blunt needles seem to be more advantageous.

U.S. high-risk patients in our study under the guidance of a low dose of LA in the surgical anesthesia was planned. ASA III patients as assessed by ultrasound guidance into the right femoral popliteal block by block, and both legs were provided surgical anesthesia. During the practice blocks with 80 mm-long needle and 10 ml of levobupivacaine 0.5% 10 ml of 2% lidocaine was performed by applying the block. Ultrasound guided femoral nerve be displayed, with the help nörostimülator right quadriceps muscle and motor responses after negative aspiration of 10 ml levobupivacaine 0.5% was applied. With ultrasound guided nerve blocks can be directly displayed as the success rate while improving the local anesthetic will also contribute to decreased. In the block under the guidance of ultrasound, a small amount of local anesthetic is allowing more than one block application

Postoperative isolated injury of the musculocutaneous nerve is a rare disorder and complication. Reported cases are claimed to present with loss of biceps and brachialis power without neuropathic pain (1,2,3). When injury occurs to one of the terminal branches of the brachial plexus, the lateral cutaneous nerve of the forearm, pain is the major symptom and it typically radiates along the radial aspect of the forearm (1,4). In the literature, isolated lesions of the musculocutaneous nerve have been attributed to repeated microtrauma, indirect trauma or direct trauma to the nerve (5). It may also occur due to strenuous extension of the forearm for prolonged periods.