EXPERIMENTAL AND CLINICAL STUDIES | |
1. | Analgesic Effect of Anatolian Propolis in Mice Kıvanç Kamburoğlu, Tuncer Özen PMID: 21644103 doi: 10.5505/agri.2011.73745 Pages 47 - 50 Objective: The aim of the present study was to assess the analgesic effect of Anatolian Propolis, which is added to toothpastes as a prophylactic component for periodontal diseases. Methods: Water, ethanol and acetone extracted Anatolian Propolis were prepared. Analgesic effect of the extracts was assessed using the tail-flick test in mice (n=6 per each extract). Comparison among groups were made by using one-way ANOVA, followed by post-hoc Scheffe's test to determine significant differences among the means of the data groups. P<0.05 was accepted as significant difference. Results: We found that water extracted Anatolian Propolis caused a significant increase, 1.61 fold increase (p<0.001 versus control), of the latency time using tail-flick test in mice. However, acetone extracted and ethanol extracted propolis led no significant effect. Conclusion: We proved the analgesic effect of water extracted Anatolian Propolis. Thus, propolis used in the composition of toothpastes may be beneficial in terms of its analgesic action in addition to its other favorable effects. |
2. | Effects of Perineural Tramadol on Nerve Conduction of Sural Nerve Mehmet Beyazova, Ertan Öztürk, Murat Zinnuroğlu, İsmail Gökyar, Avni Babacan, Kadir Kaya PMID: 21644104 doi: 10.5505/agri.2011.72792 Pages 51 - 56 Objectives: The aim of this study was to investigate whether tramadol had a dose dependent blocking effect on nerve conduction when administered perineurally to the sural nerve of healthy volunteers. Methods: 24 informed healthy subjects were randomized into four equal groups [Saline (placebo), 0.5% tramadol, 1% tramadol and 1.5% tramadol]. The study was designed to be double-blinded. Sensory nerve action potentials were recorded electroneurographically. Two mililiters of study solution was administered to sural nerve perineurally at the level of ankle by the guidance of a nerve stimulator. A sensory block was assumed to have developed when the amplitude of the averaged sensory nerve action potentials diminished below 80% of the baseline value in the subsequent recordings. Results: According to electroneurographical recordings, none of the volunteers in saline group had block. However, the block rates with 0.5%, 1% and 1.5% tramadol were 1/6, 4/6 and 6/6 respectively (p<0.05). The maximum decrement in the sensory action potential amplitudes with respect to baseline amplitudes given as median values were as follows: 7.8% with saline; 12.5% with 0.5% tramadol; 38.5% with 1% tramadol and 77.5% with 1.5% tramadol (p<0.05). While the median duration of sensory block with 0.5% tramadol was 5 minutes, it was 15 minutes with 1% tramadol and 35 minutes with 1.5% tramadol. Conclusion: Perineurally administered tramadol blocks sensory nerve conduction of sural nerve in a dose dependent manner. |
3. | The effects of morphine and fentanyl alone or in combination added to intrathecal bupivacaine in spinal anesthesia for Cesarean section Semra Karaman, Ilkben Gunusen, Meltem Uyar, Ebru Biricik, Vicdan Firat PMID: 21644105 doi: 10.5505/agri.2011.44127 Pages 57 - 63 Objectives: This randomised double-blind controlled trial examines the effects of fentanyl and morphine, alone and in combination, as adjuncts to spinal anesthesia for elective Cesarean section. Methods: Sixty women undergoing elective Cesarean section, with spinal anesthesia using 0.5% hyperbaric bupivacaine were randomly allocated to receive morphine 0.2 mg, fentanyl 25 μg, or fentanyl 12.5 μg plus morphine 0.1 mg, intrathecally. The start of spinal block, the time to T10 level, the highest sensorial and motor block level, time to regresion of sensory block to T10, the time to resolution of motor block, surgical characteristics, maternal side-effects, Apar and NACS scores, umbilical blood gas evaluations, time to first analgesic requirement were recorded. Results: There was no patient having pain during the intraoperative period. The degree and time of sensorial and motor block was similar in both groups and there was no difference in the time to T10 level and the time to reversal of motor block. The difference in time to first postoperative analgesic requirement was statistically significant. There was no difference between groups in postoperative side effects. There was no neonatal difference in Apgar, NACS and umbilical blood gas evaluations. Conclusions: The quality of postoperative analgesia with morphine, when used alone, was found to be superior to that with fentanyl. The combination of opioids offered no advantages over morphine alone. |
4. | The relation between pain and pain beliefs with socio-demographic-economic characteristics at the adult population Deniz Koçoğlu, Leyla Özdemir PMID: 21644106 doi: 10.5505/agri.2011.44127 Pages 64 - 70 SUMMARY Objective: In order to control pain which is a prevalent problem, to get knowledge regarding pain and pain beliefs is crucial. The aim of this study was to evaluate the correlation between pain, pain beliefs and the socio-demographic, economic characteristics at the adult population. Methods: This descriptive, cross-sectional study was completed with 131 individuals between 18-65 ages. A questionnaire form, evaluating socio-demographic and economical status, pain traits as well, and Pain Beliefs Scale were used for data collection. Results: 78.6% of the research group experienced pain within last one year; of 38.8% suffered from chronic pain. According to the results of logistic regression analysis, the risk factors were determined as being between 30-65 age groups (OR: 0.215 p=0.008 ) and had graduated from elementary school and lower education level (OR: 3.427 p=0.021) for experiencing life long frequent pain; being female (OR= 3.003 p=0.016 ) and married (OR: 4.550 p=0.005) for experiencing pain within last one year; being between 30-65 age groups (OR=3.027 p=0.027) and had a lower income (OR=4.932 p=0.001) for chronic pain. However the organic and psychological pain beliefs scores were similar, socio-demographic and economic determinants were not significant for organic subscale (p>0.05); lower income determined 11% of psychological subscale (R2=0.115, p<0.05). Conclusions: The conclusions obtained from the research was that socio-demographic and economic status were risk factors for experiencing pain, and cultural factors related to pain beliefs warrant investigation. |
5. | Nursing approaches toward postoperative pain of patients: Patients’ options Meryem Yılmaz, Hesna Gürler PMID: 21644107 doi: 10.5505/agri.2011.36349 Pages 71 - 79 In the study that was carried out as defining, it was aimed to determine options related to nursing practices about postoperative pain experiencing by patients and satisfaction of patients about these practices. Data were collected by two questionnaires that was prepared by researchers. Collected data were evaluated with Chi-square and number, frequency tests. 360 patient participating in this study of them 61.4% were women, 83% over 40 years old and 88% had low education. 60.4% had not surgery experience. It was determined that 30.6% of patients had undergone heart-lung (CVS) and 25.5% gastrointestinal system operation. It was found that 96.4 % of patients had experienced pain while were coughing and 81.9% getting up from the bed and difficulty 96.4%, to coughing 78.3%, mobilization and 46.7% breathing because of postoperative pain. In the study it was found that patients undergoned CVS, TAH+BSO, GİS operation had experienced more pain while they were coughing and getting up from the bed, patients undergoned dischectomy while they were walking, There were significant difference between types of operation and pain (p<0.05) and activities that patients had difficulty to do and types of operation (p<0.05). The patients said that nurses didn’t use a pain scala, give information about how pain was relieved, show what was needed to do during the activities that cause pain, help the patients to position for relieving the pain, use non-pharmacological interventions. But all of the patients were satisfied with analgesic that was administered by nurses to relieve the pain. |
CASE REPORTS | |
6. | Possible Heart Failure Associated with Pregabalin Use-Case Report Gülay Erdoğan, Dilek Ceyhan, Sacit Güleç PMID: 21644108 doi: 10.5505/agri.2011.35119 Pages 80 - 83 Pregabalin and gabapentin are widely used analgesic, anticonvulsant and anxiolytic agents as they are relatively reliable and easily tolerable. However, use of them may cause some side effects such as dizziness, somnolance, dose dependent peripheral edema and weight gain which may cause to give up the use of them. Besides, there are few reports in literature addressing old aged patients with serious chronic disease and cardiac history, develope heart failure during pregabaline application. In this case, we present a patient, without a cardiac history, treated with 300 mg/kg pregabalin due to neuropatic pain, developed peripheral and then central edema which were determined after advanced investigations. After quitting pregabalin the situation regressed. Then, peripheral edema has developed associated with recommended dose of gabapentin use instead of pregabalin. Despite the presence of any published evidence, New York Heart Association issued a warning about being careful when prescribing pregabalin to type III-IV heart failure patients. Though the effect mechanisms of pregabalin and gabapentin are not well known, calcium channel relationship may led to these side effects. In summary, we believe that pregabalin and gabapentin, which is mostly used nowadays, should be administered with care not only in patients with advanced cardiac pathology but also in all patients due to its potential side effects. |
7. | MODIFIED van-LINT TECHNIQUE FOR THE MANAGEMENT OF POSTHERPETIC NEURALGIA H. Evren Eker, Oya Yalçın Çok, Meltem Açıl, Hacer Ülger, Anış Arıboğan PMID: 21644109 doi: 10.5505/agri.2011.19981 Pages 84 - 87 Acute herpes zoster (AHZ) causes postherpetic neuralgia (PHN) in 48-75 % of patients. Nerve blocks performed in the acute phase of herpes zoster may treat the pain and prevent PHN development. Here, we present pain relief with modified van-Lint block in two cases with acute herpes zoster involving vesicules on the traces of supraorbital and supratrochlear nerves. Two female patients, 72 and 66 years old respectively, with acute herpes zoster involving vesicules on the traces of supraorbital and supratrochlear nerves starting from right periocular region to scalp presented with symptoms such as hypoaestesia, dizziness, burning, throbbing and severe pain and their initial visual analogue scale (VAS) scores for pain were 9 and 10, respectively. Supraorbital and supratrochlear nerve blockade with modified van-Lint technique was planned as the classical nerve block sites were covered with active vesicules. Following the nerve blocks, VAS scores of both patients were decreased to 1 immediately. Vesicules were faded and scabbed and symptoms such as hypoaestesia, burning and throbbing were recovered, dizziness was relieved and VAS scores were 4 and 5, respectively after one week. VAS scores were 1 and 2, respectively after 2nd injection, and all sypmtoms were resolved and no additional analgesic was required during 3 month follow-up. Modified van-Lint block with 5 mL %1 lidocaine may provide successful pain relief in acute herpes zoster involving vesicules on the traces of supraorbital and supratrochlear nerves. |
8. | Pasha-Cath in the treatment of neuropathic pain Emel Gündüz, Mert Akbaş, Arif Yeğin PMID: 21644110 doi: 10.5505/agri.2011.83097 Pages 88 - 91 Neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional or injured. A 49-year old female patient experienced right anterior arm pain radiating after the right arm operation. Visual analogue scale (VAS) score was 10. Tramadol, gabapentin and amitriptyline were started as medical treatment. In view of the persisting complaints, epidural pulse radio frequency with Pasha –Cath was scheduled. After 2 years,VAS remained at 1-2. As a result, we concleded that epidural pulse radio frequency with Pasha-Cath is an alternative and effective choice of treatment in neuropathic pain when the medical treatment alone is not sufficient. |