ISSN: 1300-0012 | E-ISSN: 2458-9446
Volume : 23 Issue : 4 Year : 2025
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Agri - Ağrı: 23 (4)
Volume: 23  Issue: 4 - 2011
REVIEW
1. The Effect Of Music Therapy On Pain And Anxiety In Intensive Care Patients
Meltem Uyar, Esra Akın Korhan
PMID: 22290677  doi: 10.5505/agri.2011.94695  Pages 139 - 146
In recent years intensive care units have been using advanced technology that provides significantly improved results in clinical treatment and care practices. However, this results in intensive care patients experiencing pain and anxiety. This pain and anxiety experienced by patients is generally brought under control by various pharmacological preparations. When a pharmacological approach is not used or is ineffective, doctors and nurses also use non-pharmacological approaches such as music to control pain and anxiety. Research has found music therapy to be an effective method of reducing pain intensity and anxiety levels in intensive care patients. Therefore, the use of music therapy is important for intensive care patients. This article will deal with the effects of music therapy on pain and anxiety management in intensive care patients.

EXPERIMENTAL AND CLINICAL STUDIES
2. Lumbar Epidural Steroid Injection: Is the Success Rate Predictable?
Alihan Derincek, Evren Eker, Ayşin Pourbagher, Murat Bekir Çınar, Metin Özalay
PMID: 22290678  doi: 10.5505/agri.2011.93898  Pages 147 - 152
Introduction: The aim of this study is to determine the relation between the percent of canal compromise and success rate of epidural steroid injection (ESI) in patients with lumbar herniated intervertebral discs.

Material and Methods: Patients with lumbar herniated intervertebral disc suffered from leg pain and treated with ESI were selected. The axial MRI showing the largest canal compromise by the herniated disc was selected for measurements. The canal and herniation area measurement were calculated from the number of pixels per cross-sectional area, multiplied by a scan correction factor, mm2 /pixel. The percent canal compromise was obtained by disc herniation area divided by canal cross-section area and multiplied by 100. For pain assessment, VAS was used before (pre-injection VAS) and a month after ESI (post-injection VAS). Demographic data, duration of symptoms, location and type of herniation were noted.

Results: 39 patients were included in this study. Mean age was 50. 21 of cases also had back pain. Mean percent canal compromise ratio was 36,1%. Mean duration of symptoms was 19,4 months. The post-injection VAS was significantly decreased when compared with pre-injection VAS (p<0,0001) and this significance was related with if duration of symptoms shorter than 3 months (p=0,021). There was a significant negative correlation between percent canal compromise and post-injection VAS (p=0,042). There was no correlation between post-injection VAS and age, sex, location and type of herniation (p>0.05).

Conclusion: The patient had shorter duration of symptoms and high percent of canal compromise could have more benefit from ESI.

3. Comparison of efficacy of dexketoprofen versus paracetamol on postoperative pain and morphine consumption in laminectomy patients
Elvin Kesimci, Tülin Gümüs, Seval Izdes, Pelin Sen, Orhan Kanbak
PMID: 22290679  doi: 10.5505/agri.2011.86548  Pages 153 - 159
Objectives: The aim of this prospective randomized, double-blind study was to evaluate the analgesic efficacy and opioid-sparing effects of preemptive single dose of dexketoprofen trometamol, in comparison with that of paracetamol or placebo, for elective lumbar disc surgery, over a 24 h investigation period.
Methods: After institutional approval and informed consent had been obtained, 75 patients scheduled for single level lumbar disc surgery were randomly allocated into three equal groups. Patients received oral dexketoprofen 25 mg (group D), 500 mg paracetamol (group P) or placebo tablets (group C) 30 min before induction of standard anesthesia. Patient-controlled analgesia was supplied postoperatively using morphine. Hemodynamics, visual analog scale (VAS), sedation score, morphine consumption and side effects were recorded at every 15 min in the first hour, and 2, 6 and 24 h after surgery.
Results: The mean pain scores were similar among groups (p>0.05). The cumulative (SD) 24-hour morphine consumption was 28.1 mg, 40.6 mg, and 43.6 mg for groups D, P and C, respectively. The amount of morphine use at 2, 6 and 24 h was significantly lower in Group D (p<0,006). Hemodynamic parameters, sedation scores and side-effects did not differ among the groups (p>0.05).
Conclusion: The study demonstrates preemptive dexketoprofen trometamol 25 mg is associated with a decrease of up to 35% in morphine consumption compared with placebo over 24 hours following lumbar disc surgery, however, paracetamol 500 mg does not show an expected opioid sparing effect comparatively.

4. Comparison of the analgesic effects of intravenous paracetamol and lornoxicam in postoperative pain following thyroidectomies
Mustafa Arslan, Ramazan Çiçek, Bahadır Celep, Hüseyin Yılmaz, Hülya Üstün Kalender
PMID: 22290680  doi: 10.5505/agri.2011.82788  Pages 160 - 166
BACKGROUND: The purpose of the present study was to determine the efficacy of lornoxicam and IV paracetamol on postoperative analgesia and the reduction in tramadol consumption.
METHODS: Sixty patients following thyroidectomy were enrolled in to the study who were ASA class 1-2, and aged between 18-72 years, and were randomized into three groups: GroupL receiving 8mg of iv lornoxicam, GroupP receiving iv 1g paracetamol and, GroupC receiving 100cc of iv saline solution. All patients received standard general anesthesia.
The postoperative salvage analgesic consumption was recorded at 0-6, 6-12 and 12-24 hour intervals. Pain scores were evaluated with a visual analogue scale at 15min, and 1, 2,4,6,8,12,18, and 24h postoperatively.
RESULTS: The time to first analgesic requirement was approximately 127.5min in GroupL, 162.3 in GroupP and 35.5min in GroupC, and found to be significantly prolonged in GroupL and GroupP. Pain scores were significantly lower in GroupP and GroupL at 15 min, 1, 8, 12, and 18hours. Twenty four hour analgesic consumption was significantly lower in GroupP and GroupL compared to GroupC. Supplemental analgesics requirement was as follows: 100% in GroupC, 50% in GroupL and 55% in GroupP. The degree of satisfaction of postoperative pain management was exellent 90% in both GroupsL and P, and 30% in GroupC.
CONCLUSION: Administration of lornoxicam and iv paracetamol following thyroid surgery decreased the postoperative pain scores and opioid requirement, as well as the incidence of nausea and vomiting; while prolonging the time to the first analgesic supplement.

5. Comparison of the maternal and neonatal effects of combined spinal-epidural block and spinal block for cesarean section
Ersin Uysallar, Semra Karaman, İlkben Günüşen, Meltem Uyar, Vicdan Fırat
PMID: 22290681  doi: 10.5505/agri.2011.39206  Pages 167 - 173
Objectives: Combined spinal-epidural block (CSEB) has gained increasing interest as it combines the reliability of a spinal block (SB) and the flexibility of an epidural block in cesarean section. We have investigated maternal and fetal effect of CSEB against SB in cesarean operation.
Material and Methods: Forty healty, term pregnant women were randomized into two groups. Patients in the CSEB and SB groups were given 1.5 mL and 2.5 mL of 0.5% hyperbaric bupivacaine intrathecally, respectively. If sensorial block did not reach T4 within 10 min, supplemental bupivacaine was injected epidurally 2 mL per unblocked segment in CSEB group. The quality and side effects of surgical anesthesia, hemodynamic parameters, Apgar scores, NACS and postoperative duration of pain were compared between the two groups.
Results: The time for the block to rich T4 level was significantly lower in SB group (p<0.05). More patients in the SB group achieved complete motor blockade sooner than in the CSEB group (p<0.05). Mean arterial pressure was lower in SB group (p<0.05). There were no significant differences between the groups in the incidences of apgar scores, cord blood gases, and NACS and adverse effects such as nausea and vomiting.
Conclusion: Both spinal and CSE block provide good surgical analgesia for cesarean section. Maternal hypotension is a risk with both technigues, but it occurs earlier and more higher with spinal block. There is no difference in neonatal outcome, provided that maternal blood pressure is cautiously monitored and hypotension promptly treated.

6. Relationship Between Migraine Type Headache in Childhood with Cow’s Milk Allergy and Egg-white Allergy
Ahmet Oğuzhan Özen, Hulya Ercan Sarıçoban, Nilgün Mutlu, Mehmet Reha Cengizlier
PMID: 22290682  doi: 10.5505/agri.2011.41636  Pages 174 - 178
Background and aim: Migraine is a very common headache disorder. Due to the co-occurrence of migraine and allergic disorders allergic mechanisms have been thought to play role in migraine pathophysiology. This study aimed to investigate the association between cow's milk allergy and egg-white allergy with migraine type headache of childhood.
Materials and methods: We included 39 children with migraine type headaches and 167 children with no headaches who had been previously evaluated in a school screening study program. Egg-white and cow's milk specific IgE levels were measured for all involved subjects.
Results: Specific IgE levels were positive for cow's milk in 4 children and for egg-white in 2 children, respectively. There was not detected meaningful relationship between food allergies and migraine. However, specific IgE levels for egg-white were significantly higher in migraineurs (p=0.008).
Conclusion: Childhood migraine does not appear to be associated with cow's milk or egg-white allergy. However, the elevation of egg-white specific IgE levels in migraine type headache may signify the possible presence of shared pathogenetic pathways in the development of migraine and food allergies.

CASE REPORTS
7. Occipital neuralgia following thoracic herpes zoster
Caner Feyzi Demir, Yahya Akalın, Said Berilgen
PMID: 22290683  doi: 10.5505/agri.2011.87699  Pages 179 - 180
Paroxysmal shooting or stabbing pain in the dermatomes of the nervus occipitalis major or nervus occipitalis minor is defined as occipital neuralgia. Initial cause of the neuralgia appears to be from inflammation, damage or irritation of these nerves. In this article we present a patient with occipital neuralgia followed by thoracic herpes lesion.