Aim: This study aims to examine the quality of life of elderly individuals suffering pain.
Material and Method: The study was carried out on 84 individuals over the age of 65 resident at a local authority administered nursing home in Izmir who were suffering pain at the time of the interview. The individuals’ introduction form, made up of 12 questions, was used to identify the individuals’ socio-demographic characteristics, and the McGill Melzack Pain Questionnaire was used to assess the pain, and the WHOQOL-OLD (World health Organization Quality of Life Scale Older Adults Module) was applied.
Findings: A significant relationship was found between the current pain severity and the quality of life scale’s sensory capacity, today’s activities and future activities, and relationship sub-fields and the total points (p<0,05).
Conclusion: It was established, as well as the elderly individuals’ socio-demographic characteristics, sub-sections such as the features, severity and time of pain also had an effect on the quality of life.

Objectives: Despite several risks, infraclavicular approaches to the brachial plexus gained popularity. The present study compared success rates, block onset times, block performance times, and frequency of adverse effects of vertical infraclavicular (VIB) and coracoid blocks (CB) in patients undergoing forearm surgery.
Methods: After ethical committee approval and informed consent 40 patients undergoing forearm surgery were included. The brachial plexus was located using a nerve stimulator and an insulated pencil point needle. Thirty ml bupivacaine 0.5% was used for the block. The blocks were assessed every minute for the first 5 min, then every 5 min for 15 min and then every 15 min and at the end of the operation.
Results: Block onset times of both groups were similar. Higher rates of sensory block were found in group CB at the 5th, 10th, and 15th minutes of assessment. Also higher rates of motor block were found in group CB at the 5th, 10th, 15th and 30th minutes of assessment. Time to perform block was shorter in group VIB. One patient in CB group required general anaesthesia. Except two vascular punctures in group CB no other side-effects were observed.
Conclusion: Coracapid block provided higher rates of sensorial and motor blocks in a similar onset time without serious complications. CB can be accepted as a safe and reliable alternative to VIB for forearm surgery.

Objectives: The aim of the study is to compare the hemodynamic effects, postoperative analgesia, time to achieve discharge criteria, and patient-surgeon satisfaction of patients who are assigned for single sided inguinal hernia repair operated under iliohypogastric ilioingıinal nerve block (IHNB) or spinal anesthesia..

Methods: Twenty-five ASA I-III patients in Group S received 15 mg 0.5% hyperbaric bupivacaine intrathecally, and 25 ASA I-III patients in Group I received IHNB with 20 mL 0.5% plain bupivacaine.
Result: Mean block application duration (16.4±3 vs 6.5±2.1 min), mean sensory block rise time (25.2±5.1 vs 6.9±3.4 min), and time to sensory block termination (262.4±65.2 vs 116.6 ±102.5 min) was found to longer in Group I with respect to Group S (p<0.001). Mean time to first mobilization (307.1±146.9 vs 456.9±131.7 min), and mean time to meet discharge criteria (4.6±0.8 vs 8.1±2.7 hr) was shorter in group I. Mean VAS scores in postoperative 1, 2, 4 and 6 th and mean tramadole consumption in 24 hr (375.6±113.1 vs 180.5±17.9 mg) were higher in Group S (p<0.001). Hemodynamic parameters, patient and surgeon satisfaction were comparable (p>0.05).
Conclusion: IHNB provides longer postoperative analgesia and earliar discharge, although takes more time to perform and to produce maximum effect, for single sided inguinal henia repair.

The aim of this study is to evaluate the patients who admitted to algology polyclinic with malign and non-malign pain, sociodemographic characteristics, type of pain and pain management retrospectively.
In this study we examined the medical assessement files of patients who admitted to our outpatient clinic of Algology Department for chronic pain between January 2000- December 2010. The sociodemographic characteristics of the patients, pain properties and treatments were reviewed retrospectively.
Within the eleven years period, a total of 6647 patients have been admitted to our clinic. 66.9 % of the patients were between the ages of 19 and 64. There was no significant difference between gender. The most common causes of pain were myofascial pain, neuropathic pain, low back pain and headache. Among malignancy related cases the most common sources were gastrointenstinal system, lung and breast regions. In 83.4 % of patients, pharmacological and invasive treatments were utilized. The most common invasive treatment modalities were, trigger point injection, dry needle application and epidural catheter application.
In conclusion, pain treatments with multidisciplinary approach applied by the increasing number of pain clinics provide favorouble results and patients quality of life is also increased. We hope our retrospective study may provide helpful data for future studies on chronic pain with its comprehensive base of patient data which covers an eleven years period.

Introduction: The aim of this study was to emphasize the necessity of multidisciplinary pain council by demonstrating the patient profile, treatment approaches, outcomes, and patient satisfaction levels obtained from our council.
Material and Methods: In this study, the age, gender, number of council evaluations, diagnoses and recommended therapies of patients were determined retrospectively. The status of the patients >1 year, outcomes of the therapies, and satisfaction levels of the patients were questioned on the phone.
Findings: The patients were most commonly diagnosed as chronic low back pain (35%) and vertebral tumor or metastasis (10%). 74 % of the patients were evaluated because of vertebral causes.
23% of the patients had good, 27% had moderate and 35 % had poor benefit; beneficence was calculated as 85%. Patient satisfaction was found as 24%, 23%, and 32%, respectively; satisfaction was calculated as 79%.
Discussion- Conclusions: Evaluation of complex patients by physicians from different disciplines has better diagnostic and treatment outcomes. In addition, multidisciplinary approach offer and perform different therapy options and this has positive effects on treatment efficiency and patient satisfaction. We are in the opinion that instead of standard treatment protocols, determining individualized multidisciplinary treatment protocols should be useful.

Introduction: The development of intracranial subdural hematoma after spinal anesthesia is a rare and serious complication that can be fatal if untreated. Needle puncture to the dura mater can cause leakage of cerebrospinal fluid, and lead to stretching and rupture of the meningeal blood vessels with resultant bleeding.

Case: A 24 years old patient, with a completely normal history and laboratory analysis, has got a L4-5 level spinal anesthesia well done at first try, using a Quinke 25 G needle and 12,5 mg bupivacaine HEAVY. The first day after spinal anesthesia, the patient started to have a headache. He applied to another hospital where he received conservative treatment with a diagnosis of post-spinal headache. But, persistence of the headache made the patient refer to our pain clinic. The headache was located behind the left ear non-postural in nature, and was associated with tinnitus. Emergency cranial computerized tomography was obtained and acute fronto-temporo-parietal subdural hematoma was reported.
Discussion: After spinal anesthesia, continued atypical headache and presence of tinnitus must alert against an underlying subdural hematoma. Early diagnosis can be made by history of the patient combined with neurological and radiological imaging methods.

Combined nerve blocks of the upper extremity and lower limb in same operation rarely performed due to the risk of systemic toxicity of local anesthetics. Therefore, general anesthesia is generally preferred in this operations. However, use of ultrasound allows reliable deposition of the anesthetic around the nerves, potentially lowering the local anesthetic requirement.
In this case report, we present a 44-year-old, ASA physical status I, male patient who was operated for upper extremity reconstruction requiring skin graft from anterolateral thigh region under ultrasound-guided infraclavicular brachial plexus block and lateral femoral cutaneous nerve block. The block was successful and no block-related complications were noted. We think that combining an ultrasound guided infraclavicular brachial plexus block and a lateral femoral cutaneous nerve block is a clinically useful and safe technique and an alternative anesthetic opinion for procedures requiring skin grafts for the upper extremity.

pressure and specific cranial imaging techniques. Headache can be accompanied by the symptoms such as tinnitus, vertigo, diplopia, nausea and vomiting. It is important for the diagnosis to show the level of CSF leakage. Epidural blood patch should be planned for the treatment of patients with no reduction of the complaints following conservative treatment.
In this case report, we have discussed the diagnostic methods of spontaneous intracranial hypotension and the importance of an epidural blood patch for its treatment in the light of the literature.

Spontaneous intracranial hypotension was first described by Schalternbarn. Severe complications like cerebral venous thrombosis and subdural hemorrhage are seldomly seen. A 40 year old men was examined for weakness of right arm started 9 months earlier and aggravated in last 3 months. He was undergo a lumbar punction because of a demyelinating plaque at C2 level in MRI. After 10 days of lumbar punction he experienced a generalised tonic clonic seizure. At kranial MRI and venography thrombosed superior sagittal and right transverse sinus and image of pachymeningitis, caused by intracranial hypotension were observed. Coincidence of these two situations together was seldomly found at literature. Thrombosis can both effect the sinuses and cortical veins. Spontaneous intracranial hypotension is a risk factor for CVT, but at only 2% CVT is seen as a complication. We think that our case can add addition to literature by having this coincidence.

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