Objectives: The aim of this study was to investigate whether Fibromyalgia and Failed Back Surgery Syndromes (FMS-FBSS) may be evaluated under the single heading of Functional Somatic Syndromes (FSS) with respect to their symptomatological characteristics such as intensity, frequency, age of onset, duration, painful areas, fear of pain, and pain coping styles; familial characteristics such as family history of chronic medical illness, psychopathology and pain; and psychological characteristics such as manner of dealing with pain, fear of pain, alexithymia, symptom interpretation, somatosensory amplification and depression.
Methods: The study comprised 150 individuals, separated into 3 groups; The FSS Group comprised 47 patients who were referred to the Physical Medicine and Rehabilitation Clinic at Istanbul University’s Faculty of Medicine with FMS (n=35) and FBSS (n=12), the healthy control group (HC Group) comprised 47 individuals, and the chronic medical illness control group (CMIC Group) was made up of 56 individuals. Turkish versions of the Toronto Alexithymia Scale, Symptom Attribution Inventory, Somatosensory Amplification Scale and Beck Depression Inventory, along with a semi-structured form questioning general health, pain and demographics were administered to all participants.
Results: FMS and FBSS participants (FSS Group) did not differ as a function of the major familial, symptomatological and clinical features considered in this study. Additionally, this group significantly differed from the HC and CMIC Groups with respect to almost all these features.
Conclusion: This study is Important Insofar as it simultaneously evaluated FMS and FBSS groups in the presence of a control group. The results suggest that FMS and FBSS, currently treated as two different diagnostic categories in general medical practice, may be evaluated under the single heading of FSS.

Objectives: This descriptive study investigated pain levels of orthopedic surgery patients, and how this pain is perceived by their relatives and nurses.
Methods: The study was carried out with 150 patients, 150 relatives and 50 nurses to determine pain intensity levels of orthopedic surgery patients and perceptions of this among their relatives and nurses. Intensity of pain was measured on a 0 to 10 visual analogue scale. Relatives and nurses were not allowed to see the patient’s pain intensity score, and each nurse was allowed to participate in pain measurement three times. The data were analyzed by descriptive statistics, the Mann Whitney-U test, Paired Sample t-Test, Linear
Regression and Spearman Correlation Analysis.
Results: The pain intensity scores given by nurses (t=9.136, p<0.001) were significantly lower than patients’ own scores. There was no significant difference between relatives’ and patients’ pain scores. In the regression analysis, pain intensity scores given by relatives
were approximately 40% lower than those given by patients, while nurses’ scores were approximately 60% lower.
Conclusion: Education on pain management and the physical and emotional reactions of patients to pain should be provided for nurses working in surgical clinics. Meanwhile, as those who spend most time with the patient, relatives should be informed about possible pain behaviors in the postoperative period in order to prepare them for their role in the patient’s care.

Objectives: Ultrasound-guided thoracic paravertebral block (TPVB) may be employed for postoperative analgesia in thoracic surgery. In application of TPVB, single injections, multiple injections or catheter techniques may be used. In this paper we present our experiences with ultrasound-guided TPVB in thoracic surgery patients for postoperative analgesia.
Methods: Patients undergoing thoracic surgery and on whom ultrasound-guided TPVB was performed for postoperative analgesia from January 2012 to March 2013 in our clinic were analyzed retrospectively. Demographic data, block technique, complications and 1st, 6th, 12th and 24th hour VAS scores were recorded.
Results: A total of 18 patients had TPVB. Single injection was administered to 9 patients, multiple injections to 5, and catheters to 4. While statistically insignificant, 1st hour VAS scores were found to be greater than 3 in the single injection and catheter groups.
Conclusion: Similarly to multiple injection and continuous TPVB administration, ultrasound-guided single injection TPVB provides effective 24-hour postoperative analgesia.

Objectives: This study tested the hypothesis that as pain brings about psychosocial changes in the pain patient, it also does in those relatives dealing with and supporting the patient. In order to test the hypothesis, comparisons of psychosocial status were made among patients with chronic pain, their relatives, and a control group (individuals having no pain and no relative with a pain disorder).
Methods: The study included 270 individuals separated into 3 groups: Patients admitted to the Pain Polyclinic at Dokuz Eylül University Faculty of Medicine with chronic pain (Group CP; n=77), relatives of these patients (Group R; n=98), and individuals age- and sex-matched to the relatives as a control group (Group C; n=95). The demographic values of all individuals were recorded, and psychological evaluations performed on all participants using the SCL 90 test.
Results: Somatization, anxiety, depression, interindividual sensibility, psychosis, paranoia, anger and general symptom index average scores were found to be high in Group R compared to Group C.
Conclusion: Changes in psychosocial status were observed in pain patients and their relatives when compared to the control group. The study recommends that in addition to evaluating the psychological status of pain patients in order to provide them with psychological and medical support, relatives of these patients should also be evaluated carefully and given psychological and medical support to enable necessary diagnosis and treatment.

Objectives: This study aimed to investigate the occurrence of low back pain in hospital employees during the previous year and its correlation with demographic data, occupational factors and chronic fatigue syndrome.
Methods: All participants provided information on their socio-demographic background, occupational characteristics, their experience of low back pain during the previous year, and chronic fatigue syndrome.
Results: The study included 365 volunteers (221 male and 144 female). The mean age was 33.1±7.2. Of the 365 participants, 218 (59.7%) had experienced low back pain in the last year. No statistically significant difference was detected in age, height, weight, level of education, smoking habits, occupation, professional working hours, shift work or levels of income between the groups with and without low back pain. Low back pain was more frequent (p<0.05) in male workers. Chronic fatigue syndrome was statistically significant in the group suffering from low back pain (p<0.05), of whom 21.5% had chronic fatigue syndrome. We detected a statistically significant relationship (p<0.05) between chronic fatigue syndrome, occupational duration and shift work.
Conclusion: To the best of our knowledge, this is the first to show the relationship between low back pain and chronic fatigue syndrome in hospital employees. Shift work and length of time in occupation are risk factors for chronic fatigue syndrome.

Objectives: In surgery clinics, postoperative pain is a common occurrence and care is needed in its treatment. One form of treatment is various acupuncture techniques. This study investigated the effect of acupuncture on postoperative analgesia in patients undergoing laparoscopic cholecystectomy.
Methods: A total of 59 patients undergoing laparoscopic cholecystectomy were included in the study; 31 comprised the acupuncture group (Group A), and 29 constituted the control group (group C). All patients underwent standard anesthesia procedures. Patientcontrolled analgesia with tramadol was administered postoperatively. Patients’ postoperative pain scores, results of the satisfaction questionnaire and amounts of tramadol used were recorded. Postoperative 0, 1st, 2nd, 6th, 12th and 18th hour controls were performed.
Results: A comparison of the groups showed Group A pain scores to be significantly lower statistically than those of Group C at all postoperative controls. There was no statistically significant difference for postoperative analgesic consumption and satisfaction level between the groups.
Conclusion: Despite detection of a reduction in postoperative pain scores, the application of acupuncture did not cause any change in the consumption of tramadol.

Spontaneous intracranial hypotension is characterized by orthostatic headache in the absence of a history of head trauma or lumbar puncture, and diagnosis is confirmed by a specific cerebrospinal fluid pressure and neuroimaging findings. It rarely presents with coma. A 62-year-old man presented with progressive cognitive decline of 2 to 4 weeks’ duration. He was diagnosed with spontaneous intracranial hypotension according to cerebrospinal fluid pressure and neuroimaging findings, and treated conservatively.

Multiple thoracic disc herniations are rare, and few reports exist in the literature. Diagnosis of these herniations is often missed because of their lack of specific clinical presentation. They may be treated conservatively or surgically. We presented a 35-year-old woman with five contiguous level thoracic disc herniations. She was admitted with upper back pain. Magnetic resonance imaging showed disc herniations at levels T6-7, T7-8, T8-9, T9-10 and T10-11. All were left sided and on the same line in the sagittal plane. The patient underwent conservative treatment. This report presented an unusual case and discussed its mechanisms.

By inhibiting sodium channels, local anesthetics (LAs) prevent sodium entering the cell and inhibit cellular depolarization. Although undesired drug reactions caused by LA usage are common, real allergic reactions are rare. The objective of this study was to discuss allergic reactions developing after application of spinal anesthetic.

Ultrasound-guided paravertebral blocks and catheter replacement techniques have been used effectively for pain relief after thoracic, cardiac and abdominal surgeries in pediatric patients. In this case report, we discuss our experience of bilateral ultrasound-guided use of thoracic paravertebral blocks for postoperative analgesia in a pediatric patient who underwent left latissimus dorsi muscle transfer (free flap) surgery.