CONTENTS | |
1. | Frontmatters Pages I - X |
REVIEW | |
2. | Analysis of short-term efficacy of radiofrequency thermocoagulation in the treatment of classic trigeminal neuralgia Qi Wang, Wen-jie Du PMID: 34988955 doi: 10.14744/agri.2021.42800 Pages 1 - 6 The objectives of the study were to explore the short-term efficacy of radiofrequency thermocoagulation for the treatment of classic trigeminal neuralgia (TGN). A retrospective analysis of 58 patients with classical TGN treated with radiofrequency thermocoagulation at our institution between 2016 and 2019, including 23 men and 35 women. The mean age of all patients was 62.1±10.9 years, the duration of the disease ranged from 2 months to 360 months, and the mean duration of the disease was 80.1±77.9 months. Patients were divided into three groups, V2, V3, and V2+V3, according to the site of symptom presenta-tion. Treatment effectiveness was evaluated by observing patients’ before surgery, after surgery, and 1-year after surgery visual pain simulation (VAS) scores. The clinical efficacy was evaluated by calculating the percentage of patients whose net improve-ment in VAS scores of the three groups of patients V2, V3, and V2+V3 reached the minimal clinically important differences MCID value of TGN. Patients’ after surgery VAS scores and 1-year after surgery VAS scores all showed meaningful improvement (p<0.001) compared with pre-operative VAS scores, and after surgery VAS scores showed meaningful change (p<0.05) com-pared with 1-year after surgery VAS scores. About 84.62%, 95.45%, and 86.96% of patients in V2, V3, and V2+V3 groups showed net improvement in after surgery VAS scores to MCID values, and 69.2%, 86.4%, and 74.0% of patients in 1-year after surgery VAS scores showed net improvement to MCID values, respectively. The early efficacy of radiofrequency thermocoagulation for classic TGN is significant, but patients have a tendency to have recurrence of pain symptoms 1 year after surgery. |
EXPERIMENTAL AND CLINICAL STUDIES | |
3. | Research for the factors effecting the headache experienced by the health-care personnel in COVID-19 pandemic: A monocentric survey study Gülçin Hacıbeyoğlu, Ayşe Seda Eren, Şule Arıcan, Resul Yılmaz, Ruhiye Reisli, Sema Tuncer Uzun PMID: 34988962 doi: 10.14744/agri.2021.47108 Pages 7 - 15 Objectives: The aim of this study is to determine the factors that may be related to the headache experienced by health-care professionals in the coronavirus disease 2019 (COVID-19) pandemic. Methods: The target population of the study consisted of the health-care professionals working in the COVID-19 pandemic. The questionnaire form consisted of 40 questions. The demographic information of the participants, the presence of contact with the COVID-19 patient, they used which personal protective equipment (PPE) and how often, the effect of the pandemic process on the lifestyle, the presence of visual defects, the effect of the pandemic process on water consumption, the presence of old or de novo headaches, the factors that may affect this headache, and the factors that reduce the pain were questioned in the survey. Results: A total of 177 health-care professionals participated in the study. About 93.8% of the participants use masks daily for more than 4 h. About 62.7% of the participants stated that their water consumption increased on the days when they used PPE. About 72.3% of the participants reported disruption in sleep patterns, 83.1% of them reported increase in their stress and anxiety. About 65.5% of the participants experienced headaches during the pandemic process. They reported that the most likely causes of headache were excessive sweating and difficulty in breathing due to the use of PPE. Conclusion: During the pandemic, a substantial portion of health-care professionals experiences headaches. Besides the physical difficulties caused by the use of PPE, the stress caused by the pandemic process should not be ignored. |
4. | Reliability and validation of Turkish version of the Dallas Pain Questionnaire Ghofran Alhomedha, Seyit Çıtaker, Gürkan Günaydın, Furqan Khan, Refia Sezer PMID: 34988958 doi: 10.14744/agri.2021.24861 Pages 16 - 22 Objectives: Evaluation of low back pain (LBP) requires a condition specific disability questionnaire along with pain and satisfaction measure such as self-assessment pain scales. Dallas Pain Questionnaire (DPQ) is a 16-item visual analog scale, developed for evaluating patient’s cognitions about the percentage that chronic pain affects four aspects of the subject’s lives. It’s easy to understand; can be answered in 3–5 min and can be scored in <1 min. This reliability and validation study offers health-care providers an opportunity to utilize this distinct questionnaire in Turkish population with back pain. The objectives are translation of Dallas questionnaire from English to Turkish language and to perform validation and reliability study. Methods: A total of 102 patients (79 women and 23 men) with mean age of 50.2 years and LBP for at least 3 months answered DPQ along with five other previously translated and validated questionnaires in Turkish language. Fifty-nine of these patients participated retest reliability after 7 days. Internal consistency and test-retest analyzes were conducted to determine the reliability and convergent validity was evaluated for the validation study. Results: The questionnaire was noted to have high internal consistency. The test-retest analysis revealed an excellent correlation (ICC=0.969). Pearson correlation coefficient shows that all subscales (sections) of DPQ are significant and comparable with each of the other questionnaires included in this study proving that it has sufficient convergent validity (p<0.001). Conclusion: The Turkish version of DPQ is content, valid, and reliable. DPQ is sensitive to use in patients with LBP. |
5. | Comparison of intraoperative and post-operative effects of serratus anterior plane block performed with ultrasound and infiltration block in patients undergoing video-assisted thoracoscopic surgery Mustafa Dikici, Selcan Akesen, Belgin Yavaşcaoğlu, Ahmet Sami Bayram, Fatma Nur Kaya, Alp Gurbet PMID: 34988957 doi: 10.14744/agri.2021.22605 Pages 23 - 32 Objectives: We aimed to compare the intraoperative and post-operative analgesic activities of the preventive applied serratus anterior plane (SAP) block and infiltration block in patients undergoing video-assisted thoracoscopic surgery (VATS). Methods: The study was carried out in 60 patients aged between 18 and 80 who were eligible for elective VATS, with the American Society of Anesthesiologists classification I-II, following ethical committee approval and written informed consent form. Patients were divided into two groups as SAP (group serratus anterior plane block [SAPB]) and group infiltration block after routine monitoring and general anesthesia induction by recording demographic data after randomization. Hemodynamic data of all patients were recorded before, after induction and within intraoperative 30 min period. Patient controlled analgesia (PCA) prepared with morphine was applied to all patients postoperatively. Intraoperative hemodynamic data and opioid consumption of patients, resting time, and coughing visual analog scale, time to first PCA dose, post-operative opioid consumption, rescue analgesic requirement, mobilization times, opioid side effects, and patient and surgical team’s satisfaction were evaluated. Results: Intraoperative hemodynamic data and opioid consumption were similar between the two groups. Post-operative pain scores (0 and 30 min, 1, 2, 4, 8, and 12 h) were lower in the SAPB group (p<0.005) and time to use the first PCA (p=0.002) was longer in the SAPB group. Post-operative PCA and rescue analgesic requirement were lower in the SAPB group (p=0.002, p=0.00). It was found that the first mobilization time was shorter in the SAPB group (p=0.003), and opioid-related side effects were similar in both groups (p=0.067). Patient and surgical team satisfaction was high in the SAPB group (p=0.004, p=0.000). Conclusion: As a result, more effective post-operative analgesia was provided with preventively SAPB, compared to infiltration block in patients undergoing VATS. |
6. | Coccydynia in patients with axial spondyloarthritis: Reflection of enthesitis? Rana Terlemez, Navid Atarod, Kenan Akgün PMID: 34988956 doi: 10.14744/agri.2021.00187 Pages 33 - 37 Objectives: In this study, we aimed to compare the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) values of patients with axial spondyloarthritis (ax-SpA) with and without coccydynia. Methods: We included 42 cases between the ages of 18 to 65 that were admitted to our clinic between August 1, 2019 and April 20, 2020 with the diagnosis of ax-SpA. The first group consisted of 13 patients with coccydynia and the second group consisted of 29 patients without coccydynia. Besides the demographic data Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP), Bath Ankylosing Spondylitis Functional Index (BASFI), and MASES values of the patients were recorded. Results: We found that 13 (29.5%) of 42 patients with ax-SpA had coccydynia. While the rate of female patients in the coccydynia group was 46.15%, in the group without coccydynia, this rate was 31.03%. The mean of MASES, ASDAS-CRP, and BASFI values of the coccydynia group was statistically significantly higher than the group without coccydynia. We found that the BASFI was the most effective factor affecting the presence of coccydynia. Conclusion: Our study supports the increased prevalence of coccydynia in patients with ax-SpA. In this study, we found that the presence of coccydynia may be associated with hypomobility rather than enthesitis. |
7. | Comparison of intraoperative and postoperative analgesic properties of ilioinguinal/iliohypogastric and sacral epidural block in pediatric unilateral inguinal hernia operations Sami Kaan Coşarcan, Ahmet Mahli PMID: 34988963 doi: 10.14744/agri.2021.48254 Pages 38 - 46 Objectives: Central blocks such as caudal, spinal, and sacral epidural are frequently used in pediatric inguinal surgeries. Furthermore, peripheral blocks have been used and successful results have been obtained in pediatric inguinal surgeries. In this study, we aimed to compare the intraoperative and postoperative analgesic efficacy of the ilioinguinal/iliohypogastric (IL/IH) block under general anesthesia with the sacral epidural block. Methods: This study was carried out in Gazi University Faculty of Medicine, Department of Anesthesiology and Reanimation, after obtaining permission from the Ethics Committee of Gazi University Faculty of Medicine and the Central Ethics Committee of the General Directorate of Pharmaceuticals and Pharmacy of the Turkish Ministry of Health, numbered B.10.0.İEG.011.00.01. Sixty patients in the American Society of Anesthesiologists I-II group between the ages of 1 and 8 years who will undergo elective unilateral inguinal hernia operation under general anesthesia were randomly divided into two groups. Group S (n=30) sacral epidural block and group I (n=30) IL/IH nerve block were planned. Results: Hemodynamic values were found to be statistically significantly lower than control values in both groups. The minimum alveolar concentration values for sevoflurane were statistically significantly lower values in both groups at all surgery periods. In terms of additional analgesic requirement, the group I was found to be statistically significantly lower than the group s at the 8th–12th h. When the first analgesic intake hours were examined, no significant difference was found between the two groups. Conclusion: In our study, group I and group S analgesic efficacy was found to be similar. |
8. | Greater occipital nerve block is an effective treatment method for primary headaches? Buse Rahime Hasırcı Bayır, Gizem Gürsoy, Ceyhun Sayman, Gülbün Asuman Yüksel, Yılmaz Çetinkaya PMID: 34988960 doi: 10.14744/agri.2021.32848 Pages 47 - 53 Objectives: Headache is one of the most common health problems, and it severely reduces the quality of life. The present study examines the efficacy of greater occipital nerve (GON) block in patients monitored for primary headaches. Methods: The present study includes 53 patients monitored by the headache outpatient clinic from March 2017 to June 2018, evaluates them for headache type, attack duration, attack frequency, severity of pain, and analgesic intake and compares the initial values with the follow-up values at months 1, 3, and 6. Results: The study group comprises 36 episodic migraine cases, 12 tension-type headache (TTH) cases, 4 chronic migraine cases, and 1 cluster headache case. In migraine group, VAS scores, attack durations, and the mean value of monthly number of attacks and analgesics taken significantly decrease compared to initial values at the end of the 6-month follow-up period. In TTH group, VAS scores, attack durations, and the mean value of monthly number of attacks and analgesics taken significantly decrease compared to initial values at the end of the 3-month follow-up period. Since only 2 of 12 patients completed the 6-month follow-up, although there was a decrease in the 6-month data, it was found to be statistically insignificant. Conclusion: Repetitive GON block is an effective treatment method for migraine and TTH. |
9. | Comparison of the eficacy of epidural steroid injection applied in cervical and lumbar regions Halil Çetingök, Meltem Kanar PMID: 34988961 doi: 10.14744/agri.2022.46872 Pages 54 - 59 Objectives: Epidural injections have been used for many years in the treatment of chronic pain in patients with chronic backleg pain and chronic neck-arm pain. We aimed to compare the efficacy of lumbar and cervical epidural steroid injections on pain palliation, duration of pain relief and patient satisfaction. Methods: This is a Retrospective, observational single-center study. A total of 159 patients (96 females, 63 males) who were performed epidural steroid injections in cervical and lumbar regions were included in the study. The patients were divided into two groups as lumbar epidural steroid injection “Group 1” and cervical epidural steroid injection “Group 2”. We retrospectively evaluated the patients for numerical rating scale (NRS) prior and after the injection, the duration of the pain relief, whether any complication occured related to injection and patient satisfaction. Results: 130 patients in Group 1 and 29 patients in Group 2 were evaluated. Median NRS before the procedure: 8 in Group 1, 7 in Group 2 and median NRS after the procedure: 3 in Group 1, 4 in group 2. Patient satisfaction with the procedure 56.15% in Group 1 and 48.62% in Group 2. Mean duration of pain relief 7.23 months in Group 1 and 8.17 months in Group 2. There were no statistically significant difference in the evaluated parameters between the two groups. Conclusion: It was observed that the pain relief, duration of pain relief and patient satisfaction were similar for cervical and lumbar epidural steroid injections. |
CASE REPORTS | |
10. | Skin depigmentation and subcutaneous fat atrophy after crorticosteroid injection for lateral epicondylitis in two elbow Mustafa Aziz Yıldırım, Kadriye Öneş, Gökşen Gökşenoğlu PMID: 34988965 doi: 10.14744/agri.2019.69320 Pages 60 - 62 Lateral epicondylitis is the most common elbow problem in adults. Corticosteroid injection for the treatment of lateral epicondylitis is a frequently used method of conservative management. A 43-year-old woman was referred to our clinic with a 6-month history of pain along the lateral side of her right and left elbow. She had been treated with 20 mg Triamsinolon heksasetonit to the right and left elbow for lateral epicondylitis with the resistance of pain After 3 weeks of the injection, the pain was completely relieved. The patient was able to move easily her elbow within normal limit. Examination also revealed depigmentation of the skin and atrophy of subcutaneous fat over the lateral epicondyle of both elbows. In the treatment of lateral epicondylitis, corticosteroid injection can be used for alternative conservative treatment. Depigmentation or subcutaneous tissue atrophy may occur inappropriate technique or excessive cortisone dose. |
11. | Temporary neurologic complication of spinal ropivacaine in an obstetric patient Nurten Kayacan, Bilge Karslı PMID: 34988959 doi: 10.14744/agri.2019.25986 Pages 63 - 66 We aimed to inform transient neurological symptoms after spinal anesthesia and to review postpartum neurological deficits of regional anesthesia. A previously healthy 25-year-old primigravid woman underwent an elective cesarean section. Hypotension and bradycardia were not observed during the operation. On the 25th day postpartum, the patient suffered from numbness and weakness at the lower extremity. On neurological assessment, the muscle strengths in the gastrocnemius and quadriceps bilaterally were 2/5 (+) and 3/5 (+), respectively. The muscle strength at foot dorsiflexion and plantar flexion were 2/5 (+) bilaterally. The patient was unable to walk on toes and walked on heels, and the lower extremities were hypoesthetic. The patellar and the Achilles tendon reflexes were bilaterally negative. No pathological findings could be detected on lumbosacral magnetic resonance imaging (MRI). Electromyography revealed a mixed type of polyneuropathy. The symptoms relieved partially at the end of the 2nd month and regressed completely at the end of the 3rd month. To prevention of irreversible postpartum permanent neurologic deficits, the diagnosis should be made using a detailed neurologic examination along with MRI or computed tomography. |
12. | Recurrented bilateral low-dose regional anesthesia under ultrasound guidance rather than general anesthesia in a high-risk patient: Rare a case Fikret Salık, Ümit Akol, Hakan Akelma, Mustafa Bıçak PMID: 34988967 doi: 10.14744/agri.2019.75735 Pages 67 - 72 Regional anesthesia practices are important because they have the advantages, for example, the patient’s awareness is open, spontaneous breathing continues, airway reflexes are preserved, analgesia continues in the post-operative period, and the patient has early mobilization. Local anesthetic at high doses and volumes are used in brachial plexus blocks with nerve stimulator. However, due to the development in ultrasound (US) technology and the increase in image quality, reduced dose of limited anesthesia, and because of its advantages such as vascular and reduced risk of pleural puncture, it has become increasingly widespread. Through US, it is possible to monitor the nerves and anatomical structures, to follow the needle, and to reduce the dose by monitoring the distribution of the local anesthetic given. Organ and tissue losses and tissue infections due to multiple exothermic burns, especially after burns, require multiple surgical procedures. While taking these patients to surgery, anesthesiologists may have difficulty in many stages. For this purpose, they prefer regional anesthesia for less complications. In our study, we aimed to present a low-dose bilateral supraclavicular, infraclavicular, and axillary block with US-guided paraplegic high-risk trauma in a patient with bilateral wounds, forearms, wrists, and wounds caused by burns. |
LETTER TO THE EDITOR | |
13. | Erector spinae plane block for post thoracotomy pain in a patient with myasthenia gravis Munise Yıldız PMID: 34988966 doi: 10.14744/agri.2020.74755 Pages 73 - 74 Erector Spina plane (ESP) block; It is a new and simple interfacial area block applied with ultrasonography. ESP is gaining popularity in abdominal and thorax surgery due to its adequate postoperative analgesia, easy administration, and low complication rate. In this case, the postoperative analgesic efficacy of bilateral ESP block performed under the guidance of ultrasonography in a myasthenic patient undergoing thymectomy surgery presented. ESB may be a good option in myasthenic patients in terms of reducing opioid need after thymectomy surgery and preventing possible postoperative complications. |
14. | The role and impact of the headache nurse specialist Ria Bhola, Devrimsel Harika Ertem PMID: 34988964 doi: 10.14744/agri.2020.67365 Pages 75 - 76 In the current paper, we aim to emphasize the pivotal role of the specialist headache nurse whose scope of work is clearly defined and detailed in western medical practice within tertiary care. |