Objectives: In this study, we aimed to compare the efficacy of two regional anesthesia methods, transversus abdominis plane (TAP) block and erector spinae plane (ESP) block, for intraoperative and postoperative pain relief in patients undergoing laparoscopic nephrectomy.
Methods: Fifty patients aged 18-80 years with American Society of Anesthesiologists (ASA) classification I-II scheduled for elective laparoscopic nephrectomy were included after ethical approval and informed consent. Patients were randomly assigned to either Group TAP (receiving TAP block) or Group ESP (receiving ESP block). Postoperatively, all patients received patient-controlled analgesia (PCA) with morphine. We evaluated intraoperative hemodynamics, additional opioid use, resting and coughing pain scores (Visual Analog Scales - VAS), time to first PCA dose, postoperative opioid consumption, rescue analgesic needs, opioid side effects, and patient and surgeon satisfaction.
Results: In Group ESP, postoperative VAS scores at 8 hours and during the first mobilization were significantly lower (p=0.019, p=0.004, respectively) compared to Group TAP. Patient satisfaction was notably higher in Group ESP (p=0.014). However, other postoperative parameters were similar between the groups (p>0.05). These findings held true when considering only radical nephrectomies, with no differences in the assessed parameters between simple and partial nephrectomies.
Conclusion: In conclusion, both TAP and ESP blocks demonstrated comparable effectiveness in postoperative pain management for laparoscopic nephrectomies. Nevertheless, due to lower VAS scores during mobilization and higher patient satisfaction, the ESP block appears to be more effective for multimodal analgesia. Further research is required to comprehensively assess their efficacy in laparoscopic radical nephrectomies.

Objectives: Migraine is a common cause of headache and a leading cause of morbidity in Türkiye. This study aimed to describe the clinical characteristics and management of migraine and to compare migraine with tension-type headache (TTH) regarding the burden of disease and healthcare resource utilization.
Methods: A total of 1368 patients (aged 18–65 years) with migraine or TTH were surveyed regarding sociodemographics, headache characteristics, clinical management, disease burden, quality of life, and healthcare resource utilization within the previous 12 months. Data from 1053 patients meeting the criteria for definite migraine (dMIG) or definite TTH (dTTH) were analyzed.
Results: The frequency and duration of attacks, the number of monthly headache days, days with analgesic consumption, and headache severity were significantly higher in dMIG compared to dTTH. Only 36.8% of definite migraineurs experiencing ≥4 monthly headache days were on preventive treatment. The negative impact on quality of life and economic loss were also higher in dMIG. Although more patients with dTTH visited a physician in the previous year, the number of physician visits was higher in dMIG. The groups were comparable regarding the percentage of patients who underwent radiological investigations due to headache; however, patients with dMIG had more brain magnetic resonance imaging and computed tomography scans.
Conclusion: Timely and accurate diagnosis and optimal management of migraine are crucial due to its significant burden. Educational programs for patients and healthcare providers, along with adherence to and persistence with preventive medications, may improve clinical outcomes.

Objectives: This study investigated nursing students’ pain beliefs and attitudes toward pain assessment.
Methods: The sample consisted of 365 nursing students from a state university in the Central Black Sea Region of Türkiye. The research was conducted between May 5th and June 9th, 2023. Data were collected using a student information form, the Pain Beliefs Questionnaire (PBQ), and the Nursing Students’ Attitudes Scale toward Pain Assessment (NSASPA). The data were analyzed using descriptive statistics, the independent sample t-test, the One-Way ANOVA test, the Tukey test, and the Pearson correlation test.
Results: Participants had a mean PBQ and NSASPA score of 3.13±0.52 and 57.66±7.47, respectively. Fourth-year students had significantly higher mean NSASPA total and subscale scores than first-year students (p=0.000). Participants who knew about pain assessment tools had significantly higher mean NSASPA total and subscale scores than those who did not (p=0.000). Participants who had used a standardized measurement tool for pain assessment before had significantly higher mean NSASPA total and subscale scores than those who had not (p=0.000). The PBQ total scores were very weakly correlated with the NSASPA total scores (r=0.125, p=0.017).
Conclusion: Participants’ attitudes toward pain assessment were negatively correlated with their pain beliefs. Therefore, nursing educators should revise the curriculum to help nursing students develop positive pain beliefs and positive attitudes toward pain assessment.

Objectives: Lateral sagittal infraclavicular approach is frequently used because it has less risk of complications and provides rapid and adequate regional anesthesia. Due to the fact that the brachial plexus is deeper in the infraclavicular region and the approach angle is sharper, it can be technically challenging. In this study, we aimed to compare the costoclavicular approach, which is a newly defined approach, with the lateral sagittal infraclavicular brachial plexus block.
Methods: This prospective, randomized, single-blind study was conducted with a total of 43 patients. There were 21 patients in the lateral sagittal infraclavicular approach group (Group L) and 22 patients in the costoclavicular approach group (Group C). A mixture of 10 ml 1% lidocaine with 10 ml 0.25% bupivacaine was given to both groups under the guidance of ultrasonography. Sensory and motor examinations were performed every five minutes for 30 minutes, and the results were recorded.
Results: Sufficient block formation time was 10 (5–30) minutes in Group C and 15 (5–30) minutes in Group L (p=0.010). Sensory and motor block formation times of each nerve (median nerve, radial nerve, ulnar nerve, and musculocutaneous nerve) were found to be shorter in Group C than in Group L (p<0.05).
Conclusion: The costoclavicular approach provides faster regional anesthesia formation than the lateral sagittal infraclavicular approach.

Objectives: Breast-conserving surgery is a common breast operation type in the world. Patients may feel severe postoperative pain after the surgery. Several regional anesthesia methods are used for postoperative pain control as a part of multimodal analgesia management after breast surgery. Erector spinae plane block (ESPB) and rhomboid intercostal plane block (RIB) are commonly used techniques for this purpose. The studies that compare these methods are limited. Therefore, we aimed to compare the efficacy of ESPB and RIB.
Methods: This prospective, randomized study included sixty female patients with ASA class I-II physical status in the study. All patients underwent general anesthesia. We performed the blocks at the end of the surgery before extubation. Participants were randomized into two groups between the operation: the Group ESPB (n=30) and the Group RIB (n=30). We performed 30 ml volume of 0.25% bupivacaine for the blocks. 400 mg ibuprofen 3x1 was ordered postoperatively, and a fentanyl PCA device (2 ml bolus, 0 ml infusion, 20 min lock time, 4 hour limit) was attached intravenously to the participants. If the pain score was ≥4, meperidine (0.5 mg/kg) was performed.
Results: There were no differences in terms of demographical data. The postoperative opioid use, pain scores, adverse events, and the need for rescue analgesia were similar between groups.
Conclusion: Both RIB and ESPB are effective regional anesthesia techniques following breast surgery. They are simple and safe methods. Anesthesiologists may prefer one or the other based on their clinical experience.

Objectives: The present study aimed to compare the pressure–pain threshold (PPT) values in patients with rheumatoid arthritis (RA) and age-gender matched controls with chronic nonspecific low back pain and to determine whether PPT values could be beneficial as a disease activity predictor after secondary fibromyalgia had been ruled out.
Methods: This study contained a cross-sectional observational study of participants with RA and chronic nonspecific low back pain controls without fibromyalgia. Visual analog scale (VAS), fatigue severity scale (FSS), pain catastrophizing scale (PCS), health assessment questionnaire (HAQ), hospital anxiety and depression scale (HADS), and disease activity score (DAS28) were administered. Pressure–pain threshold (PPT) values were measured with a baseline dolorimeter at the thumbnail bed, the dorsal aspect of the wrist, and the trapezius muscle on the dominant side.
Results: There were no differences in PPT scores at all points between RA and control groups. Female participants with RA had statistically lower PPT scores (high pain sensitization) at the wrist (p<0.001) and trapezius (p<0.001), but not at the nail bed (p=0.084). Multiple regression analysis identified only HADS-Depression as a determinant of the PPTs at all points.
Conclusion: The present study suggests that lower PPT is associated with depressive symptoms in participants with RA, and pressure algometry should be considered as an additional evaluation to detect pain/depression overlap.

Pain may be an early symptom of COVID-19 infection, most commonly seen as myalgia and headache. However, atypical presentations such as abdominal pain and leg pain can also be observed. We present seven cases of COVID-19 treated for pain. Our aim is to draw attention to low back, leg, and back pains that develop after COVID-19 infection.

Stromal vascular fraction (SVF) is a heterogeneous collection of cells obtained from adipose tissue through lipoaspiration and is an alter-native intraarticular treatment option, especially in osteoarthritis (OA). The anti-inflammatory and extracellular tissue repair-stimulating properties of SVF increase its effectiveness in regeneration and repair mechanisms. One of the most common symptoms of hemophilia A and B is hemophilic arthropathy (HA). If HA is not adequately managed initially, patients may require major surgery, including total joint arthroplasty. In a 34-year-old male patient who was treated with intraarticular adipose-derived SVF with the diagnosis of hemophilia B and right grade 4 hemophilic knee arthrosis, clinical and radiological scores showed significant improvement in the 3rd month, 6th month, and 1st year controls after the procedure. Intraarticular adipose-derived SVF treatment should be kept in mind as an effective treatment option with minimal invasiveness and few side effects in HA that does not respond to conservative treatments.

The superior hypogastric plexus (SHP) contains afferent nociceptive fibers from the pelvic structures, thus the SHP block is employed in the chronic pelvic pain (CPP) treatment in patients who do not respond to conservative treatments. A 60-year-old female patient, who did not respond to conservative treatment, underwent SHP neurolytic block after a successful diagnostic block. An excessive oblique angle approach was applied due to physical restrictions, the needle passed through the intervertebral disc resulting in the contralateral side SHP block, and the procedure was also repeated to the other side SHP. After the procedure, improvement in the patient’s NRS score and a decrease in urination frequency were detected, and these positive effects were preserved for 3 months. SHP block is a safe alternative interventional procedure in patients with CPP. If an excessive oblique angle is applied during the procedure, the needle may cross the midline, resulting in a contralateral blockage.