Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology
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Recently, ultrasonography (US) is an indispensible imaging technique in regional anesthesia practice. With the guidance of US, various invasive interventions in chronic pain pathologies of the musculoskeletal system, peripheral and neuroaxial pathologies has become possible. The management includes diagnostic blocks as weel as radiofrequency ablation and institution of neurolythic agents. ⋯ Latest publications in this field show that applicability of US in chronic pain syndromes is rapidly expanding with a good future. The additional equipment (echogenic needles, 3-D US etc.) will also expand its applications in algology practice. This review highlights different applications of US in chronic pain conditions.
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Randomized Controlled Trial
[Comparison of thoracic epidural and paravertebral analgesia for postoperative pain control after thoracotomy].
In the present randomized, controlled, and blinded study, the effects of thoracic paravertebral analgesia were compared to those of epidural analgesia on postoperative pain, hemodynamics, and respiration rate following thoracotomy. ⋯ Paravertebral block with levobupivacaine 0.1% and morphine 0.1 mg mL-1 may be an alternative form of pain relief following thoracotomy.
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Obturator nerve block is recommended to prevent obturator nerve reflex during transurethral resection. However, alternate techniques have been developed. The aim of the present study was to examine outcomes of interadductor approach. ⋯ Obturator nerve block is an effective method of preventing obturator nerve reflex. Combination of obturator nerve block and spinal anesthesia seems to be a safe method of anesthesia in transurethral surgery. Ultrasound guidance improves success rates and provides additional advantages for patient safety.
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Case Reports
Ultrasound guided continuous paravertebral block in a patient with coronary heart disease and sleep apnea syndrome.
The case of a 77-year-old patient with severe coronary heart disease who underwent radical mastectomy with axillary lymph node dissection by ultrasound-guided continuous paravertebral block (CPVB) is described in the present report. Radical mastectomy with axillary dissection is a surgical procedure that necessitates endotracheal intubation and is usually performed under general anesthesia, which carries heightened risk for patients with coronary heart disease (CHD) and sleep apnea syndrome (SAS). Ultrasound-guided CPVB is a simple and safe alternative technique that allows for the use of anesthesia and postoperative analgesia with minimal side effects.