Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology
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Randomized Controlled Trial Comparative Study
[Comparison of the effects of lidocaine, lidocaine plus tramadol and lidocaine plus morphine for intravenous regional anesthesia].
The aim of this study was to compare the effects of lidocaine alone and those of morphine or tramadol when added to lidocaine for intravenous regional anesthesia (IVRA) on tourniquet pain, the onset and regression time of motor and sensory block, the level and duration of analgesia, and analgesic consumption. ⋯ IVRA with lidocaine and morphine or tramadol improves postoperative analgesia and sensory block. However, these combinations provide no advantage on tourniquet pain, motor block quality, analgesia duration or analgesic consumption.
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Treatment of neuropathic pain is difficult despite new treatments and there is no single treatment that Works for all conditions and their underlying mechanisms. Given the increasing evidence for effective treatments of neuropathic pain, it is important for the clinician to know which drugs are most effective neuropathic pain relieving pain and associated with the fewest adverse effects and there is a need for an evidence-based algorithm to treat neuropathic pain conditions. Ideally, the evidence for the non-opioids and opioids choices in such an algorithm would be based on direct comparisons of one drug with another, for both efficacy and side effects. There are very few such direct comparisons available.
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In this study we evaluated the results of pain treatment practices according to the World Health Organization analgesic ladder treatment. and other treatment modalities in cancer patients who were admitted to an anesthesiology-based pain service. Patient characteristics, distribution of the patients according to the primary pathologic sites, initial and last distribution of the patients according to analgesic ladder treatment, other invasive or non-invasive treatment modalities, side effects, and other data related with the patients were examined. 416 of 475 (87.5%) patients were treated using the WHO analgesic ladder treatment, 57 patients (12 %) were treated by invasive techniques. The number of successfully treated patients in step I, II and III were 49 (11.77%), 307 (73.79%) and 60 (14.42) respectively. 181 of 416 (43.50%) patients used anticonvulsants or neuroleptics, 341 of 416 (81.97%) patients used antidepressants. ⋯ Over the entire treatment period, side effects were reported in 17.05% of the patients. The follow-up time for the patients was 42 +/- 109.7 days, the mean interview number was 5.6+/-7.6, the longest follow-up time was 1380 days, and the maximum number of the interviews made by the same patient was 68. In conclusion, we think that, using the World Health Organization analgesic ladder treatment and administering appropriate analgesics and adjuvants in appropriate oral doses determined for appropriate subjects could successfully treat a great number of these patients.
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Horner's Syndrome results from paralysis of the ipsilateral sympathetic cervical chain (stellate ganglion) caused by surgery, drugs (mainly high concentrations of local anesthetics), local compression (hematoma or tumor), or inadequate perioperative positioning of the patient. It occurs in 100 % of the patients with an interscalene block of the brachial plexus and can also occur in patients with other types of supraclavicular blocks. ⋯ For this reason anesthesiologists should be aware of this syndrome and if it occurs patients should be reassured and monitored closely. In this case report, we presented a case of Horner's Syndrome following lateral sagittal infraclavicular block (LSIB), a newly described technique.
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Randomized Controlled Trial Comparative Study
Comparison of epidural ropivacaine 0.2% and ropivacaine 0.2% in combination with sufentanil 0.75 microg mL-1 for postcaesarean analgesia.
Analgesic techniques after c-section must be effective producing early mobilisation to enable mothers to care effort their babies. In this study, the comparison of ropivacaine 0.2% alone, with ropivacaine 0.2%+sufentanil 0.75 microg mL-1 for patient controlled epidural analgesia (PCEA) was aimed. Fifty women (ASA-I) were enrolled in the study. ⋯ Four patients in Group-I and 21 patients in Group-II received additional analgesic. Pruritus was observed more frequently in Group-I. The addition of sufentanil 0.75 microg mL-1 to ropivacaine 0.2% for PCEA after Caesarean led to more effective analgesia and less motor weakness when compared to ropivacaine 0.2% alone, especially during early postoperative period.