Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology
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Randomized Controlled Trial
[Comparison of analgesic activity of intraarticular lornoxicam, bupivacaine and saline after knee arthroscopy].
Postoperative pain is an important parameter in discharge and rehabilitation in daycase arthroscopic knee surgery. This study compared the efficacy of intraarticular application of lornoxicam, bupivacaine and placebo on postoperative pain after arthroscopic knee surgery. With the approval of the local ethics committee and informed consent of the patients, 90 patients (ASA score I-II), aged between 18-65 years undergoing arthroscopic meniscectomy were included in this randomized, blinded, prospective study and were divided into three groups (30 patients each): 8 mg lornoxicam was applied to Group L (GL), 50 mg bupivacaine to Group B (GB) and normal saline to Group S (GS) in 20 mL volume intraarticularly. ⋯ The analgesiconsumption of GL patients at the end of 48 h were lower than GB and GS (p < 0.001 and p < 0.05). The NRS values of GL were always lower than the other groups with statistical significance at certain times. We concluded that intraarticular lornoxicam provided better pain control than bupivacaine and saline in arthroscopic knee surgery.
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Myasthenia gravis is an autoimmune disease with antibodies directed against the acetylcholine receptor at the neuromuscular junction. Anesthetists have a special interest in myasthenia gravis because of its interaction with various anesthetic agents. Unlike adult myasthenic patients; very little report has been written about the anesthetic management in children, other than in relation to thymectomy. ⋯ Specific attention should be paid to voluntary and respiratory muscle strength in myasthenia gravis patients. Caudal anesthesia allowed airway control of myasthenia gravis patients without endotracheal intubations and muscle relaxant. In conclusion, we think that caudal anesthetic technique may be considered as a safe and suitable for the myasthenic child and it may represent a valid alternative to general anesthesia for these patients.
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The study was conducted at Sahinbey Research and Intervention Hospital in order to define the interventions of health staff who were in charge of patient pain care. Those who had been an employee already between February- April 2007 were enrolled in the study. ⋯ In addition, the bullet-in questions of the scale revealed that the participants scored highest for knowledge management, followed by pain evaluation, and the least for the maintenance of physical comfort. The results of the study imply that standardization of education is mandatory to decrease individual differences due to educational status, and that more consideration should be given to pain and pain relief topics in schools providing health education.
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Case Reports
Sympathetic radiofrequency neurolysis for unilateral lumbar hyperhidrosis: a case report.
Patients with hyperhidrosis suffer from physical, social and mental discomfort which often cannot be treated sufficiently using conservative measures. A new percutaneous approach to sympathectomy using radiofrequency denervation has seemed to offer longer duration of action and less incidence of post sympathetic neuralgia. This article reports the authors' experience with sympathetic RF neurolysis in a 35 year old male with right unilateral lumbar hyperhidrosis. ⋯ Hyperhidrosis was relieved after the procedure and there were no postsympathectomy neuralgia and sexual dysfunction. The patient obtained improvement of lumbar hyperhidrosis at his first month of follow- up and was satisfied with the outcome. In conclusion, RF neurolysis of lumbar sympathetic ganglions is a safe and effective palliative procedure with minimal invasiveness for relieving excessive sweat secretion in patients with localized hyperhidrosis.
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Studies about greater occipital nerve injection in primary headaches had begun with Michael Anthony and almost all the studies today accept Anthony's studies as reference work. Although more than twenty years passed, there is not enough study about the subject. According to the present data, steroids are apparently effective in both preventive and acute attack therapy in cluster headache. ⋯ Despite the fact that local anesthetics has a role in relieving acute headache, single injection is not suitable in prophylactic treatment. In clinical practice, there is promising data about the usage of the procedure, until the beginning of the effect of principal preventive therapy in cluster headache and during the detoxification process in analgesic induced chronic migraine. Although there are case reports about the relieving acute pain in cluster headache and migraine, there is need for systematized clinical studies.