Search

Copyright of Turkiye Klinikleri Journal of Anesthesiology Reanimation is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim:The preoperative anxiety levels of the patients create negative effects in the postoperative period. In this study, we aimed to reveal the relationship between postoperative analgesia needs and preoperative anxiety levels in patients undergoing laparoscopic cholecystectomy.Methods:This study was organized as a cross-sectional study. The Preoperative Trait And State Anxiety Scales (STAI-T and STAI-S) were applied to 66 patients undergoing elective laparoscopic cholecystectomy between October 2020 and October 2021, and they were divided into two groups of high and low anxiety according to their STAI-S scores. Postoperative anxiety level was considered 0th hour when the patient was able to respond to verbal stimuli and was re-evaluated with the STAI-S scale within the first 4 h. Postoperative pain scores of the patients were recorded with the visual analogue scale at 2nd, 6th, 12th, and 24th hours. Patients who needed additional analgesia doses were recorded.Results:Sociodemographic characteristics were compared between groups, and no significant difference was found. Although the pain of our patients decreased over time, there was no significant relationship between anxiety levels and postoperative pain scores of the groups.Conclusion:This study showed that there was no relationship between the preoperative anxiety level and the postoperative analgesia score of the patients.

Copyright of Van Health Sciences Journal / Van Sağlık Bilimleri Dergisi is the property of Van Yuzuncu Yil University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective:This study aimed to determine pain treatment methods applied in intensive care units in our country, specifically the frequency of regional analgesia use and attitudes and approaches to regional analgesia, using a questionnaire.Materials and Methods:Our study was organized as a cross-sectional survey in the form of a questionnaire. A web-based questionnaire containing 31 questions was sent to specialist physicians working in the intensive care unit via e-mail. The questionnaire was sent to the participants 4 times at intervals of 4 weeks. Participants who were unable to complete the questionnaire within 4 months were considered as rejecting participation.Results:A total of 130 specialist physicians working in the intensive care unit participated in our study, wherein 45.4% stated the presence of protocol for analgesia in the intensive care unit. The highest rate of preferred methods for pain treatment was found to be opioids, followed by nonsteroidal anti-inflammatory drugs (NSAIDs), other pharmacological agents, and regional analgesia, respectively. Lumbar epidural, thoracic epidural, peripheral nerve blocks, and local infiltration were the most preferred regional analgesia methods, but it is noteworthy that the rate of regional analgesia methods was low even in cases with appropriate indications. Factors that prevent the use of regional analgesia were hemodynamic instability (53.1%), coagulation profile variability (49.2%), and easier alternative analgesia methods (44.6%). Notably, the incidence of complications in regional analgesia methods was generally very low.Conclusion:The most commonly used drugs for pain management in intensive care units were opioids and NSAIDs. A majority of the participants expressed their belief in the useful effects of regional analgesia in patients although these methods were rarely used in intensive care units.

Copyright of Turkiye Klinikleri Journal of Anesthesiology Reanimation is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Köyceğiz district of Muğla province is abundant in medicinal and aromatic plant diversity. This variety is thought to be the result of topographic and climatic factors. However, as a result of uncontrolled collection and overuse, the future of a significant part of medicinal plant species is in danger. As a result, the primary goal of the study is to record the herbal drugs used by the locals and to raise awareness about endangered species while taking into account the growing conditions. The opinions and suggestions of local people living in the Köyceğiz region about herbal products and their application in some diseases were examined in this study. The data was statistically evaluated using the Mann Whitney U and Kruskal Wallis tests because it did not have a normal distribution. As a result of the research, it was discovered that medicinal and aromatic plants, particularly thyme, sage, mountain tea, and linden plants grown in the region, are widely used in the treatment, and the oils of plants such as sweetgum and centaury are used in the treatment of wounds. Herbal treatment was determined to be the first method used by participants in cases of discomfort such as cold, cough, wound treatment, and pain relief. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess analgesic applications accompanied by numerical and verbal pain scores, radiological imaging, and consultation requests for genital traumas, which affect a small percentage of middle and high school students. Materials and Methods: This retrospective study included 237 middle school and high school age, 10-18 years old patients who applied to the emergency department due to genital trauma between January 2019 and December 2020. The types of trauma, radiological imaging, genital organ injuries, analgesia applications, consultations, and verbal and numerical pain scale scores of patients were all evaluated. Results: Of the 237 patients included in the study, 90 (38%) were female, and the mean age was 13.80±2.37 years (range, 10-18 years). Of the patients, 136(57.4%) were admitted with falls, 63(26.6%) traffic accidents, 35(14.8%) penetrating and 3(1.3%) iatrogenic injuries. The numerical pain score was 6.63±1.43 in falls, 6.09±1.66 in traffic accidents, 4.80±1.53 in penetrating injuries, and 3.67±1.15 in iatrogenic traumas. Analgesics were administered to 93(39.2%) of all patients. The severity of pain was mild in 43(18.1%) patients. It was moderate in 140(59.1%) and severe in 54(22.8%). Conclusion: Genital traumas that occur alone are extremely rare and are frequently associated with multiple organ injuries. Genital traumas have a wide variety of etiological causes and complications. In cases of pediatric genital trauma, the use of verbal and numerical pain scales may be beneficial in evaluating patients, determining imaging requirements, and determining analgesia applications.

Objective: This study aimed to determine pain treatment methods applied in intensive care units in our country, specifically the frequency of regional analgesia use and attitudes and approaches to regional analgesia, using a questionnaire. Materials and Methods: Our study was organized as a cross-sectional survey in the form of a questionnaire. A web-based questionnaire containing 31 questions was sent to specialist physicians working in the intensive care unit via e-mail. The questionnaire was sent to the participants 4 times at intervals of 4 weeks. Participants who were unable to complete the questionnaire within 4 months were considered as rejecting participation. Results: A total of 130 specialist physicians working in the intensive care unit participated in our study, wherein 45.4% stated the presence of protocol for analgesia in the intensive care unit. The highest rate of preferred methods for pain treatment was found to be opioids, followed by nonsteroidal anti-inflammatory drugs (NSAIDs), other pharmacological agents, and regional analgesia, respectively. Lumbar epidural, thoracic epidural, peripheral nerve blocks, and local infiltration were the most preferred regional analgesia methods, but it is noteworthy that the rate of regional analgesia methods was low even in cases with appropriate indications. Factors that prevent the use of regional analgesia were hemodynamic instability (53.1%), coagulation profile variability (49.2%), and easier alternative analgesia methods (44.6%). Notably, the incidence of complications in regional analgesia methods was generally very low. Conclusion: The most commonly used drugs for pain management in intensive care units were opioids and NSAIDs. A majority of the participants expressed their belief in the useful effects of regional analgesia in patients although these methods were rarely used in intensive care units. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to compare intravenous analgesia (IVA) and intermediate cervical plexus block (ICPB) in terms of acute pain scores and opioid consumption in patients undergoing carotid endarterectomy (CEA) under general anesthesia. Materials and methods: Following the induction of anesthesia, dexketoprofen trometamol 50 mg was administered before the surgical incision, and paracetamol 1 g was given at the end of the surgery and continued at 6 hour intervals for group IVA. Whereas, ultrasound-guided intermediate cervical plexus block was performed in ICPB group. VAS scores, morphine consumption, length of stay, and patient satisfaction status were compared. Results: A total of 109 patients (57 in the IVA group and 52 in the ICPB group) between January 2015 and June 2021 were enrolled. The mean VAS score after extubation was significantly lower in the ICPB group (4.1±1.4 vs 1.2±0.8, p = 0.005). Total morphine consumption was found to be significantly lower in the ICPB group (13.1±4.4 mg vs 3.9±2.4 mg, p < 0.001). The hospital stay was 3.1±1.3 days in the IVA group, while it was 2.2±0.9 days in the ICPB group (p = 0.0014). The patients in the ICPB group were found to be significantly more satisfied (3.4±1.4 vs 1.2±0.8, p < 0.001). Conclusion: Intermediate cervical plexus block provides lower acute pain scores and lower opioid consumption compared to intravenous analgesia in patients undergoing CEA under general anesthesia. In addition, this combined technique shortens the ICU and hospital length of stay and improves patient satisfaction.

Ultrasound-guided thoracic paravertebral block (TPVB) is a promising new technique for use in children of various ages. In this case report, a successful ultrasound (USG) guided TPVB procedure in premature neonate is described. A 3-day-old 1600-g neonate, born at 32 weeks of gestation, was underwent thoracostomy for esophageal atresia with esophageal fistula repair. At the end of the surgery, USG-guided TPVB were successfully performed using a linear probe in the paramedian position. USG-guided TPVB could be an alternative method for providing effective analgesia in a premature neonates in the future.

This research was conducted to examine the effect of postoperative pain level on sleep quality in patients who undergo major urological surgery. The research was carried out as a descriptive-sectional type study between January-September 2021. The sample of the research consisted of 107 patients who met the inclusion criteria of the study. Data were collected by using the "Patient Description Form", "Numeric Rating Scale" and "Richards-Campbell Sleep Scale" (RCSQ). For statistical analysis of data, IBM SPSS Statistics 25 (IBM SPSS, Turkey) program was used. Before starting the study, necessary ethics committee and institutional permission were obtained. It was determined that the average of the pain level of the patients was above the moderate level before the second dose of painkillers (5.99±3.21) after the surgery, and the mean score of the RCSQ 64.17±25.5 was above the moderate level. It was determined that as the pain level of the patients increased, the sleep quality decreased (p<0.05). As the result of the study, it was determined that the pain levels of the patients who had major urological surgery were severe and their sleep quality was moderate; In addition, it was concluded that as the pain level of the patients increased, their sleep quality decreased. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to present our experiences with intrathecal morphine used for postoperative analgesia in the patients underwent thoracic surgery in our clinic. Materials and Methods: In this study, a total of 18 adult patients who underwent thoracic surgery and were administered intrathecal morphine for postoperative analgesia between January 2020 and June 2020 were evaluated retrospectively. The patients were divided into two groups: Group 1; 10 mcg/kg intrathecal morphine grup, Group 2; 7 mcg/kg intrathecal morphine group. Demographic data, doses of morphine administered, duration of surgery and anesthesia, intraoperative anesthetic agent consumption, postoperative hemodynamic variables, pain scores, additional analgesic requirement and side effects were recorded. Results: Twelve of the patients (66.7%) were administered 10 mcg/kg and 6 of them (33.3%) 7 mcg/kg intrathecal morphine according to ideal body weight. Intraoperative anesthetic agent consumption was found to be lower in Group 1 compared to Group 2, but this difference was not statistically significant. Pain scores at rest were statistically lower in Group 1 at 12, 24 and 48 hours postoperatively. Pain scores at effort were also statistically lower in Group 1 at 12, 18, 24 and 48 hours postoperatively. Conclusion: Intrathecal morphine is a safe postoperative analgesia option for thoracic surgery patients. We believe that intrathecal morphine at a dose of 10 mcg/kg provides more effective analgesia than 7 mcg/kg without increasing the frequency of side effects. [ABSTRACT FROM AUTHOR]

Objective: Total hip replacement (THR) is associated with severe postoperative pain. In this study, we aimed to compare fascia iliaca compartment block (FICB) with epidural block in the prevention of postoperative pain. Material and Method: Our study included 40 patients; who underwent epidural analgesia and FICB. At the end of the operation, (Group FICB) who underwent ultrasound-guided FICB for postoperative analgesia and received 100 milligrams Bupivacaine hydrochloride +250 micrograms fentanylcitrate. Patients in Group EPI were given 100 milligrams bupivacaine hydrochloride and 250 micrograms fentanyl citrate an elastomeric pump containing 100 milligrams Bupivacaine hydrochloride +250 micrograms fentanylcitrate with 75 cc saline added, giving a total of 100 ml and infusing 2 cc/hour continuously for 48 hours was installed through an epidural catheter to obtain postoperative analgesia. Time to first analgesia request after the operation, total milligrams of meperidine received in the postoperative 24 hours, postoperative VAS scores at the 30th minute, 2nd hour, 6th hour, 12th hour, and 24th hour and patient satisfaction levels were evaluated. Results: VAS scores at the postoperative 2nd, 6th, 12th, and 24th hours were statistically significantly higher in Group FICB compared to Group EPI (p <0.001). In addition, it was observed that the total analgesic consumption in the postoperative period was statistically significantly higher in Group FICB compared to Group EPI (p <0.001). The evaluation of patient satisfaction levels revealed that patients in Group EPI were very much satisfied (p <0.001). Conclusion: In our study; we found out that postoperative pain levels and analgesic consumption were lower in epidural anaesthesia patients compared to the patients, who underwent fascia iliaca compartment block. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Faculty of Pharmacy of Ankara University / Ankara Üniversitesi Eczacilik Fakültesi Dergisi is the property of Ankara University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction:Capnography is a proven effective tool for procedural sedation and analgesia (PSA); however it is hardly available in developing countries like Iran. This study aimed to discover the frequency of hypoventilation in paediatric patients who received intramuscular (IM) ketamine and evaluate the relationship between end-tidal carbon dioxide (ETCO2) changes and other vital signs.Methods:This was a cross-sectional study conducted in 2019. Paediatric patients (under 14 years old) who underwent PSA with 5 mg/kg of ketamine given IM participated in this study. ETCO2 was monitored by the mainstream CO2 sensor. Hypoventilation was defined as ETCO2 variation >10 mmHg from the baseline. Patients ETCO2, oxygen saturation (SPO2), pulse rate (PR), respiratory rate (RR) and blood pressure (BP) were continuously monitored and recorded. The specificity and sensitivity of SPO2 for detecting 10 mmHg change in the ETCO2 level were calculated. In addition, the PR, RR and BP were grouped based on patients’ age (1-3 and 3-6 years) and compared between patients who had hypoventilation and others.Results:A total of 121 patients were enrolled in the study. The mean ± standard deviation of age was 2.89±1.48 years (minimum =1.2 and maximum =5.8 years). Nineteen (15.7%) patients had >10 mmHg changes in the ETCO2 level. In both age groups, PR and RR had a significant difference between patients with hypoventilation and other patients (p=0.001 in 1-3 years and 0.003 in 3-6 years).Conclusion:Hypoventilation was frequent among paediatric patients who received IM ketamine; however, it was minimal and required simple airway manoeuvres. Pulse oximetry was not accurate to detect this small amount of hypoventilation. Thus, capnography would provide better monitoring during ketamine PSA.

Background: Perioperative period is characterized by stressful and rapidly changing physiological responses. During this period, many factors and stimuli lead to the activation of the sympathetic nervous system, causing various hemodynamic changes, mainly tachycardia. Studies showed that stress and hemodynamic changes occurring during this period are associated with increased cardiac damage, morbidity and mortality. Beta blockers can prevent these negative results due to stress, thanks to their sympatholytic effects. Esmolol hydrochloride is a selective β-1 receptor blocker with a rapid onset and very short duration of action. Our aim in this study is to investigate the effect of perioperative esmolol use on perioperative hemodynamics, the amount of inhalation agent and narcotic consumed, and the amount of analgesic drug consumed postoperatively in patients undergoing non-cardiac operation and at moderate-high risk for the development of cardiac events. Materials and Methods: 40 patients undergoing elective grade 3-4 urology and general surgery operations under general anesthesia and have medium-high risk of perioperative cardiac event development according to the revised cardiac risk index and Mangano criteria were included in the study. Patients were randomized to esmolol (n=20) and control group (n=20). Esmolol group was loaded with esmolol 500 µg/kg/min for 1 minute intravenously (i.v.) and maintained as the heart rate to be <80/min., whereas 0.9% NaCl i.v. was given to the control group. Results: There was no significant difference between two groups in terms of age (P=0.910), gender (P=0.519), surgical grade (P=0.288), and ASA scores (P=0.218). However; heart rate (HR) and mean arterial pressure (MAP) decreased significantly after drug loading compared to basal value in esmolol group, whereas there was no significant change in control group. There was no difference between two groups in terms of sevoflurane consumption, but the frequency of additional fentanyl requirement (P=0.047) and the amount of consumed fentanyl (P=0.039) were significantly lower in esmolol group. In the postoperative period, it was detected that HR and MAP values were significantly lower in esmolol group than control group. However, there was no difference between two groups in terms of postoperative pain and morphine consumption. Conclusions: We demonstrated that use of esmolol provides an effective hemodynamic stabilization in the perioperative and postoperative period and reduces the amount of consumed narcotics perioperatively in patients undergoing noncardiac surgery with mediumhigh risk. However, we could not detect a significant effect of esmolol on the amount of consumed inhalation agent and postoperative analgesic use. [ABSTRACT FROM AUTHOR]

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Virtual reality is an advanced cognitive technique that has been widely used in health care applications in recent years, especially in burn injuries. Burn injuries, which are a serious and multifaceted injury, affect the patient not only physically but also psychologically, and patients need help in overcoming and coping with this situation. The effect of virtual reality has been proven as an important non-pharmacological analgesia method in the relief of pain in the acute and rehabilitation processes of the burn injury process. At the same time, it has been determined that it has positive effects on the anxiety and fear experienced by the patients. It has been emphasized that virtual reality accelerates the re-epithelialization process and supports the healing process in burn patients. The aim of this study is to evaluate the use and effects of virtual reality, which is a potential and important technology for nursing care and multidisciplinary healthcare team, in the treatment of burn patients. [ABSTRACT FROM AUTHOR]

Critical covid-19 patients admitted to the intensive care unit often require analgesia and sedation. There is an increased need for sedation and analgesia due to the pathophysiological characteristics of the disease itself, the severity of the disease, and concerns about its transmission to healthcare providers. In the management of sedation in Covid-19 critical care patients, individualized patient sedation and analgesia management, side effect profiles of various agents, patient characteristics, and availability of drugs should be considered. Increasing patient safety and improving intensive care outcomes are the main objectives. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health Sciences / Sağlık Bilimleri Dergisi is the property of Erciyes Universitesi Saglik Bilimleri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Health anxiety is the excessively negative interpretation of normal physical signs in an individual with no physical disease. Having knowledge information about the health anxiety levels of patients is one of the criteria that will affect the treatment of the patients’ pain. The aim of this study was to evaluate the preoperative health anxiety of laparoscopic cholecystectomy patients together with the perception of postoperative pain and the requirement for analgesia.Methods: The study included 41 patients of American Society of Anesthesiologists(ASA) grade I-II, aged 18-65 years who were to undergo a laparoscopic cholecystectomy operation and a control group of 40 healthy individuals. The Health Anxiety Inventory was applied to the patients preoperatively and to the control group. In the postoperative period, the patients were followed up for 24 hours with a patient-controlled analgesia device prepared with tramadol. Visuel Analog Scale(VAS) values of patients were below 4 due to the use of patient controlled analgesia device. Total analgesic consumption was recorded. The results were compared statistically.Results: No significant difference was determined between the patient and control groups in respect of age, gender and body mass index (p gt;0.05). The VAS score of all the patients was less than four. The mean total tramadol consumption of the patients in the first 24 hours postoperatively was 221.58±73.06. The analgesia consumption of female patients was significantly higher than that of males (p=0.013). The health anxiety results of the patient group were found to be significantly higher than the control group (p lt;0.001). A positive correlation was determined in the patient group between health anxiety and the total analgesia requirement (r=0.813, p lt;0.01). Conclusions: In conclusion, high level of analgesia consumption was determined in those with high health anxiety and in female patients. When planning postoperative pain treatment, consideration of the gender of the patient and the level of health anxiety will make a positive contribution to the treatment.

Objective: Inadequate pain management after laparoscopic cholecystectomy is an important problem that can lead to complications and negatively affect the patient’s recovery. Transversus abdominis plane block can contribute to postoperative analgesia in abdominal surgeries. The aim of this study is to investigate the effects of preoperative unilateral or bilateral transversus abdominis plane block on perioperative analgesia in patients underwent laparoscopic cholecystectomy and its contribution to patient comfort. Methods: A total of 75 patients were randomized into 3 groups as Group-1 (n=25) without unblocking, Group-2 (n=25) with unilateral block and Group-3 (n=25) with bilateral block. Block was applied to Group 2 and Group 3 under general anesthesia before surgery. Demographic characteristics of patients, intraoperative opioid consumption, postoperative 30 min, 2, 4, 8, 12 and 24 hours VAS rest-VAS cough scores, analgesic consumption in patient controlled analgesia, postoperative additional analgesic requirement, side effects, mobilization times and patient satisfaction were recorded. Results: The dose of remifentanil consumed intraoperatively was significantly lower in Group-3. VAS values were significantly different among the groups until the 12th hour postoperatively. The VAS rest and VAS cough values were lower in the Group 3. There was a significant difference among the groups in the patient-controlled analgesia devices when the bolus dose demand/given amounts and the total amount of drugs requested/consumed were compared. Total drug consumption was determined in the highest Group-1 and the lowest in Group-3. The satisfaction scores of the patients in group-3 were higher than the other groups. Conclusion: Our study showed that transversus abdominis plane block application in laparoscopic cholecystectomy surgeries contributed to decreased perioperative analgesic consumption and lower VAS scores up to 12 hours. Transversus abdominis plane block, which was performed with laparoscopic cholecystectomy in the preoperative period, has been shown to be an effective analgesic method. [ABSTRACT FROM AUTHOR]

Copyright of Agri: Journal of the Turkish Society of Algology / Türk Algoloji (Ağrı) Derneği'nin Yayın Organıdır is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Anterior cervical discectomy and fusion (ACDF) surgery is a procedure that can cause moderate pain in the postoperative period. Superficial cervical block (SCB) is a regional anesthe- sia technique that can provide analgesia during and after surgery. The aim of this study is to investigate the effect of ultrasound-guided SCB block on pain scores and postoperative opioid consumption in patients undergoing ACDF surgery. Method: Forty-eight patients planned to undergo single or two levels of ACDF surgery were ran- domly divided into two groups as SCB and Control (C). Ultrasound -guided SCB was performed in the SCB group (n=24) with 10 mL of 0.25% bupivacaine. No intervention was made to the control group (n=24) before the operation. Intravenous 50 mg dexketoprofen was administered to both groups half an hour before the end of the operation and at the 12th hour postoperatively. Patient- controlled analgesia (PCA) device containing fentanyl was connected to the patient. Postoperative visual analog scale (VAS) scores, opioid consumption, need for rescue analgesia and side effects were recorded. Results: There was no statistically significant difference between the groups in terms of demographic data, anesthesia and surgery times. Compared to the control group, VAS scores were sta- tistically low at all measurement times in the SCB group (p<0.05). The 24-hour total opioid con- sumption was statistically significantly higher in the control group relative to the SCB group (375.83±235.96 µg vs. 112.50±102.41 µg p<0.001). The need of rescue analgesia was statisti- cally higher in the control group compared to the SCB group (12/24 vs. 0/24, p<0.001). Conclusion: We believe that US-guided SCB can be an effective component of the multimodal analge- sia protocol by reducing opioid consumption and pain scores in patients undergoing ACDF surgery. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Anesthesiology Reanimation is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Pediatric Emergency & Intensive Care Medicine / Çocuk Acil ve Voğun Bakım Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We aimed to evaluate postoperative analgesia of intravenous paracetamol or caudal block at pediatric patients with using FLACC scale who underwent urologic intervention retrospectively. Material and Methods: The files of 55 patients aged between 0 and 12 who underwent urological surgery between April 2019 and July 2019 were evaluated retrospectively. Pediatric patients undergoing caudal epidural analgesia were referred to as Group 1, while Group 2 was given iv paracetamol. FLACC scores were administered for 50 minutes, once every 10 minutes. Scores at 10, 20, 30, 40 and 50 min were calculated. Patients who underwent additional analgesics based on the score were noted. Results: The mean age of the patients was 5.5 ± 3.4 years in Group 1 and 6.2 ± 3.6 years in Group 2. Mean duration of surgery was 36.9 ± 25.5 minutes in Group 1 and 23.5 ± 17.2 minutes in Group 2. Postoperative FLACC scores were significantly higher in group 2 at 10, 20, 30, 40 minutes compared to Group 1, and again significantly higher at 50 minutes. No additional postoperative analgesic requirement was required in Group 1 (0%), while 14 patients (50%) in group 2 received iv paracetamol 15 mg / kg as an additional analgesic. Conclusion: We found that the application of caudal epidural analgesia to prevent postoperative pain was effective. Caudal analgesia should be preferred in pediatric patients when it is considered to reduce requirement of additional analgesics in postoperative period, avoiding the side effects and reducing costs. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Agri: Journal of the Turkish Society of Algology / Türk Algoloji (Ağrı) Derneği'nin Yayın Organıdır is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: We aimed to evaluate the efficacy of preemptive oral tramadol-placebo, tramadol-pregabalin and tramadolparacetamol combination on postoperatif tramadol consumption in patients undergoing breast reduction operation. Materials and Methods: Sixty adult patients between 18-65 years of age, undergoing breast reduction surgery were included in this study, randomly divided into three groups. Each of groups were received 35 mg drop tramadol one hour before surgery. Additionally Group I (n=20) patients received 75 mg pregabalin tablet and Group II (n=20) patients received 500 mg paracetamol tablet preoperatively, and Group III (n=20) patients accepted as control group. 30 minutes before the end of operation Postoperative 24 hour pain scores, total tramadol consumption, supplement analgesic requirement, extubation, recovery time and side effects were recorded. Results: Postoperative 10th and 60th min Visual Analogue Scale scores were lower in group II compared to others. The consumption of tramadol in Group I was lower than the others when the total amount of tramadol consumtion was grouped as 120 mg≥ and 120mg <. Conclusion: The combinations of pregabalin and tramadol and paracetamol and tramadol did not cause any difference in terms of postoperative pain scores, 24-hour total tramadol consumption compared with tramadol alone. [ABSTRACT FROM AUTHOR]

Introduction: Greater than half of cancer patients suffer from the pain, which is the one of the major problems that disrupt the quality of life at, any time during the disease. Pain should be decreased as soon as possible and the maintenance treatment should be planned in these groups of patients. The World Health Organization (WHO) suggests the use of a three-step analgesic ladder approach including non-opioid, weak opioid and strong opioids according to the severity of the pain. However, the pain palliation can’t be accomplished in more than 80% of patients because of the wrong thoughts of health professionals, patients and patients’ relatives about narcotic analgesics.Methods: In this study 72 lung cancer patients, hospitalized between 29 July 2013 to 31 December 2015 at Izmir Katip Çelebi University Atatürk Education and Research Hospital Palliative Care and Support Service were assessed retrospectively about pain palliation.Results: Patients mean ages 61.2 ± 8.2 and 77.8% (56) were male, and 22.2% (16) were female. Patients applied with different complaints such as Inability to feed, pain, general condition disorders, shortness of breath and nausea and 27.8% (20) of patients had only admitted with pain. The median duration of hospital stay was 7 (2-45) days, which is the 18.1% of patients were not given any analgesics. 49.2% (29) of patients have second line treatment, 50.8% (30) had received third line treatment. Hospitalization indication and discharge status of the patients was statistically significant association between analgesic use (p = 0.002; p = 0.03).Conclusion: Cancer pain is the most common symptom affecting the quality of life negatively. Pain management should be well known by clinicians. Success in the treatment of pain patients linked to multidisciplinary approach include the whole psychological and social environment will be possible with the treatment applied by step approach.

Trauma is one of the leading causes of death worldwide. Stress response secondary to injury occurs at these patients. Because of pain respiratory rate can increase at them. In this regards airway management and hemodynamic stability are important parameters in trauma patients. Ketamine has noncompetitive antagonistic properties on the receptor of N-methyl-D aspartate (NMDA) and it can stimulate brainstem by noradrenalin reuptake inhibition. For that it can be used on monitorization of hemodynamic unstable trauma patients which monitorization is not suitable. We aimed to investigate the frequency of ketamine use in clinical practice in trauma patients and whether it is the preferred agent in traumatic brain injuries and injuries with increased intraocular pressure (IOB) by reviewing the literature. [ABSTRACT FROM AUTHOR]

Objective: The study was designed to compare the postoperative analgesic efficacy of epidural tramadol or epidural morphine as adjuvant to levobupivacaine in major abdominal surgery. Methods: Patients in ASA I-II group aged between 18 and 65 years were included in study. Epidural catheter was introduced. Patients were randomised into three groups to receive levobupivacaine (Group L), levobupivacaine+ morphine (Group LM) and levobupivacaine+tramadol (Group LT). General anaesthesia was administered to all patients. The solution intended for Group L contained 25 mg 0.5% levobupivacaine+15 mL saline, that for Group LM contained 25 mg 0.5% levobupivacaine+14.5 mL salin+100 µg morphine and that for Group LT contained 25 mg 0.5% levobupivacaine+13 mL salin+100 mg tramadol, which was administered via epidural catheter as loading dose 30 min before the end of the operation. Patient-controlled analgesia device was connected to the epidural catheter for evaluating postoperative analgesia. Bolus dose was adjusted to 12 mg levobupivacaine in Group L, 12 mg levobupivacaine +1.2 mg morphine in Group LM and 12 mg levobupivacaine+12 mg tramadol in Group LT. Lock-out period was adjusted to 15 min in three groups. Quality of analgesia was evaluated using Visual Analogue Scale; administered and demand doses of levobupivacaine, morphine and tramadol were compared at 30 min, 1, 2, 6, 12 and 24 h postoperatively. Results: Visual Analogue Scale scores were significantly higher in Group L than Groups LM and LT. Nausea and vomiting observed in Group L were lesser than those in Groups LM and LT. Conclusion: Continuous epidural analgesia using levobupivacaine combined with morphine or tramadol is an effective method for managing postoperative analgesia in major abdominal surgery. [ABSTRACT FROM AUTHOR]

Background: Inadequate or overdose use of analgesics is becoming increasingly important; therefore, analgesia methods are developing day by day. Transversus abdominis plan (TAP) block is a method for pain control in abdominal surgeries under ultrasound guidance. In our study, we aimed to investigate the area where TAP block should be applied by taking measurements from different regions under ultrasound guidance. Methods: Thirty patients aged between 18-65 years were included in the study. Linear oblique muscle, external oblique muscle, and transverse abdominal plan sheath width from the anterior axillary region and medial axillary line from the anterior abdominal region, from the subcostal region of the ultrasound to the anterior abdomen, and from the upper iliac crest were recorded. The image sharpness of these regions (poor, good and very good) was evaluated and recorded. Results: Internal oblique muscle, external oblique muscle, transversus abdominus muscle widths and transversus abdominus fascia were found to be lower and statistically significant (P <0) when comparing the anterior axillary line (A1) over Krista iliac line with the median axillary line (A2)., 05). Internal oblique muscle and transversus abdominus fascia were found to be lower in the measurements taken when comparing the anterior axillary line (B1) under the costal edge with the median axillary line (B2) and were found to be statistically significant (P <0.05). Conclusion: We believe that the probe should be made over the medial axillary line when TAP block is applied because the measurements are higher than the anterior axillary line and the image clarity is better. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to compare the effects of fentanyl, remifentanyl and ketamine applied for analgesia during colonoscopy on hemodynamics and sedo-analgesia quality. Methods: A total of 81 patients, who were scheduled for elective colonoscopy, were included in the study. Groups were randomized according to closed envelope method. Group K received 0.5 mg/kg ketamine, group F, 1 µg/kg fentanyl, and group R received 1 µg/kg remifentanil. Anaesthetist administered the analgesic agents at a dose of 1 mL/10 kg body weight without knowing the ingredient. Hemodynamic variables, total amount of propofol consumed, time of the endoscope to reach the cecum, and duration of colonoscopy were recorded. After the procedure, Modified Aldrete Score, patient, colonoscopist and anesthesiologist satisfaction were evaluated. Statistical analysis of the data was performed. Results: The demographic characteristics of the patients included in the study and the distribution of the patients between the groups were similar. There were no significant differences in duration of colonoscopy, hemodynamic changes, oxygen saturation, satisfaction scores, quality of analgesia, recovery and recovery after the procedure between the groups. Conclusion: As a result, ketamine, fentanyl, and remifentanyl applied for analgesia during colonoscopy have similar hemodynamic alterations and analgesic quality, therefore these agents may be substituted for one another for colonoscopy procedures. [ABSTRACT FROM AUTHOR]

Purpose: The object of this randomized and doubleblinded study was to compare the efficacy of intrathecally applied levobupivacaine at different doses with or without morphine added in elective Cesarean section operations with spinal anesthesia. Materials and Methods: The study was planned as prospective, randomized and double-blinded in ASA I-II group of sixty women who were 37-42 weeks pregnant and applied spinal anesthesia for cesarean section. Patients were r andomized i nto t wo g roups. 1 2.5 m g (3 m l) levobupivacaine to group L, 10 mg levobupivacaine + 0.1 mg morphine (3 ml) to group LM were applied intrathecally. Sensory and motor block durations, postoperative immediate 24 hour VAS pain scores, time to the first need for analgesia, hemodynamic and respiratory parameters, sedation levels, APGAR scores, patients' satisfaction and complications were recorded. Results: No significant difference was found between groups in terms of time to motor block formation and termination, time to sensory block formation and its two segment decline, and patients' satisfaction. Rescue analgesic need for the first timein group L was earlier compare to group LM (158.6 ± 31.8 minutes and 176.6 ± 37.16 minutes respectively). Conclusion: Despite levobupivacaine dose reduction, its combination with low-dose morphine was resulted in prolongation of spinal analgesia without significant increase in the frequency of side effects and complications with similar anesthesia and analgesia levels. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to investigate the effects of 2% lidocaine gel only and 2% lidocaine gel-diclofenac combination on pain in male patients undergoing flexible cystoscopy. Methods: The records of male patients who underwent flexible cystoscopy for lower urinary system symptoms and bladder tumor contol cystoscopy between April 2016, and April 2017, were reviewed. Patients with active urinary infection, urethral stricture, additional procedures during cystoscopy like biopsy, catheter withdrawal, or insertion, and sensory neurological defects were excluded from the study. Patients were divided into two groups according to the analgesic used. Overall, 116 patients in Group I were treated with 2% lidocaine gel, and patients in Group II were treated with 2% lidocaine gel and intramuscular diclofenac. In the gel group, 10 cc of 2% lidocaine gel was instilled into the urethra 15 min before the procedure and immediately before the procedure. In the other group, 75 mg diclofenac was intramuscularly administered 30 min before the 2% lidocaine gel instillation. All operations were performed by the same urologist. VAS scores were filled after the procedure, and the groups were compared. Results: The mean age of the patients was 61±13.1 years in Group I and 59±13.2 years in Group II (p=0.060). The mean duration of the procedure was 341±427 in Group I and 342±51.1 in Group II (p=0.586). There was a statistically significant difference between the groups in pain scores (group I: 6.1±2.5; group II: 4.3±1.7; p<0.001). Conclusion: Intravenous administration of diclofenac, which was performed 30 min before the use of 2% lidocaine gel in males undergoing flexible cystoscopy, provides more effective analgesia than urethral gel alone. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate 1:1 mixture of ketamine and propofol for sedative/analgesic efficacy, patient comfort and postoperative complications. Methods: The anesthesia and nursing records of patients who received ketamine-propofol mixture in Bezmialem Vakıf University Hospital between 2009 and 2010 were retrospectively documented. Results: Of the 51 adult patients who received ketamine-propofol sedation, 39 patients had ASA 1-2 score while 12 patients had ASA 3-4 score. No patient had apnea, desaturation, hypotension or vomiting. Two patients who had postoperative agitation received midazolam. All patients were transferred to the surgical ward when Aldrete scores were >8. Surgeon and patient satisfaction were high except in 2 patients. Conclusion: Ketamine and propofol mixture for the purpose of sedation and analgesia is a practical method with minimal negative effects on respiration and hemodynamic variables, however, hallucination associated with ketamine may be observed. We conclude that due to the lack of hypnotic activity, 1/2 or 1/3 instead of 1/1 ketamine and propofol mixture would be more appropriate. (The Medical Bulletin of Haseki 2015; 53:41-6)

Mnemonics are commonly used in medical procedures as cognitive aids to guide clinicians all over the world. The mnemonic ‘FAST HUG’ (Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, Head-of-bed elevation, stress Ulcer prevention, and Glycemic control) was proposed almost ten years ago for patient care in intensive care units and have been commonly used worldwide. Beside this, new mnemonics were also determined for improving routine care of the critically ill patients. But none of this was accepted as much as “FAST HUGS”. In our clinical practice we delivered an another mnemonic as FAST HUGS with ICU (Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, Head-of-bed elevation, Stress ulcer prevention, and Glucose control, Water balance, Investigation and Results, Therapy, Hypo-hyper delirium, Invasive devices, Check the daily infection parameters, Use a checklist) for checking some of the key aspects in the general care of intensive care patients. In this review we summarized these mnemonics.

Aim: Changes in the metabolic, endocrine, and immune systems caused by surgical trauma and pain are associated with increased concentrations of the biological mediators such as cytokines. Preemptive epidural analgesia may affect pain caused by surgical trauma and the corresponding neurohumoral response induced by the neuromediators. This study investigated the effects of preemptive epidural analgesia on postoperative pain and cytokine levels. Methods: A total of 60 children undergoing urological surgery were randomly assigned to either the preemptive epidural analgesia (Preempt EA, n=31) group or the postoperative epidural analgesia (Postop EA, n=29) group. Epidural infusion was started before the surgical incision in Preempt EA group and after the peritoneal closure in the Postop EA group. Blood samples were collected preoperatively (before anesthesia induction), 1 h and 24 h after surgery. Plasma TNF-α and IL-2 levels were measured by ELISA. Postoperative pain was assessed using the FACES pain scale, and postoperative analgesia was evaluated 1 h and 24 h after surgery. Results: Although TNF-α levels were increased 1 h and 24 h after surgery compared to preoperative levels in both groups, the levels were significantly higher in the Postop EA group. IL-2 levels were significantly higher at both postoperative time points in the Preempt EA group than in the Postop EA group. There were no significant differences in pain scores between the groups. Conclusion: Our results suggest that preemptive epidural analgesia may attenuate the proinflammatory response but has no effect on pain intensity. (The Medical Bulletin of Haseki 2013;51:162-7)

Anesthesia and analgesia management play a critical role in war and terror trauma patients. These include targeted damage control resuscitation, establishing a safe airway, management of required fluid and blood transfusions, perioperative management, adequate sedation and analgesia, postoperative and intensive care interventions. In these injuries that are beginning to increase nowadays, all anesthesiologists should have knowledge of anesthesia and analgesia management of such trauma patients and should form their own management plans. [ABSTRACT FROM AUTHOR]

Objective: In this prospective, randomized and controlled trial, the effects of thoracic epidural analgesia (EA) and thoracic paravertebral block analgesia (PA) on postoperative pain and hemodynamic parametres after thoracotomy were compared. Material and Method: : A total of of 44 patients (11 women and 33 men) who were scheduled for elective open lung surgery were included in this study. The cases were randomly divided into two groups. Postoperative analgesia was performed with an epidural catheter placed below the level of the incision line planned for thoracotomy (T5-6 or T6-7), before anesthesia in the EA group and it was performed with thoracic paravertebral block before extubation at the end of the operation in the PA group. In the EA group. 25 μg of fentanyl+0.125% of bupivacaine 7.5 ml of bolus were delivered into the epidural space, while in the PA group 0.125% bupivacaine and 25 μg fentanyl were delivered into three levels (T5-T8) as single injections for a total amount of 15 ml. Visual analogue scale (VAS) scores for pain, and also hemodynamic values (mean arterial blood pressure, heart rate) and arterial blood gas values were recorded at postoperative 1, 2, 3, 5, 8, 12 and 24. hours. Results: There was no statistically significant difference between baseline and postoperative VAS scores between the groups and when VAS measurements were compared according to the follow-up periods in both groups, there was no significant difference in the first three hours in both the epidural and paravertebral groups (p>0,05). There were no side effects or complications in both groups (p>0,05). Conclusion: Paravertebral block may be a good alternative to the epidural block because of ease of application, low side effect profile and complication rates and similar pain control. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Anesthesiology Reanimation is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Kısa süreli fakat potansiyel olarak ağrılı prosedürler için sedasyon, sıklıkla acil serviste uygulanmaktadır. İdeal bir sedatif rejimi analjezi ve anksiyoliz sağlaması yanısıra minimal yan etki oluşturmalı, havayolu reflekslerini korumalı, kardiyorespiratuvar depresyona yol açmamalı ve prosedür sonrası hızlı derlenmeye olanak vermelidir. Sedasyondaki amaç, hastanın işlem boyunca işlemi rahat tolere edebileceği şartları sağlamaktır.Biz bu çalışmada, prosedüral sedasyon ve analjezi için kullanılan bir alfa-2 agonist ajan olan dexmedetomidinin klinik özelliklerini güncel literatür ışığında açıklamaya çalıştık.

Burn injury is one of the most serious injuries that mankind may face. In addition to serious inflammation, excessive fluid loss, presence of hemodynamic instability due to intercurrent factors such as debridements, infections and organ failure, very different levels and intensities of pain, psychological problems such as traumatic stress disorder, depression, delirium at different levels that occur in patient with severe burn are the factors which make it difficult to provide the patient comfort. In addition to a mild to moderate level of baseline permanent pain in burn patients, which is due to tissue damage, there is procedural pain as well, which occurs by treatments such as grafting and dressings, that are severe, short-term burst style 'breakthrough' pain. Movement and tactile stimuli are also seen in burn injury as an effect to sensitize the peripheral and central nervous system. Even though many burn centers have established protocols to struggle with the pain, studies show that pain relief still inadequate in burn patients. Therefore, the treatment of burn pain and the prevention of possible emergence of future psychiatric problems suc as post-traumatic stress disorder, the sedative and anxiolytic agents should be used as a recommendation according to the needs and hemodynamic status of individual patient. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 26-30)

Risk assesment, preoperative drug regulation, the anesthesia and analgesia techniques are very important and the effectivity on success of surgery is grade. So, these topics in arthroplasty were review under current knowledge. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate 1:1 mixture of ketamine and propofol for sedative/analgesic efficacy, patient comfort and postoperative complications. Methods: The anesthesia and nursing records of patients who received ketamine-propofol mixture in Bezmialem Vakıf University Hospital between 2009 and 2010 were retrospectively documented. Results: Of the 51 adult patients who received ketamine-propofol sedation, 39 patients had ASA 1-2 score while 12 patients had ASA 3-4 score. No patient had apnea, desaturation, hypotension or vomiting. Two patients who had postoperative agitation received midazolam. All patients were transferred to the surgical ward when Aldrete scores were >8. Surgeon and patient satisfaction were high except in 2 patients. Conclusion: Ketamine and propofol mixture for the purpose of sedation and analgesia is a practical method with minimal negative effects on respiration and hemodynamic variables, however, hallucination associated with ketamine may be observed. We conclude that due to the lack of hypnotic activity, 1/2 or 1/3 instead of 1/1 ketamine and propofol mixture would be more appropriate. [ABSTRACT FROM AUTHOR]

Newborns are frequently exposed to painful diagnostic and therapeutic procedures during follow-up in the neonatal intensive care unit. Therefore, treatment and relief of pain should be considered a part of any such procedures. The first step in relieving pain is to assess it. The detection of changes in biochemical, physiological and behavioral parameters during pain have led to the development of a scoring system based on these changes. Many methods are used to relieve pain; however, non-pharmacological approaches are recommended during minor procedures in particular. Breastfeeding and sucrose administration are the most common of these approaches. Depending on the causes and severity of pain, various pharmacological agents may be used when appropriate. Opioid analgesics are often the first line of treatment. However, opioids should be selected only if the pain is severe; moreover, such treatment should be terminated as soon as possible. [ABSTRACT FROM AUTHOR]