搜索结果：Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology

This study examines the professional satisfaction levels of algology specialists, their expectations regarding their educational processes, their academic careers, their experiences of violence in healthcare, their future expectations, and the challenges they face. In addition, it explores the impact of algology on the family and social life of physicians working in this field, its contribution to academic and personal rights, and its effect on economic situations. Participants in this study were physicians who switched from neurology, anesthesiology and reanimation, and physical medicine and rehabilitation branches to the algology subspecialty. The study was conducted by volunteer participants who completed a 30-question survey. A total of 91.5% of the participants worked in tertiary healthcare institutions, 76.6% were between the ages of 30 and 40, 66% were male, and 57.4% were physicians who had transitioned from anesthesiology and reanimation. The findings highlight the need for regulations to improve the working conditions of algology specialists, eliminate existing difficulties, strengthen the training curriculum, and prevent violence in healthcare. This study aims to raise awareness about the problems and expectations of algology specialists in Türkiye, to develop a solution-oriented road map, and to provide insights into what can be done to deliver higher-quality healthcare services and train qualified and satisfied physicians. Our study fills an important gap in the literature in this field, as it is the first study conducted among specialties in this context.

This study aims to compare the analgesic efficacy and procedural efficiency of pectoral (PECS II) blocks performed using artificial intelligence (AI)-integrated ultrasonography (USG) versus conventional USG in patients undergoing modified radical mastectomy (MRM). Between November 2021 and March 2023, a total of 70 female patients scheduled for unilateral MRM under general anesthesia were included in this randomized study. The patients were randomly allocated into two groups: USG group (n = 35) and AI-USG group (n = 35). A fourth-year anesthesiology resident performed the PECS II blocks under the supervision of a senior anesthesiologist. The primary outcome was the postoperative pain score as assessed by Visual Analog Scale (VAS) at 12 hours. Secondary outcomes included pain scores at other postoperative time points, total opioid consumption, time first to rescue analgesia request within 24 hours, and the resident's skill development at the end of the study. The mean age was 55.3&#xb1;11.4 (range, 35 to 75) years. Intraoperative remifentanil consumption was higher in USG group than in AI-USG group; however, the difference was not statistically significant (p > 0.05). The durations of anesthesia and surgery were shorter in AI-USG group (p = 0.005 and p = 0.008, respectively). A comparison of local anesthetic injection times between the first 35 and the last 35 patients revealed a statistically significant decrease in the USG group (4.0 min vs. 3.0 min, p = 0.014). The VAS pain scores in the post-anesthesia care unit were initially higher in the AI-USG group (p = 0.05); however, at 12 and 24 postoperative hours, VAS scores were significantly lower than those in the USG group (p = 0.005 and p < 0.001, respectively). There was no significant difference in total tramadol consumption via PCA during the first 24 hours postoperatively (p > 0.05). Surgeon satisfaction scores were lower in the AI-USG group (p = 0.037). Our study results suggest that AI-enhanced USG guidance is associated with improved analgesic outcomes and may offer clinical and educational advantages in the performance of PECS II blocks, particularly for residents in training. The integration of AI into routine USG-guided regional anesthesia practice holds promise for improving procedural consistency and supporting novice practitioners.

This study aimed to evaluate whether the magnesium depletion score (MDS), an indicator of magnesium deficiency, is associated with the development of complex regional pain syndrome type 1 (CRPS-1) in patients with traumatic extremity injuries. Between November 2024 and May 2025, a total of 117 patients who suffered from traumatic extremity injuries were included. Demographic and clinical data of the patients were collected and recorded, and the MDS was calculated. Age, sex, body mass index (BMI), smoking status, alcohol consumption, diabetes, hypertension, duration of immobilization, MDS, and injury-related characteristics were evaluated as potential risk factors for CRPS-1 development. Of the patients, 40 were male and 77 were female with a mean age of 51.9 &#xb1; 15.01 (range, 20 to 91 years). In a total of 42.7% of patients with traumatic extremity injuries, CRPS-1 developed. The female-to-male ratio was higher among patients with CRPS-1 than among those without. The MDS, hypertension, diabetes, smoking, and alcohol consumption were not found to be independent risk factors. However, prolonged immobilization (more than one month) was found to be an independent risk factor for the development of CRPS-1. Our study results suggest that the MDS score is not a risk factor for developing CRPS-1, but immobilization for more than one month significantly increases the risk. Taken together, these findings indicate that the duration of immobilization following injury may be a more decisive factor in the development of CRPS-1 than demographic and clinical characteristics.

This study aimed to compare the effects of intra-articular steroid injection (IASI) and IASI combined with intra-articular pulsed radiofrequency (IAPRF) on pain and functional activities in stage II-III knee osteoarthritis. This randomized controlled trial included patients with knee pain persisting for more than 3 months. The participants were randomized into two groups: IAPRF + steroid injection (Group 1) and steroid injection only (Group 2). The injections were administered under fluoroscopic guidance, and the needle was advanced to the midline of the tibiofemoral joint. Group 1 received 8 mg of intra-articular dexamethasone after IAPRF application for 360 s at 45 V, with the temperature not exceeding 42&#xb0;C. Group 2 received 8 mg of intra-articular dexamethasone only. Pain intensity and participation in daily activities were evaluated using the Numerical Rating Scale and the Western Ontario and McMaster Universities Arthritis Index, respectively, before the procedure and 1, 4, and 12 weeks after the procedure. A total of 54 patients were included in the study. Demographic data, baseline pain levels, and functional activities did not differ between the groups. Pain intensity at 4 and 12 weeks after the procedure was lower in Group 1. Participation in daily living activities was significantly higher in Group 1 at 12 weeks after the procedure. IAPRF combined with intra-articular steroid significantly improves pain during the early-to-mid period and participation in daily living activities in the mid-term in stage II-III knee osteoarthritis.

This study aims to determine the effect of position changes on pain in stroke patients who are unable to communicate verbally in the intensive care unit (ICU). Between August 2021 and February 2022, a total of 129 stroke patients who were unable to communicate verbally in the ICU were included in this cross-sectional study. Data were collected using the Personal Information Form, Critical Care Observation Tool (CPOT), Behavioral Pain Scale (BPS), Motor Activity Assessment Scale (MAAS). Of a total of 129 patients included in the study, 56 were male and 73 were female with a mean age of 73.5&#xb1;11.2 (range, 45 to 92) years. There was a significant difference in conditions such as heart rate, blood pressure, oxygen saturation value, changes in pupils, sweating, nausea-vomiting, and pallor-redness on the skin before, during, and after the position change (p < 0.05). In the multiple comparisons, the values before and after the intervention were lower than the values during the position change. There was a significant relationship between CPOT, BPS and MAAS in the study (p < 0.05). Stroke patients in the ICU who are unable to communicate verbally experience pain associated with position changes, as evidenced by both behavioral responses and physiological alterations. In-service training programs should be organized for intensive care nurses to enhance their ability to recognize and evaluate pain-related behaviors.

This study aims to investigate the prevalence of neuropathic pain in shoulder pain, its relationship with nociplastic pain, and the effects of both pain types on functional outcomes. Between May 2024 and December 2024, a total of 73 patients with non-traumatic shoulder pain persisting for more than three months were included in this multi-center, prospective, cross-sectional study. Participants were classified according to diagnoses of rotator cuff disorders, subacromial impingement, adhesive capsulitis, osteoarthritis, or calcific tendinitis. Assessments were performed using the Visual Analog Scale (VAS), the Short Form of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS-SF), the Central Sensitization Inventory (CSI), and the Shoulder Pain and Disability Index (SPADI). Of the patients, 28 were male and 45 were female with a mean age of 54.89&#xb1;10.24 (range, 32 to 70) years. Neuropathic pain was present in 26% of patients, while 28.8% exhibited central sensitization (CS), indicating nociplastic pain. Patients with both neuropathic and nociplastic pain had significantly higher SPADI scores (p < 0.05), indicating greater functional impairment. However, nociplastic pain alone was not significantly associated with disability. Patients with CS had higher VAS scores and longer symptom duration (p < 0.05), indicating its role in pain chronicity. In non-traumatic shoulder disorders, neuropathic and nociplastic pain mechanisms overlap; however, their clinical impacts differ. Nociplastic pain increases pain perception, whereas neuropathic pain is more strongly associated with functional impairment. These findings highlight the importance of multidisciplinary treatment strategies that target both pain components rather than focusing solely on CS.

The modified thoracoabdominal nerves block through the perichondrial approach (M-TAPA) and the oblique subcostal transversus abdominis plane block (OSTAP) provide effective analgesia management after abdominal surgeries. There are limited studies comparing these two blocks in the literature. We aimed to compare M-TAPA and OSTAP in patients who underwent laparoscopic inguinal hernia repair. Patients with ASA status I-II, aged between 18 and 65 years, scheduled for elective TAPP under general anesthesia were included in the study. The patients were randomized into two groups: Group M-TAPA (n=30) and Group OSTAP (n=30). Blocks were performed using a total of 60 ml of 0.25% bupivacaine (30 ml per side). Postoperatively, all patients were routinely prescribed intravenous ibuprofen 400 mg three times a day. If a patient's NRS score was &#x2265;4 at any time, a dose of 100 mg intravenous tramadol was administered for rescue analgesia. The duration of the block procedure was significantly longer in the OSTAP group. The need for rescue analgesia and opioid consumption were similar between the groups. In the first two postoperative hours, static and dynamic NRS scores were lower in the M-TAPA group than in the OSTAP group. There were no differences between the groups in terms of the rate of adverse events. Patient satisfaction (Likert scale) was higher in the M-TAPA group. The M-TAPA block is not inferior to the OSTAP block following laparoscopic inguinal hernia repair surgery. Moreover, the M-TAPA block may be an alternative option to the OSTAP block, as it is easy to apply.

While post-thoracotomy pain syndrome is a known phenomenon in thoracic surgery, its occurrence after pleural shunt placement has not been described in the literature. A 41-year-old female with a history of Chiari I decompression surgery was admitted with a complaint of paresthesia, neuropathic pain affecting all extremities, and gait difficulty. Cervical magnetic resonance imaging revealed a C2-7 syringomyelia, and a syringopleural shunt was placed. The patient improved both clinically and radiologically, but after four months of follow-up, she complained of pain near the thoracic incision and in the dermatome relevant to the intercostal nerve root. The wound was surgically explored, and reactive changes to the shunt catheter were found near the intercostal nerve root. The shunt was subsequently removed, and a syringoarachnoidal shunt was placed instead. The patient improved postoperatively and was discharged without any complications. In conclusion, careful consideration of the location and course of the intercostal nerves is essential when placing pleural shunt systems.

Damage to an epidural catheter by a spinal needle is a hypothetical complication, as mentioned in the literature. We present a case report where the epidural catheter was damaged and sheared by a spinal needle when the same interspace was used for the introduction of both the epidural and spinal needles. The damage to the catheter went unnoticed until drug infusion via the catheter was planned. The intended drug could not be delivered. In a scenario where the drug could have been delivered via the damaged catheter, the tissue plane in which the drug extravasates and its possible implications may not be known. What was once purported to be a rare and hypothetical complication could no longer be just that.

In this study, we analyzed the effect of the application time of intravenous (IV) lornoxicam in preventing postoperative pain. This placebo-controlled study was conducted on 72 patients undergoing elective femoropopliteal bypass surgery. The patients were randomly divided into three groups. Group I (n=25) was administered IV 8 mg lornoxicam 20 minutes before incision and IV 2 mL saline at the end of the surgery; Group II (n=24) was administered IV 2 mL saline 20 minutes before incision and IV 8 mg lornoxicam at the end of the surgery; Group III (n=23) was administered IV 2 mL saline 20 minutes before incision and IV 2 mL saline at the end of the surgery. All patients used IV morphine via a patient-controlled analgesia device. Postoperative pain was measured using the visual analog scale (VAS), and patients with a VAS score >3 were administered intramuscular 75 mg naproxen sodium. The VAS scores were significantly higher in Group III compared with Group I at the 0th, 1st, 2nd, and 3rd hours and with Group II at the 1st, 2nd, and 3rd hours (p<0.05). As far as 24-hour morphine and naproxen sodium consumption were concerned, there was a significant statistical difference between the three groups (p<0.05); comparing Group I and II, there was no difference (p>0.05). Regardless of the time it is applied, lornoxicam reduces postoperative pain and consumption of opioids within the initial 3 hours.

Schwannomas are benign tumors originating from the peripheral nerve sheath. Although they rarely involve the sciatic nerve, their presence may result in sciatica, a condition characterized by pain radiating along the course of the sciatic nerve from the buttock or gluteal region. Despite being an uncommon cause of sciatica, sciatic nerve schwannomas present diagnostic challenges and management complexities. Their occurrence within the sciatic nerve is frequently overlooked, underscoring the need for accurate diagnosis and individualized therapeutic strategies. Surgical intervention is the primary treatment modality for sciatic nerve schwannomas and is associated with highly favorable outcomes when an appropriate surgical approach is employed. In this report, we present a case of chronic sciatica caused by a large schwannoma. Our aim is to emphasize the critical role of comprehensive imaging techniques and meticulous pathological evaluation in achieving an accurate diagnosis and guiding effective treatment planning in such cases.

This study aims to evaluate the validity of the Visual Analog Scale-Tension (VAS-T). This cross-sectional study included a total of 100 patients with chronic pain and 100 individuals without pain complaints between April 2021 and April 2022. All participants completed a sociodemographic information form, the Visual Analog Scale for Tension (VAS-T), the Depression Anxiety Stress Scale (DASS-42), and the Toronto Alexithymia Scale (TAS-20). Additionally, patients with chronic pain completed the Visual Analog Scale for Pain (VAS-P) and algometer assessments. The discriminant, concurrent, and convergent validity of the VAS-T was evaluated. Concerning discriminant validity, analyses revealed that individuals in the pain group exhibited significantly higher VAS-T scores compared to the control group (p < 0.001). There was a significant correlation between VAS-T scores, muscle tension algometer scores, and anxiety, stress, and alexithymia levels (p < 0.01). Participants reporting low tension on the VAS-T differed significantly from those reporting high tension regarding these variables (p < 0.05). The self-reported VAS-T is a rapid, practical and valid self-reported tool for assessing muscle tension.

Dexmedetomidine and clonidine have been studied separately as adjuvants with levobupivacaine, but there is no literature comparing the two drugs for caudal anesthesia in children. We compared the analgesic efficacy and adverse effects of clonidine and dexmedetomidine as adjuvants to levobupivacaine for caudal analgesia in children undergoing infraumbilical surgeries. In this prospective randomized study, 100 pediatric patients (3 to 8 years) of either sex, scheduled for infraumbilical surgery, were randomly allocated to two equal groups in a double-blind manner. After induction of anesthesia using a standard technique, caudal anesthesia was administered using 0.2% levobupivacaine (1 ml/kg) with either 1 &#xb5;g/kg dexmedetomidine (Group A) or 1 &#xb5;g/kg clonidine (Group B). Hemodynamic parameters, motor block, degree of sedation, postoperative analgesia, use of rescue analgesics, and side effects were evaluated for 24 hours. The mean duration of analgesia in Group A (12.7&#xb1;2.4 h) was higher than in Group B (10.6&#xb1;2.2 h), which was statistically significant (p=0.000). The mean duration of sedation was higher in Group A, although it was statistically insignificant. Hemodynamic parameters were comparable in the two groups. No significant side effects were observed in the groups. Dexmedetomidine (1 &#xb5;g/kg) added to 0.2% levobupivacaine (1 ml/kg) for caudal block provides prolonged analgesia with better sedation scores when compared to clonidine (1 &#xb5;g/kg) with 0.2% levobupivacaine (1 ml/kg) for below umbilical surgeries in pediatric patients, without increasing the incidence of adverse effects. Hence, we would recommend the use of 1 &#xb5;g/kg dexmedetomi-dine as an adjuvant to 0.2% levobupivacaine.

This study aims to assess whether the Turkish version of the Migraine-Specific Quality of Life Questionnaire v2.1 (MSQ v2.1) is a reliable and valid tool for evaluating the impact of migraine on daily functioning and overall quality of life. This multi-center, descriptive, prospective study included a total of 182 migraine patients between December 2023 and May 2024. All patients were assessed at two visits with a four-week interval. The Turkish MSQ v2.1 was evaluated for comprehensibility, patient-physician reliability, internal consistency, test-retest reliability, and construct validity. Of a total of 182 patients, 19 were male and 163 were female with a mean age of 40.8&#xb1;12.2 (range, 18 to 73) years. Item comprehensibility was high, with 94 to 97.8% at Visit 1, and from 98.4 to 100% at Visit 2. A strong correlation was observed between self-administered and physician-administered MSQ v2.1 scores at Visit 1 (r = 0.916, p < 0.001). Internal consistency was excellent, with Cronbach's alpha values of 0.932 at Visit 1 and 0.912 at Visit 2. Test-retest reliability was moderate (r = 0.468, p < 0.001). Construct validity was supported by strong correlations with the Headache Impact Test-6 (r = 0.751 at Visit 1 and r = 0.772 at Visit 2), monthly headache days (r = 0.453 and 0.553), and Numeric Rating Scale scores (r = 0.539 and 0.564), all with p < 0.001. The Turkish MSQ v2.1 is a reliable and valid tool for assessing health-related quality of life (HRQL) in migraine patients. It demonstrates excellent internal consistency, moderate test-retest reliability, and strong correlations with established measures of HRQL, headache severity, migraine frequency, and supporting its use in clinical practice and research.

To compare the effects of paravertebral block (PVB) and erector spinae plane block (ESPB) on intraoperative and postoperative analgesia and pulmonary function in patients undergoing video-assisted thoracoscopic surgery (VATS). A total of 49 patients aged 18-70 years with ASA scores of 2-3 who underwent elective VATS were included in the study. Patients were randomized into two groups using a web-based system. Those who received thoracic PVB were assigned to Group I, and those who received ESPB to Group II. Patients were monitored using the surgical plethysmographic index and bispectral index during the intraoperative period. Preoperative, intraoperative, and postoperative blood gas samples were analyzed to assess the impact on pulmonary function. Block application time, intraoperative and postoperative analgesic consumption, the presence of block-related complications, and length of hospital stay were recorded. There was no significant difference between the groups in terms of intraoperative and postoperative analgesic consumption, operation time, or length of hospital stay (p>0.05). Postoperative VAS scores were similar, and there was no significant difference in preoperative, intraoperative, or postoperative arterial blood gas values between the two groups (p>0.05). ESPB is as effective as PVB in controlling acute postoperative pain and is easier to perform.

Cervical epidural injections are frequently applied in the treatment of radicular pain caused by cervical disc herniation. This study aimed to investigate and compare the effectiveness of cervical epidural steroid injection and cervical epidural steroid + bupivacaine injection using Neck Disability Index (NDI) and Visual Analog Scale (VAS) scores. A total of 91 patients were included in the study. Patients who received cervical epidural steroid and cervical epidural steroid + bupivacaine were classified as Group I and Group II, respectively. Demographic characteristics, pain duration, and baseline VAS (VAS0) and NDI (NDI0) scores were recorded. Patients were also evaluated at the first and sixth months, and VAS1, NDI1, VAS6, and NDI6 scores were assessed. Demographic characteristics and mean pain durations of the groups were similar, and VAS and NDI scores did not differ significantly at baseline, the first, and sixth months. Within each group, the VAS6 score was significantly lower than VAS0 (p=0.01) and VAS1 (p=0.01) scores, while the NDI6 score was also significantly lower than NDI0 (p=0.01) and NDI1 (p=0.01) scores in Group I. Similarly, the VAS3 score was significantly lower than VAS0 (p=0.01) and VAS1 (p=0.01) scores, and the NDI3 score was significantly lower than NDI0 (p=0.01) and NDI1 (p=0.01) scores in Group II. Our findings showed that the combination of epidural steroid + bupivacaine in cervical interlaminar epidural injections yields similar clinical effects to those of steroid alone, providing comparable improvement in functional status.

This study aims to assess the efficacy of erector spinae plane block (ESPB) for postoperative analgesia in patients undergoing total hip arthroplasty (THA) under spinal anesthesia. In this randomized-controlled trial, a total of 30 patients (American Society of Anesthesiologists Class I-III, 20 to 65 years) who underwent elective unilateral THA under spinal anesthesia were included between January 2023 and December 2023. The patients were randomized either to Group E (n = 15) to receive ultrasound-guided lumbar ESPB with 40 mL of 0.25% bupivacaine in addition to spinal anesthesia (2.5 mL of 0.5% hyperbaric bupivacaine with 10 &#xb5;g of fentanyl), or Group C (n = 15) who received spinal anesthesia alone. Primary outcomes were duration of analgesia and Visual Analog Scale (VAS) scores at 6 h. Secondary outcomes included VAS scores at 0, 0.5, 2, 4, 12, 24 h and total additional analgesic requirement in the first 24 h. Of a total of 30 patients included in the study, 22 were male and 8 were female with a mean age of 36.86 &#xb1; 13.24 (range, 18 to 65) years. The duration of analgesia was significantly longer in group E (10.76 &#xb1; 1.96 h vs. 4.18 &#xb1; 1.36 h; p < 0.01). The VAS scores were lower in group E at 0.5 h (p = 0.009), 2 h (p < 0.001), 4 h (p < 0.001), 6 h (p < 0.001), and 12 h (p = 0.02). Additional analgesic requirement during the first 24 h was higher in Group C. Surgeon and patient satisfaction scores significantly improved in Group E. No hemodynamic instability or motor weakness was observed. Lumbar ESPB with 40 mL of 0.25% bupivacaine significantly prolongs postoperative analgesia and reduces pain scores and analgesic consumption in patients undergoing THA under spinal anesthesia. Based on these findings, lumbar ESPB may provide effective and safe adjunctive analgesia in this patient population.

This study aimed to translate the Clinically Aligned Pain Assessment (CAPA) Scale into Turkish, perform its cultural adaptation, and evaluate its validity and reliability in Turkish patients. This single-center, cross-sectional study included a total of 105 patients with pain lasting at least one week between March 2026 and June 2026. The translation process followed standardized forward-backward procedures. Reliability was assessed using internal consistency and test-retest analysis (n = 68, 48-72 h). Construct validity was evaluated with exploratory factor analysis, and convergent validity was examined using Numeric Rating Scale (NRS). Of a total of 105 participants, 37 were male and 68 were female with a mean age of 46.90 &#xb1; 11.974 (range, 23 to 71) years. In the study, the CAPA-TR showed good internal consistency (Cronbach's alpha = 0.859) and excellent test-retest reliability (intraclass correlation coefficient = 0.959). Item-total correlations were above 0.30 for all items. Floor and ceiling effects were below acceptable thresholds. Exploratory factor analysis revealed a single-factor structure explaining 66.2% of the total variance. No significant correlation was found between CAPA-TR scores and NRS. Our study results suggest that CAPA-TR is a valid and reliable multidimensional tool for pain assessment in Turkish-speaking patients. It provides a practical and patient-centered approach that may support more comprehensive evaluation of pain in clinical practice.

Low back pain is a widespread medical condition seen in middle-aged and elderly individuals, causing labor loss, high treatment costs, depression, and poor life quality. This study aimed to investigate pain levels, life quality, and depression in patients undergoing facet radiofrequency (RF) and/or transforaminal epidural steroid injection (TFESI) for the treatment of chronic low back pain (CLBP). The records of 51 patients with low back pain lasting more than three months who underwent interventional procedures for pain management were reviewed retrospectively. Patient data including age, sex, type of interventional treatment, visual analog scale (VAS) scores before and after the procedure, SF-36 life quality scores, and Beck Depression Scale (BDS) scores were obtained from patient tracking forms and the hospital information system. A total of 51 patients (35 males, 16 females) who received interventional treatment were included in the study. The mean age of the patients was 48.37&#xb1;13 years. Patients underwent facet RF (n=14), TFESI (n=23), or both procedures combined (n=14). Compared to pre-procedure values, VAS and BDS scores at the third and sixth months were significantly lower (p<0.05), while SF-36 life quality scores were significantly higher (p<0.05). No significant difference was observed between the third and sixth months (p>0.05). In chronic low back pain, interventional treatments such as facet RF and/or TFESI were found to reduce pain and depression levels and improve life quality.