Abstract Background Quadratus lumborum block (QLB) is a fascial plane block. There is no randomized study on the efficacy of QLB for lumbar surgery. We evaluated the efficacy of QLB for postoperative pain management and patient satisfaction after lumbar disc herniation surgery (LDHS). Methods Sixty patients with ASA score I-II planned for LDHS under general anesthesia were included. We allocated the patients into two groups: the QLB group ( n = 30) or the control group ( n = 30). QLB was performed with 30 ml 0.25% bupivacaine in the QLB group. Paracetamol 1 g IV 3 × 1 was ordered to the patients at the postoperative period. If the NRS score was ≥ 4, 1 mg/ kg tramadol IV was administered as rescue analgesia. Results There was a reduction in the median static NRS at 0 h and 2 h with QLB compared to the control group ( p < 0.05). There was no difference in the resting NRS at any other time point up to 24 h. The median dynamic NRS was significantly lower at 0, 2, 4, 8, and 16 h in the QLB group ( p < 0.05). The need for rescue analgesia was significantly lower in the QLB group. The incidence of nausea was significantly higher in the control group. The postoperative patient satisfaction was significantly higher in the QLB group ( p < 0.05). Conclusion We found that the QLB is effective for pain control following LDHS.
Thoracic paravertebral block can provide analgesia for unilateral chest surgery and is associated with a low complication rate. Horner syndrome also referred to as oculosympathetic paresis, is a classic neurologic constellation of ipsilateral blepharoptosis, pupillary miosis, and facial anhidrosis resulting from disruption of the sympathetic pathway supplying the head, eye, and neck. We present a patient with an ipsilateral transient Horner syndrome after ultrasound guided single shot of 15 mL 0.25% levobupivacaine for thoracic paravertebral block at T5–6 level. It should be kept in mind that even a successful ultrasound guided single shot thoracic paravertebral block can be complicated with Horner syndrome due to unpredictable distribution of the local anesthetic. O bloqueio paravertebral torácico pode proporcionar analgesia para cirurgia torácica unilateral e está associado a um baixo índice de complicações. A síndrome de Horner (também denominada paralisia oculossimpática) é uma constelação neurológica clássica de blefaroptose ipsilateral, miose pupilar e anidrose facial devido a distúrbio da via simpática que fornece inervação para a cabeça, olhos e pescoço. Apresentamos o caso de um paciente com síndrome de Horner transitória ipsilateral após a administração de injeção única de 15 mL de levobupivacaína a 0,25% para bloqueio paravertebral torácico ao nível de T5-6 guiado por ultrassom. Devemos considerar que mesmo um bloqueio paravertebral torácico bem-sucedido com a administração de injeção única e guiado por ultrassom pode ser complicado com a síndrome de Horner devido à distribuição imprevisível do anestésico local.
Transversus abdominis plan (TAP) bloğu son yıllarda kullanımı yaygınlaşmış rejyonel anestezi tekniğidir. Bu blok tekniğinin cerrahi sonrası akut ağrıda kullanımı ile ilgili bir çok çalışma olmasına rağmen kronik ağrı yönetiminde kullanımı ile ilgili veriler kısıtlıdır. Nöropatik karakterde ve uzamış batın ön duvarı ağrısı olan olguda TAP bloğun tanı ve tedavideki etkinliğini değerlendirmeyi amaçladık.
BACKGROUND: Pulsed radiofrequency (PRF) used for knee pain originating from osteoarthritis is one of these methods. OBJECTIVES: The aim of the study was to evaluate the knee functional status and pain palliation following the application of pulse radiofrequency in patients with cardiac comorbid dis ease who were diagnosed with advanced stage osteoarthritis. METHODS: Thirty-eight patients with high surgical risk having cardiac comorbidities with grade 3–4 gonarthrosis according to the Kellgren-Lawrence classification were retrospectively analyzed. PRF was applied to the saphenous nerve of each patient. Visual Analog Scale for knee pain evaluation both at rest and on movement and the Lysholm Knee Scoring Scale for function evaluation were used. The patient status was evaluated before the procedure and at the first and sixth months after the procedure. RESULTS: The mean age was 68.8 years (range, 53–82 years). Both the rest and movement post-procedural Visual Analog Scale scores at first and sixth months were significantly lower than pre-procedural values (p< 0.001). A statistically significant improvement was also determined when pre- and one and six months post-procedural Lysholm scores were compared (p< 0.001). CONCLUSIONS: PRF is a safe and function sparing minimally invasive pain palliation method for knee osteoarthritis in elders with cardiac comorbidity.
Aim: The aim of this study is to identify the risk variables for mortality in patients undergoing venoarterial extracorporeal membrane oxygenation (VA ECMO) in order to better predict their prognosis.Material and Methods: Following a retrospective analysis of VA ECMO patients treated between January 2013 and April 2021, they were classified into mortality and survival groups.Those over the age of 18 and on VA ECMO for more than 24 hours were included in the study.Results: A total of 50 patients were included in the study, and the mortality rate was found to be 84%.VA ECMO support lasted an average of 5.8± 4.61 (1-18) days, while ICU stays averaged 17.8± 25.85 (1-124) days.(p < 0.05).The MELD-XI score (modeling end-stage liver disease without INR), the ECMO-ACCEPTS score (a VA ECMO scoring system for patients undergoing ECMO), the 18th and 24th lactate levels, the lactate peak value within the first 24 hours, following ECMO were all factors associated with mortality.Discussion: The MELD-XI score, calculated during the early period, and the measurements of lactate levels at 12 hours, 18 hours, and 24 hours, and the peak lactate value, rather than lactate clearance, were identified as crucial prognostic factors for mortality.Furthermore, the ECMO-ACCEPTS score was also determined to be a significant predictor of mortality.
Objective: Evaluation of the effectiveness of ultrasound (US)-guided erector spinae plane block (ESPB) and thoracic paravertebral block (TPVB) compared to no intervention control group for postoperative pain management in video assisted thoracic surgery (VATS) patients.Method: Three groups -Group ESPB, Group TPVB and the control group (n=30 per group) were included in this prospective, randomized, controlled study.The US-guided blocks were performed preoperatively in the ESPB and TPVB groups.Intravenous patient-controlled postoperative analgesia via fentanyl was administered in all of the patients.The patients were evaluated using visual analogue scale (VAS) scores, opioid consumption, and adverse events.Results: At all time intervals fentanyl consumption and VAS scores were significantly lower both in ESPB and TPVB groups compared to the control group (p<0.001).Block procedure time was significantly lower and success of one time puncture was higher in Group ESPB as compared with that in Group TPVB (p<0.001).Conclusion: ESPB and TPVB provide more effective analgesia compared to control group in patients who underwent video-assisted thoracic surgery.ESPB had a shorter procedural time and higher success of single-shot technique compared to TPVB.
Behçet Hastaliği remisyon ve alevlenmeler ile seyreden otoimmün, kronik, multisistemik, inflamatuar bir hastaliktir.Sistemik bir hastalik olan Behçet Hastaliğinda gastrointestinal, solunum, kardiyovasküler, kas iskelet ve sinir sistemi tutulumu olabilir.Behçet hastalarinda damaryolu kanülasyon ve entübasyon işleminden anestezik ilaç uygulamasina kadar olan tüm anestezik girişimler hastaliği alevlendirebilir ve organ toksitesine neden olabilir, bu yüzden hem elektif hem de acil ameliyatlarda anestezi yönetimi sirasinda çok dikkatli olunmalidir.Bu
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