Millerryan0536

The aim of this study was to compare the efficacy of an intercostal nerve block, which has been used for many years in the treatment of postherpetic neuralgia, and the more recent alternative of an erector spinae plane (ESP) block.

The records of 39 patients who were treated in the algology department for postherpetic neuralgia between May 1, 2015 and May 1, 2018 were evaluated retrospectively. Patients who received an intercostal nerve block constituted Group 1 and those who received an ESP block were categorized as Group 2. The change in numeric rating scale (NRS) and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scores in the short term and in the long term were the primary results of the study.

The NRS, LANSS, and sleep interference scale (SIS) scores of the patients in Group 1 and Group 2 were found to be significantly lower at the 24th hour, week 4, and week 12 compared with the values obtained before block application. In Group 1, the scores recorded at week 4 and week 12 were significantly higher than the 24th hour values, whereas no difference was observed between these results in Group 2. There was no significant difference between the groups in the week 4 and week 12 scores. Similarly, no significant difference was observed in the NRS, LANSS, or SIS scores before the block application or at the 24th hour. However, the scores at week 4 and week 12 were significantly lower in Group 2 compared with Group 1.

The results indicated that an ESP block significantly decreased neuropathic pain symptoms and the need for additional treatment in postherpetic neuralgia treatment in the long term.

The results indicated that an ESP block significantly decreased neuropathic pain symptoms and the need for additional treatment in postherpetic neuralgia treatment in the long term.

A thoracolumbar interfascial plane (TLIP) block is a novel ultrasound (US)-guided technique that provides effective analgesia after lumbar spinal surgery. Two approaches for a TLIP block have been defined a classical (cTLIP) technique and a modified (mTLIP) technique. A literature review revealed no published comparison of the 2 techniques. This study examined the practicality and analgesic efficacy of US-guided mTLIP and cTLIP blocks following lumbar disc surgery.

Sixty patients aged 18-65 years with an American Society of Anesthesiologists classification of I or II who were scheduled for lumbar disc surgery under general anesthesia were included. US-guided mTLIP (n=30) and cTLIP (n=30) blocks were performed. The performance time of the block procedures, the success of a one-time block, postoperative pain scores, opioid consumption, adverse effects, and block-related complications were recorded and analyzed.

The performance time was significantly less in the mTLIP group (p<0.001). The success of a one-time block was significantly higher in the mTLIP group (p<0.001). The active/passive visual analog scale scores, intraoperative and postoperative opioid consumption, and rescue analgesic requirements were similar between the groups (p>0.05).

The results showed that a US-guided mTLIP block had a shorter performance time and a higher one-time block success rate compared with the cTLIP block. The quality of analgesia provided by the mTLIP and cTLIP blocks was similar.

The results showed that a US-guided mTLIP block had a shorter performance time and a higher one-time block success rate compared with the cTLIP block. The quality of analgesia provided by the mTLIP and cTLIP blocks was similar.

The aim of this study was to evaluate the efficiency of a thoracic paravertebral block (TPVB) for postoperative analgesia in cases of a laparoscopic cholecystectomy performed under general anesthesia.

A total of 78 patients aged 18-70 years, with an American Society of Anesthesiologists classification of I-III who were to undergo an elective laparoscopic cholecystectomy were enrolled. The patients were randomly separated into 2 groups Group 1 (38 patients) received a TPVB performed unilaterally at T6 before surgery and Group 2 (40 patients) received only general anesthesia. Postoperatively, both groups received patient-controlled analgesia with an infusion pump. Visual analog scale (VAS) scores at rest and with movement were recorded during the first 24 hours after surgery. Tramadol consumption during the first 24 hours, nausea and vomiting rate, time to first passage of bowel gas and defecation, nutrition, mobilization, and discharge were also noted.

The patients who received an ultrasonography-guided TPVB had significantly lower postoperative VAS scores at rest and on movement at 4, 6, 12,18, and 24 hours and significantly lower levels of postoperative tramadol consumption. It was observed that 77.5% of the patients in Group 2 needed at least 1 dose of additional fentanyl intraoperatively. Group 2 had a significantly higher vomiting rate and it was observed that the time of first bowel gas and defecation, nutrition, and mobilization was later. There was no significant difference between groups in the discharge time.

Preoperatively performed TPVB provided efficient analgesia after a laparoscopic cholecystectomy. A TPVB can also reduce perioperative and postoperative opioid requirements.

Preoperatively performed TPVB provided efficient analgesia after a laparoscopic cholecystectomy. A TPVB can also reduce perioperative and postoperative opioid requirements.Osteonecrosis or avascular necrosis of the femoral head is a pathologic process due to inadequate blood supply resulting the death of the cells in bone tissue and collaps of joint. Avascular necrosis is a progressive disease mainly affecting adults in middle age and leads substantial loss of joint function. Osteonecrosis of the femoral head during or just after pregnancy is a rare clinical entity. Therefore several causes of osteonecrosis schould be well-known, little is known about pregnancy as an etiological factor for femoral head. We present a case of a 30-year-old female with bilateral avascular necrosis of the femoral head that developed during the peripartum period.Headache is a common symptom in subarachnoid hemorrhage (SAH). Often, pain control is difficult and opioid use can have a complicated effect on the patient's state of consciousness. In this study of 2 cases, opioid consumption was reduced while effective pain control of headache occurring after endovascular treatment of an intracranial aneurysm was achieved using an ultrasound-guided, bilateral greater occipital nerve (GON) block. Case 1 was a 59-year-old male patient with a Glasgow Coma Scale (GCS) of 13 who was diagnosed with Fisher scale grade 3 SAH. HL 362 Coiling and stenting were performed for an anterior communicating artery aneurysm. Cerebrospinal fluid drainage was provided with a lumbar spinal catheter. Case 2 was a 55-yearold male patient with a GCS of 15 who underwent coiling of a fusiform aneurysm in the left basilar artery and stenting of the stenotic region due to a basilar artery aneurysm. After the procedure, the visual analog score (VAS) of the patients was 9 and 7, respectively, and a bilateral GON block was performed with ultrasound guidance.