PubMed İndeksli Açık & Kapalı Erişimli Yayınlar
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Item An add-on therapy for neuropathic pain: Infiltration block with diclofenac sodium and lidocaine through the hypertrophic scar tissue(2019) Eker, Hatice Evren; Yalcin Cok, Oya; Bozdodan Ozyilkan, Nesrin; Aribodan, Anis; 30633313In some situations, the cause of the supposed neuropathic pain might be related to abnormal tissue recovery such as scar formation due to wound retraction that might create mechanical compression on the nerve tissue. In this report we describe infiltration block with diclofenac sodium and lidocaine through the hypertrophic scar tissue to reduce mechanical stress in 3 patients. The infiltration technique might resolve the tension of the contracted scar tissue by tearing the adhesions and the eliminated mechanical compression would reduce the pressure on nerve tissue and hence neuropathic pain symptoms.Item Comparison of Sedoanalgesia Versus Ultrasound-Guided Supraclavicular Brachial Plexus Block for the Prevention of the Pain During Endovascular Treatment of Dysfunctional Hemodialysis Fistulas(2019) Gedikoglu, Murat; Andic, Cagatay; Guzelmansur, Ismail; Eker, Hatice Evren; Bolgen, Cagatay; 31342099Purpose Although intravenous sedation and analgesia have been widely used as a first choice to relieve pain during treatment of dysfunctional hemodialysis fistulas by interventional radiology, the sedoanalgesic drugs have a considerable risk of respiratory depression, especially in hemodialysis patients. In this study, we compared the utility and efficiency of ultrasound-guided supraclavicular brachial plexus block versus sedoanalgesia for the prevention of pain during endovascular treatment of dysfunctional hemodialysis fistulas Materials and Methods Patients were randomized into two groups: ultrasound-guided supraclavicular brachial plexus block (n = 34) or sedoanalgesia group (n = 34). A visual analogue scale from no pain (= 0) to worst pain possible (= 10) was used to assess the pain intensity. Patient and operator satisfaction were graded from 0 to 2: 0, not satisfied at all; 1, partially satisfied; 2, satisfied (very well or complete satisfaction). Both groups were compared in terms of pain scores, patient and operator satisfaction as well as complications. Results The median pain score was significantly lower in the block group compared to the sedoanalgesia group, 0 (0-4) versus 6 (2-10), p = 0.0001. Patient satisfaction and operator satisfaction were significantly higher in the block group than in the sedoanalgesia group (p = 0.0001). Severe oxygen desaturation occurred in five (14.7%) patients following the administration of sedoanalgesia. No side effects or complications related to block procedure occurred in any patient. Conclusion Ultrasound-guided supraclavicular brachial plexus block has advantages over the sedoanalgesia during endovascular treatment of dysfunctional hemodialysis fistulas. It can provide safe and efficient analgesia with excellent procedural satisfaction in adult hemodialysis patients.Item Effect of low dose dexmedetomidine premedication on propofol consumption in geriatric end stage renal disease patients(2015) Ergeneoglu, Pinar; Akin, Sule; Bali, Cagla; Eker, Hatice Evren; Cok, Oya Yalcin; Aribogan, Anis; 26323728Background and objective: Sedation in dialysis dependent end-stage renal disease patients requires caution as a result of performing high doses of sedatives and its complications. Multidrug sedation regimens might be superior and advantage on lesser drug consumption and by the way adverse events which occur easily in end-stage renal disease patients. We evaluated the effects of dexmedetomidine premedication on propofol consumption, sedation levels with Observer's Assessment of Alertness and Sedation scores and the bispectral index and the hemodynamic changes, potential side effects in geriatric patients with end-stage renal disease who underwent hip fracture surgery under spinal anesthesia. Method: In this randomized, controlled, double-blind study 60 elderly patients (age >= 65 years) with end-stage renal disease and hip fracture scheduled for anterograde femoral intramedullary nailing were assigned to groups that received either intravenous saline infusion (Group C) or dexmedetomidine 0.5 mu g/kg/10 min infusion for premedication (Group D). All the patients received propofol infusion after the induction of the spinal anesthesia. Results: Total propofol consumption, propofol dose required for targeted sedation levels according to Observer's Assessment of Alertness and Sedation scores and bispectral index levels, recovery times were significantly lower in Group D (p< 0.001). The time to reach to Observer's Assessment of Alertness and Sedation score 4 and to achieve bispectral index <= 80 was significantly lower in Group C compared with Group D (p< 0.001). Adverse events were similar in both groups. Conclusion: Dexmedetomidine premedication lowers intraoperative propofol consumption to maintain targeted level of sedation. Therefore low dose dexmedetomidine premedication in addition to propofol infusion might be an alternative in geriatric patients with end-stage renal disease for sedation. (c) 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.