Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology
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Case Reports
Pain management with intrathecal clonidine in a colon cancer patient with opioid hyperalgesia: case presentation.
Hyperalgesia is normally an increase in the response to a painful stimulant. Opioid-induced hyperalgesia (OIH) is a situation frequently encountered in algology clinics. Its treatment is complicated and problematic and often requires alternative methods. ⋯ Both cancer pain and OIH were controlled with clonidine 90 µg/day. He was more relaxed, and his pain was tolerable until his death. Intrathecal clonidine administration may be an effective method for the treatment of OIH.
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A major advantage of ultrasound (US) has been reduction in the amount of local anaesthetic (LA) needed for successful blocks. Reduced LA requirement reduces the risk of LA toxicity when multiple blocks are to be done for surgery of more than one extremity in the same patient. The 38-year-old female was scheduled for elective surgery of polydactilia in her right foot and syndactili in her right hand. ⋯ Surgery was performed uneventfully on both extremities. This is the first case report in the literature in which multiple blocks were applied to two different extremities, the leg and arm. In conclusion, our case report is a good example of multiple blocks in different extremities being performed successfully and safely according to US guidance and using low doses of local anaesthetics.
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Hemicrania continua (HC) is a rare primary headache disorder. It presents some autonomic features (including conjunctival injection, ptosis, eyelid edema, lacrimation, nasal congestion, and rhinorrhea). ⋯ In this case report, we present a patient who had indomethacin resistance with an associated pregabalin response. Pregabalin may be an effective treatment for hemicrania continua in some patients with indomethacin resistance.
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Case Reports
Ultrasound-guided psoas compartment block and general anesthesia for arthroscopic knee surgery: a case report.
Anesthetizing the lumbar plexus at its origin facilitates a more "complete" psoas compartment block compared to peripheral approaches. It is usually performed using surface anatomical landmarks, and the site for local anesthetic injection is confirmed by observing quadriceps muscle contraction to peripheral nerve stimulation. Ultrasound may provide guidance alone or together with the aid of nerve stimulation during nerve blocks. ⋯ Anesthesia and surgical procedures were completed successfully without any additional anesthetic/analgesic requirement or complication. The postoperative period was pain-free both at rest and during mobilization for 24 hours. This case report shows that ultrasound-guided psoas compartment block is feasible and efficient for peri- and postoperative analgesia during knee arthroscopy.
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Case Reports
[Who is responsible for the postoperative nerve injury? Anesthesia? Orthopedics? Trauma?].
In the pathogenesis of peripheral nerve injury, mechanical as well as vascular pressure, and chemical reasons play a role. In the applications of peripheral nerve block, there can be mechanical injury due to the type of needle and intrafascicular injections. ⋯ In addition, trauma may be the reason for posttraumatic nerve injury. In this presentation, we discussed the causes of postoperative nerve damage, which is seen after the operation of the distal humerus fracture.