{"title":"Evaluation of the efficacy and safety of combined pulsed radiofrequency and transforaminal epidural steroid injection in herpes zoster-related pain.","authors":"Esra Ertilav, Öznur Yıldırım, Osman Nuri Aydın","doi":"10.14744/agri.2024.70104","DOIUrl":"https://doi.org/10.14744/agri.2024.70104","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we aimed to evaluate the effectiveness of pulsed radiofrequency (PRF) and transforaminal anterior epidural steroid injection (TFAESI) applied to the dorsal root ganglion (DRG) in herpes zoster pain.</p><p><strong>Methods: </strong>The results of patients who underwent DRG PRF and TFAESI for herpes zoster-related pain in the algology clinic were evaluated retrospectively. Demographic and clinical examination findings (gender, age, involved dermatome, side, neurologic examination, medications used), VAS scores, and complications were recorded at 1, 6, and 12 months after the procedure.</p><p><strong>Results: </strong>Data of 93 patients were evaluated. Sixty-six patients were in the acute/subacute pain phase, while 27 patients had postherpetic neuralgia (PHN) at presentation. Eleven patients (C2-4: 1, C3-5: 2, C4-6: 2, C5-7: 2, C6-8: 2, C7-T1: 2) underwent cervical DRG PRF and TFAESI. Seventy-five patients underwent thoracic DRG PRF and TFAESI (T1-3: 2, T2-4: 6, T3-5: 4, T4-6: 11, T5-7: 9, T6-8: 9, T7-9: 6, T8-10: 5, T9-11: 9, T10-12: 7, T11-L1: 3, T12-L2: 4). Seven patients underwent lumbar DRG PRF and TFAESI (L1-3: 3, L2-4: 1, L5-S2: 3). VAS scores for all three regions were significantly lower than pre-procedure scores at 1, 6, and 12 months after the procedure (p<0.001, p<0.001, p=0.008, respectively). While 2 patients developed nausea and dizziness due to subdural and intravenous leakage after the procedure, no fatal complications were recorded in any patient.</p><p><strong>Conclusion: </strong>In herpes zoster-associated refractory neuropathic pain, fluoroscopy-guided combined DRG and TFAESI application methods provide long-term effective pain control and are safe both in the acute/subacute phase and in patients who develop PHN.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"83-90"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intractable post dural puncture headache in a patient with undiagnosed intrathoracic meningocele.","authors":"Dr Reena, Subash Sankaralingam, Swati Singh, Amrita Rath, J Manikandan, Ashutosh Vikram","doi":"10.14744/agri.2024.46667","DOIUrl":"https://doi.org/10.14744/agri.2024.46667","url":null,"abstract":"<p><p>Post dural puncture headache (PDPH) is a troublesome complication of dural puncture. Although its risk factors and management have been extensively discussed in the literature, the underlying cause may sometimes remain unclear, making treatment challenging for anaesthesiologists. We describe a noteworthy case of PDPH following spinal anaesthesia administered for an emergency cesarean section in a patient with known neurofibromatosis. Despite conservative and pharmacological treatment, followed by an autologous epidural blood patch, no symptomatic relief was achieved. Neuroimaging of the brain and spine revealed a large intrathoracic meningocele (IM). Although rare, intrathoracic meningocele should be considered in patients with neurofibromatosis who develop intractable PDPH after dural puncture, with neuroimaging being the most effective diagnostic tool.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"121-124"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intrathecal injection in the difficult patient guided by ultrasonography: Two case reports.","authors":"Meryem Onay, Semih Boyacı, Mehmet Sacit Güleç","doi":"10.14744/agri.2022.81598","DOIUrl":"https://doi.org/10.14744/agri.2022.81598","url":null,"abstract":"<p><p>Intrathecal injection is traditionally performed by identifying the interlaminar spaces using anatomical landmarks. However, obesity, previous spinal surgery, the presence of deformity, or age-related changes may hinder the detection of these landmarks. Poor or failed identification of anatomical landmarks leads to difficulties in performing the neuraxial technique, an increased number of needle insertions, and associated complications. In this study, we discuss our experience with ultrasonography-guided neuraxial block in two patients: one with super morbid obesity (BMI >50) and the other with severe scoliosis (Cobb angle >50°).</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"129-132"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Identifying nursing students' attitudes towards patients with chronic pain: Quantitative study.","authors":"Nefise Cevriye Sucu Çakmak, Nurcan Çalışkan","doi":"10.14744/agri.2024.25593","DOIUrl":"https://doi.org/10.14744/agri.2024.25593","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify nursing students' attitudes towards patients with chronic pain.</p><p><strong>Methods: </strong>This descriptive study was conducted between May and June 2023 with the students of the Department of Nursing. No sample selection was made in the study; the aim was to reach the entire population. The population consisted of 450 students. The sample included 398 students who agreed to participate in the study. Data were collected using the Personal Data Form and the Scale for Healthcare Professionals' Attitudes towards Patients with Chronic Pain. Permission for the study was obtained from the Ethics Committee.</p><p><strong>Results: </strong>According to the study findings, 31.1% of the students always encountered patients with chronic pain, and 69.3% had not received training on chronic pain management. As students' grade level increased, their scores from the sensitivity and misconception orientation factors also increased (p<0.05). As the frequency of encountering patients with chronic pain increased, scores from the sensitivity orientation factor significantly increased (p<0.05). Those who felt insufficient in pain management had significantly lower scores from the sensitivity orientation factor.</p><p><strong>Conclusion: </strong>The results showed that students' attitudes towards patients with chronic pain were good, although not very good. Among the students, those who were female, had more clinical practice experience, frequently encountered patients with chronic pain, and felt sufficient in pain management had stronger positive attitudes towards patients with chronic pain.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"91-99"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nihad Nazarzade, Aysun Genç, Can Konca, Şehim Kutlay, Şiyar Ersöz, Volkan Genç
{"title":"Transcutaneous electrical nerve stimulation is a promising novel non-pharmacological treatment alternative for mastalgia: A randomized clinical trial.","authors":"Nihad Nazarzade, Aysun Genç, Can Konca, Şehim Kutlay, Şiyar Ersöz, Volkan Genç","doi":"10.14744/agri.2024.13845","DOIUrl":"https://doi.org/10.14744/agri.2024.13845","url":null,"abstract":"<p><strong>Objectives: </strong>The main objective of this study is to determine the effectiveness of transcutaneous electrical nerve stimulation (TENS) treatment on pain and quality of life in mastalgia, a condition for which treatment has not yet reached a consensus.</p><p><strong>Methods: </strong>This randomized controlled clinical trial was completed with 20 women suffering from mastalgia. Patients were randomly assigned to the TENS treatment and sham application groups. Pain intensity, pain patterns, and quality of life were evaluated with the Breast Pain and SF-36 questionnaires before and 10 days after treatment in all patients.</p><p><strong>Results: </strong>TENS treatment significantly reduced the total breast pain score (from 257.6±47.3 to 123.6±11.6 for the TENS group vs 217.7±42.7 to 209.7±54.4 for the sham group) (p<0.001) and analgesic use (p=0.024) compared to the sham group. The pain patterns of patients shifted to a more brief, momentary, or transient pattern in the TENS group, whereas they did not change in the sham TENS group. There was significant improvement in the total SF score (p<0.001) and six subscales of the SF-36 (physical and social functioning, energy/fatigue, pain, general health, and health change) in favor of the TENS group.</p><p><strong>Conclusion: </strong>TENS seems to be a promising treatment for mastalgia. It is safe, has a rapid onset of action, and can be self-administered.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"75-82"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pain medicine specialists in compulsory service: Struggles, limitations, and policy needs.","authors":"Gözde Çelik, Gül Köknel Talu","doi":"10.14744/agri.2025.48265","DOIUrl":"https://doi.org/10.14744/agri.2025.48265","url":null,"abstract":"<p><strong>Objectives: </strong>Compulsory service programs aim to improve healthcare equity by distributing specialists to underserved regions. However, pain medicine specialists face unique challenges, including professional isolation, limited resources, financial dissatisfaction, and restricted career growth. This study evaluates their experiences and explores potential policy improvements.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among pain medicine specialists who have completed or are fulfilling compulsory service. The survey included multiple-choice, Likert-scale, and open-ended questions assessing demographics, workload, resource availability, financial compensation, career impact, and job satisfaction. Descriptive statistics and thematic analysis were applied using SPSS 20.0.</p><p><strong>Results: </strong>Forty-nine specialists participated, with an average of 15.1 years in practice. Reported challenges included inadequate access to essential medical equipment (36.8%), lack of trained support personnel (67.3%), and professional isolation (63.3%). Financial dissatisfaction was high (48.9%), and 65.3% lacked additional housing or travel support incentives. Career limitations were notable, with 40.8% reporting restricted access to continuous education and 45.7% feeling that compulsory service negatively impacted their professional growth. Safety concerns, including workplace security and encounters with drug-seeking patients, were raised by 27.7% of respondents.</p><p><strong>Conclusion: </strong>Compulsory service poses significant challenges, affecting job satisfaction, career advancement, and service effectiveness. Policy improvements should include structured financial incentives, better resource allocation, support for continued education, and enhanced workplace security to improve retention and care quality in underserved areas.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"106-111"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Transient coma: A complication after neurolytic celiac plexus and splanchnic nerve blocks in a patient with superior mesenteric artery syndrome.","authors":"Derya Bayram, İbrahim Aşık","doi":"10.14744/agri.2022.80688","DOIUrl":"https://doi.org/10.14744/agri.2022.80688","url":null,"abstract":"<p><p>The unintentional intravascular injection of alcohol or phenol during the neurolytic block of the celiac plexus or splanchnic nerves can cause major side effects, which are rare but potentially fatal. We report a case of a 42-year-old female with a history of epigastric pain, persistent postprandial vomiting, and weight loss due to superior mesenteric artery syndrome, who underwent a fluoroscopy-guided neurolytic splanchnic nerve block with phenol and a celiac plexus block with alcohol, complicated by transient coma immediately after the procedure. Any pain originating from visceral abdominal structures can be effectively reduced by the neurolytic block of the celiac plexus or splanchnic nerves. Although the systemic effects of alcohol and phenol are not normally expected, physicians should be aware of serious complications such as intoxication, seizures, and unconsciousness due to intravascular injection.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"115-120"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Derya Özkan, Savaş Altınsoy, Sevda Gökçe Gürpınar, Faruk Mehmet Çatma
{"title":"PENG block experiences in high-risk hip fracture geriatric patients: Case Series.","authors":"Derya Özkan, Savaş Altınsoy, Sevda Gökçe Gürpınar, Faruk Mehmet Çatma","doi":"10.14744/agri.2022.80948","DOIUrl":"https://doi.org/10.14744/agri.2022.80948","url":null,"abstract":"<p><p>We aimed to share our experiences with pericapsular nerve group (PENG) block for perioperative analgesia in proximal femoral nailing for four frail elderly patients. PENG block is a novel technique for postoperative analgesia in hip surgery. Ultrasound-guided PENG block in hip fractures can relieve pain, contribute to intraoperative low-dose spinal anesthesia, and maintain postoperative analgesia.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"112-114"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preeclampsia with posterior reversible encephalopathy syndrome and cerebral venous sinus thrombosis in a pregnant patient with COVID-19.","authors":"Sevda Diker, Ferda Selçuk, Uğurcan Balyemez","doi":"10.14744/agri.2023.88965","DOIUrl":"https://doi.org/10.14744/agri.2023.88965","url":null,"abstract":"<p><p>Since its discovery in December 2019, coronavirus disease 2019 (COVID-19) has been linked to a variety of systemic effects in addition to pulmonary involvement. Pregnancy increases the risk of severe COVID-19 symptoms. COVID-19 during pregnancy worsens maternal and fetal outcomes such as preterm delivery, preeclampsia, and vascular complications. Herein, we report the case of a pregnant woman with COVID-19 who developed preeclampsia, posterior reversible encephalopathy syndrome (PRES), and cerebral venous sinus thrombosis (CVST) in the peripartum period. We discussed the possible link between these neurological complications and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Headache can be observed in the natural course of SARS-CoV-2 infection; however, it can also result from numerous etiologies such as preeclampsia, PRES, and CVST in the peripartum period. An accurate diagnosis is crucial, as the treatment and prognosis of each differ.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"125-128"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuba Tanyel Saraçoğlu, Burak Erken, Duygu Gizem Karali Bingül, Halil İbrahim Onmaz
{"title":"A barrier to adequate cancer-related pain treatment in Türkiye: Awareness of algology.","authors":"Tuba Tanyel Saraçoğlu, Burak Erken, Duygu Gizem Karali Bingül, Halil İbrahim Onmaz","doi":"10.14744/agri.2024.00936","DOIUrl":"https://doi.org/10.14744/agri.2024.00936","url":null,"abstract":"<p><strong>Objectives: </strong>Cancer-related pain negatively affects the quality of life of most patients with cancer. As pain can impact sleep, function, and sociability, the adequate treatment of cancer pain is of great importance. The present study, therefore, aimed to evaluate the awareness of algology and its effects on pain management among patients with cancer in Türkiye.</p><p><strong>Methods: </strong>This study was conducted at the Oncology Outpatient Clinic and Chemotherapy Unit of Başakşehir Çam and Sakura City Hospital between November 2023 and April 2024. Patients' awareness of algology, factors affecting awareness, and the influence of algology clinics on pain management were assessed using an 11-item questionnaire.</p><p><strong>Results: </strong>The awareness of algology among cancer patients was 31%, although this percentage increased with greater pain intensity and longer disease duration. In this study, 78.6% of participants reported experiencing pain. Additionally, 91.1% of patients receiving treatment at an algology clinic acknowledged the pain management as adequate. After receiving brief information about algology, 82.5% (n=211) of the patients who were previously unaware of this discipline reported that they would consider visiting an algology clinic for pain treatment.</p><p><strong>Conclusion: </strong>Adequate pain management is of great importance to cancer patients and their caregivers; however, in Turkey, patients lack sufficient information about algology, which may pose a barrier to effective pain treatment.</p>","PeriodicalId":101341,"journal":{"name":"Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology","volume":"37 2","pages":"100-105"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}