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Öğe Comparison of cooled and conventional radiofrequency applications for the treatment of osteoarthritic knee pain(Wolters Kluwer Medknow Publications, 2021) Kocayiğit, Havva; Beyaz, Serbülent GökhanBackground and Aims: Osteoarthritis is a progressive degenerative joint disease that affects the joint cartilage and surrounding tissues. It has been determined that osteoarthritis-induced knee pain is the most common cause of physical disability in the elderly. Material and Methods: In this study, the genicular nerve RF treatments of patients with osteoarthritic knee pain conducted at the Sakarya University Training and Research Hospital in the algology clinic of the Anaesthesiology and Reanimation Department between January 2016 and December 2016 were retrospectively examined. The preoperative and postoperative 2 nd, 6 th, and 12th week visual analog scale (VAS) and Turkish validated Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were recorded. In addition, any complications after the treatment and side effects (bleeding, neurological damage, infection, etc.) were recorded in the file. Results: When the data of the patients were evaluated statistically, the preoperative VAS and WOMAC scores were found significantly decreased compared with the postoperative 2 nd week, 6 th week, and 12th week scores in patients who applied both conventional radiofrequency (RF) and cooled RF. However, there was no statistically significant difference between the two techniques. Conclusion: We found that both cooled and conventional RF techniques in genicular nerve ablation are similarly effective in reducing pain in patients with osteoarthritis-induced knee pain and improving patients' physical functions. The complication rates are very low and there was no superiority to each other. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.Öğe Effectiveness of ozone-oxygen mixture by ultrasonography-guided facet medial branch block in the treatment of cervicogenic dizziness(Wolters Kluwer Medknow Publications, 2022) Yılmaz, Mahmut Sinan; Demir, Gürkan; Kocayi?it, Havva; E?ilmez, O?uz Kadir; Beyaz, Serbülent GökhanPurpose: Among many central and peripheral causes of vertigo, one of the factors whose pathophysiology is not yet understood is cervicogenic dizziness (CD). There are studies reporting that CD may benefit from facet joint medial bundle branch block (MBB). The purpose of our study was to share our experiences of MBB application using ultrasonography (USG) in patients diagnosed with CD. Materials and Methods: After physical examination and necessary cervical imaging, C1, C2 and C3 cervical facet joint MBB and ozone injection were performed using USG for patients who had vertigo and accompanying cervical pathology and neck pain. In order to evaluate the effectiveness of the treatment, pain levels with the Visual Analog Scale (VAS) and the effect of vertigo on the quality of life with the 'Dizziness Handicap Inventory (DHI)' Turkish validation questionnaire were documented. Results: Thirty-five patients who met the criteria were included in the study. The mean age of the patients was 50.8 ± 10.7. Of the 35 patients, 10 (28.6%) were male and 25 (71.4%) were female. There was a significant difference between the preoperative period and the postoperative 1 st, 2 nd, and 6 th week VAS scores. A significant difference was found between the preoperative and the postoperative 2 nd and 6 th week DHI questionnaire survey results as well. Conclusions: In the follow-up after the procedures, it was observed that vertigo complaints of the patients decreased significantly. © 2022 Indian Journal of Otology | Published by Wolters Kluwer - Medknow.Öğe Epidural blockade for alternative management of priapism: a case report of child with T-cell acute lymphoblastic leukemia(Elsevier Inc., 2021) Gökçe, Ahmet; Gül, Deniz; Orhan, Mehmet Fatih; Büyükavcı, Mustafa; Demir, Gürkan; Beyaz, Serbülent GökhanPriapism is a clinical condition that rarely presents with leukemia in childhood. Management of priapism treatment can become more complex and difficult when accompanied by acute leukemia. We presented a 16 years old child with t-cell acute lymphoblastic leukemia (ALL) who developed priapism. Due to the failure of conservative methods and intracavernosal drainage, we performed epidural blockade which has limited data reported with successful results in the literature before shunt surgery.Öğe Evaluation of increased intracranial pressure with the optic nerve sheath diameter by ultrasound in epiduroscopic neural laser discectomy procedures(AM SOC INTERVENTIONAL PAIN PHYSICIANS, 2021) Beyaz, Serbülent Gökhan; Kaya, Burak; Ülgen, Ali Metin; Şahin, Fatih; Kocayiğit, Havva; Issı, Zeynep TuncerBackground: In order to clarify the camera image and open the adhesions mechanically during epiduroscopy, saline is injected continuously in the epidural area. As a result, an increase in intracranial pressure is to be expected in theory. Increased intracranial pressure can be evaluated by measuring by optic nerve sheath diameter. Objectives: This study was designed to evaluate the relationship between optic nerve sheath diameter measurements and intracranial pressure, after injecting fluid to the epidural area during epiduroscopy procedures performed in our clinic. Study Design: Retrospective study. Setting: Sakarya University Training and Research Hospital. Methods: During the epiduroscopy procedure, pre and postoperative bilateral optic nerve sheath diameters were measured with an ultrasonography probe. With the patients' eyelids closed, the probe was placed on the orbita in the sagittal plane, measuring 3 mm posterior of the papilla. Results: While there was a statistically significant difference between pre- and post-operative optic nerve sheath diameter measurements, there was no significant correlation with processing time, amount of fluid delivered, or fluid delivery rates. Limitations: One of the limitations of this study is the retrospective collection of data. A second limitation is that repetitive measurements were not performed, instead of a single postoperative measurement. Conclusion: We think more prospective randomized controlled studies are required to examine the increase in the diameter of the optic nerve sheath, which is an indirect indicator of increased intracranial pressure after epiduroscopy applications, in order to determine whether the pressure increase is associated with the rate of fluid delivery, the total fluid amount, or the processing time.Öğe The interrelation between body mass index and post-dural puncture headache in parturient women(Wolters Kluwer Medknow Publications, 2021) Beyaz, Serbülent Gökhan; Ergönenç, Tolga; Sarıtaş, Aykut; Şahin, Fatih; Ülgen, Ali Metin; Eman, Ali; Doğan, BurcuBackground and Aims: Post-dural puncture headache is seen more frequently in pregnant women due to stress, dehydration, intra-abdominal pressure, and insufficient fluid replacement after delivery. Obesity protects against post-dural puncture headache in pregnant women; increased intra-abdominal fat tissue reduced cerebrospinal fluid leakage by increasing the pressure in the epidural space. Therefore, this study investigated the influence of body mass index on post-dural puncture headache in elective cesarean section patients in whom 27G spinal needles were used. Material and Methods: The study included 464 women who underwent elective cesarean section under spinal anesthesia. Dural puncture performed with a 27G Quincke spinal needle at the L3-4 or L4-5 intervertebral space and given 12.5 mg hyperbaric bupivacaine intrathecally. The patients were questioned regarding headache and low back pain 6, 12, 24, and 48 h after the procedure, and by phone calls on days 3 and 7. Results: Post-dural puncture headache developed in 38 (8.2%) patients. Of the patients who developed post-dural puncture headache, 23 (60.5%) had a body mass index <30 and 15 (39.5%) had a body mass index =30. Of the patients who did not develop post-dural puncture headache, 258 (60, 6%) had a body mass index <30 and 168 (39, 4%) had a body mass index =30. Conclusion: This prospective study found the body mass index values did not affect post-dural puncture headache in the elective cesarean section performed under spinal anesthesia. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.Öğe Investigation of the relationship between lumbar spine MRI findings and pain in patients who received and did not receive Parkinson's treatment(2023) Issı, Zeynep; Eren, Fatma Ayşen; Gürsoy, Gözde; Beyaz, Serbülent GökhanObjectives: Parkinson's disease is a chronic, progressive neurodegenerative disorder. Pain is a common symptom in Parkinson's disease, but the prevalence, characteristics, and documentation of its relationship with Parkinson's disease are insufficient. In this study, it was aimed to evaluate the relationship between lumbar spine magnetic resonance imaging (MRI) findings in patients who received and did not receive Parkinson's treatment. Methods: The demographic characteristics of patients with diagnosed Parkinson's disease were retrospectively obtained from the records. Their pain was grouped and the Hoehn Yahr stage at the first examination, and the interventional treatments performed were recorded. MRI measurements were made in the axial plane and sagittal plane of the spinal canal, whereas Ligamentum flavum measurements were made on both the right and left sides. Results: Twenty-six patients were included in the study. The average age was 73.5. Notably, 57.7% of patients were not diagnosed with Parkinson's disease prior to admission, while the Hoehn Yahr stage mostly comprised Stage 2 with 53.8%. Additionally, low back, waist, and hip pain was observed in 84.6% (n = 22), whereas 61.5% (n = 16) of patients experienced radicular pain. Epidural injections accounted for 33.2%. On lumbar MRI, the most narrow spinal segment on axial measurement was shown to be L4-L5. The axial spinal canal measurement of the Hoehn Yahr 1 group was observed to be significantly lower than the Hoehn Yahr 2 group. Conclusions: Optimal management for lumbar pain that increases with age is currently inadequate. There is a need to conduct larger studies on pain complaints, which is one of the frequently experienced non-motor symptoms in Parkinson's disease, as well as the interventional methods applied.Öğe Pain ladder of the palliative care center for cancer pain management. A new perspective from Turkey based on EFIC standards(KARE PUBL, 2021) Beyaz, Serbülent Gökhan; Demir, Gürkan; Hacıbekiroğlu, İlhanIt is known that the pathophysiology and treatment strategies of cancer pain, acute and chronic pain, which are not clearly classified in the traditional approach to pain management, are different. Cancer pain is the most common symptom seen after cancer diagnosis and 40% of cancer patients who have completed curative treatment experience chronic pain. Many physicians who encounter patients with intractable pain are known to be concerned about using potent opioids due to their potential side effects. To be more successful against cancer pain, educational strategies to address concerns about treating pain with strong opioids should be planned and implemented regularly. Palliative Care Centers in our country are key in the care of cancer patients and in the treatment of cancer pain. First of all, it is more appropriate that these centers are preferably under the responsibility of Anesthesiology and Reanimation specialists as stated in the law, and their knowledge and experience about the use of all analgesics, especially opioids, and their side effects will also provide a significant advantage. In this article, we offer some recommendations for the implementation of the standards established by EFIC (The European Pain Federation) on the management of cancer pain in our country.Öğe Total knee arthroplasty postsurgical chronic pain, neuropathic pain, and the prevalence of neuropathic symptoms: a prospective observational study in Turkey(DOVE MEDICAL PRESS LTD, 2021) Sahin, Fatih; Beyaz, Serbülent Gökhan; Karakus, Nazim; Inanmaz, Mustafa ErkanPurpose: Chronic post-surgical pain (CPSP) is a detrimental condition that persists at least two months after surgical procedures and seriously affects patients' quality of life. Although its incidence varies according to operation types and definitions, its prevalence is between 3% and 85%. The purpose of this study is to evaluate the prevalence of CPSP and neuropathic pain in patients undergoing TKA for osteoarthritis. Patients and Methods: In this study, patients who had undergone total knee arthroplasty (TKA) were examined prospectively and observationally. 42 patients were included in the study. Numeric rate scale (NRS) for developing chronic pain, Douleur Neuropathique 4 (DN-4) questionnaire to evaluate neuropathic pain and symptoms, and von Frey filaments to evaluate mechanical hyperesthesia and alladony. Results: NRS scores were 1 or higher for all patients. Twenty-seven patients constituted the mild pain group (NRS: 1-4), and 15 patients constituted the moderate pain group (NRS: 4-7). The number of patients defined as having "neuropathic pain," according to DN-4 scores, was 17 (40.4%; DN-4 >= 4). The moderate pain group reported greater severity of neuropathic symptoms on average than the mild pain group (p = 0.039). When patients knees affected by TKA were divided into suprapatellar, patellar, and infrapatellar regions and evaluated with von Frey filaments, a significant difference was found between the three regions (p < 0.05). Conclusion: In this study, we showed-unlike other studies-that the rate of neuropathic pain was higher among CPSP patients, and all patients had neuropathic symptoms. In evaluating patients knees with von Frey filaments, we showed that the neuropathic component of patients' pain occurred mostly in the knee's infrapatellar region. Although the incidence of CPSP and neuropathic pain in these patients was higher than expected, we think CPSP, its diagnosis, and its treatment present an important issue that requires further examination.Öğe An unexpected weight loss in a morbid obese patient with spinal cord stimulation therapy for chronic neuropathic pain(Springer, 2021) Beyaz, Serbülent Gökhan; Kaya, BurakObesity is a multifactorial and complex disease that occurs due to the interaction of genetic and environmental factors. It has been reported that 7% of the adult population globally and 27% of the American population are obese [1]. Obesity is associated with myocardial infarction, cerebrovascular diseases, and sudden death among cardiovascular diseases and increasingly affects the young population.
