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    Comparison of cooled and conventional radiofrequency applications for the treatment of osteoarthritic knee pain
    (Wolters Kluwer Medknow Publications, 2021) Kocayiğit, Havva; Beyaz, Serbülent Gökhan
    Background 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.
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    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 Tuncer
    Background: 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.