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  • Küçük Resim
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    Efficacy of intraarticular application of ketamine or ketamine-levobupivacaine combination on post-operative pain after arthroscopic meniscectomy (vol 23, pg 2721, 2015)
    (Springer, 2016) Işık, Cengiz; Demirhan, Abdullah; Yetiş, Tevfik; Ökmen, Korgün; Sarman, Hakan; Tekelioğlu, Ümit Yaşar; Duran, Turan
    Purpose To evaluate the efficacy of intraarticular injection of ketamine or ketamine plus levobupivacaine on post-operative analgesia in patients undergoing arthroscopic meniscectomy. Methods A prospective, randomized, double-blind study was performed on 60 patients aged 18–65 years who planned to undergo elective arthroscopic meniscectomy. The patients were divided into three groups: the ketamine group (n = 20) received 1.0 mg/kg of intraarticular ketamine in 20 ml of normal saline, the ketamine–levobupivacaine group (n = 20) received 0.5 mg/kg of intraarticular ketamine plus 50.0 mg of 0.25 % levobupivacaine in 20 ml of normal saline, and the control group (n = 20) received 20 ml of intraarticular normal saline. A visual analogue scale (VAS) was used to determine the efficacy of analgesia at 1, 2, 4, 6, 8, 12, and 24 h post-operatively. Results There were statistically significant differences in the median VAS scores among the three groups according to Bonferroni adjustment at all time points (p < 0.01), with the exception of 6 and 24 h post-operatively. The median VAS scores at 1, 2, and 4 h post-operatively were higher in the control group than in the two treatment groups (p < 0.001). The median VAS scores in the control group at 1, 2, 4, 6, 8, and 12 h post-operatively and those in the ketamine group at 4, 8, and 12 h post-operatively were significantly higher than those in the ketamine–levobupivacaine group (p < 0.05). Conclusion Intraarticular ketamine provides effective post-operative analgesia. Addition of intraarticular levobupivacaine to ketamine may provide better amelioration of pain after outpatient arthroscopic meniscectomy. Level of evidence I.
  • Küçük Resim
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    Efficacy of the greater occipital nerve block in recurrent migraine type headaches
    (Via Medica, 2016) Ökmen, Korgün; Dağıstan, Yaşar; Dağıstan, Emine; Kaplan, Necati; Cancan, Emre
    Aims: We aimed to evaluate six months of results following repeated GON blocks. Methods: We evaluated the results from GON block performed on 60 patients. Briefly, we applied a standard 2 mL of 0.5% Bupivacaine GON blockage once a week for 4 weeks. We recorded the Visual Analog Scale (VAS) scores, the number of migraine attacks and the Migraine Disability Assessment Questionnaire (MIDAS) scores. The study subjects were not allowed to use medication for prophylaxis, and Ibuprofen (400 mg, 1200 mg at maximum) was prescribed for any migraine attacks. Results: The initial mean number of attacks per month before starting treatment was 8.33 + 2.31. After treatment, the initial MIDAS mean was found to be 2.82 per month; this declined to 1.47 in 3rd, and was 1.50 in the 6th month. The individual month values were found to be significant, and were listed respectively as, 1st month: 3.95 + 2.52, 2nd month: 3.23 + 1.82, 3rd month: 2.60 + 1.90, 4th month: 2.68 + 2.10, 5th month: 2.58 + 1.90 and 6th month: 2.58 + 1.90. The mean VAS scores were recorded as follows for each month: 6.28 +/- 1.24, 3.13 +/- 0.97, 2.55 +/- 1.19, 2.35 +/- 1.26, 2.38 +/- 1.20 and 2.48 +/- 1.30, respectively. This difference was noted to be statistically significant. No difference regarding the efficacy of the treatment was determined when the results were compared across age groups. Conclusion: We assume that GON blockage with 2 mL of 0.5% Bupivacaine can be a supportive treatment in migraine treatment, with no serious adverse effects reported. (C) 2016 Polish Neurological Society. Published by Elsevier Sp. z o.o. All rights reserved.