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Biomedical subjects

Serdar Erdine

Publications and source records attributed to Serdar Erdine.

12 recordsLinked to original sources
PubMed2006

Comparison of pulsed radiofrequency with conventional radiofrequency in the treatment of idiopathic trigeminal neuralgia.

The aim of this prospective, randomized, double-blinded study was to evaluate the effect of pulsed radiofrequency (PRF) in comparison with conventional radiofrequency (CRF) in the treatment of idiopathic trigeminal neuralgia. A total of 40 patients with idiopathic trigeminal neuralgia were included. The 20 patients in each group were randomly assigned to one of the two treatment groups. Each patient in the Group 1 was treated with CRF, whereas each patient in the Group 2 was treated by PRF. Evaluation parameters were: pain intensity using a Visual Analogue Scale (VAS), patient satisfaction using a Patient Satisfaction Scale (PSS), additional pharmacological treatment, side effects, and complications related to the technique. The VAS scores decreased significantly (p<0.001) and PSS improved significantly after the procedure in Group 1. The VAS score decreased in only 2 of 20 patients from the PRF group (Group 2) and pain recurrence occurred 3 months after the procedure. At the end of 3 months, we decided to perform CRF in Group 2, because all patients in this group still had intractable pain. After the CRF treatment, the median VAS score decreased (p<0.001) and PSS improved (p<0.001) significantly. In conclusion, the results of our study demonstrate that unlike CRF, PRF is not an effective method of pain treatment for idiopathic trigeminal neuralgia.

Adult↗
PubMed2005

Effects of pulsed versus conventional radiofrequency current on rabbit dorsal root ganglion morphology.

Lesioning using radiofrequency (RF) current has been increasingly used in clinical practice for the treatment of pain syndromes. Although formation of heat causing "thermocoagulation" of the nervous tissues is thought to be responsible of the clinical outcome, a more recent modality of RF application named pulsed radiofrequency (PRF) delivers the RF current without producing destructive levels of heat. In our study, we compared the effects of conventional RF (CRF) and PRF on rabbit dorsal root ganglion (DRG) morphology, including also control and sham operated groups. The setting of the experiment and the RF parameters used were similar to those used in current clinical practice. The specimens were analyzed both with light microscopy and electron microscopy, two weeks after the procedure. At the light microscopic level, all groups had preserved the normal DRG morphology and no differences were observed between them. In the electron microscopic analysis there were no pathological findings in the control and sham operated groups. But the ganglion cells in the RF groups had enlarged endoplasmic reticulum cisterns and increased number of cytoplasmic vacuoles which were more evident in the CRF group. Some of the ganglion cells in the CRF group had mitochondrial degeneration, nuclear membrane disorders or loss of nuclear membrane and neurolemma integrity. The myelinated and unmyelinated nerve fibers were of normal morphology in all groups. Our results suggest that PRF application is less destructive of cellular morphology than CRF at clinically used "doses". Before making certain judgements, more experimental and clinical studies should be planned.

Animals↗
PubMed2005

Celiac ganglion block.

The percutaneus blockade of the celiac plexus is being performed nearly for a century. The aim of performing celiac plexus and splancnic nerve blocks was surgical anesthesia at the beginning. But because of the technical demands and variable results of celiac plexus and splanchnic nerve blocks as a surgical anesthetic, over time, these techniques were supplanted by spinal anesthesia and segmental blockade of the somatic paravertebral nerves. As celiac plexus and splanchnic nerve blocks were falling into disuse for surgical anesthesia, the clinical utility of these techniques was becoming apparent in the new specialty of pain management. Celiac plexus and splancnic nerve blocks are effective in relieving chronic abdominal pain, especially originating from the malignancies of the pancreas, liver, gallbladder, omentum, mesentery, and alimentary tract from the stomach to the transverse portion of the large colon. The relevant anatomy, indications, cotraindications, different application techniques and results of celiac blockade is reviewed in this paper.

Abdominal Pain↗
PubMed2005

[Percutaneous lumber nucleoplasty].

Low-back pain is one of the most common causes for seeking professional medical assistance and the most frequent cause of absence from work. It is not rare that the intervertebral discs are the etiological factor. Degenerated discs with internal disruptions may cause axial back pain whereas protrusion or herniation of a disc may result in radicular pain. Open surgical procedures targeting the intervertebral discs are carried out frequently for years. But especially because of its lack of superiority over the conventional therapies in the long-term and the risk of development of failed back surgery syndrome, the investigators are forced to develop minimally invasive techniques of disc decompression. In the last two decades, better understanding of the spinal anatomy, function and pain generating mechanisms along with the technological achievements, has accelerated the development of many modalities for the treatment of low back pain. Chemonucleolysis, automated percutaneous lumbar discectomy (APLD), intradiscal laser discectomy, intradiscal electrothermal therapy (IDET) and most recently percutaneous nucleoplasty are the minimally invasive techniques developed for this aim. Percutaneous nucleoplasty is a minimally invasive technique which uses radiofrequency energy to ablate the nucleus pulposus in a controlled manner for disc decompression. The current data about this new technique is insufficient yet, but the preliminary reports indicate that the technique is relatively safe and the outcomes are encouraging.

Diskectomy, Percutaneous↗
PubMed2004

Efficacy of coeliac plexus and splanchnic nerve blockades in body and tail located pancreatic cancer pain.

Palliative treatment, pain therapy and quality of life (QOL) are very important in pancreatic cancer patients. We evaluated the pain relieving efficacy, side effects and effects on QOL of neurolytic coeliac plexus blockade (NCPB) and splanchnic nerves neurolytic blockade (SNB) in body and tail located pancreatic cancer. The study protocol was approved by the local ethics committee. Patients were randomly divided into two groups. Coeliac group; GC, N = 19 were treated with coeliac plexus blockade, whereas the patients in splanchnic group; GS, N = 20 were treated with bilateral splanchnic nerve blockade. The VAS values, opioid consumption and QOL (Patient satisfaction scale=PSS, performance status scale=PS) were evaluated prior to the procedure and at 2 weeks intervals after the procedure with the survival rates. The demographic features were found to be similar. The VAS differences (difference of every control's value with baseline value) in GS were significantly higher than the VAS differences in GC on every control meaning that VAS values in GS decreased more than the VAS values in GC. GS patients were found to decrease the opioid consumption significantly more than GC till the 6th control. GS patients had significant improvement in PS values at the first control. The mean survival rate was found to be significantly lower in GC. Two patients had severe pain during injection in GC and 5 patients had intractable diarrhoea in GC. Comparing the ease, pain relieving efficacy, QOL-effects of the methods, splanchnic nerve blocks may be an alternative to coeliac plexus blockade in patients with advanced body and tail located pancreatic cancer.

Adult↗
PubMed2004

Myofascial pain syndrome in the differential diagnosis of chronic abdominal pain.

Myofascial pain syndrome is a painful musculoskeletal condition, and a quite common cause of chronic pain. It is characterized by the development of trigger points that are locally tender when active, and refer pain through specific patterns to other areas of the body. Its etiological factors are various; trauma, vertebral column diseases, systemic disorders, psychological distress, lack of motion, and chilling of the body parts. Myofascial pain syndrome may be misdiagnosed as arising from a visceral source especially if its probability is not kept in mind and a proper patient examination is lacking. Although there are many therapeutic approaches, trigger point injections can be diagnostic and therapeutic.

Abdominal Pain↗
PubMed2004

Percutaneous annuloplasty in the treatment of discogenic pain: retrospective evaluation of one year follow-up.

In this study, we have evaluated clinical results of the discTRODE system, in 15 patients with discogenic pain. All procedures were performed under sterile conditions with fluoroscopic guidance. After identifying the disc space under fluoroscopy, the introducer of the discTRODE was introduced using a tunneled vision. After inserting the introducer; navigable, semi-rigid discTRODE catheter was advanced through the introducer and directed medially and contralaterally along the posterior nuclear-annular interface. The SMK Thermocouple Electrode was placed in the outer-annulus on the contralateral side so as to monitor local tissue temperature. The treatment temperature was manually increased in a step-wise progression from 50 degrees C to 65 degrees C. Patient outcomes were evaluated during follow-up visits at 1, 3, 6 and 12th months post-procedure. Before the procedure and at each visit during the follow-up period, patients completed Visual Analogue Pain Scale (VAS) and Short Form-36 Health Status Questionnaire (SF-36). Annuloplasty was performed without difficulty in all patients, there were no complications associated with disc puncture such as discitis or disc rupture. Symptoms improved in 10 of 15 (66.6 %) of the patients on the SF-36 Physical Function subscale, in 9 of 15 (60 %) on the SF-36 Bodily Pain subscale and in 9 of 15 (60 %) on the VAS scores. 5 of 15 of the patients did not show improvement on any scale. This technique seems to be a reliable method for patients complaining of discogenic pain. However, prospective randomized controlled studies comparing different approaches are needed.

Adult↗
PubMed2002

Precautions during epidural neuroplasty.

Scar formation in the epidural space due to previous operations or presence of inflammation in and around the nerve roots or spinal nerves in patients with back pain or radiculopathy have been documented in patients suffering from spinal pain. Several methods targeting the scar formation and inflammation have been used. Epidural neuroplasty is one of the recently used methods. The goals of neuroplasty are to break down fibrous adhesions that may prevent free movement of structures in the intervertebral foramen and in the bony vertebral canal. However, epidural neuroplasty is not free of complications. During epidural neuroplasty, unintended dural puncture, administration of hypertonic saline to the subarachnoid/subdural space, catheter shear, infection, and haemodynamic instability during the application are the most commonly observed complications. The most commonly seen complications of epidural neuroplasty are due to the procedure or the drugs administered. Complications relating to the procedure are usually seen immediately, while complications relating to drug administration are typically seen later. In this article, we discuss not only the possible complications during epidural neuroplasty, but their prevention and management as well.

Journal Article↗
PubMedDate not supplied

Transdiscal approach for hypogastric plexus block.

BACKGROUND AND OBJECTIVES: In this study, we have performed hypogastric plexus block using a posterior transdiscal approach in 20 patients diagnosed with pelvic pain because of cancer. METHODS: The L(5)-S(1) interdiscal space was identified with fluoroscopy. A needle attached to a 5-mL syringe was introduced through the disc and advanced under lateral fluoroscopic control until resistance was lost. After verifying proper position, 5 mL of 10% aqueous phenol was administered through the needle. After drawing back the needle, cephazolin 50 mg in 1 mL was administered to the disc to prevent discitis. The visual analog scale (VAS) values, daily analgesic requirements, and patient satisfaction were evaluated before the procedure, at 24 hours and then every month for 3 months after the procedure. RESULTS: Disc puncture was performed without difficulty in all patients, there were no complications associated with disc puncture such as discitis or disc rupture. Twelve patients had statistically significant pain relief immediately after the block (P <.05). Fifteen patients were satisfied after the block, and their daily analgesic requirement decreased significantly. No pain relief was observed in 5 patients. CONCLUSIONS: Transdiscal approach to the hypogastric plexus appears to be a safe and effective procedure. However, prospective randomized controlled studies comparing different approaches are needed to increase our knowledge of hypogastric plexus block.

Adult↗