Objectives: Hyaluronic acid (HA) is used for intraarticular treatment of hip osteoarthritis (OA). The objective of this study was to determine the efficacy of intraarticular injection of HA through a lateral approach under fluoroscopic control for advanced hip OA.
Methods: The study included 21 patients with advanced hip OA. All patients received 2.5 ml HA injection once a week for 3 weeks by lateral approach under fluoroscopic control. Disability (Lequesne index), pain scores (visual analog scale-VAS) and analgesic use of patients were assessed before treatment and 1, 3 and 6 months after the treatment.
Results: Lequesne index and VAS pain scores measured 1, 3 and 6 months after treatment were significantly lower compared to baseline scores (p<0.001). Although analgesic use was significantly reduced 1 and 3 months after treatment compared to baseline (p<0.05), no difference was determined in analgesic use at the 6th month (p>0.05). No side effect was observed.
Conclusion: In conclusion, intraarticular HA injection through a lateral approach under fluoroscopic control was shown to be a safe and effective method for patients with advanced hip OA.

Objectives: The aim of this study was first to find out the effect of music therapy on postoperative analgesia and second to determine the duration of its effect.
Methods: Seventy patients who were undergoing elective cesarean delivery were enrolled. The patients were randomly allocated into two groups as follows: In Group 1, patients listened to music through a headphone for one hour after surgery, while in Group 2, patients did not listen to any music during the same period. In the postanesthesia care unit, patients were connected to a Patient Controlled Analgesia (PCA) device. The PCA device (tramadol 3 mg/ml) was set to deliver a bolus of 20 mg, with a lockout interval of 15 min and 4-hour maximal dose of 150 mg. Postoperative pain was assessed with a visual analog scale (VAS) and consumption of tramadol was recorded at 4, 8, 12, 16, 20 and 24 hours.
Results: There was a significant decrease in Group 1 with respect to PCA delivery frequency at the 4th hour postoperatively (p<0.05). Concerning the postoperative tramadol consumption, values measured at the 4th hour were significantly lower in Group 1 (p<0.05). The total amount of tramadol consumption and additional analgesic use in the postoperative 24 hours were again lower in Group 1 when compared with Group 2 (p<0.05). All VAS values were lower in Group 1 when compared with Group 2 (p<0.05).
Conclusion: We suggest that music therapy given after surgery decreases postoperative pain in the first 24 hours and the analgesic consumption during the first four hours.

Objectives: Our prospective, randomized, double-blind study aimed to detect the effect of intrathecal levobupivacaine combined with fentanyl or morphine on the postoperative analgesia in patients undergoing cesarean section.
Methods: After approval by the hospital ethics committee and obtaining written informed consent, ASA I-II parturients undergoing elective cesarean section were enrolled in this study. None of the patients had any contraindication for spinal anesthesia or sensitivity to local anesthetics. Patients were randomly assigned in a double-blinded fashion to receive either intrathecal 10 mg 5% levobupivacaine + 0.1 mg morphine (Group M, n=30) or 10 mg 5% levobupivacaine + 20 mcg fentanyl (Group F, n=30). The onset of sensorial block and anesthesia, interval of effective analgesia until the first analgesic requirement, disappearance of motor block according to modified Bromage scale, duration of spinal analgesia, additional analgesic requirement, amount of additional analgesic, adverse effects, and postoperative patient satisfaction were recorded.
Results: The additional analgesic requirement period was significantly longer in Group M than Group F (p<0.001). Intraoperative and postoperative complications were significantly higher in Group F than Group M (p<0.05). Intended, delivered and total analgesic amount values were significantly higher in Group F than Group M (p<0.001). Patient satisfaction and presentation elsewhere were significantly higher in Group M than Group F (p<0.01).
Conclusion: Despite more adverse effects, additional analgesic requirement is lower in Group M, and the long-term painless postoperative period accounts for the choice by mothers.

Objectives: The control of postoperative pain is very important for the success of root canal treatment. The aim of this study was to research the factors that affect pain periods and pain intensity during and after endodontic treatment.
Methods: The study included 128 patients. The teeth were grouped according to their type, location and vitality. Root canals were prepared by Hero-shaper and crown-down methods, and filled by lateral condensation. The postoperative 12th hour and postoperative 1st, 3rd, 7th and 15th day Visual Analog Scales (VAS) scores of the patients were recorded and analyzed by statistical methods.
Results: After treatment, the postoperative pain scores were statistically higher in devital than vital teeth. VAS pain score demonstrated statistical differences at the beginning of the treatment between anterior and molar teeth (p=0.012) and also at 3, 7 and 15 days after treatment between premolar and molar teeth (p=0.002, p=0.006, p=0.048, respectively). According to the localization of teeth, on the 3rd, 7th and 15th postoperative days, VAS scores were the highest in the mandibular teeth (p=0.014, p=0.036, p=0.023).
Conclusion: In postoperative pain evaluation, type, localization and vitality of teeth were determined as important. In addition, analysis of the factors that affect treatment as a whole will positively impact the issues of patient satisfaction, workload and cost.

Scleroderma is a multisystemic disease of unknown etiology. The systemic disturbances cause difficulties in anesthesia practice. We present a successfully combined sciatic femoral block performed in a multisystemic scleroderma case who was planned for foot amputation. Combined sciatic-femoral block was planned for the patient, for whom left foot amputation was decided by the Orthopedics Department, with related physical weakness, probable difficult airway, and accompanying cardiac and pulmonary diseases. Following the required preoperative evaluation, sciatic and femoral block was performed with a total 15 ml volume consisting of 3 ml levobupivacaine 7.5% and 1 ml lidocaine 2% added to 11 ml NaCl 0.09% subsequently. Additional analgesic treatment was not required perioperatively, and the patient was hemodynamically stable. Tramadol infusion was applied with Patient Controlled Analgesia device at the 8th hour. The patient was discharged on the postoperative 10th day. We think that in high-risk severe cachectic systemic scleroderma cases, general anesthesia and central blocks are contraindicated. If gastrointestinal and cardiac involvements are present, as in our case, combined femoral-sciatic block may be considered as an alternative anesthetic technique.

Intracranial hypotension is usually seen in middle-aged adults and appears with orthostatic headache. It is characterized by low cerebrospinal fluid (CSF) pressure and pachymeningeal-dural thickening on magnetic resonance imaging (MRI). Lumbar puncture, dural rupture with CSF leakage secondary to spinal anesthesia or spinal traumas, and under-production or over-absorption of CSF due to some metabolic events such as dehydration, uremia and diabetic coma are the main etiologic factors. It is sometimes considered as idiopathic when no etiologic factor is present. In addition, some connective tissue disorders have risk of CSF leakage due to spontaneous dural rupture. Neck pain, tinnitus, nausea and vomiting, and diplopia may accompany headache. 
CSF leakage can be identified by computerized tomography (CT) myelography, CSF-flow MRI, and radionuclide cisternography. Bed rest, fluid resuscitation, caffeine, theophylline, and non-steroidal antiinflammatory drugs (NSAIDs) are important treatment options. In patients resistant to therapy, interventional measures such as epidural saline or blood patch can be applied. In this case report, we evaluated the results of pain treatment options in a patient having headache due to intracranial hypotension who was hospitalized in the Neurology Department of Ege University Hospital.

Continuous plexus and peripheral nerve blocks offer the potential benefits of prolonged analgesia and faster functional recovery after surgery in pediatric patients. We report the feasibility of a new patient position and long-axis nerve scan with ultrasound (US) for controlling perineural catheter placement for continuous mid-femoral sciatic nerve block in a pediatric case. We think that long-axis view of the sciatic nerve with US during placement of perineural catheters in a child is an effective technique.