Objectives: Postdural puncture headache (PDPH) may occur 12–72 hours after spinal anesthesia. PDPH causes patient discomfort following spinal anesthesia and therefore it presents a challenging situation for anesthetists.
Methods: This prospective randomized study enrolled 613 patients who were 18 years or older and who had been operated under spinal anesthesia. The spinal anesthesia procedure was performed with the patient in a sitting position through the L3-4, L4-5 interspaces, using 25 and 26 gauge (G) quincke and pencil-point spinal needles. The gender, age, body mass index, level of sensory block, mobilization time of the patients and also the experience and physical fatigue condition of the physicians were recorded. In the postoperative period all patients were questioned as to whether they experienced headache. These questions were repeated at postoperative 1st, 24th, 48th and 72nd hours in the hospital and on the 7th day by phone after they were discharged.
Results: Compared to older patients, patients between the ages of 25 to 40 (p<0.001) and compared to other operations, C/S patients (p: 0.003) experienced headaches more frequently in the postoperative period. The other two important factors were the experience (p: 0.013) and the physical fatigue of the physician (p: 0.001) on the day of surgery.
Conclusion: The experience and good physical condition of the physician, TUR or anorectal surgery, a patient over 40 years of age and using pencil-point spinal

Objectives: Ultrasonography-guided regional anesthesia (UGRA) applications are important in the practice of the anesthesiology and algology in our country as well as in the world. Despite the positive effect on the patient care of the UGRA, there is concern that ultrasound probes may be used repeatedly and assume a vector role in pathogen transport. There is no standard protocol in our country to provide basic hygiene before UGRA techniques, which is a part of the daily practices of anesthesiologists. In the study, it was aimed to investigate the probes and skin disinfection habits applied by the anesthesiologists.
Methods: After the approval of the ethics committee, random selection was made from the UGRA-administered clinics in our country and the questionnaire consisting of 14 questions was e-mailed (e-mail) to 430 participants.
Results: Distribution of preferred agents for USG probe disinfectant: povidone iodine 45.5%, octenidine 8%, chlorhexidine 5.4%, alcohol solutions 7.1 %. The rate of participants who indicated that they had received a disinfection course or certificate to engage in UGRA-related initiatives was 39.3%.
Conclusion: Although the most commonly used disinfectant povidone iodide and disinfection training rate is less than 50%, the incidence of UGRA-associated infection is very low. In our country, we believe that the study has provided data on the preferences of disinfection methods of anesthetists in UGRA applications. However, we believe that it is required to be worked in larger study groups that include more anesthesiologists, in order to provide more generalizable data.

Objectives: In this study, we aimed to adapt the Revised Nonverbal Pain Scale (NVPS-R) into Turkish, and to test reliability and validity of the scale.
Methods: A total of 74 patients who were admitted to eight intensive care units in two hospitals between May 2016 and August 2017 were included in this study. All patients were over 18 years old, mechanically ventilated, and sedated. The data were obtained 1 min before, during and 20 min after the aspiration using the NVPS-R-TR and Critical Care Pain Observation Tool (CPOT).
Results: Language, content, construct validity and reliability analyses were performed for the reliability and validity of the scale. Factor loadings in explanatory factor analysis were sufficient (0.790–0.900), and the fit indices of the scale were acceptable values in confirmatory factor analysis (x2/SD: 2.414, RMSEA: 0.066, CFI: 0.910, SRMR: 0.073, GFI: 0. 950 and AGFI: 0.930). After internal consistency analyses of the scale, the item-total correlation was sufficient (0.604–0.794), and Cronbach’s alpha score was 0.776.
Conclusion: NVPS-R-TR is a reliable and a valid measuring tool for the pain evaluation of sedated adults who are under mechanical ventilation in the intensive care unit.

Objectives: When researches examined, cancer pain and other cronic pain, serious mismanagement and undermedication in treating chronic pain especially using opioids continuing problem. This study was designed to examine the barriers to adequate opioid usage, especially as they could be associated with experience and medical discipline.
Methods: The survey conducted among phycians working in Ankara Numune education and research hospital on July of 2015. A 29 item survey was used to measure physicians attitudes and knowledge about using opioids.
Results: We have included 156 doctors in our study.We found that %82.7 of doctors have not been educated in the pain subject.%48.8 of doctors see themselves capable of prescribing opioid medication and %67.9 of doctors are feeling uneasy when prescribing opioids also a lot of doctors are not willing to give prescriptions of opioids.When analyzing our data we have found that opioids related prejudices are not related with title or experience.İt is interesting that the doctors who were anxious when prescribing opioids to their patients they want for themselves when in need opioid precriptions and again when in need they want increasing doses of opioid.
Conclusion: Resembling the studies in the literature in our study, we’ve found that doctors have poor knowledge about opioids and opiophobia it’s frequent among the doctors.Poor knowledge of opioids and overcoming the opiophobia and medicating with opioids when medical status of patients emposes made us think that in service training should be started immeadiately.

Objectives: This study aims to test the validity and reliability of the Turkish form of Pain Coping Inventory (PCI) originally developed by Kraaimaat ve Evers (2003) and where pain coping is conceptualised as the composite of cognitive and behavioral active and passive strategies.
Methods: The sample consisted of a total of 279 participants with various pain complaints where 232 were women (83.2%) and 47 were men (16.8%). Besides the Turkish form of PCI, General Self-Efficacy Scale, Pain Self Efficacy Questionnaire-2, Ways of Coping Inventory and Pain Coping Questionnaire were used to determine criterion and convergent validity of the scale.
Results: The principal component analysis revealed that the scale had six factors of distraction, pain transformation, comforting thinking, worrying, resting and withdrawal. The internal consistency of the subscales varied between.53 ile.77. The correlations of the subscales of PCI with criterion and convergent validity scales were significant.
Conclusion: The results suggest that PCI can be a useful tool for assessing coping strategies of pain patients with varying complaints of pain.

Neurological complications of cardiac surgery is known for almost a century. Brachial plexus injury after coronary artery bypass grafting is not a rare complication, but the frequency of reporting is less because these are temporary and often symptoms requiring treatment. in a few cases peripheral neuropathy findings are permanent and causes of disability. Diagnosis is based on symptoms, imaging and electrophysiological studies and it is important that both treatments for both medical and legal liability. Here in 63-year-old male patient was diagnosed brachial plexus injury lasting neuropathic pain the left upper limb after uneventful coronary artery bypass surgery presented and causes and consequences were discussed with literature.

In some situations, the cause of the supposed neuropathic pain might be related to abnormal tissue recovery such as scar formation due to wound retraction that might create mechanical compression on the nerve tissue. In this report we describe infiltration block with diclofenac sodium and lidocaine through the hypertrophic scar tissue to reduce mechanical stress in 3 patients. The infiltration technique might resolve the tension of the contracted scar tissue by tearing the adhesions and the eliminated mechanical compression would reduce the pressure on nerve tissue and hence neuropathic pain symptoms.

Hearing loss after spinal anesthesia is one of the rare complications. It has been suggested that low frequent hearing loss develops after the development of endolymphatic hydrops in the cochlea due to CSF escape after dural puncture. Hearing loss after nonotologic surgical procedures is very rare and usually can only be determined by audiometric evaluation. We aimed to present the sudden unilateral hearing loss and healing process in a patient who underwent spinal anesthesia for elective anterior cruciate ligament surgery in this postoperative period.