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Background We aimed to evaluate pain scores one year after impar ganglion block in patients with coccydynia who did not benefit from conservative treatment. Methods The medical records of 29 patients with coccydynia were reviewed. Patients who were referred to the algology clinic and underwent impar ganglion blocks were retrospectively evaluated. Demographic data, time to the onset of pain, causes of pain, X-ray findings, administered invasive procedures, and visual analog scale (pain) scores were recorded. Results A total of 29 patients were included in the study, 10 males (34%) and 19 females (66%). The average age and body mass index were 53.45 ± 9.6 and 29.55 ± 4.21 respectively. In 21 patients, the onset of pain was associated with trauma. Nineteen patients (65.5%) had anterior coccygeal angulation. The average visual analog scale score before undergoing an impar ganglion block was 7.4 ± 1. After the procedure, the scores at < 3 months, 3–6 months and 6 months-1 year follow-up intervals were significantly lower (p < 0.05). Furthermore, visual analog scale scores at the 3–6 months and 6 months-1 year periods were significantly lower in patients who received diagnostic blocks plus pulse radiofrequency thermocoagulation than in patients who underwent a diagnostic block only. Conclusions The impar ganglion block provides effective analgesia without complications in patients with coccydynia. Pulse radiofrequency thermocoagulation combined with a diagnostic block prolongs the analgesic effect of the procedure.

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Objectives: To evaluate whether using laryngeal mask airway (LMA) made a difference in terms of airway security, hemodynamic changes, complications, and recovery times compared to tracheal intubation during the procedure in patients undergoing general anesthesia for endovascular treatments of unruptured cerebrovascular aneurysms. Methods: The electronic medical records database, patient files, and anesthesia charts were examined between May 2008 and September 2016 to identify patients with the following inclusion criteria: 1) aged 18-70 years; 2) American Society of Anesthesiologists (ASA) classification I-III; 3) diagnosis of unruptured CVA; 4) Glasgow coma scale of 15 without neurological deficit; and 5) underwent elective EVT under general anesthesia. Results: Tracheal tube (TT) was used in 46 patients (group TT, n=46) and LMA in 42 patients (group LMA, n=42). Mean arterial pressure (MAP) levels were increased to >20% of baseline in 14 patients (30.4%) after intubation and in 6 (13%) after extubation in group TT. All LMA patients remained within normal MAP limits ( p <0.05). Six patients (13%) displayed coughing or straining at extubation in group TT whereas none in group LMA ( p <0.05). Recovery and discharge times were similar ( p >0.05). Conclusion: Laryngeal mask airway and TT provided comparable airway security during procedure. Laryngeal mask airway attenuated stress response in hemodynamic parameters at intubation and extubation and smoother emergence compared to TT without delay in recovery.

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Sorumlu Yazar)Öz Amaç: Pseudomonas aeruginosa özellikle yoğun bakım ünitelerinde (YBÜ), yatan hastalarda enfeksiyonlara neden olan fırsatçı bir patojendir. Son yıllarda artan antibiyotik direnci P.aeruginosa enfeksiyonlarının tedavisini zorlaştırmaktadır. Bu çalışmanın amacı yoğun bakım ünitelerinden izole edilen P.aeruginosa suşlarının antibiyotik direnç oranlarını saptamaktır. Gereç ve yöntem: Dört yıllık bir süre zarfında yoğun bakım ünitelerinden mikrobiyoloji laboratuvarına gönderilen çeşitli örneklerden izole edilen P.aeruginosa suşları çalışmaya dahil edilmiştir. Bakteri tanımlaması ve antibiyotik duyarlılık testleri konvansiyonel yöntemler ve otomatize sistemler kullanılarak yapılmıştır. Bulgular: Toplam 688 P.aeruginosa suşu çalışmaya dahil edilmiştir. Suşların izole edildiği örnekler arasında endotrakeal aspirat örnekleri ilk sırada (%53,3), idrar örnekleri ikinci sırada (%27) saptanmıştır. İzole edilen P.aeruginosa suşlarının en dirençli olduğu antibiyotik siprofloksasin (%34,7) olarak bulunmuştur. Seftazidime %29,4, sefepime %28,1, karbapenemlere %27,3, piperasilin-tazobaktama %24,6, gentamisine %19,3, amikasine %7,9 oranında direnç tespit edilmiştir. Ayrıca, direnç oranlarının yıllar içinde değiştiği gözlenmiştir. Sonuç: P.aeruginosa suşlarının antimikrobiyal ajanlara direnç oranları hastaneler arasında farklılık göstermektedir. Bu nedenle her hastane belirli aralıklarla kendi antibiyotik direnç profilini gözden geçirmeli ve ampirik tedavi seçeneklerini belirlemelidir. Anahtar kelimeler: Yoğun bakım üniteleri, Pseudomonas aeruginosa, antibiyotik direnci.