Bilateral superficial cervical plexus block combined with bilateral greater occipital nerve block reduces the impact of different sources of pain after thyroid surgery with less consumption of morphine-PCA: a randomized trial

Bayir, Omer/0000-0001-9445-6129WOS: 000358736300006Background Our aim was to demonstrate the analgesic efficacy of the bilateral superficial cervical plexus block (BSCPB) combined with bilateral greater occipital nerve block (BGONB) on different sources of pain after thyroid surgery; in terms of pain scores and morphine-PCA consumption in the first 24 h. Materials and method Sixty patients were randomized into three groups; Group C (n = 20) to receive management without blocks; Group GS (n = 20), the combination of BSCPB and BGONB; and Group S (n = 20), BSCPB alone. Levobupivacaine of 0.25 % (15 ml (each side) for BSCPB; 5 ml (each side) BGONB) was used for nerve blocks. All patients received morphine-PCA for the first 24 h postoperatively. In all, 0 h, 1 h, 2 h, 4 h, 6 h, 12 h, and 24 h were the measurement times for incision pain at rest, pain on swallowing, headache, and posterior neck pain scores (VAS) and PONV. Requirement for rescue analgesics and 24 h morphine consumption were recorded. Results Incision pain scores at rest and on swallowing was lower in Groups GS and S (p 3 was lower in Group GS (p < 0.001). In Groups GS and S 24 h morphine consumption was lower, compared to Group C (p < 0.001). PONV and rescue analgesic use were similar. Conclusion The combination of three-injection technique BSCPB with BGONB performed before surgical incision by using 0.25 % levobupivacaine, significantly reduced incision pain at rest, incision pain on swallowing, headache and posterior neck pain after thyroid surgery, while reducing morphine consumption in 24 h postoperatively

The awareness of physicians and allied health professionals about cardiopulmonary rehabilitation: A cross-sectional survey study [Kardiyopulmoner rehabilitasyon konusunda hekimler ve diger sagli{dotless}k çali{dotless}şanlari{dotless}ni{dotless}n farki{dotless}ndali{dotless}k düzeyi: Kesitsel bir anket çali{dotless}şmasi{dotless}]

Objective: Cardiopulmonary (CPR) programs were developed to improve and stabilize the physical, psychological, social, mental, professional, and economic conditions of patients with cardiovascular and pulmonary diseases. Although it is known that CPR reduces mortality and morbidity, it is not widely implemented as it is in Turkey. In this study, we aimed to determine the level of CPR awareness among physicians and allied health professionals. Material and Methods: This was a multi-center, cross-sectional survey study. The study included physicians, nurses, physiotherapists, and other allied health professionals who were informed about the survey and provided written consent to participate. Results: A total of 727 volunteers from 12 different centers were included in the study. Of the participants, 59.5% were physicians, 31.4% were nurses, 5.9% were physiotherapists, and 3.2% were other allied health professionals; 79.3% participants answered the question on if they have had any idea about CPR. Participants indicated that patients should be referred to cardiac pulmonary rehabilitation after a coronary artery bypass (83.8%), chronic obstructive pulmonary disease (83.2%), and cardiac valve surgery (38.9%). Only 40.1% of the survey participants provided information about CPR to patients, while 20.5% did not provide any information about CPR. Conclusion: This survey study determined that in centers where CPR could be implemented, health professionals have knowledge about CPR. If the study were conducted nationwide, the level of awareness might be even lower. Although it is an idea of CPR, the level of knowledge for this issue is not adequate. As the number of the CPR centers will increase, the knowledge of doctors and allied health professionals will advance. © 2014 by Turkish Society of Physical Medicine and Rehabilitation