The Local Anesthetic and Pain Relief Activity of Alkaloids

Alkaloids have been known for several centuries and have been mainly obtained from natural sources that presented important properties with biochemical, pharmacological, and medical effects in living organisms. Alkaloids are derived from amino acids like other important molecules in the functioning of life in our body. Hence, alkaloids are considered as pharmacologically important. Alkaloids are secondary metabolites widely distributed in leaves, stem, root, and fruits of plants which synthesize them. However, administration and consumption of them at right doses are beneficial in terms of health; excess doses will be definitely poisonous and may cause even death. The pharmacological activities of alkaloids are quite diverse. They are important natural products with a wide range of medicinal properties including relief of pain (e.g., morphine), analgesic (e.g., codeine), antiarrhythmic (e.g., quinidine), antibacterial (e.g., chelerythrine), antiasthma (e.g., ephedrine), cholinomimetic (e.g., galantamine), and vasodilatory (e.g., vincamine)

A Case of Pneumothorax after Phrenic Nerve Block with Guidance of a Nerve Stimulator

Hiccups have more than 100 etiologies. The most common etiology has gastrointestinal origins, related mainly to gastric distention and gastroesophageal reflux disease. Intractable hiccups are rare but may present as a severe symptom of various diseases. Hiccups are mostly treated with non-invasive or pharmacological therapies. If these therapies fail, invasive methods should be used. Here, we present a patient on whom we performed a blockage of the phrenic nerve with the guidance of a nerve stimulator. The patient also had pneumothorax as a complication. Three hours after intervention, a tube thoracostomy was performed. One week later, the patient was cured and discharged from the hospital. In conclusion, a stimulator provides the benefit of localizing the phrenic nerve, which leads to diaphragmatic contractions. Patients with thin necks have more risk of pneumothorax during phrenic nerve location

Fluoroscopy guided cervical interlaminar steroid injections in patients with cervical pain syndromes: A retrospective study

CONCLUSION: Fluoroscopy guided CILESI is a safe and an effective treatment for patients with cervical pain syndromes. The success rates show that a large percentage of the patients may obtain relief from radicular symptoms and avoid surgery for the follow-up period up to 12 months

Comparison of efficacy of intra-articular morphine and steroid in patients with knee osteoarthritis

Introduction: Primary therapeutic aim in treatment of osteoarthritis of the knee is to relieve the pain of osteoarthritis. The aim of this study was to compare the efficacy of intra-articular triamcinolone with intra-articular morphine in pain relief due to osteoarthritis of the knee in the elderly population. Materials and Methods: Patients between 50 and 80 years of age were randomized into three groups. Group M received morphine plus bupivacaine intra-articularly, Group T received triamcinolone plus bupivacaine intra-articularly, and Group C received saline plus bupivacaine intra-articularly. Patients were evaluated before injection and in 2nd, 4th, 6th, and 12th weeks after injection. First-line supplementary analgesic was oral paracetamol 1500 mg/day. If analgesia was insufficient with paracetamol, oral dexketoprofen trometamol 50 mg/day was recommended to patients. Results: After the intra-articular injection, there was statistically significant decrease in visual analog scale (VAS) scores in Groups M and T, when compared to Group C. The decrease of VAS scores seen at the first 2 weeks continued steadily up to the end of 12th week. There was a significant decrease in Groups M and T in the WOMAC scores, when compared to Group C. There was no significant difference in the WOMAC scores between morphine and steroid groups. Significantly less supplementary analgesics was used in the morphine and steroid groups. Conclusion: Intra-articular morphine was as effective as intra-articular triamcinolone for analgesia in patients with osteoarthritis knee. Intra-articular morphine is possibly a better option than intra-articular steroid as it has lesser side effects

Comparison of the efficacies of I-gel (TM) and LMA-ProSeal (TM) for airway management in pediatric patients

Conclusion: This study suggested that I-gel is an effective and safe alternative supraglottic airway device for use in children

Preemptive Analgesic Effect of Ketamine in Children with Lower Abdominal Surgery

Objective: Preemptive analgesic effect of low dose ketamine has been supported by clinical studies in adults. The aim of this study was to evaluate the analgesic effect of ketamine applied at different times in children who underwent lower abdominal surgery. Material and Methods: A total of 90 children having ASAI-II physical status between 3 and 12 was randomly divided into three groups as pre, int and post groups. Ketamine were given to these groups in the following manner respectively; 1mg/kg intravenous ketamine before incision (pre-incisional); the same dose ketamine 10 minutes following the first incision (intraoperative); and ketamine at the end of the surgical operation (postoperative). The pain of patients was assessed by postoperative pain scale (CHIPPS) in children and infants; the sedation status of children was assessed by Ramsey's sedation scale. The first analgesic requirement time was recorded. Results: No significant difference was found in demographic characteristics of the three groups (p>0.05). Lower CHIPPS scores were found in Group Post throughout all measurement periods (p<0.05). Group Post was found to have significantly higher sedation levels compared with the other two groups (p=0.003). Conclusion: No analgesic effect was obtained using by pre-incisional and intraoperative i.v.1mg/kg ketamine, during lower abdominal surgery in children. Further studies with different drugs are needed to clarify this topic