Background: Hemorrhoidectomy is a common surgical procedure associated with significant postoperative pain. The conventional analgesic methods used for hemorrhoidectomy often have adverse effects and may not provide adequate pain relief. The sacral erector spinae plane block (ESPB) is a newly introduced technique that has shown promise in various surgical procedures. This prospective, randomized, controlled trial aimed to evaluate the analgesic effects of sacral ESPB following hemorrhoidectomy. Methods: Seventy patients undergoing hemorrhoidectomy were divided into 2 groups: the control group and the sacral ESPB group. Bilateral sacral ESPB was performed in the sacral ESPB group, whereas no intervention was performed in the control group. The numeric rating scale at rest and during the active period (mobilizing) was used as the primary outcome measure. Secondary outcome measures were the cumulative doses of tramadol, the number of patients who required rescue analgesia postoperatively, and quality of recovery-15 Turkish version patient recovery quality. Results: The sacral ESPB group had significantly low numeric rating scale scores at various time points (P < .05). More patients in the control group needed rescue analgesia during the postoperative period (P < .001). The dosages of tramadol consumption after the first 24 hours postoperatively were significantly lower in the sacral ESPB group compared with the control group (P < .001). Furthermore, quality of recovery-15 Turkish version scores were high in the sacral ESPB group (P < .001). Conclusion: The results suggest that sacral ESPB is an effective method for post-hemorrhoidectomy pain management, reducing the need for additional analgesics and improving patient recovery.

Background and Objectives: Circumcision is the most frequently performed surgery in male pediatric patients. The postoperative period is characterized by significant pain due to the sensitivity of the foreskin and low pain threshold in children. This study aimed to evaluate the effects of sacral erector spinae plane block (S-ESPB) and ring block on postoperative face, legs, activity, cry, and consolability (FLACC) pain scores after circumcision in children. We also assessed the amount of rescue analgesia used, the time to the first administration of rescue analgesia, potential problems, and parental satisfaction. Materials and Methods: This study was a prospective, randomized, multicenter trial conducted at two tertiary healthcare centers in Turkey. The patients were divided into two groups: Group S (patients who received the S-ESPB) and Group R (patients who received the ring block). The primary outcome measure was the FLACC score at 1 h postoperatively. Secondary outcome measures included FLACC scores at 0, 2, 4, and 6 h after surgery, the total dose of rescue analgesia, time to first rescue analgesia, complications, and parental satisfaction. Results: Group S exhibited significantly lower FLACC scores than Group R at all time (0, 1, 2, 4, and 6 h) points (respectively, p = 0.013, p < 0.001, p = 0.004, p = 0.006, and p = 0.002). Group S required significantly less rescue analgesia and exhibited a significantly longer duration of analgesic efficacy compared to Group R (p = 0.001 and p = 0.002, respectively). Conclusions: The S-ESPB is a safe and effective form of analgesia for managing pain following pediatric circumcision surgery.

BACKGROUND:Epiduroscopy is commonly used for the evaluation and treatment of low back pain. Saline with or without local anesthetic addition was used to visualize epidural space structure during this procedure. A rapid increase in epidural space pres...

Multi-modal analgesic strategies, including regional anesthesia techniques, have been shown to contribute to a reduction in the use of opioids and associated side effects in the perioperative setting. Consequently, those so-called multi-modal approaches are recommended and have become the state of the art in perioperative medicine. In the majority of intensive care units (ICUs), however, mono-modal opioid-based analgesic strategies are still the standard of care. The evidence guiding the application of regional anesthesia in the ICU is scarce because possible complications, especially associated with neuraxial regional anesthesia techniques, are often feared in critically ill patients. However, chest and abdominal wall analgesia in particular is often insufficiently treated by opioid-based analgesic regimes. This review summarizes the available evidence and gives recommendations for peripheral regional analgesia approaches as valuable complements in the repertoire of intensive care physicians’ analgesic portfolios.

Objective: We aimed to investigate the relation of platelet count (PLT), mean platelet volume (MPV) and platelet distribution width (PDW) with other acute phase reactants in COVID-19 new corona virus. Material and Methods: Thirty one patients with COVID-19 were included in to study. There were three groups as outpatient (Group 1, OP)(n=6), hospital (Group 2, H)(n=16) and intensive care unit (Group 3, IC)(n=9) in this analytic study. Results: WBC (White Blood Cell), CRP (C-Reactive Protein) values were significantly different in all groups. PDW values were significantly lower in Group 3 than Group 1, 2. The result of ROC analysis was 10.9 as a cut-off value (Area under the curve, AUC)=0.407) Conclusions: This study indicates that lower PDW may frequently develop in COVID-19 cases and there is a relation between thrombocytosis and acute phase reactants, that is, the inflammatory response. So we can offer that PDW should be used as a marker of Covid-19 disease severity, but it needs more studies in the future.