Postoperative pain can lead to serious complications in the short and medium term. It may also increase the risk of converting acute pain into chronic pain, leading to the development of postthoracotomy pain syndrome (PTPS). The aim of this study was to demonstrate the effectiveness of erector spinae plane block (ESPB) and paravertebral block (PVB) in managing acute postoperative pain and preventing the development of PTPS in patients undergoing thoracotomy and lobectomy. This prospective, randomized study included American Society of Anesthesiologists (ASA) class II-III patients aged 18–70 years who underwent elective unilateral lobectomy via a thoracotomy. The study was conducted at Başakşehir Çam and Sakura City Hospital, following approval from the hospital’s ethics committee on May 20, 2022 (protocol number: KAEK.2022.05.155). Patients were randomly assigned into ESPB (n = 30) and PVB (n = 30) groups using a computer-generated randomization sequence prior to surgery. Intravenous patient-controlled analgesia (PCA) was provided for 24 h postoperatively. Resting numerical rating scala (NRS) and Prince Henry Hospital Pain Scale (PHHPS) scores were evaluated at 0, 2, 6, 12, and 24 h after surgery. Pain levels were further assessed via telephone interviews using the NRS at 2 weeks and 2 months postoperatively. The baseline NRS score was significantly lower in the PVB group (3.97 ± 0.61) compared to the ESPB group (4.37 ± 0.85) (p = 0.044). The mean number of PCA requests, mean opioid consumption and number of patients receiving rescue analgesics were significantly lower in the PVB group than in the ESPB group (p < 0.05). No significant differences were observed between the groups in hemodynamic parameters (p > 0.05). PTPS developed in 3 patients (1 in PVB, 2 in ESPB), with no significant intergroup difference (p = 0.561). PVB and ESPB provided effective acute pain control after thoracotomy, with PVB showing superior outcomes in analgesic use and pain scores. Early management of postoperative pain may improve short-term recovery and potentially reduce PTPS incidence, which was 5% in our study—lower than reported in the literature. ClinicalTrials.gov (ID NCT06964698). The clinical trial was retrospectively registered on April 02, 2025.

Background/Objectives: After the earthquakes in Turkey, many citizens were injured, and a long ongoing process requiring physiological and psychological treatments began. The aim of this study was to observe the pain and psychological changes in earthquake victims in light of the QoR-15 score. Methods: After approval by the local ethics committee (Decision No. 2023-194), earthquake victims with catheters in trauma and reconstructive surgery were retrospectively evaluated. Demographic and catheterization data were collected. Baseline, 24 h, 72 h QoR-15 (Quality of Recovery-15), and VAS (Visual Analog Scala) scores were compared for changes over time. Results: A total of 40 catheters were placed in 29 patients (after the exclusion of children, 36 catheters were evaluated in 26 (15 w/11 m) patients). The mean age of the patients was 35.57 ± 13.69 years, and the duration of catheterization was 8 (4.25–12.75) days. An infusion of 0.1% bupivacaine 0.5–1 mg/kg/24 h was started routinely. The QoR-15 scores of the patients at baseline, 24 h, and 72 h were 80.45 ± 17.76, 95.27 ± 15.16, and 101.06 ± 15.52, respectively (p < 0.001). The VAS scores of the patients at baseline, 24 h, and 72 h were 4.61 ± 1.41, 1.79 ± 1.36, and 0.76 ± 0.86, respectively (p < 0.001). Conclusions: In this study, a significant improvement in QoR-15 and VAS scores was achieved as a result of catheter insertion in earthquake victims. Considering that post-traumatic injuries require repeated surgeries and that pain aggravates the existing psychological state, it can be said that catheterization is beneficial.

The Medical Bulletin of Sisli Etfal Hospital

Background/Objectives: After the earthquakes in Turkey, many citizens were injured, and a long process requiring physiological and psychological treatments started in the ongoing process. The aim of this study was to observe the pain and psychological changes in earthquake victims in light of the QoR-15 score. Methods: After approval by the local ethics committee (Decision No. 2023-194), earthquake victims with catheters in trauma and reconstructive surgery were retrospectively evaluated. Demographic and catheterization data were collected. Baseline, 24-hour, and 72-hour QoR-15 (Quality of Recovery-15) and VAS (Visual Analog Scala) scores were compared for changes over time. Results: A total of 40 catheters were placed in 29 patients (after the exclusion of children, 36 catheters were evaluated in 26 (15 w/11 m) patients). The mean age of the patients was 35.57 ± 13.69 years, and the duration of catheterization was 8 (4.25–12.75) days. Infusion of 0.1% bupivacaine 0.5–1 mg/kg/24 h was started routinely. The QoR-15 scores of the patients at baseline, 24-hour, and 72-hour were 80.45 ± 17.76, 95.27 ± 15.16, and 101.06 ± 15.52, respectively (p<0.001). The VAS scores of the patients at baseline, 24-hour, and 72-hour were 4.61 ± 1.41, 1.79 ± 1.36, and 0.76 ± 0.86, respectively (p<0.001). Conclusions: In this study, a significant improvement in QoR-15 and VAS scores was achieved as a result of catheter insertion in earthquake victims. Considering that post-traumatic injuries require repeated surgeries and that pain aggravates the existing psychological state, it can be said that catheterization is beneficial.

Endobronchial solitary papillomas are extremely rare lung neoplasms origi-nating from the bronchial surface epithelium. They often present with cough or recurrent hemoptysis. These tumors are benign, but they should be fol-lowed closely because they may even have a low probability of malignant transformation features. It should be kept in mind that malignancy may devel-op especially if the patient is a smoker. Although the etiology is not known for certain, it is thought to be caused by human papillomavirus in some cases. A 43-year-old male patient was admitted with a complaint of chronic cough. Rigid bronchoscopy was performed for diagnostic and therapeutic purposes after imaging techniques revealed a lesion obstructing the lumen of the right main bronchus. The pathology result was reported as mixed bronchial papil-loma. We aimed to present our case because of its rarity and to indicate that chronic cough must be further evaluated.

This study investigates the application of bispectral index (BIS) monitoring in rigid bronchoscopy to enhance anesthetic delivery and patient outcomes, a topic that remains underexplored. A retrospective analysis of 155 patients undergoing elective rigid bronchoscopy under general anesthesia was conducted. Patients were divided into BIS-monitored and conventional anesthesia groups. Inclusion criteria were adults aged over 18 years with American Society of Anesthesiologists (ASA) physical status I-IV. No significant demographic differences were found between the groups. The BIS group showed significant reductions in propofol usage (231.40 ± 74.63 mg vs. 190.19 ± 91.83 mg, p= 0.003) and prednol dosage (94.27 ± 42.56 mg vs. 79.71 ± 18.97 mg, p= 0.020). Remifentanil administration approached statistical significance (56.99 ± 34.69 mcg vs. 45.36 ± 36.75 mcg, p= 0.055). No significant demographic differences were found between the groups. The BIS group showed significant reductions in propofol usage (231.40 ± 74.63 mg vs. 190.19 ± 91.83 mg, p= 0.003) and prednol dosage (94.27 ± 42.56 mg vs. 79.71 ± 18.97 mg, p= 0.020). Remifentanil administration approached statistical significance (56.99 ± 34.69 mcg vs. 45.36 ± 36.75 mcg, p= 0.055).