Abstract Background and objective: Pectoral nNerve (PECS) block type-1 is an Ultrasound (US)-guided interfacial block that can be performed for postoperative analgesia management after breast surgery. In the procedure, a local anesthetic solution is injected into the interfacial area between the Pectoralis Major muscles (PMm) and Pectoralis minor muscles (Pmm). The present study compared PECS block type-1 administered preoperatively or postoperatively for postoperative analgesia after breast augmentation surgery. Methods: The patients were randomly divided into three groups (n = 30 in each): a preoperative PECS block group (Pregroup), postoperative PECS block group (Postgroup), and control group (Group C). Opioid consumption and Visual Analogue Scale (VAS) scores were evaluated at postoperative period. Results: The pains scores in the Pregroup were significantly lower than those in the control group. Although there was no significantly difference in the VAS scores of the Postgroup and control group at postoperative 1 hour, the scores in the Postgroup were significantly lower than those in the control group at all the other evaluated times (p < 0.05). The VAS scores in the Pregroup were significantly lower than those in the Postgroup 8 hours after the surgery. Opioid consumption was significantly lower in the Pregroup as compared with that in the other two groups (p < 0.05). The use of rescue analgesia in the Pregroup was significantly lower than that in the other groups (p < 0.05). Conclusion: Performing PECS block type-1 preoperatively reduced VAS scores and opioid consumption after breast augmentation.

Resumo Introdução: A cirurgia de quadril é uma cirurgia de grande porte que causa dor intensa no pós-operatório. Embora a dor durante o repouso seja consideravelmente reduzida, a mobilização é importante em termos de complicações tromboembólicas. O bloqueio doquadrado lombar é uma técnica analgésica regional que bloqueia os ramos nervosos de T6-L3. Esse bloqueio pode fornecer analgesia adequada e reduzir o consumo de opioides após cirurgiasde quadril. Relato de caso: Realizamos o bloqueio contínuo do quadrado lombar tipo 3 em dois pacientes submetidos à artroplastia de quadril. Durante as 24 hs de pós-operatório foram registrados os escores de dor, o consumo de anestésicos locais em analgesia controlada pelo paciente e a necessidade de analgésicos adicionais. Em dois pacientes, os escores de dor pós-operatória foram < 6 durante o repouso e fisioterapia. O paciente foi mobilizado no período pós-operatório imediato, sem precisar de analgésico opioide adicional e sem fraqueza muscular. Discussão: O bloqueio contínuo do quadrado lombar pode ser usado para aliviar a dor aguda no pós-operatório de cirurgia de quadril porque fornece anestesia unilateral sem fraqueza muscular.

Abstract Introduction: Hip surgery is a major surgery that causes severe postoperative pain. Although pain during rest is usually considerably reduced mobilization is important in terms of thromboembolic complications. The quadratus lumborum block is a regional analgesic technique that blocks T6-L3 nerve branches. This block may provide adequate analgesia and reduce opioid consumption after hip surgery. Case report: We performed continuous quadratus lumborum type 3 block in two patients who underwent hip arthroplasty. Postoperative 24-h pain scores, local anesthetic consumptions on patient-controlled analgesia and additional analgesic requirement were recorded. In two patients, postoperative pain scores were less than 6 during rest and physiotherapy. Patient was mobilized in the early postoperative period without additional opioid analgesic requirement and without muscle weakness. Discussion: Continuous quadratus lumborum block may be used to relieve postoperative acute pain in hip surgery because it provides one-sided anesthesia without muscle weakness.

RESUMO Objetivo: Avaliar o efeito da cirrose na camada de fibras nervosas da retina e na espessura da coroide através da tomografia de coerência óptica com imagem de profundidade aprimorada. Métodos: Este estudo transversal, de único centro, foi realizado no departamento de Oftalmologia da Universidade Bulent Ecevit com a participação do departamento de medicina interna em gtastroenterologia. Os pacientes que foram tratados com o diagnóstico de cirrose (n = 75) foram examinados na clínica da oftalmologia. Foram incluídos pacientes correspondentes em idade e sexo (n = 50) que fossem saudáveis e possuíssem o critério de inclusão exigido pelo estudo. Realização de exame oftalmológico completo: acuidade visual com tabela de Snellen, a medida da pressão intraocular com tonometria de aplanação, biomicroscopia do segmento anterior e posterior, gonioscopia, medida do comprimento axial, exame de campo visual, camada de fibras nervosas da retina, macular central e medidas de espessura de coroide. Resultados: A diferença entre os valores de pressão intraocular não foram estatisticamente significativos entre os grupos cirrótico e controle (p=0,843). Entretanto, a espessura da camada de fibras nervosas da retina foi significativamente mais fina no grupo cirrótico em todas as regiões (p=0,001) e a espessura subfoveal da coroide também foi significativamente mais fina no grupo cirrótico (p=0,001). Além disso, a espessura macular central do grupo cirrótico foi significativamente mais grossa do que no grupo de controle (p=0,001). Conclusão: Por fim, as espessuras das camadas de fibras nervosas da retina e subfoveal da coroide foram significativamente mais finas nos pacientes com cirrose.

ABSTRACT Purpose: To evaluate the effect of cirrhosis on peripapillary retinal nerve fiber layer and choroidal thickness with enhanced depth imaging optical coherence tomography. Methods: This cross sectional, single center study was undertaken at Bulent Ecevit University Ophthalmology department with the participation of internal medicine, Gastroenterology department. Patients who were treated with the diagnosis of cirrhosis (n=75) were examined in the ophthalmology clinic. Age and sex matched patients (n=50) who were healthy and met the inclusion, exclusion criteria were included in the study. Complete ophthalmological examination included visual acuity with Snellen chart, intraocular pressure measurement with applanation tonometry, biomicroscopy of anterior and posterior segments, gonioscopy, axial length measurement, visual field examination, peripapillary retinal nerve fiber layer, central macular and subfoveal choroidal thickness measurements. Results: The difference between intraocular pressure values was not statistically significant between cirrhosis and control group (p=0.843). However, mean peripapillary retinal nerve fiber layer thickness was significantly thinner in cirrhosis group in all regions (p<0.001) and subfoveal choroidal thickness was significantly thinner in cirrhosis group also (p<0.001). Moreover, central macular thickness of cirrhosis group was significantly thicker than the control group (p=0.001). Conclusion: Peripapillary retinal nerve fiber layer and subfoveal choroidal thickness was significantly thinner in cirrhosis patients.