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Background We aimed to evaluate the effect of combined spinal-epidural (CSE) anesthesia versus general anesthesia with an epidural catheter (GE) on the quality of postoperative recovery in abdominal hysterectomy patients. The recovery outcomes were assessed using the Quality of Recovery-15 (QoR-15) scale. Methods This prospective, single-center observational study included 87 female patients (aged 18–75 years). Their ASA physical status varied from I to III, and they had a planned elective abdominal hysterectomy scheduled. We divided them into two groups based on the type of anesthesia administered: the CSE group and the GE group. The primary outcome consisted of the total QoR-15 score we measured 24 h after the operation. Among the secondary outcomes were the incidence of postoperative nausea and vomiting (PONV), analgesic consumption, pain scores assessed using the Numerical Rating Scale (NRS), the need for rescue analgesia, time to mobilization, hospitalization duration and the surgeon satisfaction score. Results At 24 h post-surgery, the CSE group had a significantly higher QoR-15 score compared to that of the GE group, with scores of 131.97 ± 8.67 and 122.93 ± 13.41, respectively ( p  = 0.001). Additionally, the CSE group required less analgesic consumption, averaging 119.53 ± 33.16 ml compared to 149.32 ± 53.11 ml in the GE group ( p  = 0.002). The need for rescue analgesia was also lower in the CSE group, with 9.30% of patients requiring it compared to 27.27% in the GE group ( p  = 0.031). Furthermore, pain scores measured using the NRS and the PONV incidence were significantly lower in the CSE group during the first three hours after surgery ( p  < 0.001). However, there were no significant differences in the time to mobilization, length of hospital stays, or surgeon satisfaction scores between both groups. Conclusion Combined spinal-epidural anesthesia provides a better quality of postoperative recovery for patients undergoing abdominal hysterectomy. This technique improves pain control, reduces the need for opioids, and minimizes nausea and vomiting. These findings suggest that combined spinal-epidural anesthesia may enhance patient comfort and well-being during recovery.

Background This study aimed to compare the personality belief scores of patients who chose either general or spinal anesthesia during cesarean delivery (CD) and explore the relationship between personality beliefs, and anxiety levels. Methods This prospective study included expecting mothers, aged 18–45 years, who were classified as ASA II-III, scheduled for elective CD. Anesthesia (general or spinal) was selected based on the patient’s preference. Patients with emergency CD indications, contraindications to either anesthesia type, or inability to complete the evaluation scales were excluded. After collecting sociodemographic data and medical history, patients completed the Spielberger Trait Anxiety Inventory (STAI II) and Personality Belief Questionnaire Short Form (PBQ-SF). On the day of surgery, patients were asked to complete the Spielberger State Anxiety Inventory (STAI I) in the preoperative waiting room. After discharge, the collected results were analyzed and compared based on the women’s anesthetic choices (general or spinal anesthesia). Results The study included 150 patients, with 71 expressing a preference for spinal anesthesia and 79 indicating a preference for general anesthesia. The dependent, narcissistic, and borderline personality belief scores, as well as the state anxiety (STAI I) scores, were significantly higher in the spinal anesthesia group than in the general anesthesia group (dependent p  = 0.003, narcissistic p  = 0.013, borderline = 0.018, STAI I = 0.01). These differences had small to medium effect sizes (η² = 0.053, 0.040, 0.034, respectively). Spearman’s correlation analysis revealed weak positive correlations between state anxiety (STAI I) scores and dependent (rho = 0.237, p  = 0.004), narcissistic (rho = 0.287, p  < 0.001), histrionic (rho = 0.300, p  < 0.001), and borderline (rho = 0.231, p  = 0.005) personality belief scores.A weak positive correlation was also observed between trait anxiety (STAI II) scores and dependent personality belief scores (rho = 0.193, p  = 0.018). Conclusions Women who preferred spinal anesthesia had higher scores in dependent, narcissistic, and borderline personality beliefs compared to those who preferred general anesthesia. Although weak, these personality beliefs were also associated with preoperative anxiety. Although these findings are inconclusive, they indicate that personality traits may influence anesthesia preference for CD. Trial registration The study was registered on ClinicalTrials.gov (Identifier: NCT06795321).

Hip fracture surgeries in patients present significant challenges, particularly in managing pain during spinal anesthesia positioning. The Pericapsular Nerve Group Block (PENG) has shown promise in addressing this issue, but the ideal volume of local anesthetic for PENG is still uncertain. In our study, we aimed to analyze the effects of administering PENG block with two different volumes on analgesic quality for patients undergoing hip fracture surgery. In this prospective, randomized controlled trial, the effects of administering a PENG block with 20 mL versus 30 mL of local anesthetic in patients undergoing hip fracture surgery under spinal anesthesia were compared. The primary outcome was pain during spinal anesthesia positioning, and secondary outcomes included postoperative pain scores and opioid consumption. A total of 60 patients were analyzed, with 30 in each group. Critical parameters such as the time of spinal anesthesia administration and the satisfaction of the anesthesiologist showed no significant differences (p=0.918; p=0.741, respectively). NRS scores recorded before, during, and after the positioning for spinal anesthesia exhibited similar patterns (p=0.290; p=0.247; p=0.288, respectively). The cumulative opioid requirements did not exhibit a statistically significant difference at 24 hours (p = 0.098). Quadriceps weakness was significantly more in the PENG-30 group 6 hours after surgery but had recovered by the 9th hour (p= 0.004). In patients undergoing hip fracture surgery, the effects of applying the PENG block with 20 mL or 30 mL of local anesthetic are comparable in terms of positioning for spinal anesthesia and postoperative analgesic requirements.

Neuroendocrine carcinoma is one of the uncommonly seen pathologies of the urinary bladder. Macroscopic hematuria is frequently encountered symptom in patients with neuroendocrine carcinoma. We report a 45-year-old man with left solitary kidney and oliguria for five days the development of acute renal failure (ARF) with the impaired general condition. The underlying cause being identified as pure type large-cell neuroendocrine carcinoma of the bladder. Large-cell neuroendocrine carcinoma of the bladder is an uncommon fatal tumor. No macroscopic hematuria or urological symptom was observed in our case. Advanced ectasia was not observed in the kidney, and the patient's clinical status was complicated with ARF. It must not be forgotten that in some bladder tumors, the patient's general condition may be impaired without urological symptoms.

Abstract Objective The purpose of this study was to evaluate the analgesic effect of a prilocaine + bupivacaine combination in patients undergoing periprostatic nerve block (PNB) by comparing its effects with those of prilocaine alone. Design Single center, single-blind, prospective descriptive study. Subjects Four hundred patients with transrectal prostate biopsy pain. Methods The patients in this prospective, randomized controlled study were divided into two groups. The first group received prilocaine during PNB (Group 1), whereas the second received a prilocaine + bupivacaine combination (Group 2). Results The mean visual analog scale (VAS) scores immediately after biopsy were 2.52 ± 0.7 and 2.53 ± 0.9, respectively (P = 0.35). VAS values were significantly lower in Group 2 at one and six hours following the procedure. The most painful part of the biopsy according to many patients was the probe insertion. Conclusions The prilocaine + bupivacaine combination is an effective analgesic method during prostate biopsies and for one and six hours after prostate biopsy.

Study objective The ultrasound-guided (US-guided) suprainguinal fascia iliaca block (SIFIB) is a regional anesthesia procedure that targets the lumbar plexus. It offers versatility in clinical practice, serving as both a standalone method for adequate pain management and a primary anesthesia option. Our aim was to present clinical insights gained from the application of US-guided SIFIB, whether as a standalone procedure or in conjunction with another block, across various clinical indications for lower extremity surgeries. Methodology Our study is a retrospective cohort analysis designed to identify cases in which the SIFIB was used as a component of the main anesthetic method and to determine the success of the anesthetic method in patients undergoing lower extremity surgery between March 2022 and March 2023 in a tertiary hospital. Data such as block success, perioperative additional analgesic need, patients' demographic details, and block characteristics were obtained from electronic and paper-based patient records and analyzed. Main results We analyzed data from 16 patients who underwent lower extremity surgeries under SIFIB. Among these, 10 patients received SIFIB as their sole anesthesia method, while six underwent surgery with a combination of sciatic block and SIFIB. Briefly, the types of surgery were amputations, soft tissue excision, revision of knee prostheses, excision of knee tumors, patella implant removal, patellar ligament repair, patellar fracture repair, distal femur fractures (internal fixation), and vascular surgery. Six patients necessitated additional analgesics. No statistically significant differences were observed in demographic details, block onset time, and surgical duration between patients requiring and not requiring sedoanalgesia during surgery (p>0.05). Conclusion For patients planning lower extremity surgery, considering SIFIB alone or combined with a sciatic block as part of anesthesia management is a valid option, offering an alternative to a lumbar plexus block.Study objective The ultrasound-guided (US-guided) suprainguinal fascia iliaca block (SIFIB) is a regional anesthesia procedure that targets the lumbar plexus. It offers versatility in clinical practice, serving as both a standalone method for adequate pain management and a primary anesthesia option. Our aim was to present clinical insights gained from the application of US-guided SIFIB, whether as a standalone procedure or in conjunction with another block, across various clinical indications for lower extremity surgeries. Methodology Our study is a retrospective cohort analysis designed to identify cases in which the SIFIB was used as a component of the main anesthetic method and to determine the success of the anesthetic method in patients undergoing lower extremity surgery between March 2022 and March 2023 in a tertiary hospital. Data such as block success, perioperative additional analgesic need, patients' demographic details, and block characteristics were obtained from electronic and paper-based patient records and analyzed. Main results We analyzed data from 16 patients who underwent lower extremity surgeries under SIFIB. Among these, 10 patients received SIFIB as their sole anesthesia method, while six underwent surgery with a combination of sciatic block and SIFIB. Briefly, the types of surgery were amputations, soft tissue excision, revision of knee prostheses, excision of knee tumors, patella implant removal, patellar ligament repair, patellar fracture repair, distal femur fractures (internal fixation), and vascular surgery. Six patients necessitated additional analgesics. No statistically significant differences were observed in demographic details, block onset time, and surgical duration between patients requiring and not requiring sedoanalgesia during surgery (p>0.05). Conclusion For patients planning lower extremity surgery, considering SIFIB alone or combined with a sciatic block as part of anesthesia management is a valid option, offering an alternative to a lumbar plexus block.

The aim of this study was to evaluate the relation of maternal pain catastrophizing score with children who underwent circumcision postoperative pain. This prospective cohort study was performed between March 2022 and March 2023 at Samsun University, Turkey. Demographic characteristics of mothers and children, mothers’ education level, presence of chronic pain, and Beck Depression Inventory scores were recorded preoperatively. Pain catastrophizing was assessed by applying the pain catastrophizing scale (PCS) to the mothers of children who experienced postoperative circumcision pain. The mothers were divided into low-pain catastrophizing (Group 1) and high-pain catastrophizing (Group 2) group. A total of 197 mothers and sons participated in the study, with 86 (43.6%) in Group 1 and 111 (56.4%) in Group 2. Significant differences were found between the two groups in terms of the mothers’ PCS scores (p < 0.001), education levels (p = 0.004), chronic pain scores (p = 0.022), and Beck Depression Inventory scores (p < 0.001). Our findings showed that children with high pain catastrophizing mothers experience greater postoperative pain than those with low pain catastrophizing mothers. This may be attributable to a mother’s specific cognitive style for coping with pain, which is associated with the child’s responses to painful experiences.

Introduction: The management of postoperative pain following lumbar disc herniation (LDH) surgery is crucial for the quality of recovery. The effectiveness of multimodal analgesia plans increases when interfascial plane blocks are included. This study sought to compare the analgesic efficacy of preoperative ultrasound-guided TLIP (thoracolumbar interfascial plane) blocks and posterior QLBs (quadratus lumborum blocks) in patients undergoing LDH surgery. Methods: Patients undergoing elective LDH surgery under general anesthesia were randomized into two groups: thoracolumbar interfascial plane block (Group T) and posterior quadratus lumborum block (Group Q). Block applications were performed 30 min before anesthesia induction. In the postoperative period, analgesia control was provided with a patient-controlled analgesia device. The patients’ 24 h cumulative opioid consumption was examined. Pain scores were evaluated in the 0th, 3rd, 6th, 9th, 12th, and 24th hours. Results: The mean 24 h cumulative morphine consumption for patients was statistically insignificant when Groups T and Q were compared (9.14 ± 7.03 mg vs. 8.66 ± 6.58 mg, p = 0.788). Pain scores at rest and during movement as well as morphine consumption were similar between groups in the 0th, 3rd, 6th, 9th, 12th, and 24th hours (p > 0.05). Conclusions: The study determined that the utilization of TLIP blocks and posterior QLBs prior to anesthesia induction yielded comparable outcomes in terms of reducing postoperative analgesic consumption and enhancing the efficacy of multimodal analgesia in individuals undergoing single-distance lumbosacral spine surgery under general anesthesia.

ObjectivesOvarian cancer is one of the most fatal gynecologic malignities. miR-16-5p, miR-17-5p, and miR-638 genes were found to have been associated with ovarian cancer in accordance with the data obtained from the previous microarray research performed by Tuncer et al. (J Ovarian Res 13(1):99, 2020). The expression levels of these miRNAs in the peripheral blood samples of 142 ovarian cancer patients, and 97 healthy controls were investigated for performing the validation, and to identify whether these genes were the possible biomarkers to be used in the early diagnosis of high-risk ovarian cancer patients, and in the prognosis of patients.MethodsThe miRNA expression analysis was performed using the miRNA-specific cDNA synthesis, and real-time PCR methods following the RNA isolation from the peripheral blood lymphocytes.ResultsmiR-16-5p, miR-17-5p, and miR-638 miRNA gene expression levels were found to have twofold higher expression levels in patient groups compared with the gene expression levels in healthy controls, and were statistically significant (p < 0.05). In addition, the comparison of the miRNA expression levels with the clinical data of patients showed that there was a significant difference with smoking history and the increased expression level of miR-17-5 (p: 0.007). There was a significant difference between the increased expression level of miR-638 with the locally advanced stage, and abdominal/pelvic metastatic patients (p: 0.03).ConclusionsThe obtained data suggest that miR-16-5p, miR-17-5p, and miR-638 molecules might be the noninvasive biomarkers in identifying the ovarian cancer. However, the investigation and monitoring of the changeability of these biomarkers in benign ovarian diseases, and during the treatment must be performed in future studies for identifying the accurate diagnostic, and prognostic features of miRNAs.

MicroRNAs (miRNAs) have major roles in nearly all cellular process including gene expression, and may behave as oncogene or tumor suppressor gene by binding to complementary sequences in the target mRNA. The circulating microRNA-15a (miRNA-15a) and microRNA-16-1 (miRNA-16-1) of 15 healthy adults and of 40 untreated patients diagnosed with diffuse large B-cell lymphoma (DLBC) were recruited to investigate the expression levels. The expression levels of miRNA-15a, and miRNA-16-1 genes of the untreated DLBCL patients, and healthy individuals with matched age, sex and ethnicity were examined. MicroRNA expression profiles obtained from peripheral blood were investigated. The samples were collected from 40 patients diagnosed with DLBC patients, and from 15 healthy controls. Two miRNAs were selected, and expression profile was examined using a quantitative real-time polymerase chain reaction (qPCR) based on the previous studies. Statistically significant expression level differences (p < 0.05) were detected for miRNA-16-1 in DLBCL patients and healthy control groups. miRNA-16-1 gene expression level was found approximately ninefold higher in the patient group compared to the controls; however, no statistical difference was detected in the expression profile of miRNA-15a between the both groups. On the other hand, the decreased gene expression in miRNA16-1 was observed in 88.3% of DLBCL patients. These results suggested that there was no statistically significant decrease in the miRNA-15a gene expression in DLBCL patients (p > 0.05). On the contrary to the literature, miRNA-16-1 expression level was suppressed in DLBCL group in our study, however no whole gene silencing was performed. MicroRNA-16-1 might be suggested to behave as a tumor suppressor in DLBCL in our study.