Gabapentinoids and lactation: Review of the literature.

Gabapentin and pregabalin, which belong to the gabapentinoid drug family, are widely used, especially in neuropathic pain treatment, due to their effectiveness in pain management. Although many of the comorbidities and symptoms that limit the use of gabapentinoids are clearly described in the literature, there is limited data on their use during lactation. A 33-year-old female patient was admitted to our clinic with neuropathic pain and muscle weakness in her left lower extremity following spinal anesthesia for a cesarean section. We aimed to present the gabapentin treatment of a breastfeeding patient with persistent neuropathic pain in light of a literature review.

[A rare cause of headache; case report of trigeminal neuralgia concomitant with idiopathic intracranial hypertension]. / Nadir bir bas agrisi nedeni; trigeminal nevralji ve idiyopatik intrakraniyal hipertansiyon birlikteligi: Olgu sunumu.

Trigeminal neuralgia (TN) is the condition of sudden, usually unilateral, very short-lasting, stinging, and recurrent pain in the distribution area of one or more branches of the trigeminal nerve. Idiopathic intracranial hypertension (IIH) is an increase in intracranial pressure associated with normal cerebrospinal fluid composition that is not due to a secondary cause. Although not frequent, the association of IIH and TN has also been reported. We aimed to present a rare case report in which TN is concomitant with IIH. A 56-year-old female patient was admitted to our clinic with the complaint of jabbing pain that may feel like an electrical shock on the right side of her face. In the patient's history, she was diagnosed with TN 8 years ago. She had a lightning-flashing pain in the area corresponding to the right mandibular nerve dermatome. Her pain attacks lasted 1-2 min, and recurring 15-20 times during the day. In the CISS sequence cranial MRI, bilateral perioptic CSF distance showed mild prominence, prominence in Meckel caves, and empty sella appearance features. These findings were found to be compatible with intracranial hypertension. As a result,based on these findings, the patient was diagnosed with TN or trigeminal neuropathy accompanying IIH. While patients diagnosed with TN may be associated with IIH, also trigeminal nerve may be affected, although not as much as other cranial nerves in patients with a diagnosis of IIH. The use of cranial MRI may prevent an additional pathology to be missed.

Effect of preoperative hospitalisation period on postoperative cognitive dysfunction in patients undergoing hip surgery under regional anaesthesia.

AIM OF THE STUDY: The main objective of this prospective and observational study was to investigate the effect of the preoperative hospitalisation period on early postoperative cognitive dysfunction (POCD) development in patients undergoing total hip replacement surgery under regional anaesthesia. MATERIALS AND METHODS: Between November 2013 and September 2014, 64 patients were enrolled in the study. Mini Mental Test (MMT) scores were obtained on the initial admission day (MMT1), 24 hours prior to the surgery (MMT2) and 24 hours after the surgery (MMT3). The patients were divided into two groups according to the MMT scores: 'no cognitive dysfunction' (group 1) and 'cognitive dysfunction' (group 2). Differences between the groups were evaluated statistically. The statistical significance level was set as P < .05 in a 95% confidence interval. RESULTS: The POCD incidence rate was calculated as 43.8% in all patients. The preoperative hospitalisation duration was significantly longer in patients with POCD than in patients without POCD (P < .001). The factors that affected POCD development were found to be advanced age (P < .001), high American Society of Anesthesiologists scores (P = .004), the presence of comorbid disease (P = .025), durations of surgery (P = .018) and decreased postoperative haematocrit levels (P = .014). CONCLUSION: In this study, we observed that patients with early POCD had relatively longer preoperative hospitalisation periods than those in patients without POCD. We consider that prolonged preoperative hospitalisation may contribute to increased POCD incidence rates in patients with risk factors.