Faculty of Medicine

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    Clinical Effectiveness of Single Lumbar Periradicular Infiltration in Patients with Sciatica
    (Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2023-07-15)
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    Kostova, Masha
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    Ristikj-Stomnaroska, Daniela
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    Periradicular therapy (PRT) is a minimally invasive radiological procedurein patients with chronic lumbar pain.The aim of the study is to identify clinical and radiological predictive factors for treatment success after a single PRT treatment in patients with sciatica.The study includes a prospective follow-up of 166 patients treated with PRT. The pain intensity is determined according to the VAS scale and the degree of improvement is presented as excellent (over 75%), good (50-70%), moderate (25-49%), and weak (less than 25%). The follow up of the treated patients was done at 2 weeks, 3 and 6 months. In patients with pain duration up to 3 months, the improvement was excellent in n=32 (58.18%) after 2 weeks, after 3 months n=41 (74.55%) and after 6 months n=41 (74.55%). This stands in contrast to patients with pain over 1 year. The percentage of improvement after 6 months, post-intervention, was highest in patients without nerve root compression (86.25±19.2),and the highest improvement after 6 months was in patients with localization of pain at the L4-L5 level (69.69±29.7), the greatest improvement after six months was in patients with extraforaminal hernia (62.82±34.3), and the lowest in patients with central stenosis (40.21±30.7).Our study results suggest that the shorter a pain duration, low-grade root compression, injection level and type of herniation area predictor the more favourable response patients have to transforaminal epidural steroid injection in patients with sciatica.
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    Analgesia in Kidney Transplant Recipients
    (Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs, 2021-01)
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    Sasho Dohchev
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    Introduction. To our knowledge, currently no consen sus or guidelines exist regarding perioperative and post operative analgesia management in renal transplant re cipients. Methods. We conducted an observational prospective clinical study to evaluate the analgesia management prac tice in kudney transplant recipients. All consecutive pa tients who underwent kidney transplant surgery were enrolled in this observational clinical study. According to current analgesia management practice in our insti tution, patients were divided in two groups: patients who received general anesthesia and epidural analgesia we re group E, and patients who received general anesthesia and i.v. analgesia were group G. The primary outcome measure in this study was VAS score and 24 h analgesia requirements. The second outcome measures were com plications and/or side effects related to analgesia treatment. Results. Group E had lower VAS pain score both at rest and on movement but only in the first 2 h, (VAS at rest E. 3.1±0.3 vs. G. 4.0±0.3, VAS on movement E. 4.2±0.6 vs. G. 4.5±0.3, p<0.05). The pain score by VAS scale did not differ between the groups at 6 h, 12 h and 24 h postoperatively, p=NS. Additionally, a small differ rence was noticed in side effects. Patients in group E had reported more side effects than patients in group G. Conclusion. The study highlighted the variety in clinical practice regarding anesthesiologist preferences for pain management in kidney transplant recipients. This eva luation did not show any difference between anesthetic techniques and clinical results.