With the increase in ultrasound use, regional anesthesia practices have gained popularity and many novel techniques are being described. However, the rapidly increasing number of new block techniques also led to confusion. Therefore, seven basic regional anesthesia techniques that are effective in most of the surgeries have been listed as “Plan A Blocks.” The purpose of this review is to introduce the basic sono-anatomy and indications of Plan A blocks.

Objectives: In recent years, with the development of technology, screen exposure among university students has increased and caused various physical and psychological effects. The aim of this study is to investigate the relationship between screen exposure and neck disability, headache, stress, depression, anxiety, and sleep disorders in university students.
Methods: Two hundred and twenty-six students were evaluated online in this study. Study outcomes were headache, depression, anxiety, stress, neck disability, and sleep quality.
Results: When the screen exposure was examined, it was observed that the stress, anxiety, and depression levels of the students increased as the smartphone use increased (p<0.05). Headache severity (p=0.028) in those who use smartphones for 7 h or more; It was observed that the frequency of severe neck disability increased in those who used a smartphone or computer for 7 h or more (p=0.005, p=0.026).
Conclusion: To prevent physical and psychological problems that may arise due to the increase in screen use time in university students, it is necessary to monitor the frequency of screen use of the students, to organize trainings that explain the physical and psychological effects of long-term screen exposure and increase the level of awareness.

Objectives: Multifidus has an important role in spinal stability, and multifidus degeneration causes long-term disability and low back pain. This study aimed to investigate the effect of multifidus cross-sectional area on transforaminal epidural steroid injections (TFESI).
Methods: Patients with single-level disc herniation were included in the study. Total multifidus cross-sectional area (TM-CSA) and functional cross-sectional area (FM-CSA) were measured from axial T2 MRI of the patients, and FM-CSA/TM-CSA ratio was calculated for determination of muscle degeneration or fat infiltration. Numerical Rating Scale (NRS) scores at the pre-injection, 3rd week, and 3rd month visits were recorded. A decrease of 50% or more in the NRS score in the 3rd month was accepted as a treatment success (TS), and patients were divided into TS and treatment failure groups.
Results: A total of 120 patients were included in the study; 57 of the patients were female, and 63 of them were male. Of the patients included in the study, 68 had herniation at the L5-S1 disc level and 52 had herniation at the L4-L5 disc level. FM-CSA and FM-CSA/TM-CSA ratio were found to be significantly lower below the disc herniation level on the affected side (p<0.05). The affected side TM-CSA and FM-CSA were higher in the TS group and TM-CSA/FM-CSA ratios were equal in both groups.
Conclusion: Multifidus CSA was found to be lower on the affected side. However, the effect of multifidus CSA on the success of TFESI has not been determined.

Objectives: This study aimed to determine the physical activity (PA) level of individuals with migraine and examine its effects on pain intensity (PI), disability, and quality of life (QoL).
Methods: Individuals diagnosed with migraine between the ages of 18 and 55 were included in the study. PA levels are assessed by the International PA Questionnaire Short Form (IPAQ-SF), PI with the McGill Melzack Pain Questionnaire, disability with the Migraine Disability Assessment Scale (MIDAS), and QoL with the World Health Organization QoL Scale Short Form (WHOQOL-BREF).
Results: A total of 88 individuals, with a mean age of 34.11±10.51 years, were included in the study; 53.41% were low active (LA), 30.68% were moderate active (MA), and 15.91% were high active (HA). The physical health of LAs (p=0.047) was lower than that of MAs. General (p<0.001), physical (p<0.001), and psychological (p=0.003) health scores were lower than HAs. LAs had a higher disability (p=0.042) and PI (p=0.001) than HAs. There was a weak negative correlation between PA and PI (p=0.001) and disability (p=0.005), and a weak positive correlation between PA levels and social (p=0.007) and environmental (p=0.013) scores, and moderate positive correlations with physical (p=0.000), general (p=0.000), and psychological (p=0.000) scores.
Conclusion: It was observed that as PA levels increased, PI decreased, and functionality and QoL increased in patients with migraine. Ensuring exercise continuity seems to be effective for improving the negative effects of migraine.

Objectives: The aim of this study was to evaluate the efficacy of consecutive facet medial branch (FMB) radiofrequency denervation (RFD) and dorsal root ganglion pulse radiofrequency (DRG PRF) therapy in patients with chronic lumbar facet joint pain.
Methods: The study included 27 patients with chronic lumbar pain who had ≥50% pain reduction after FMB block for suspected lumbar facet syndrome and subsequently underwent FMB RFD together with PRF to the adjacent DRG. The patients were retrospectively analyzed in terms of age, gender, pre-procedure symptom duration, history of previous back surgery, FMB RFD and DRG PRF level and side, and numerical rating scale scores immediately before and at 1, 3, and 6 months after the procedure, and subjective pain reduction at 6 months post-treatment. Treatment success was defined as ≥50% subjective pain reduction at 6 months.
Results: A total of 19 women and 8 men with a mean age of 57.7±12.4 years were analyzed. Twenty patients (74.1%) had no prior history of low back surgery. The success rate of the procedure in terms of subjective pain reduction at 6 months was 82.5% (n=25). The subjective percentage of pain reduction at post-procedure 6 months was significantly lower in patients with a pre-procedure symptom duration of 12 months or longer compared to those whose pre-procedure symptom duration was <12 months (p=0.04).
Conclusion: Our study results show that the analgesic efficiency of DRG PRF added to FMD RFD treatment can be increased in patients with short symptom durations.

Objectives: To reduce the drug side effects and facilitate the emergence from anesthesia after complex spine surgery, various methods have been proposed. One of these methods is ESPB, which has been less studied. Hence, we conducted this study to evaluate the effectiveness of ESPB on the use of anesthetic drugs in lumbar spine surgery.
Methods: In this study, 70 patients undergoing lumbar spine fusion surgery were studied. Patients were randomly divided into two groups: the case group (n=35), in which bilateral ESPB was done, and the control group (n=35). After standard anesthesia protocols, anesthesia was maintained with isoflurane in both groups. Intraoperative isoflurane and perioperative opioid consumption were recorded. Statistical analysis was performed using SPSS software version 21.
Results: Intraoperative use of fentanyl in the case group was significantly lower than the control group (14.29±21.5 vs. 65.96±73.33 µg, p<0.001). Furthermore, isoflurane consumption in the intervention group compared to the controls was significantly lower (20.71±5.02 versus 28.83±8.68 mL, p<0.001). Moreover, the emergence time was significantly shorter in the case group than in the control group (8.49±4.30 minutes versus 15.00±4.94, p<0.001). In the post-anesthesia care unit 1 h after surgery, the pain scores in the case group were significantly lower than the controls (p<0.001).
Conclusion: ESPB under ultrasound guidance is an effective method of regional anesthesia/analgesia for lumbar spine surgery (fusion) by decreasing the consumption of anesthetics during and following the surgery.

Objectives: Pregabalin (PGB) is used in drug-resistant epilepsy. Also, it has analgesic effects in painful syndromes. Depression and anxiety are commonly seen in epilepsy and neuropathic pain patients. PGB is often combined with anxiolytics and antidepressants. We aimed to investigate the antidepressant and anxiolytic effects of PGB and compare its effects with those of antidepressant and anxiolytic drugs and their combined use.
Methods: Wistar Albino rats were used, and PGB (5, 10, 20, and 40 mg/kg), amitriptylin (AMT), fluoxetine (FLX), ketamine (KET), and diazepam (DZM), as well as combinations of PGB (20 mg/kg) with AMT, FLX, KET, and DZM, were administered. Elevated plus maze, forced swimming, and locomotor activity tests were performed.
Results: In the elevated plus maze, PGB10, 20, 40, AMT, FLX, and DZM increased open arm time. The PGB20+FLX combination increased compared to PGB20. In forced swimming, PGB doses increased immobility time. AMT, FLX, DZM, and KET decreased compared to control and PGB doses. Other combinations of PGB20 reversed immobility time, except FLX. In locomotor activity, PGB20, AMT, KET, and DZM decreased distance.
Conclusion: PGB had a depressant effect in all doses and a dose-dependently anxiolytic effect. In combinations of PGB with AMT, KET, and DZM, it reversed their antidepressant effects. We assumed FLX could be preferred instead of AMT in patients using PGB. When PGB is used in combination, drug interactions should be considered. These results are also very remarkable in terms of pharmacoeconomics.

Objectives: The aim is to determine the pain beliefs and related factors of cancer patients.
Methods: The study was designed as a descriptive and analytical type. It was completed between January and June 2019 with 100 individuals who were 18 years of age or older, who were receiving chemotherapy, and who agreed to participate in the study. Data were collected using a patient information form, a pain assessment form, and the Pain Beliefs Scale.
Results: In the results of the regression analysis, the psychological belief scores of those who acted nervously were statistically 0.408 points higher than those who acted calmly. Organic beliefs scores were statistically 0.814 points and 0.599 points higher in basically literate and primary school graduates, respectively, compared to university graduates. They were 0.372 points higher for those whose income was less than their expenditure compared to those whose income was balanced with their expenditure, 0.414 points higher in those who had experienced pain in the last 6 months compared to those who had not, and 0.561 points higher in those who did not use non-pharmacological methods in pain control compared to those who did. Those who expressed pain verbally were found to have points that were 0.447 higher than those who did not say they had pain.
Conclusion: Based on the results obtained, it is recommended that cancer patients be given training that will improve self-management and self-efficacy with cognitive-behavioral methods, taking into account their pain beliefs and affecting factors, in order for them to be successful in pain management.

Objectives: This study aims to compare the effectiveness of the Transversus Abdominis Plane (TAP) block applied to reduce postoperative pain in laparoscopic cholecystectomy surgery by ultrasonography (USG) and laparoscopy.
Methods: A total of 170 patients who underwent laparoscopic cholecystectomy were divided into three groups. Group L received TAP block by laparoscopy, Group U received TAP block by USG, and the control group (Group C) did not receive TAP block. Bilateral subcostal 15 mL 0.5% bupivacaine was used for the TAP block. We recorded patients’ demographic data and hemodynamic parameters, surgery time, anesthesia time, time of first postoperative analgesic need, visual analog scale (VAS) scores, time to first flatulence and stool, degree of nausea-vomiting, and the Turkish Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-T) scores.
Results: We observed no statistically significant differences between the groups in terms of age, gender, or American Society of Anesthesiologists scores, and body mass index was higher in Group U compared to the other groups (p<0.05). The VAS score was significantly higher in the control group at all times compared to the other two groups (p<0.001). VAS measurements were higher in Group U at postoperative 1st and 12th h compared to Group L (p<0.001). Surgery time and anesthesia time were significantly different between the groups (p=0.001). Group C showed high VAS scores, high pain severity by APS-POQ-R-T at the 24th postoperative hour, and low sleep quality and patient satisfaction.
Conclusion: For laparoscopic cholecystectomy surgery, applying TAP block with the help of USG is effective in postoperative pain management. Applying TAP block with laparoscopy is easy since it does not require additional preparation or equipment during the procedure and may be preferred in the absence of a USG device.

Red ear syndrome (RES) is a rare condition of unknown etiology characterized by episodic attacks of unilateral ear pain, redness, and burning sensation. A 31-year-old male patient was admitted to our clinic with a severe headache reaching up to 5 h, presenting with short bursts of electric shock-like sensation, burning, and tingling in the left side of his face. The patient was unresponsive to previous medical treatments. Lidocaine 10% through the intranasal route for sphenopalatine ganglion and stellate ganglion blockade under the guidance of fluoroscopy also failed. Given that the Red-Ear syndrome shares similar pathophysiological pathways with trigeminal autonomic cephalalgias, the patient was treated with high-dose intravenous methylprednisolone, and since then, he has been symptom-free for 6 months. High-dose steroid therapy might be a good alternative in late-onset RES as a transition treatment.

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.

Post-herpetic neuralgia (PHN) is the most common chronic complication of herpes zoster and the most common pain syndrome associated with infections. There are medical and interventional treatment options in PHN, and some patients may be resistant to the preferred medical treatments. This situation negatively affects the quality of life of the patient. Interventional treatments come to the fore, especially in patients in whom medical treatments are not sufficient, and systemic side effects such as hepatotoxicity and nephrotoxicity occur. Erector spinal plane block (ESPB) is a recently described ultrasound-guided regional anesthesia technique. It is especially used to prevent post-operative pain due to trunk surgeries. In this study, ESPB was administered with methylprednisolone and bupivacaine in five patients who developed PHN after thoracic herpes zoster and did not have an expected response to three-month medical treatments. Pain severity was assessed using the Numerical Pain Rating Scale. We want to emphasize that ESPB, which is applied with steroids and anesthetics, is a speedy and longacting treatment option that increases the quality of life of the patient, has low side effects, and is a cost-effective treatment option.