Amaç: Radyofrekans (RF) aðrý tedavisi için yýllardýr kullanýlmaktadýr. RF’in sinirler üzerindeki etkisi ve etki mekanizmasý halen net olarak ortaya konulmamýþtýr. Bu çalýþmanýn amacý; Pulsed RF (P-RF) ve Devamlý RF (C-RF)’nin oluþturduðu etkiyi ýþýk ve elektron mikroskobisi aracýlýðýyla incelemek ve farklýlýklarýný ortaya koymaktýr.
Gereç ve Yöntem: Bu çalýþmada 60 adet Rattus Norvegicus cinsi rat 6 gruba ayrýlarak kullanýlmýþtýr. Kontrol grubu alýnmamýþtýr. Sham grubunda elektrotlar yerleþtirilmiþ ancak akým uygulanmamýþtýr. P-RF 120 saniye (sn), P-RF 240 sn, C-RF 120 sn, C-RF 240 sn, 42 ˚C’de diðer gruplara uygulanmýþtýr. Siyatik sinir kesitleri alýnmýþ, ýþýk ve elektron mikroskopunda incelenmiþtir.
Bulgular: Sham, P120 ve C120 gruplarý normal sýnýrlarda tespit edilmiþtir. P240 grubunda bir takým morfolojik deðiþiklikler izlense de bütün örnekler incelendiðinde bu durumun ihmal edilebilir olduðu sonucuna varýlmýþtýr. C240 grubunda ise hem miyelinli hem de miyelinsiz sinir liflerinde, ýþýk ve elektron mikroskopunda aðýr deformasyon izlenmiþtir. Schwann hücrelerinde dramatik yapýsal bozukluklar gözlemlenmiþtir.
Sonuç: P120, P240 ve C120 tedavileri siyatik sinirde herhangi bir deformiteye yol açmamýþtýr. C-RF 240 saniye uygulanmasý ise sinir yapýsýnda patolojik deðiþikliklere yol açmaktadýr.

Objectives: Radiofrequency (RF) has been used for many years for pain treatment. The effects of RF on nerves and the underlying mechanism of these effects are not clearly understood. The aim of this study is to show the effects of Pulsed (P-RF) and Continuous (C-RF) RF in light and electron microscopy, and to determine the differences between them.
Methods: In this study, a total of 60 Rattus norvegicus rats were used in 6 groups. No procedure was performed on the control group. In the Sham group, the electrodes were placed but no current was applied. P-RF for 120 seconds, P-RF for 240 seconds, C-RF for 120 seconds, and C-RF for 240 seconds at 42 °C were applied respectively to the other groups. Sections obtained from sciatic nerves were examined with light and electron microscopy.
Results: Examinations of the Sham, P120, and C120 groups were normal. In P240, some morphological changes were observed, but when all samples were examined, these abnormalities were evaluated as negligible. In C240, severe deformation of both myelinated and non-myelinated nerve fibers was observed under an electron and light microscope. Dramatic structural deformities in Schwann cells were observed.
Conclusion: P120, P240, and C120 treatments did not produce any deformities in the sciatic nerve. The application of C-RF for 240 seconds produced pathological alterations in the nerve structure.

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Amaç: Erektör spina plan bloðunun (ESPB), açýk subkostal nefrektomiye giren hastalarda postoperatif morfin tüketimini azaltacaðý hipotezinden yola çýktýk.
Gereç ve Yöntem: Etik kurul onayý ve bilgilendirilmiþ hasta onamý alýndýktan sonra çalýþmamýza; ASA I-II, 18-65 yaþ aralýðýnda, elektif þartlarda anterior subkostal kesi ile nefrektomi operasyonu planlanan 46 hasta dahil edildi. Hastalar kapalý zarf yöntemiyle rastgele ESPB ve Kontrol olmak üzere iki gruba ayrýldý. ESPB grubuna, ameliyathane odasýna alýnmadan önce blok köþesinde T10 seviyesinden 20 ml %0.25 bupivakain ile erektör spina plan bloðu yapýldý. Her iki gruba da intravenöz morfin ile hasta kontrollü analjezi yöntemi uygulandý.
Bulgular: ESPB grubunda intraoperatif remifentanil tüketimi Kontrol grubuna kýyasla istatistiksel olarak belirgin þekilde azdý (1069.5±211.54 µg vs 1471.4±202.21 µg) (p<0.001). Hastalarýn postoperatif morfin tüketimleri de ESPB grubunda azdý (16.8±4.13 mg vs 33.65±6.91 mg) (p<0.001). ESPB grubundaki hastalarýn Numerik Derecelendirme Skalalarý kontrol grubuna kýyasla daha düþüktü (p<0.001). Hastalarýn ek analjezik ihtiyacý ESPB grubunda daha azdý (%35 vs %95, p<0.001). ESPB grubunda hasta memnuniyeti Kontrol grubuna kýyasla daha fazlaydý (p=0.009). Bulantý, ESPB grubunda Kontrol grubuna kýyasla azdý (p=0.007).
Sonuç: Nefrektomi operasyonu geçiren hastalarda preemptif ESPB uygulanmasý güvenli ve faydalý bir analjezik yöntemdir.

Objectives: We began with the hypothesis that the erector spinae plane block (ESPB) would decrease postoperative morphine consumption in patients scheduled for open subcostal nephrectomy.
Methods: After obtaining ethics committee approval and informed patient consent, American Society of Anesthesiologists I-II, 46 patients between the ages of 18 and 65 who were scheduled for elective nephrectomy with an anterior subcostal incision were included in this study. Patients were randomly divided into two groups, the ESPB and the control group, using the sealed envelope technique. In the ESPB group, ESPB was applied with 20 mL of 0.25% bupivacaine at the T10 level at the block corner before being taken to the operating room. Patient-controlled analgesia with intravenous morphine was applied to both the ESPB and the control groups.
Results: Intraoperative remifentanil consumption in the ESPB group was statistically significantly less than in the control group (1069.5±211.54 micrograms versus 1471.4±202.21 micrograms) (p<0.001). Postoperative morphine consumption of the patients was also lower in the ESPB group (16.8±4.13 milligrams versus 33.65±6.91 milligrams) (p<0.001). The numeric rating scales of the patients in the ESPB group were lower than in the control group (p<0.001). The additional analgesic requirements of patients were less in the ESPB group (35% vs 95%, p<0.001). Patient satisfaction was higher in the ESPB group compared to the control group (p=0.009). Nausea was lower in the ESPB group than in the control group (p=0.007).
Conclusion: Preemptive administration of ESPB is a safe and beneficial analgesic method in patients undergoing open subcostal nephrectomy.

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Amaç: Bu çalýþmada, koksikodinili hastalarda uyku kalitesi ile anksiyete, depresyon ve özürlülük arasýndaki iliþkiyi incelemeyi amaçladýk.
Gereç ve Yöntem: Bu prospektif kesitsel çalýþmada, koksikodini tanýsý almýþ 60 hasta deðerlendirildi. Hastalarýn klinik ve demografik özellikleri kayýt altýna alýndý. Görsel Analog Skala (VAS), Oswestry Özürlülük Ýndeksi (ODI), Beck Depresyon Envanteri (BDI), Beck Anksiyete Envanteri (BAI) ve Pittsburgh Uyku Kalitesi Ýndeksi (PSQI) deðerlendirme araçlarý kullanýlarak hastalar deðerlendirildi.
Bulgular: Koksidinili 60 hastanýn 47’sinde (%78.3) depresif semptomlar ve 49’unda (%81.6) anksiyete tespit edildi. Ayrýca, 46 hasta (%76.7) düþük uyku kalitesine sahipti. Uyku kalitesi ile anksiyete ve depresif semptomlar arasýnda istatistiksel olarak anlamlý pozitif bir iliþki bulundu (p<0.001); özürlülük indeksi deðerleri ile ise istatistiksel olarak zayýf pozitif bir korelasyon saptandý.
Sonuç: Koksidinili hastalarda özürlülük arttýkça depresif semptomlar, anksiyete ve düþük uyku kalitesi de artmaktadýr. Koksikodini daha önce nevrotik bozukluklarla iliþkilendirilmiþ olsa da, düþük uyku kalitesine yol açan mekanizmalar net deðildir.

Objectives: In this study, our aim was to investigate the relationship between sleep quality, anxiety, depression, and disability in patients with coccydynia.
Methods: This prospective cross-sectional study evaluated 60 patients diagnosed with coccydynia. Clinical and demographic characteristics of the patients were recorded. Outcome measures included the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI), which were analyzed.
Results: Depressive symptoms and anxiety were detected in 47 (78.3%) and 49 (81.6%) of the 60 patients, respectively. Additionally, 46 (76.7%) patients were identified as poor sleepers. Our results demonstrated a statistically significant positive correlation between the quality of sleep and anxiety and depressive symptoms scores (p<0.001); there was also a statistically weak positive correlation with disability index values.
Conclusion: Depressive symptoms, anxiety, and poor sleep quality are exacerbated by disability in coccydynia. While coccydynia has been previously associated with neurotic disorders, the mechanisms underlying poor sleep quality remain unclear.

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Amaç: Karpal tünel sendromu (KTS), en sýk görülen periferik sinir sýkýþma sendromudur. Bu çalýþma, fonoforez ve düþük seviyeli lazer tedavisinin (LLLT) orta dereceli KTS’nin tedavisinde tendon ve sinir kaydýrma egzersizlerine ek katkýsýný elektrofizyolojik, ultrasonografik ve klinik olarak deðerlendirmeyi amaçlamaktadýr.
Gereç ve Yöntem: Örneklem, orta dereceli KTS’li 45 hastadan oluþmakta ve üç gruba randomize edilmiþtir. Grup 1’e fonoforez ve egzersiz, Grup 2’ye LLLT ve egzersiz, Grup 3’e ise sadece egzersiz uygulandý. Katýlýmcýlar tedavi öncesi ve tedavi sonrasý 6. ve 12. haftalarda elektrofizyolojik, klinik ve ultrasonografik olarak deðerlendirildi.
Bulgular: Tedavi sonrasý 6. ve 12. haftalarda tüm gruplarda klinik parametrelerde (Boston Fonksiyonel Durum Skalasý, Boston Semptom Þiddet Skalasý, istirahat vizüel analog skalasý ve aktivite vizüel analog skalasý) düzelme saptandý (p<0.05). Tedavi sonrasý 12. haftada tüm gruplarda ultrasonografik parametrede (kesit alaný) düzelme saptandý (p=0.017).
Sonuç: Fonoforez ve LLLT, egzersiz tedavisine ek bir etki saðlamamaktadýr. Egzersiz tedavisi, orta derecede KTS’nin tedavisinde ultrasonografik ve klinik sonuçlara olumlu katký saðlayabilir.

Objectives: Carpal Tunnel Syndrome (CTS) is the most common peripheral nerve compression syndrome. This study aims to evaluate the additive contribution of phonophoresis and low-level laser therapy (LLLT) to tendon and nerve gliding exercises electrophysiologically, ultrasonographically, and clinically in the treatment of moderate CTS.
Methods: The sample consisted of 45 patients with moderate CTS, randomized into three groups. Group 1 received phonophoresis and exercise, Group 2 received LLLT and exercise, and Group 3 received exercise alone. Participants were evaluated electrophysiologically, clinically, and ultrasonographically before treatment and at the 6th and 12th weeks after the treatment.
Results: An improvement was observed in clinical parameters (Boston Functional Status Scale, Boston Symptom Severity Scale, visual analog scale at rest, and visual analog scale during activity) for all groups at the 6th and 12th weeks after the treatment (p<0.05). An improvement was also noted in the ultrasonographic parameter (cross-sectional area) for all groups at the 12th week after the treatment (p=0.017).
Conclusion: Phonophoresis and LLLT do not provide additional effects to exercise therapy. Exercise therapy alone may positively contribute to ultrasonographic and clinical outcomes in the treatment of moderate CTS.

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Amaç: Lumbosakral radiküler aðrý (LRA), nöropatik aðrýnýn en sýk sebeplerinden biridir ve genellikle dorsal kök gangliyonu (DRG) veya spinal sinirlerdeki inflamasyon sonucu ortaya çýkar. Kronik LRA durumunda, tüm tedavi yöntemlerine raðmen baþarý oranlarý genellikle yüksek deðildir. DRG’ye uygulanan pulsed radyofrekans (PRF) tedavisi sýkça tercih edilir, ancak etkinliði üzerine çeþitli araþtýrmalar mevcuttur. Çalýþmamýzýn amacý, kliniðimizde yaygýn olarak uyguladýðýmýz PRF tedavisinin 154 hastanýn verileri üzerinden etkinliðini ortaya koymaktýr.
Gereç ve Yöntem: Üç aydan uzun süren LRA’sý olan ve PRF tedavisi uygulanan hastalar incelendi. Tedavinin etkinliðini deðerlendirmek için 1. ay ve 6. ay kontrollerinde nümerik aðrý skorlarý (NRS) deðerlendirildi.
Bulgular: Tedavi öncesine göre 4. hafta ve 6. ay kontrollerinde NRS’ler anlamlý þekilde düþük bulundu (p<0.001). Ancak, 4. hafta ile 6. aydaki ortalama NRS’ler arasýnda fark bulunamadý.
Sonuç: Giriþimsel aðrý yöntemlerinde baþarý, aðrý skorlarýnda en az %50’lik bir düþüþ olarak kabul edilir. Literatürde LRA’da PRF tedavisinin baþarý oranlarý %30 ile %60 arasýnda deðiþmektedir, bu da çalýþmamýzdaki 4. hafta ve 6. aylýk sonuçlarla uyumludur. PRF tedavisi, düþük yan etki profili ve uzun vadede düþük maliyetiyle yaygýn olarak kullanýlmaktadýr. Bununla birlikte, uygulama süresi gibi prosedürel konularda tam olarak standartlaþtýrýlmýþ bir uygulama henüz yoktur ve geniþ katýlýmlý prospektif çalýþmalara ihtiyaç duyulmaktadýr.

Objectives: Lumbosacral radicular pain (LRP) is one of the most common causes of neuropathic pain. This pain often arises from inflammation in the dorsal root ganglia (DRG) or spinal nerves. Despite various treatment modalities, success rates are not very high in chronic LRP cases. Pulsed radiofrequency (PRF) therapy, frequently applied to the DRG, is widely used, but its effectiveness is often questioned in various studies. The primary aim of our study is to evaluate the effectiveness of PRF treatment in 154 patients.
Methods: Patients with LRP for longer than 3 months, treated with PRF, were included in this study. To assess the efficacy of PRF treatment, numerical rating scale (NRS) scores were evaluated at the 4th-week and 6th-month follow-ups.
Results: The NRS scores were significantly lower at the 4th-week and 6th-month follow-ups compared to pre-treatment levels (p<0.001). However, there was no significant difference between the mean NRS scores at the 4th week and 6th month.
Conclusion: Success in interventional pain procedures is often considered as at least a 50% reduction in pain scores. The success rate for PRF treatment for LRP in the literature varies between 30% and 60%, which is similar to our findings at the 4th week and 6th month. PRF treatment is widely used due to its low side-effect profile and cost-effectiveness in the long term. There is no fully standardized practice regarding procedural aspects, such as the duration of the application, and prospective studies with larger participation are needed.

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Amaç: Türk Anesteziyoloji ve Reanimasyon Uzmanlarýnýn trunkal/fasyal plan bloklarýnýn (FPB) çeþitli ameliyatlarda kullanýmýna yaklaþýmlarýný deðerlendirmekti. FPB’lerin perioperatif yönetimini deðerlendirmek için bir anket tasarladýk.
Gereç ve Yöntem: Türkiye’deki çeþitli hastanelerde çalýþan Anesteziyoloji ve Reanimasyon uzmanlarý ve asistanlarýna gönüllü katýlýmlý bir anket uyguladýk. Katýlýmcýlarla 1 Haziran – 10 Eylül 2022 tarihleri arasýnda e-posta ve akýllý telefon mesajlaþma uygulamalarý kullanarak iletiþime geçtik. FPB’lerin perioperatif yönetimi ile ilgili bir anket formu doldurmalarýný istedik.
Bulgular: Ankete 242 anesteziyoloji uzmaný ve asistan yanýt verdi. Katýlýmcýlarýn çoðu (%42.3) 3. basamak (eðitim ve araþtýrma veya üniversite) hastanelerde anestezi uzmaný olarak çalýþmaktaydý. Katýlýmcýlarýn %90’ý bu bloklarý klinik uygulamalarýnda kullanmaktaydý. Öncelikli olarak kullanýlan gövde bloðu erektör spina planý (ESP) bloðuydu (629 yanýt).
Sonuç: Türkiye’deki anestezi ve reanimasyon uzmanlarý FPB’lere oldukça aþinadýr ve bu bloklarý klinik uygulamada sýklýkla kullanmaktadýr. Anestezistlerin öncelikli tercih ettiði bloklarýn ESP ve TAP bloðu olduðu tespit edildi. Ekipman eksikliði, FPB’lerin uygulanmamasýnýn önemli bir nedenidir. Bu bloklar için ek eðitim ve öðretim ihtiyacý vardýr.

Objectives: Our aim was to assess the approach of Turkish Anesthesiology and Reanimation Specialists to the perioperative use of truncal/fascial plane blocks (FPB) in various surgeries. A survey was designed to evaluate the perioperative management of FPBs.
Methods: Anesthesiology and Reanimation specialists and residents in various hospitals in Türkiye were surveyed on a voluntary basis. We contacted them between June 1 and September 10, 2022, using email and smartphone messenger applications. They were asked to complete a questionnaire form regarding the perioperative management of FPBs.
Results: A total of 242 anesthesiology specialists and residents responded to the survey. Most participants (42.3%) were anesthesiology specialists in 3rd level (academic, teaching, or university) hospitals. 90% of the participants use these blocks in their clinical practice. The primarily used FPBs were the erector spinae plane (ESP) (629 responses in all categories).
Conclusion: The anesthesia and reanimation specialists in Türkiye are reasonably familiar with FPBs and use these blocks frequently in clinical practice. The primarily preferred blocks seem to be ESP and TAP blocks. Lack of equipment is a major reason for the non-performance of FPBs. There is still a lack/need for additional education and training for these blocks.

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Amaç: Bu çalýþmanýn amacý, lomber faset eklem sendromu (LFS) olan hastalarda, fizik tedavi kliniklerinde uygulanan TENS (Transkütanöz Elektriksel Sinir Stimülasyonu) ile algoloji kliniklerinde uygulanan konvansiyonel radyofrekans termokoagülasyon (CRF) ve pulse radyofrekans denervasyon (PRF) tedavi yöntemlerinin etkinliklerini karþýlaþtýrmaktýr.
Gereç ve Yöntem: Çalýþmaya, Ege Üniversitesi Týp Fakültesi Hastanesi Fizik Tedavi ve Rehabilitasyon Anabilim Dalý ile Algoloji Bilim Dalý polikliniklerine, en az 3 aydýr devam eden ve medikal tedaviye yanýt vermeyen lomber faset eklem sendromuna baðlý aðrý þikâyeti ile baþvuran hastalar arasýndan seçilenler dahil edildi. Toplam 60 hasta, her bir grupta 20 hasta olacak þekilde üç gruba ayrýldý. Ýlk gruptaki hastalara konvansiyonel RF iþlemi, ikinci gruptakilere 15 gün boyunca günde 30 dakika TENS, üçüncü gruptakilere ise PRF uygulandý. Hastalar baþlangýçta, birinci ve altýncý ay sonunda olmak üzere toplamda üç kez deðerlendirildi.
Bulgular: Her üç tedavi grubunda da, aðrý skorlarý, Oswestry Engellilik Ýndeksleri, el-yer mesafesi ölçümleri, 20 metrelik yürüme süreleri, 6 dakikalýk yürüme mesafeleri, Beck Depresyon Envanteri ve SF-36 skorlarýndaki deðiþimler 1. ve 6. aylarda istatistiksel olarak anlamlý bulundu (p<0.05). Tedavi gruplarý karþýlaþtýrýldýðýnda, herhangi bir deðerlendirme parametresinde bir grubun diðer bir gruba üstünlüðü saptanmadý (p>0.05).
Sonuç: Lomber faset eklem sendromu olan hastalarda, CRF ve PRF gibi daha invaziv prosedürlerden önce non-invaziv bir tedavi yöntemi olan TENS'in kullanýlmasýnýn daha uygun olabileceði sonucuna varýlmýþtýr. Ancak, daha büyük hasta örneklemi içeren ileri çalýþmalara ihtiyaç olduðu belirtilmiþtir.

Objectives: We aimed to compare the effectiveness of TENS, used in physical therapy departments, and continuous radiofrequency thermocoagulation (CRF) and pulsed radiofrequency denervation (PRF), used in algology departments, in patients with lumbar facet syndrome (LFS).
Methods: Subjects were selected from patients with LFS visiting outpatient clinics of physical therapy and algology departments at Ege University School of Medicine, whose pain was refractory to medical treatment for at least 3 months. Subjects were randomized into 3 groups. A total of 60 patients, with 20 in each group, were enrolled. The first group received CRF, the second group received TENS for 30 minutes a day for 15 days, and the third group received PRF. Patients were assessed at baseline, at the end of the first and sixth months, for a total of three times.
Results: Improvements at month 1 and month 6 were found to be statistically significant in all three treatment groups with respect to their pain scores, Oswestry Disability Indexes, hand-floor distance measurements, 20-meter walking times, 6-min walking distances, Beck Depression Inventory, and most of the SF-36 domain scores (p<0.05). A comparison of the treatment groups showed no superiority of any group over the others in any assessment parameters (p>0.05).
Conclusion: We suggest that it might be more appropriate to use TENS, a non-invasive treatment, before trying more invasive procedures like CRF and PRF in these patients. However, it has been stated that further studies involving a larger patient sample are needed.

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Gabapentinoid grubuna ait olan gabapentin ve pregabalin ilaçlarý, aðrý tedavisinde gösterdikleri etkinlikler nedeniyle, özellikle nöropatik aðrý tedavisinde günümüzde yaygýn olarak kullanýlmaktadýr. Gabapentinoid kullanýmýný kýsýtlayan ek hastalýklar ve semptomlar çoðunlukla literatürde net olarak tanýmlanmýþ olmakla birlikte, bu ilaçlarýn emzirme dönemindeki kullanýmýna iliþkin çok az veri bulunmaktadýr. Kliniðimize 33 yaþýnda bir kadýn hasta, sezaryen operasyonu sýrasýnda uygulanan spinal anestezi esnasýnda baþlayan, sol alt ekstremitede nöropatik nitelikte aðrý ve kas gücü kaybý þikayetiyle baþvurmuþtur. Emzirme dönemindeki ve nöropatik aðrýsý devam eden hastamýza uygulanan gabapentin tedavisini, literatür bilgileri eþliðinde sunmayý amaçladýk.

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.

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Spinal anestezi sonrasýnda nadiren dural membranýn delinmesi ve beyin omurilik sývýsý basýncýnýn azalmasý sonucunda endolenfatik hidrops meydana gelebilir. Bu durum, tinnitus ve iþitme kaybý gibi iþitsel komplikasyonlara yol açabilir. Tinnitusa baþ aðrýsý ve iþitme kaybý eþlik edebilir. Bu olgu sunumunda, spinal anestezi altýnda bilateral tüp ligasyonu operasyonu geçiren hastada, intraoperatif erken dönemde ortaya çýkan ve spontan olarak gerileyen izole bilateral tinnitus sunulmuþtur.

Rarely, endolymphatic hydrops may occur after spinal anesthesia due to the perforation of the dural membrane and a decrease in cerebrospinal fluid pressure. Consequently, auditory complications such as tinnitus and hearing loss may arise. Tinnitus can be accompanied by headache and hearing loss. In this case report, isolated bilateral tinnitus, which occurred in the early intraoperative period and spontaneously regressed in a patient who underwent bilateral tubal ligation under spinal anesthesia, is presented.

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Küme baþaðrýsý, hipotalamik disfonksiyon veya uyku döngüleri ile iliþkili nadir görülen þiddetli bir baþaðrýsýdýr. Uluslararasý Baþaðrýsý Bozukluklarý Sýnýflamasý’nda (ICHD-3-2018) primer baþaðrýsý grubunda yer alýr. Bu olgu sunumunda, ortalama yýlda 2–3 küme atak periyodu geçiren, dental implant tedavisinden sonra küme baþaðrýsý ataklar arasý beþ kat daha uzun remisyon gösteren ve kardiyak stent tedavisinden sonra iki yýldan fazla bir süredir atak geçirmeyen 62 yaþýnda bir erkek hastayý sunuyoruz.

Cluster headache is a rare, severe headache associated with hypothalamic dysfunction or sleep cycles. It is classified in the primary headache group in The International Classification of Headache Disorders-3-2018 (ICHD-3-2018). In this case report, we present a 62-year-old male patient whose cluster headache showed a five times longer remission interval after dental implant treatment and ceased for more than two years following cardiac stent therapy.

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Bu olgu raporunda, kulak cerrahisi geçirecek olan hastada ultrason eþliðinde Nervus Auricularis Magnus sinir bloðu deneyimimizi paylaþmak istedik. Sinir bloðu; 71 yaþýnda, sað dýþ kulakta basal hücreli karsinomu bulunan hastaya uygulandý. Hastanýn birçok komorbiditesi vardý (kalpte stent, hipertansiyon gibi). Bu nedenle bölgesel anestezi tercih edildi.

The Greater Auricular Nerve (GAN), a branch of the cervical plexus, is used to provide anesthesia or pain relief in the ear and neck region. This case report details the use of a GAN block in a 71-year-old male patient with basal cell carcinoma on his right auricular helix. Due to multiple comorbidities (myocardial infarction resulting in a cardiac stent, hypertension), regional anesthesia was preferred. We aim to share our experience with the GAN block for ear surgery.

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