Amaç: Total Kalça Artroplastisi (TKA), komorbiditeleri olan hastalarda riskli bir teklif olabilir ve kronik kalça aðrýsý (CKA) için sistemik analjezikler gerektirebilirler. Geleneksel aðrý ilaçlarý tam aðrý rahatlama saðlamayabilir veya kabul edilemez yan etkilere sahip olabilirken, etkili klinik sonuçlar için kalça artiküler sinirlerinin (KAS) puls radyofrekans (PRF) tedavisi önerilmiþtir. Konvansiyonel sistemik analjeziklerdeki baz aðrýsýna kýyasla CKA’da PRF-KAS’ýn etkinliðini belirledik.
Gereç ve Yöntem: Aðustos 2015 ve Aralýk 2021 tarihleri arasýnda, þiddetli komorbidite durumlarý ve þiddetli kronik kalça aðrýsý olan 31 yetiþkin hastaya, tanýsal bir blokajý takiben bir PRF-KAS iþlemi uygulandý. Tüm 31 hasta, femoral ve obturator sinirlerin artiküler dallarýna PRF aldý. Demografik parametreler, nümerik derecelendirme skalasý (NDS), Harris Kalça Skoru (HKS), WOMAC skorlarý, bu skorlarýn baz deðerlerinden deðiþimi ve herhangi bir yan etki tedavi öncesi ve tedaviden sonra 1. gün, 1. hafta, 6. hafta ve 6. ayda kaydedildi.
Bulgular: PRF-KAS uygulanan tüm hastalar, 1. gün, 1. haftanýn sonunda ve 6. haftada, baz deðerlere kýyasla NDS, HKS ve WO-MAC skorlarýnda önemli bir iyileþme bildirdi (p<0.001). Çalýþma süresince prosedür sonrasý herhangi bir yan etki belgelenmedi.
Sonuç: PRF-KAS, kronik aðrý yönetimi için güçlü bir alternatiftir ve iliþkili komorbidite durumlarý göz önünde bulunduruldu-ðunda artroplastiden mahrum býrakýlacak hastalarda fiziksel iþlevselliði ve günlük aktiviteye dönüþü artýrýr.

Objectives: Total Hip Arthroplasty (THA) may be a risky proposition in patients with comorbidities, and they may require systemic analgesics for chronic hip pain (CHP). Since traditional pain medications may not provide complete pain relief or carry prohibitive adverse effects, pulsed radiofrequency (PRF) treatment of the hip articular nerves (HAN) has been proposed for effective clinical outcomes. We determined the efficacy of PRF-HAN in improvement in CHP compared to baseline pain on conventional systemic analgesics.
Methods: Between August 2015 and December 2021, 31 adult patients with severe comorbid conditions and excruciating chronic hip pain were subjected to a PRF-HAN procedure following a diagnostic block. All 31 patients received PRF of the articular branches of the femoral and obturator nerves. Demographic parameters, numerical rating scale (NRS), Harris Hip Score (HHS), WOMAC scores, the change of these scores from baseline, and any adverse effects were recorded before treatment and on day 1, 1st week, 6 weeks, and 6 months after treatment.
Results: All the patients who underwent the PRF-HAN reported a significant improvement in NRS, HHS, and WOMAC scores compared to the baseline values on day 1, at the end of the 1st week, and the 6th week (p<0.001). No adverse events were documented in the study post-procedure until the end of 6 months.
Conclusion: PRF-HAN is a strong alternative for chronic pain management and augments physical functioning and a return to daily activity in patients who would be deprived of arthroplasty considering associated comorbid conditions.

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Amaç: Ýntravenöz opioidler ve lokal anestezik infiltrasyonlarý, geleneksel olarak postoperatif aðrýyý gidermek için kullanýlýr. Rejyonel anestezi alanýndaki geliþmelerle birlikte, artýk postoperatif analjezi için çeþitli yöntemler kullanýlabilmektedir. Bu çalýþmanýn amacý, perkütan nefrolitotomi (PCNL) uygulanan hastalarda hem intraoperatif opioid tüketimini hem de postoperatif analjezik kullanýmýný azaltmada erektör spina düzlem bloðunun (ESPB) etkinliðini araþtýrmaktýr.
Gereç ve Yöntem: PCNL yapýlan toplam 60 hasta, ESPB uygulanan 30 hasta (Grup I) ve kontrol grubundaki 30 hasta (Grup II) olmak üzere iki gruba ayrýldý. Her biri 30 hastadan oluþan iki grup için intraoperatif ve postoperatif opioid kullanýmlarý kaydedildi. Ameliyat sonrasý 1, 3, 6, 12 ve 24. saatlerde elde edilen görsel analog skala (VAS) skorlarý ile hastalarýn aðrý düzeyleri deðerlendirildi ve her iki gruptaki hastalarýn ameliyat sonrasý memnuniyetleri sorgulandý ve birbirleriyle karþýlaþtýrýldý.
Bulgular: Grup I ve Grup II hastalarý arasýnda intraoperatif opioid gereksinimi (p=0,00), postoperatif ilk 24 saatteki analjezik gereksinimi (p=0,00), hasta memnuniyet durumu (p=0,00) ve postoperatif 1, 3, 6 ve 12. saatlerde elde edilen VAS skorlarý açýsýndan anlamlý bir farklýlýk tespit edildi. Postoperatif 24. saatte elde edilen VAS skoru açýsýndan anlamlý bir fark bulunmadý.
Sonuç: ESPB, ultrasonografi (USG) rehberliðinde uygulanabilen, PCNL uygulanan hastalarda belirgin postoperatif analjezi ve memnuniyet saðlayan basit ve kullanýþlý bir tekniktir.

Objectives: Intravenous opioids and local anesthetic infiltrations are traditionally used to relieve postoperative pain. With developments in the field of regional anesthesia, several methods are now available for postoperative analgesia. This study aimed to investigate the efficacy of the erector spinae plane block (ESPB) in reducing both intraoperative opioid consumption and postoperative analgesic use in patients undergoing percutaneous nephrolithotomy (PCNL).
Methods: A total of 60 patients who underwent PCNL were divided into two groups: 30 patients who received ESPB (Group I) and 30 patients in the control group (Group II). Intraoperative and postoperative opioid usage were recorded for both groups. The pain levels of the patients were evaluated using visual analog scale (VAS) scores obtained at 1, 3, 6, 12, and 24 hours postoperatively. Postoperative satisfaction of the patients in both groups was also questioned and compared.
Results: A significant difference was detected between Group I and Group II patients in terms of intraoperative opioid require-ments (p=0.00), analgesic requirements in the first 24 hours postoperatively (p=0.00), patient satisfaction status (p=0.00), and VAS scores obtained at 0, 3, 6, and 12 hours postoperatively. No significant difference was found in VAS scores at the 24th postoperative hour.
Conclusion: ESPB is a simple, convenient technique that can be performed under ultrasound guidance. It provides remarkable postoperative analgesia and satisfaction in patients undergoing PCNL.

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Amaç: Bu çalýþmanýn amacý, akut herpes zoster (HZ) hastalarýnda aðrý tipini (nosiseptif veya nöropatik) ve nöropatik aðrý bile-þenlerini araþtýrmaktýr.
Gereç ve Yöntem: Ocak 2021 ile Ocak 2022 tarihleri arasýnda Deri ve Zührevi Hastalýklar polikliniðine baþvuran akut HZ’li hastalar retrospektif olarak belirlendi. Cinsiyet ve yaþý içeren demografik veriler, döküntü lokalizasyonu, aðrý þiddeti ve nöropatik aðrý bileþenleri kaydedildi. Aðrý þiddeti ve nöropatik aðrý bileþenleri, sýrasýyla Görsel Analog Skala (VAS) ve Douleur Neuropat-hique 4 (DN4) kullanýlarak deðerlendirildi.
Bulgular: Çalýþmaya toplam 58 hasta (33 kadýn, 25 erkek) dahil edildi. DN4 anketine göre, 35 hastada (%60.3) nöropatik aðrý mevcuttu. Kaþýntý, yanma, iðne batmasý ve karýncalanma, diðer nöropatik aðrý belirti ve semptomlarýndan daha fazla deneyimlendi. Nöropatik aðrýsý olan kadýn hasta sayýsý, erkek hastalara göre anlamlý olarak fazla saptandý (p=0.021). Döküntü daðýlýmý veya yaþ ile nöropatik aðrý arasýnda anlamlý farklýlýk saptanmadý (p>0.05). Kaþýntý, genç hastalarda anlamlý olarak daha fazla saptandý (p=0.02).
Sonuç: Nöropatik aðrý, akut HZ’li hastalarýn yarýsýndan fazlasýnda mevcuttu ve kadýnlarda daha yaygýndý. Yaþ, cinsiyet ve dö-küntü daðýlýmý açýsýndan bazý nöropatik aðrý bileþenleri arasýnda farklýlýklar mevcuttu. Bu çalýþmanýn bulgularý, akut HZ’nin yönetimi ve tedavisi için yol gösterici olabilir.

Objectives: The aim of this study was to investigate the pain type (nociceptive or neuropathic) and neuropathic pain components in patients with acute herpes zoster (HZ).
Methods: Patients with acute HZ referred to the outpatient Dermatology and Venereology clinic between January 2021 and January 2022 were retrospectively detected. The demographic data including gender and age, rash localization, pain severity, and neuropathic pain components were recorded. Pain severity and neuropathic pain components were evaluated using a Visual Analog Scale (VAS) and Douleur Neuropathique 4 (DN4), respectively.
Results: The study included a total of 58 patients, comprising 33 females and 25 males. Of these patients, 35 (60.3%) were found to have neuropathic pain. Itching, burning, pins and needles, and tingling were the most frequently reported neuropathic pain signs and symptoms. The proportion of female patients with neuropathic pain was found to be significantly higher than that of male patients (p=0.021). No significant differences were observed in the distribution of pain across different body sites or in the age of patients with neuropathic pain (p>0.05). Itching was significantly more common in younger patients (p=0.02).
Conclusion: In conclusion, the study found that over half of the patients with acute HZ experienced neuropathic pain, and this was more frequently observed in female patients. Analysis of different components of neuropathic pain showed significant differences in age, gender, and site distribution. The findings of this study may have important implications for the manage-ment and treatment of acute HZ.

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Amaç: Bu çalýþmanýn amacý, epidural steroid enjeksiyonunun kadýnlardaki menstrüel siklus üzerine etkisini araþtýrmak ve menstrüel deðiþiklikler yaþayanlarda risk faktörlerini belirlemektir.
Gereç ve Yöntem: Epidural steroid enjeksiyonu yapýlan 18–55 yaþ arasý toplam 78 kadýn retrospektif olarak incelendi. Hastalar telefonla aranarak epidural enjeksiyon sonrasý adet döngülerinde bir deðiþiklik olup olmadýðý soruldu. Demografik ve klinik özellikler, boy ve kilo, eðitim durumu, alkol ve sigara kullanýmý, ek hastalýklar, çocuk sayýsý, doðum kontrol yöntemi, sezaryen/doðum, düþük ve kürtaj öyküsü gibi veriler kaydedildi.
Bulgular: Servikal interlaminar epidural steroid enjeksiyonu yapýlan 12 hastanýn beþinde, lomber transforaminal epidural steroid enjeksiyonu yapýlan 56 hastanýn 27’sinde, lomber interlaminar epidural steroid enjeksiyonu yapýlan iki hastanýn birinde ve kaudal epidural steroid enjeksiyonu yapýlan sekiz hastanýn üçünde adet döngüsünde deðiþiklik görüldü. Obezite olan hasta sayýsý, deðiþiklik gösteren hastalarda, olmayanlara göre daha fazlaydý ve bu istatistiksel olarak anlamlý bir farktý (sýrasýyla %41,7 ve %14,3; p=0,007).
Sonuç: Çalýþmamýz, epidural steroid enjeksiyonlarýnýn adet döngüsündeki deðiþikliklerle iliþkili olduðunu düþündürmektedir. Obezite, epidural steroid enjeksiyonlarýndan sonra adet döngüsü deðiþiklikleri için bir risk faktörüdür.

Objectives: The aim of this study was to investigate the effect of epidural steroid injections on the menstrual cycle of women and to identify risk factors in those with changes.
Methods: A total of 78 women who had epidural steroid injections between the ages of 18 and 55 years were retrospectively analyzed. The patients were called by phone and asked whether there was any change in their menstrual cycles after the epidural injections. Data including demographic and clinical characteristics, body height and weight, education status, alcohol and smoking habits, comorbidities, number of children, birth control method, history of cesarean section, miscarriage, and abortion were recorded.
Results: Changes in the menstrual cycle were seen in five of 12 patients who underwent cervical interlaminar epidural steroid injection, in 27 of 56 patients who underwent lumbar transforaminal epidural steroid injection, in one of two patients who underwent lumbar interlaminar epidural steroid injection, and in three of eight patients who underwent caudal epidural steroid injection. The number of patients with obesity was higher in the patients with changes than those without, indicating a statistically significant difference (41.7% vs. 14.3%, respectively; p=0.007).
Conclusion: Our study suggests that epidural steroid injections are associated with changes in the menstrual cycle. Obesity is a risk factor for menstrual cycle changes after epidural steroid injections.

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Amaç: Bu çalýþmanýn amacý, altta yatan herhangi bir sebep bulunamayan mastalji hastalarýnda fibromiyalji taramasýnýn yapýlmasýnýn önemi ve fibromiyalji tedavisinin mastalji üzerine etkisinin araþtýrýlmasý.
Gereç ve Yöntem: Bu çalýþma, Kasým 2017 ile Kasým 2020 tarihleri arasýnda Kocaeli Üniversitesi Genel Cerrahi Anabilim Dalý Polikliniðine meme aðrýsý ile baþvuran (n=120) hastalar üzerinde yapýlmýþtýr. Bilinen kanser, sistemik romatolojik hastalýk, geçirilmiþ meme ameliyatý ve memesinde 3 cm’den büyük kitle olan hastalar çalýþma dýþý býrakýlmýþtýr. Çalýþmaya dahil edilen (n=30) hasta Fizik Tedavi ve Rehabilitasyon bölümüne yönlendirilmiþtir. Toplam 13 hasta fibromiyalji tanýsý almýþtýr. On iki hasta 3 aylýk selektif serotonin noradrenalin reuptake inhibitörü (Duloksetin) tedavisi almýþtýr. Hastalarýn tedavi öncesi ve sonrasý hayat kaliteleri, Cardiff meme aðrý skorlarý, VAS skorlarý deðerlendirilmiþtir. Kalan 17 hasta mastalji nedeniyle takip edilmiþtir.
Bulgular: Fibromiyalji ve sadece mastalji olan hastalarýn karþýlaþtýrýlmasýnda benzer demografik bulgular saptanmýþtýr. Üç ayýn sonunda, meme aðrýlarý tamamen düzelmiþtir. Duloksetin tedavisi sonrasý hastalarýn VAS, aðrý noktalarý, SF-36 skorlarý ve Cardiff meme skorlarýnda belirgin düzelme gözlenmiþtir.
Sonuç: Sebebi açýklanamayan meme aðrýlarýnda fibromiyalji akýlda tutulmalýdýr. Duloksetin tedavisi, mastalji ve fibromiyalji olan hastalarýn meme aðrýsý ve hayat kalitesinde düzelme saðlamaktadýr.

Objectives: The aim of this study is to examine the effect of fibromyalgia (FM) treatment on mastalgia by performing fibromyalgia screening in patients who applied for mastalgia and whose underlying cause could not be found.
Methods: Patients who applied to Kocaeli University General Surgery Outpatient Clinic between November 2017 and November 2020 with breast pain were included (n=120). Patients without cancer, systemic disease, previous breast surgery, and breast mass larger than 3 cm (n=30) were referred to the Physical Therapy and Rehabilitation Outpatient Clinic. A total of 13 patients (43%) were diagnosed with FMS. Twelve of them were given selective serotonin-noradrenaline reuptake inhibitor (duloxetine) treatment for 3 months. Turkish version of the Short Form – 36 (SF-36) quality of life scores, Visual Analog Scale (VAS), Cardiff breast pain score before and after treatment were compared. The remaining 17 patients were followed as only mastalgia.
Results: Patients with fibromyalgia and mastalgia had similar demographic results. At the end of the 3rd month, the complaints of breast pain completely regressed in all of the patients. Statistically significant changes were detected in VAS score, the number of trigger points, and SF-36 quality of life scores, Cardiff breast pain score after duloxetine treatment.
Conclusion: In the presence of unexplained mastalgia, fibromyalgia should be kept in mind. Duloxetine treatment improved the breast pain and quality of life in patients with mastalgia and fibromyalgia.

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Kalça osteoartriti (OA) sýklýðý toplumda yaklaþýk %10 olup, genellikle yaþlý hastalarda özürlülüðe ve sosyal kýsýtlýlýða neden olmaktadýr. Eklem içi enjeksiyonlar, kalça eklemi için en sýk uygulanan giriþimsel tedaviler arasýndadýr. Ayrýca, femoral ve obturator sinirin duyusal dallarýnýn bloklarý, hem taný hem de tedavi amaçlý etkili olduðu bildirilmiþtir. Kalça eklemi ve duyusal dallar için tek iðne giriþi ile iþlem planlandý. Femoral sinirin duyusal dalý için iðne, anterior inferior iliak spine’nýn altýna doðru, kalça ekleminin anterolateral kenarýna yakýn, yaklaþýk 45 derecelik bir açýyla ilerletildi ve kemik temasý saðlandý. Sonrasýnda, obturator sinirin duyusal dalý için iðne, pubis ve iskium bileþkesinin altýndaki alana doðru yaklaþýk 45 derecelik bir açýyla ilerletildi, kemik temasý saðlandý ve blok uygulandý. Son olarak, iðne femur baþ-boyun bileþkesinin orta noktasýna doðru daha dik bir açýyla ilerletildi ve kontrast madde sonrasý eklem içi enjeksiyon yapýldý. Kalça osteoartritli 3 hastaya bu yöntem ile iþlem yapýldý ve 3 aylýk takipte iyilik saðlandý. Kalça eklemi ve periferik duyu dallarýnýn tek iðne giriþi ile bloke edilmesinin hýzlý ve etkili bir yöntem olduðunu düþünüyoruz. Ancak, yöntemin etkinliðini ve güvenliðini belirlemek için prospektif kontrollü çalýþmalara ihtiyaç vardýr.

Hip osteoarthritis (OA) is found in approximately 10% of the population and often causes disability and social limitations in elderly patients. Intra-articular injections are among the most frequently applied interventional treatments for the hip joint. Femoral and obturator sensorial nerve blocks have also been reported to be effective for both diagnostic and therapeutic purposes. A single needle insertion was performed for the blockage of the hip joint and sensory branches. For the sensory branch of the femoral nerve, the needle is advanced at nearly a 45-degree angle toward below the anterior inferior iliac spine near the anterolateral edge of the hip joint. For the sensory branch of the obturator nerve, the needle is advanced at nearly an angle of 45 degrees toward the area below the junction of the pubis and ischium. Finally, for joint injection, the same needle was advanced toward the midline of the anterior femoral head–neck junction at a steeper angle, and blocks were applied. Three patients with hip osteoarthritis were injected with this method and well-being was achieved in a 3-month follow-up. We think that blockage of the hip joint and peripheral sensory branches with a single needle insertion is a fast and effective method. However, prospective controlled studies are needed to determine the efficacy and safety of the method.

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Kronik karýn duvarý aðrýsýnýn palyasyonu için ultrasonografi kýlavuzluðunda yapýlan TAP blok sonrasýnda geliþen ve koil embolizasyonu ile baþarýlý þekilde durdurulan karýn duvarý hematomu ile ilgili deneyimimizin paylaþýlmasý amaçlandý.

We aimed to share our experience with an abdominal wall hematoma that developed after an ultrasonography-guided TAP block performed for the palliation of chronic abdominal wall pain. Bleeding was successfully stopped with coil embolization.

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Anterior kutanöz sinir sýkýþma sendromu (ACNES), özgül bir anterior karýn duvarý bölgesinde, orta ila þiddetli kronik aðrý, hiperestezi/hipoestezi ve ýsý/soðuk algýsýnda deðiþikliðe sebep olan, bir veya daha fazla interkostal sinirin ön dallarýnýn innerve ettiði bölgeye atfedilebilen bir durumdur. Þu anda mevcut olan tedavi seçeneklerinden hiçbiri uzun vadede veya kesin olarak etkili olmamýþtýr. Son yýllarda, bu gibi saf duyusal nöropatileri, kablosuz periferal sinir stimülatörleri (PNS) implantasyonu ile tedavi etmeye baþladýk, modüler ve kiþiselleþtirilmiþ analjezi güvenliðine ulaþtýk. Ýki yýldýr 8. interkostal sinirin ACNES’inden muzdarip 41 yaþýnda bir erkek hastanýn vakasýný rapor ediyoruz. Ýlk olarak, 8. interkostal sað sinirin anterior kutanöz dalýnýn iki ardýþýk ultrason kýlavuzluðunda tanýsal bloklarýný gerçekleþtirdik ve ardýndan hastayý ultrason kýlavuzluðunda sinir dekompresyonunu takiben nöromodülasyon ve darbeli-radyofrekans (PRF) uygulamasý için seçtik. Tam istihdam, genç yaþ ve tedavinin birkaç kez tekrarlanmasý gerekliliðini göz önünde bulundurarak, onu ultrason kýlavuzluðunda Periferal Sinir Stimülasyonu (PNS) implantasyonu için deðerlendirdik ve kablosuz elektrodu sað 8. interkostal sinirin anterior dalýna yerleþtirdik ve tonik stimülasyonu 100 Hz PW 200 ms olarak programladýk. Hasta, hemen aðrýda rahatlama bildirdi ve bu sorun için bir daha asla ilaç almadý, iki yýllýk takipte. PNS, özellikle ACNES gibi sadece duyarlý nöropatilerde kronik nöropatik aðrýnýn yönetiminde giderek artan bir rol oynamýþtýr. Bu tema üzerine gelecek araþtýrmalarý destekliyoruz.

Anterior cutaneous nerve entrapment syndrome (ACNES) is a cause of moderate to severe chronic pain, hyperesthesia/hypoesthesia, and altered perception of heat/cold in a specific region of the anterior abdominal wall, referable to the territory of innervation of one or more anterior branches of the intercostal nerves. None of the therapeutic options currently available has proved to be effective in the long term or decisive. In recent years, we have begun to treat purely sensory neuropathies, such as this, with the implantation of wireless peripheral nerve stimulators (PNS), achieving the safety of modular and personalized analgesia. We report the case of a 41-year-old man suffering from ACNES of the 8th intercostal nerve for two years. We first performed two consecutive ultrasound-guided diagnostic blocks of the anterior cutaneous branch of the 8th intercostal right nerve and then elected the patient for ultrasound-guided nerve decompression followed by neuromodulation and pulsed-radiofrequency (PRF). Taking into account full employment, young age, and the likelihood of having to repeat the treatment several times, we considered him for Peripheral Nerve Stimulation (PNS) implantation under ultrasound guidance, and we implanted the wireless lead at the anterior branch of the right 8th intercostal nerve, and programmed tonic stimulation 100 Hz PW 200 ms. The patient reported immediate pain relief and never took medication for this problem again, at two years follow-up. PNS has had an increasing role in the management of chronic neuropathic pain, especially in merely sensitive neuropathies like ACNES. We support future research on this theme.

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Mandibular sinir bloðu sonrasý görülebilecek nadir yan etkilerden biri ve en dramatik sonuçlara sahip olan komplikasyon, oküler komplikasyonlardýr. Mandibular sinir bloðu genellikle diþ hekimleri tarafýndan uygulandýðýndan, bu komplikasyon çoðunlukla intraoral mandibular sinir bloðu sonrasýnda görülmektedir. Mandibular sinir, trigeminal sinirin üçüncü bölümüdür ve Gasser ganglionunun en kaudal ve lateraldeki kýsmýdýr. Foramen ovale aracýlýðýyla orta kranial fossadan çýkar. Bu bölgede, koronoid çýkýntýdan geçerek yapýlan bir blok yöntemi tanýmlanmýþtýr. Genellikle anatomik belirteçler kullanýlarak yapýlan bu blok, trigeminal nevralji tedavisinde kullanýlmaktadýr. 42 yaþýndaki kadýn hasta, trigeminal nevralji tanýsý ile maksiller ve mandibular blok için kliniðimize kabul edilmiþtir. Lokal anestezik uygulamasýnýn hemen ardýndan hasta, tamamen görme kaybý yaþadýðýný belirtmiþtir. Görme kaybý þikayeti yaklaþýk 1 dakika sürdükten sonra, hastanýn diplopi þikayeti 2 saat 10 dakika devam etmiþtir. Bu vaka raporu, beklenmedik bir yan etki olarak ekstraoral teknikle uygulanan mandibular blok sonrasýnda or-taya çýkan oküler komplikasyonlarý sunmaktadýr.

Ocular complications are one of the rare side effects that can be seen after a mandibular nerve block and have the most dramatic results. Since the mandibular nerve block is mostly performed by dentists, this complication is mostly seen after an intraoral mandibular nerve block. The mandibular nerve is the third division of the trigeminal nerve. It is the most caudal and lateral part of Gasser’s ganglion. It arises from the middle cranial fossa through the foramen ovale. In this region, a block method, which is performed by passing through the coronoid process, has been defined. This block, usually made using anatomical markers, is used in the treatment of trigeminal neuralgia. A 42-year-old female patient was admitted to our department for a maxillary and mandibular block with a diagnosis of trigeminal neuralgia. Immediately after the administration of the local anesthetic, the patient described a complete loss of vision. The complaint of vision loss lasted for about 1 minute, after which the patient’s complaint of diplopia continued for 2 hours and 10 minutes. This case report presents the ocular complications after a mandibular block applied with the extraoral technique as an unexpected side effect.

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