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    Anesthetic techniques: focus on lumbar erector spinae plane block
    (Dove Medical Press LTD, 2020) Tulgar, Serkan; Aydın, Muhammed Enes; Ahıskalıoğlu, Ali; De Cassai, Alessandro; Gürkan, Yavuz
    Defined in the last decade, erector spinae plane block (ESPB) is one of the more frequently used interfacial plans, and it has been the most discussed block among the recently defined techniques. Lumbar ESPB administered at lumbar levels is relatively novel and is a new horizon for regional anesthesia and pain practice. In this article, we aim to explain and introduce different approaches and explain the possible mechanism of action of lumbar ESPB. The objective of this review is to analyze the case reports, clinical and cadaveric studies about lumbar ESPB that have been published to date. We performed a search in Pubmed and Google Scholar database. After a selection of the relevant studies, 59 articles were found eligible and were included in this review. While we believe that lumbar ESPB is reliable and easy, we suggest that its efficacy and indications should be verified with anatomical and clinical studies, and its safety should be confirmed with pharmacokinetic studies. Moreover, the possibility of complications must be considered.
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    Interfascial plane blocks as shortcut alternatives for regional anesthesia and pain management for SARS-CoV-2 days: Not deeper, not longer. Be safe for everyone
    (Elsevier, 2020) Tulgar, Serkan; Ahıskalıoğlu, Ali; Thomas, David Terence; Gürkan, Yavuz
    Dear editor, SARS-CoV-2 (COVID-19) has been a problem for the whole world since the beginning of 2020, and the war against this virus should be the top priority of all healthcare professionals. Elective surgical procedures have been delayed or significantly reduced. Many issues that were our first priority before the pandemic have now been pushed into the background. The anesthesiology community has been testing new methods for opioid sparing anesthesia and analgesia for years and setting in these methods as a principle in the protocols we chose; we cannot currently, due to the Covid-19 pandemic condemn patients to opioids [[1], [2], [3]]. In this article, we want to emphasise the main target as perioperative analgesia and chronic pain management, and we describe what we believe is the right way forward for achieving this goal. In recent years, metanalyses have been published showing that the use of interfacial blocks as part of multimodal analgesia reduces postoperative opioid requirement in surgical patients [4]. We have some suggestions in the analgesia plan of patients that are suspect of having or have been diagnosed with COVID-19.
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    Quadrant and dermatomal analysis of sensorial block in ultrasound- guided erector spinae plane block
    (AVES, 2022) Selvi, Onur; Tulgar, Serkan; Şerifsoy, Talat Ercan; Lance, Robert; Thomas, David Terence; Gürkan, Yavuz
    Objective: As a novel procedure now gaining popularity, erector spinae plane block has been the subject of many studies. However, dermatomal coverage of the sensory block caused by erector spinae plane block has been rarely studied. The goal of this study is to evaluate the sensory block resulting from erector spinae plane block applied at the T9 vertebral level. Materials and Methods: This observational, prospective, blinded study was conducted on 50 adult patients undergoing laparoscopic abdominal surgery. All patients underwent bilateral erector spinae plane block at the T9 level after completion of the surgery while under general anesthesia. In order to further evaluate the sensory blockade, we divided the hemiabdomen–hemithorax region into 4 quadrants: dorsal-medial, dorsal- laterel, ventral-lateral, and ventral-medial. The sensorial evaluation was performed using the pinprick test, 2 hours following the application of erector spinae plane block. Results: A total of 28 female and 22 male patients were examined in this study. Complete failure of the block was recorded in 7 patients, with no thoracic/lumbar segmental or quadrant involvement. Successful sensory block was achieved in 67% of the dorsolateral quadrants, 58% of the dorsomedial quadrants, 69% of the ventrolateral quadrants, and 55% of the ventromedial quadrants. Conclusion: Cutaneous sensory block of erector spinae plane block at T9 vertebral level revealed variable results and low failure rates. Administration of erector spinae plane block for postoperative analgesia in thoracoab- dominal surgeries requires further randomized controlled trials to confirm its effectiveness and convenience.