Glossopharyngeal nerve block (GPNB) can provide effective anesthesia for procedures involving the oropharynx and upper airway. Ultrasound-guided GPNB (UGPNB) may be particularly useful when conventional sedation or topical anesthesia is undesirable because of the risk of respiratory or cardiovascular complications. In this article, we report the use of UGPNB as an alternative anesthetic technique for gastroduodenal endoscopy in a 57-year-old male patient with AMI and gastrointestinal bleeding. In this patient requiring emergency endoscopy, UGPNB was performed via the peristyloid approach to provide oropharyngeal anesthesia while minimizing the need for sedation. The block effectively suppressed the gag reflex and provided adequate procedural conditions while maintaining hemodynamic stability. No procedure-related complications or adverse effects were observed, and the patient reported no discomfort following the procedure. In conclusion, UGPNB may be a useful alternative to sedation for endoscopy in high-risk cardiac patients.

Spontaneous cerebrospinal fluid (CSF) leaks are uncommon but significant causes of orthostatic headaches, often resulting from dural injuries. Although lumbar epidural blood patches (EBPs) are commonly used to treat such leaks, cervical EBPs are rarely performed due to the higher risk of complications, including spinal cord injury. This case series presents two patients with spontaneous cervical CSF leaks successfully treated with cervical EBPs under fluoroscopic guidance. The first case involved a 24-year-old female who presented with a two-month history of severe orthostatic headaches and tinnitus and a Visual Analog Scale (VAS) score of 8. After a cervical EBP with 3 mL of autologous blood, her symptoms resolved. The second case describes a 55-year-old male with a history of radiotherapy who presented with a VAS score of 10 and a four-month history of orthostatic headaches. A cervical EBP using a total of 6 mL of blood led to complete symptom resolution. Both cases highlight the efficacy and safety of cervical EBPs when performed with careful imaging guidance and minimal blood volumes. These findings suggest that this approach should be considered in cases of refractory cervical CSF leaks.

Complex regional pain syndrome (CRPS) is a painful condition which may develop after trauma. A 28-year-old male patient with severe hand pain that persisted despite long-term and multidisciplinary treatment was admitted to our clinic. The patient had severe pain and cutaneous findings. His extreme cutaneous findings were diagnosed as dermatosis neglecta (DN) associated with CRPS. To the best of our knowledge, this is the first reported case of DN occurring in association with CRPS. This case report highlights that extreme skin changes may occur in the advanced stages of complex regional pain syndrome, and when this stage is reached, treatment becomes challenging and can be controlled with irreversible treatments such as amputation.

An aging population and longer lifespans have markedly increased the number of shoulder surgeries. Technological advances have made arthroscopic techniques increasingly prominent owing to their minimally invasive nature and lower risk to surrounding structures. Effective postoperative pain management is, therefore, essential and has prompted continued advances in nerve block techniques. Although the interscalene brachial plexus block (ISBPB) is widely regarded as the standard technique for shoulder surgery, phrenic nerve involvement may result in hemidiaphragmatic paresis. The clinical significance of this effect depends largely on the patient's respiratory reserve. The search therefore continues for techniques that optimize postoperative analgesia while preserving respiratory function. In this review, we aim to provide an evidence-based overview to assist anesthesiologists in selecting patient- and procedure-specific regional anesthesia techniques that achieve an appropriate balance between analgesic efficacy and safety.