Güven GÜLEN, Taylan AKKAYA, Derya ÖZKAN, Mehmet KAYDUL, Orhan GÖZAYDIN, Haluk GÜMÜŞ

Comparison of spring-loaded, loss of resistance and hanging drop techniques in lumbar epidural blocks

Amaç: Spring -Loaded enjektör (SL), epidural aralığa girildiğinde diğer geleneksel tekniklere göre daha objektif bulgu veren bir direnç kaybı enjektörüdür. Bu çalışmanın amacı, elektif transüretral rezeksiyon prosedürlerinde epidural blok uygulanan hastalarda SL enjektör, konvansiyonel direnç kaybı (DK) enjektörü ve asılı damla (AD) tekniklerini epidural aralık bulma süresi ve postepidural bel ağrısı sıklığı açısından karşılaştırmaktır. Gereç ve Yöntem: Bu çalışmada elektif transüretral rezeksiyon yapılacak olan 60 hasta yer aldı. Hastalar randomize olarak üç gruba ayrıldı. Epidural blok birinci grupta SL enjektörü ile (n=20), ikinci grupta DK enjektörü ile (n=20), üçüncü grupta AD ile (n=20) uygulandı. Tüm hastalarda epidural aralığı bulma süresi, girişim sayısı, dural ponksiyon sıklığı ve bel ağrısı insidansı operasyon boyunca ve operasyon sonrası 4 hafta boyunca değerlendirildi. Bulgular: Epidural aralığı bulma süresi grup 1’de 29.1±9.16 sn, grup 2’de 45.25±19.58sn; grup 3’de 47.35±11.42sn idi (p0.005). Sonuç: Konvansiyonel DK enjektörü ve AD teknikleriyle karşılaştırıldığında SL enjektörü kullanıldığında epidural aralık bulma süresinin daha kısa olduğu bulunmuştur.

Lomber epidural bloklarda spring-loaded, direnç kaybı ve asılı damla tekniklerinin karşılaştırılması

Objectives: The spring-loaded syringe is a loss of resistance syringe that provide a more objective sign that the epidural space has been entered compared with the traditional techniques. The aim of this study was to compare the time required to locate the epidural space and the backache incidence with the spring-loaded (SL), loss of resistance (LOR) and the hanging drop (HD) techniques for epidural blocks in patients undergoing transurethral resection procedure. Methods: Sixty patients undergoing transurethral resections were enrolled in the study. The patients were randomly assigned to one of three groups. Epidural block was performed in the first group with a spring-loaded syringe (n=20), in the second group with loss-of-resistance syringe (n=20), and in the third group with the hanging drop technique (n=20). The required time to locate the epidural space, the number of attempts, the incidence of dural puncture and the backache incidence were assessed during the procedure and for four weeks after the procedure in all patients. Results: The required time to locate the epidural space was 29.1±9.16 seconds in Group 1; 45.25±19.58 seconds in Group 2, and 47.35±11.42 seconds in Group 3 (p<0.001). In Group 1this was significantly shorter than the other two groups. There was no significant difference in the number of attempts, the incidence of dural puncture and backache incidence between the three groups (p>0.05). Conclusion: The use of SL syringe was found to have a shorter time period to locate the epidural space when compared with the LOR syringe and hanging drop technique.

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