Yavuz GÜRKAN, ALPARSLAN KUŞ, CAN AKSU, Mine SOLAK, Kamil TOKER, Çiğdem OHTAROĞLU

Değişen akımlar ve Türkiye'de rejyonal anestezi uygulamaları

Amaç: Ultrasonografinin rejyonal anestezi (RA) pratiğine girmesi RA de önemli gelişme ve değişimlere neden olmuştur. Bu gelişmeler RA uygulama yöntemleri ve blok seçimlerini de etkilemiştir. Bu çalışmanın amacı ülkemizde RA da kullanılan araç ve uygulamalar hakkında bilgi sahibi olmaktır. Gereç ve Yöntem: 2011 senesi Ulusal RA Kongresi sırasında kongre katılımcılarına 10 sorudan oluşan bir anket formu dağıtıldı. Demografik verilerin yanı sıra RA tekniklerinden hangilerini uyguladıkları ve periferik sinir bloğu uygulamalarında sinir lokalizasyonu için kullandıkları yöntemler soruldu. Katılımcılara RA konusunda aldıkları eğitimlerini yeterli görüp gör- medikleri ve bir RA kursuna katılıp katılmadıklarını soruldu. Bulgular: Formlar 95 kişi tarafından dolduruldu. En sık uygulama spinal anestezi idi. Periferik sinir blokları RA uygulama- larının sadece %12sini kapsamaktaydı. En sık uygulanan periferik sinir bloğu ise aksiller bloktu. En yaygın kullanılan sinir lokalizasyon yöntemi öncelikle nörostimülasyon ve takiben ultrasonografi idi. Katılımcıların %58inin aldıkları RA eğitimi yeterli bulmadıkları, %50sinin mesleki gelişim amacıyla bir kursa katıldığı tespit edildi. Sonuç: Sinir lokalizasyonunda en sık nörostimulasyon kullanıldığı ancak ultrasonografinin de hızla yaygınlaştığı gözlenmiş- tir. En sık uygulama nöroaksiyal bloklardır. RA eğitimin hala geliştirilmesi kanaatindeyiz.

Changing trends and regional anesthesia practices in Turkey

Objectives: Introduction of ultrasound into regional anesthesia (RA) practice has resulted in important changes and developments in RA. These developments have had a major influence on the way of practice and choice of blocks. The purpose of this study was to present the most recent instruments used in RA and clinical applications in our country. Methods: A questionnaire consisting of 10 questions were distributed to the participants of the National RA Congress in 2011. Be- sides demographic data, RA techniques used and the method of nerve location was questioned. Participants were asked whether they were satisfied with their training in RA and i f they participated in a RA course. Results: A total of 95 participants filled out the forms. Spinal anesthesia was the most commonl y performed technique. Peripheral nerve blocks constitute onl y 12% of RA practice. Axillary block was the most commonl y performed peripheral nerve block technique. The most commonl y used nerve localization methods were nerve stimulation and ultrasound. The majority of the participants (58%) were not satisfied with their RA training and hal f (50%) participated in a course for continuing medical education. Conclusion: Nerve stimulation is the most performed method, whereas US is increasingly becoming popular. The most commonly performed blocks are central neuroaxial blocks. All in all, there is still room for improvement in RA training.

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