Muhammed Murat KURNAZ, Ayşın ERSOY, Zekeriya ERVATAN, Nurdan ÜNLÜ, Aysel ALTAN

Diz artroskopilerinde tek taraflı spinal anestezi ve kombine siyatik-femoral sinir bloğunun hemodinami, ameliyat sonrası analjezi ve derlenme özellikleri açısından karşılaştırılmas

Amaç: Bu randomize, kontrollü, tek kör çalışmada; diz artroskopilerinde levobupivakain ile yapılan kombine siyatik-femoral sinir bloğu; etkinlik, derlenme özellikleri, hasta ve cerrah memnuniyeti ile erken dönem ameliyat sonrası ağrı üzerine etkileri açısından tek taraflı spinal anestezi ile karşılaştırılmıştır. Gereç ve Yöntem: Çalışmaya alınan olgular iki gruba ayrıldı. Grup I deki olgulara (n=20)toplam %0.5lik 40 cc levobupiva- kain ile kombine siyatik-femoral sinir bloğu uygulandı. Grup II deki olgulara (n=20) lateral dekübit pozisyonda 7.5 mg levo- bupivakain ile tek taraflı spinal anestezi (ULSA) uygulandı. Olgular anestezi düzeyi T12 olana kadar (maksimum 10 dk.) bu pozisyonda bekletildi. Cerrahi anestezi düzeyine ulaşmak için geçen zaman, iki taraflı duyusal ve motor blok düzeyleri kayde- dildi. Postanestezik derlenme skoru ≥12 olması için geçen süre kaydedildi. Ameliyat sonrası dönemde, ameliyat sonrası anal- jezi (VAS) değerleri, motor blok seviyeleri, yan etkiler, hastanın ve cerrahın memnuniyeti 1., 3., 6. ve 12. saatlerde kaydedildi. Bulgular: Cerrahiye hazır olma süresi Grup II de istatistiksel olarak anlamlı düzeyde kısa bulundu. Hasta ve cerrah mem- nuniyetleri arasında iki grup arasında istatistiksel açıdan fark bulunamadı: İlk altı saatteki VAS değerleri grup I de grup IIye göre belirgin olarak düşüktü (p

Comparison of hemodynamics, recovery profile and postoperative analgesia of unilateral spinal anaesthesia with combined sciatic-femoral nerve block in knee arthroscopy

Objectives: In this randomized, controlled, blind study, a combined sciatic- femoral nerve block with levobupivacaine was compared with a unilateral spinal anaesthesia with respect to effectiveness, patient and surgeon satisfaction, and the effect on postoperative pain in arthroscopic knee surgery. Methods: Patients were randoml y divided into two groups. Group I (n=20) received a combined sciatic- femoral nerve block with levobupivacaine 0.5% totalling 40 ml. In group II (n=20), a spinal anaesthesia in the lateral decubitus position (ULSA) with 7.5mg levobupivacaine 0.5% was performed, and patients were kept in the same position to achieve an anaesthesia level of T12 (maximum 10 minutes). The development of motor and sensorial block on both sides and onset time to surgical anaesthesia were recorded. The time required for the postoperative recovery score to be ≥12 was recorded. In the postoperative period, postoperative analgesia (VAS), motor block, side effects, and patient and surgeon satisfaction were recorded at the 1st, 3rd, 6th and 12th hours. Results: Time of readiness for surgery was signi ficantl y shorter in Group II (p<0.05). All patients were satisfied with both techniques. There were no di fferences in judgement between the groups. VAS scores at the 6th hour were signi ficantl y lower in group I than in group II (p<0.05). Conclusion: Combined sciatic- femoral nerve block for outpatient arthroscopic knee surgery offers satisfactory anaesthesia, with a clinical profile similar to that of low-dose spinal anesthesia. Sciatic- femoral nerve blocks are associated with signi ficantl y lower pain scores during the first 6 postoperative hours

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