Özgür YILMAZ, Ayten SARAÇOĞLU, Olgaç BEZEN, Türker ŞENGÜL

Modifiye radikal mastektomi uygulanan hastalarda torakal paravertebral blok uygulamasının ameliyat sonrası analjezi üzerine etkileri

Amaç: Meme cerrahisinden sonra hastaların %50sinde kronik ameliyat sonrası ağrı geliştiği gösterilmiştir. Çalışmalarda pa- ravertebral bloğun meme cerrahisi için hem etkili bir anestezi hem de analjezi yöntemi olduğu gösterilmiştir. Bu çalışmadaki amacımız 150 mg levobupivakain ile tek doz torakal paravertebral blok uygulanan mastektomi hastalarında ameliyat sonrası analjezi ve opioid kullanımını araştırmaktır. Gereç ve Yöntem: Meme kanseri tanısı olan ve modifiye radikal mastektomi ve aksiller disseksiyon uygulanan 20-65 yaş arası 40 hasta çalışmaya alındı. Hastalar kontrol grubu (Grup K, n=20) ve torakal paravertebral grup (Grup T, n=20) olarak iki ayrı gruba ayrıldı. Hastalar ameliyat sonrası 0, 1, 6, 12 ve 24. saatlerde istirahat sırasında ağrı için 0-10 mmlik Vizüel Analog Skala (VAS) ile sorgulandı. Ameliyat sonrası kullanılan ek tramadol miktarları (1.5 mg/kg iv infüzyon) kaydedildi. Bulgular: Kontrol grubundaki hastaların postoperatif 0, 1, 6, 12 ve 24. saat VAS skorları torakal paravertebral blok uygulanan gruptan anlamlı olarak yüksek bulunmuştur (p

Effects of a thoracic paravertebral block on postoperative analgesia in patients undergoing modified radical mastectomy

Summary Objectives: Following mastectomy, 50% of patients have chronic postoperative pain. Studies have shown that a paravertebral block is an effective method of analgesia as well as anaesthesia. The aim of this study is to compare postoperative pain values and opioid consump- tion after a single dose of 150 mg levobupivacaine with a thoracic paravertebral block in patients undergoing mastectomy. Methods: Enrolled in the study were forty patients, aged 20 to 65, diagnosed with breast cancer, and undergoing modi fied radical mas- tectomy and axillary dissection. Patients were randomized into two groups, as control group (group K, n=20) and thoracic paravertebral group (Group T, n=20). Postoperative pain values were recorded at 0, 1st, 6th, 12th and 24th hour at rest, using a 0-10 mm Visual Analogue Scale (VAS). Additional quantities of postoperative tramadol (1.5 mg/kg, iv infusion) were recorded. Results: Postoperativel y, at 0, 1st, 6th, 12th and 24th hour, patients in the control group had signi ficantl y higher VAS values than the group treated with a thoracic paravertebral block (p<0.01). Compared to VAS scores at postoperative 0 h, there was a statisti- call y signi ficant decrease in VAS scores at 1st, 6th, 12th and 24th hour in both groups (p<0.01). Additional use of tramadol was signi ficantl y lower in group T (p<0.01). Conclusion: A paravertebral block with a single dose of 150 mg levobupivacaine before general anaesthesia in patients undergoing modi fied radical mastectomy and axillary l ymph node dissection decreases postoperative pain values and the need for analgesics during the postoperative 24 hours

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