AHMET KEMALETTİN KOLTKA, MEHMET İLKE BÜGET, Emre Sertaç BİNGÜL, Ali ERŞEN, Süleyman KÜÇÜKAY, ATA CAN ATALAR, NÜZHET MERT ŞENTÜRK

Postoperative analgesia after arthroscopic shoulder surgery: A comparison between single-shot interscalene block and single-shot supraclavicular block

Amaç: Artroskopik omuz cerrahisi hastalarında postoperatif analjezik olarak opioidler, nonsteroid analjezikler ve lokal anestetikler kullanılabilir. Çalışmamızda tek doz interskalen blokla tek doz supraklavikular bloğun postoperatif analjezik etkinliklerini karşılaştırılması amaçlandı.Gereç ve Yöntem: Etik kurul ve hastalardan izin alındıktan sonra interskalen (GİSB) veya supraklavikular blok (GSKB) uygulanması için kontrendikasyonu bulunmayan ASA I-II 50 hasta randomize olarak ikiye ayrıldı. İki gruba da preoperatif dönemde ultrason eşliğinde blok yapılarak 30 ml %0.5 bupivakain uygulandı. Postoperatif dönemde intravenöz morfin 0.3 mgr/saat infüzyon, 1 mgr bolus doz ve kilitli kalma süresi 20 dakika olacak şekilde hasta kontrollü analjezi uygulandı. Hastaların postoperatif vizuel analog skala (VAS: 0-10 cm) değerleri 4., 8., 12. ve 24. saatlerde sorgulandı, ek analjezik ihtiyaçları ve tekniğe bağlı yan etki ve komplikasyonlar kaydedildi. 24 saat sonunda hasta memnuniyeti (HM) sorgulandı.Bulgular: VAS değerlerine bakıldığında 4. saat VAS değeri GSKB'ta daha düşüktü ve 8, 12 ve 24. saat VAS değerleri GİSB'ta daha düşüktü ancak istatistiksel olarak gruplar arasında fark yoktu. İSB grubunda %28 hastaya ek analjezik verilirken SKB grubundaki %68 hastaya ek analjezik verildi (p

Artroskopik omuz cerrahisinde postoperatif analjezi: Tek doz interskalen blok ile tek doz supraklavikular blok karşılaştırlması

Objectives: In arthroscopic rotator cuff surgery for postoperative analgesia opioids, nonsteroid analgesics, and local anesthetics can be used. This study aimed to compare the effectiveness, additional analgesic requirements, patients satisfaction, and complications of single-shot interscalene and supraclavicular blocks.Methods: After obtaining the ethics committee’s approval and informed consent, 50 ASA I-II patients were randomized to either the interscalene (GISB) or supraclavicular (GSCB) group. Preoperatively, patients received an ultrasonography-guided block using 30 ml of 0.5% bupivacaine. In the postoperative period, morphine patient-controlled analgesia was administered as a 0.3-mg/h basal dose and 1-mg bolus dose, with a 20-min lockout time. Postoperative visual analog scale (VAS; 0–10 cm) scores of the patients were evaluated at 4, 8, 12, and 24 h postoperatively; additional analgesic requirements, adverse effects, and complications were recorded. Patient satisfaction (PS) scores were evaluated after 24 h.Results: VAS scores at 4 h were lower in the GSCB group than in the GISB group, and the VAS scores at 8, 12, and 24 h were lower in the GISB group than in the GSCB group, with no statistical significance. Additional analgesic requirements was 28% in the GISB group and 68% in the GSCB group (p < 0.05). Total morphine consumption was lower in the GISB group than in the GSCB group (18.95±9.2 mg vs. 30.6 ± 9.6 mg; p < 0.001). PS scores were higher in the GISB group than in the GSCB group (7.0±1.0 vs. 6.1±0.9; p < 0.01). Adverse effects and complication rates were similar in both the groups. In GISB group, seven patients (28%) had nausea/vomiting, whereas in the GSCB group, 12 patients (48%) had nausea/vomiting. This difference was statistically insignificant.Conclusion: Supraclavicular block can be considered as an alternative to interscalene block for arthroscopic shoulder surgery

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