Emre ERBABACAN, Çiğdem AKYOL BEYOĞLU, Aylin ÖZDİLEK, Fatiş ALTINTAŞ, Birsel EKİCİ, Sevim PURİSA, Güniz KÖKSAL, Elif Aybike ÖZMUMCU

Subkostal transversus abdominal plan bloğun mesh ile inguinal herniorafi sonrası akut ve subakut ağrı gelişimi üzerine etkisinin araştırılması: Randomize, klinik çalışma

Amaç: Subkostal transvers abdominis plan bloğunun (TAP) postoperatif ağrı üzerindeki etkisi halen araştırma konusudur. Bu çalışmanın amacı, inguinal herniorafi hastalarında postoperatif subakut ağrı üzerine subkostal TAP bloğunun etkisini değerlendirmektir. Gereç ve Yöntem: Genel Anestezi altında mesh ile elektif tek taraflı inguinal herniyorafi geçirecek olan 18-75 yaş arasındaki ASA skoru 1-3 olan hastalar çalışmaya alınmıştır. Elli hastaya postoperatif ağrı tedavisi için iv analjezik verildi (grup I), elli hastaya operasyondan sonra iv analjeziye ek olarak subkostal TAP blok uygulandı (grup II). Operasyondan 1 ay sonra gruplar arası numerik ağrı skalası Mann-Whitney U testi ile karşılaştırdı. Hastaların operasyondan sonra 15. Dakika. 1, 6, 12, 24. saat, 15. gün NRS skorları ile 15 gün ve 1 ay sonraki yaşam kalitesi skorları (LQS) değerlendirildi. Bulgular: Postoperatif 15. dakika, 1, 6, 12, 24. saat, 15. gün (p=0.00) ve 1. aydaki NRS değerleri grup II’de grup I’e göre anlamlı derecede düşük bulundu (p=0.02). Ameliyattan 15 gün sonra LQS açısından gruplar arasında anlamlı fark yoktu (p=0.013). Gruplar arası karşılaştırmada LQS birinci ayda Grup I’deki postoperatif 15. güne kıyasla daha yüksekti (p=0.201). Sonuç: Subkostal TAP bloğu akut dönemde ve inguinal herniorafi yapılan hastalarda ameliyat sonrası ilk ayda etkili bir postoperatif ağrı tedavisi sağlamaktadır.

Evaluation of the effects of subcostal transversus abdominis plane block on acute and subacute pain development following inguinal herniography: Randomized clinical study

Objectives: The effect of subcostal transversus abdominis plane (TAP) block on postoperative pain is contradictive. The aim of this study was to evaluate the effect of subcostal TAP block on subacute pain in patients who have undergone inguinal herniography. Methods: Patients aged between 18 and 75 years with American Society of Anesthesiologists 1–3 and who were to undergo elective unilateral inguinal herniography with mesh under general anesthesia were included. Fifty patients were under an intravenous analgesic regimen (group I) and 50 patients underwent subcostal TAP block postoperatively in addition to the intravenous analgesic regimen (group II). The primary outcome measure was pain scores 1 month postoperatively by comparing Numerical Rating Scale values with the Mann–Whitney U test between groups I and II. Secondary outcome measures were life qualification scores 1 month postoperatively and pain scores 24 h and 15 days postoperatively. Results: Postoperative 15th-min; 1st-, 6th-, 12th-, and 24th-h; 15th-day (p=0.00); and 1st-month Numerical Rating Scale values were significantly lower in group II than in group I (p=0.02). No significant difference was observed between the groups in terms of LQS 15 days postoperatively (p=0.013). On group comparison, LQS was higher in the 1st month than at the 15th day postoperatively in group I (p=0.201). Conclusion: Subcostal TAP block provides an effective postoperative pain treatment in the acute period and in the 1st postoperative month in patients undergoing inguinal herniography.

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