Alparslan KUŞ, Yavuz GÜRKAN, ZEHRA İPEK ARSLAN AYDIN, Ali Gül AKGÜL, CAN AKSU, Kamil TOKER, Mine SOLAK

Torasik cerrahide ultrason rehberliğinde paravertebral blok deneyimlerimiz

Amaç: Torasik cerrahide ameliyat sonrası anal jezi amacıyla ultrason rehberliğinde torasik paravertebral blok (TPVB) tercih edi- lebilmektedir. Torasik paravertebral blok uygulamalarında tekli, çoklu enjeksiyon veya kateter teknikleri kullanılabilir. Yazımızda toraks cerrahisi geçiren hastalara ameliyat sonrası anal jezi amacıyla uyguladığımız ultrason rehberliğindeki TPVB deneyimleri- mizi paylaşmayı amaçladık. Gereç ve Yöntem: Kliniğimizde, Ocak 2012 ile Mart 2013 arasında torasik cerrahi geçiren ve ameliyat sonrası analjezi amacıyla ultrason rehberliğinde TPVB uygulanan hastalar geriye dönük olarak incelendi. Demografik veriler, blok tekniği, komplikasyon- lar ve birinci, altıncı, 12., 24. saat Vizüel Analog Skala (VAS) skorları kaydedildi. Bulgular: Toplam 18 hastaya TPVB uygulandı. Dokuz hastaya tek enjeksiyonla, beş hastaya çoklu enjeksiyonla ve dört hastaya ise kateter yardımı ile TPVB uygulandığı tespit edildi. İstatistiksel olarak anlamlı olmamakla birlikte tekli enjeksiyon ve kateter gruplarında ilk saatteki VAS skorunun üçün üzerinde olduğu tespit edildi. Sonuç: Ultrason rehberliğinde tek enjeksiyon TPVB, çoklu enjeksiyon ve sürekli TPVB uygulamalarında olduğu gibi ameliyat sonrası ilk 24 saat etkin analjezi sağlayabilmektedir.

Our ultrasound-guided paravertebral block experiences in thoracic surgery

Objectives: Ultrasound-guided thoracic paravertebral block (TPVB) may be employed for postoperative analgesia in thoracic surgery. In application of TPVB, single injections, multiple injections or catheter techniques may be used. In this paper we pres- ent our experiences with ultrasound-guided TPVB in thoracic surgery patients for postoperative analgesia. Methods: Patients undergoing thoracic surgery and on whom ultrasound-guided TPVB was performed for postoperative analgesia from January 2012 to March 2013 in our clinic were analyzed retrospectively. Demographic data, block technique, complications and 1st, 6th, 12th and 24th hour VAS scores were recorded. Results: A total of 18 patients had TPVB. Single injection was administered to 9 patients, multiple injections to 5, and catheters to 4. While statistically insignificant, 1st hour VAS scores were found to be greater than 3 in the single injection and catheter groups. Conclusion: Similarly to multiple injection and continuous TPVB administration, ultrasound-guided single injection TPVB pro- vides effective 24-hour postoperative analgesia

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