Aksiller blokda perinöral fentanil uygulamasının anestezi ve analjeziye etkileri

Randomize, çift kör çalışmanızda lokal anestezik solüsyona ekleyerek perinöral verdiğimiz fentanilin;bloğun başlama süresi, intraoperatif anestezi ve postoperatif anestezi ve postoperatif analjezi süresi üzerine etkilerini araştırmayı amaçladık. Brakiyal pleksusun aksiller bloğu ile el cerrahisi planlanan 75 olgu 15' er kişilik 5 gruba ayrıldı.Grup K (kontrol grubu), Grup $FM_1$ Grup $FM_2$' de 100 mg % 0.5 bupivakain (20 mL) + 200 mg %2 lidokain (10 mL) + serum fizyolojik (10 mL) kullanılırken Grup $FA_1$' de 1 $mu$ $kg^{-}1$ ve Grup $FA_2$' de 2 $mu$ $kg^{-}1$ fentanil bu solüsyona eklendi.Grup $FM_1$ ve Grup $FM_2$' de ise sırasıyla 1 $mu$ $kg^{-}1$ , 2 $mu$ $kg^{-}1$ fentanil intramusküler olarak uygulandı. Gruplardan $FA_1$ ve $FA_2$' de sensoriyal bloğun anlamlı olarak erken başlandığını, postoperatif ilk analjezik gereksinim sürelerinin kontrol grubuyla karşılaştırıldığında, tüm gruplarda klinik olarak daha uzun olduğunu, ancak istatistiksel olarak anlamlı olmadığını saptadık. Sonuç olarak; aksiller brakiyal pleksus blokajında perinöral fantanil uygulamasının blok başlama süresini kısalttığı, fakat postoperatif analjeziye etkisinin olmadığı kanısına vardık.

Anahtar Kelimeler:

Fentanil, Analjezi, Brakial pleksus, Anestezikler, lokal, Çift kör metot

Effects of the perineural fentanyl on anesthesia and analgesia during axillary block

In this randomized and double-blind study;we aimed to investigate the effects of the perineural fentanyl added to local anesthetic solution, on the onset of blockkade period, duration of intraoperative analgesia and postoperative anesthesia.75 patients who were allocated in 5 groups were scheduled for hand surgery under axiller plexus anesthesia. In Groups K (control group), $FM_1$ and $FM_2$ : a combination of 100 mg 0.5 % bupivacaine (20 mL) + 200 mg 2% lidocaine (10 mL) + saline (10 mL) was used.1 $mu$ $kg^{-}1$ fentanyl in Group $FA_1$ and 2 $mu$ $kg^{-}1$ fentanyl in Group $FA_2$ were added to the solution.In groups $FM_1$ and $FM_2$, intramuscular injection of 1 $mu$ $kg^{-}1$ fentanyl and 2 $mu$ $kg^{-}1$ fentanyl were administered respectively. We established that the onsets of sensory block in Group $FA_1$ and $FA_2$ were significantly shorter than those in the other groups and that postoperative first analgesic requirement times were longer in all groups than the control group but this was not statistically significant. We concluded that perineural fentanyl application acceleated onset of block in axillary brachial plexus blockgade but had no effect on postoperative analgesia.

Keywords:

Fentanyl, Analgesia, Brachial Plexus, Anesthetics, Local, Double-Blind Method,

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