Çocuklarda üst ekstremite Tendon transfer cerrahisinde uygulanan interskalen bloğun postoperatif analjezik etkinliği

Amaç: İnterskalen blok, cerrahi girişimlerden sonra analjezi sağlamak amacıyla çocuklarda kullanılan tekniklerden birisidir. Çalışmamızda, üst ekstremitede tendon transfer cerrahisi uygulanacak olan hastaların postoperatif dönemdeki ağrılarının tedavisinde interskalen blok uygulanmasının etkinliğini araştırdık. Yöntem: Tendon transfer cerrahisi uygulanacak, ASA I-III, 2-13 yaş arası, 40 hasta çalışmaya dahil edildi. Tüm çocuklar genel anestezi aldıktan sonra; Grup I (n=20)’de operasyon sonunda ultrasonografi (USG) yardımıyla interskalen blok uygulandı. Grup II (n=20)’deki hastalara lokal anestezik yerine, eş değer miktarda serum fizyolojik verildi. Her iki gruptaki hastalara operasyon bitiminden 30 dakika önce hasta kontrollü analjezi (HKA) başlandı. Hastaların; 1., 6., 12., 24., 36. ve 48. saatlerdeki Visual Analog Score (VAS) değerleri, Children’s and Infant’s Postoperative Pain Score (CHIPPS) değerleri, istenilen-verilen HKA analjezik miktarları, yan etkiler, ek analjezik ilaç kullanımları ve aile memnuniyetleri kaydedildi. Bulgular: VAS değerleri grup II’ de, 1., 6., 12., 24., 36. ve 48. saatlerde anlamlı şekilde yüksekti (p< 0,05). CHIPPS skorları grup I ‘de, 1., 6., 12. ve 24. saatlerde daha düşük bulundu (p< 0,05). Grup I’ deki hastaların analjezik ihtiyaçları daha azdı (p< 0,05) ve aile memnuniyetinin daha fazla olduğu görüldü (p< 0,05). Grup I’ deki hastalarda hiç ek analjezik ihtiyacı olmadı. Bulantı oranı grup I ‘de daha düşüktü (p< 0,05). Sonuç: İnterskalen blok uygulanan hastalarda; postoperatif dönemde analjezik gereksiniminin azaldığı ve aile memnuniyetinin daha fazla olduğu sonucuna varıldı.

The postoperative analgesic effect of interscalene block for children undergoing tendon transfer operation in upper extremity

Objective: Interscalene block is new techniques which is used for postoperative analgesia in children. We investigated the efficacy of interscalene block in treatment of postoperative pain of children in tendon transfer cases in upper extremity. Method: Fourty patients between 2-13 ages in ASA I-III who would undergo tendon transfer surgery were enrolled in our study. After all the children in study have taken general anesthesia, in group I (n=20); interscalene block was performed by the help of ultrasonography after the operation. This block was not applied in group II by local anesthetics; instead of serum physiologic was given. In both groups, 30 minutes before the end of the operation, patient controlled analgesia (PCA) was started. Visual analogue scores (VAS), children&#8217;s and infant&#8217;s postoperative pain scores (CHIPPS), desired and given PCA analgesic amounts, side effects, family satisfaction and additional analgesic drug usages in postoperative 1., 6., 12., 24., 36., 48., hours were recorded. Results: VAS scores were higher at 1., 6., 12., 24., 36. and 48. hours in group II (p<0.05). CHIPPS scores were lower in group I at 1., 6., 12., 24. hours (p< 0.05). The required analgesic amount was lower in group I. Family satisfaction was higher in group I (p< 0.05). No other analgesic drug was given in group I. The rate of nausea was lower in group I (p< 0.05). Conclusion: In patients in which interscalene block was performed required analgesic amount was lower in postoperative period and family satisfaction was higher.

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Kaynak Göster

  • ISSN: 1300-0578
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1993
  • Yayıncı: Hira Gizem Fidan

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