Özlem Selvi CAN, Enver ÖZGENCİL, Menekşe HASDOĞAN, Feyhan ÖKTEN

Diz artroplastisisinde postoperatif ağrı tedavisinde femoral sinir bloğu

Total diz artroplastisi sonrası postoperatif dönem oldukça ağrılıdır. Bu tür operasyonlar genellikle yaşlı, yandaş sistemik hastalıkları bulunan ve bu hastalıkları nedeniyle çeşitli ilaçlar kullanması gereken hasta grubuna uygulanan girişimlerdir. Bu durumda seçilecek anestezi tekniğiyle birlikte postoperatif iyi ağrı kontrolü morbidite ve mortalitenin azalmasını sağlar. Son zamanlarda yapılan çalışmalar total diz artropastisi sonrasında epidural analjezinin en etkin analjezi yöntemi olduğunu göstermektedir. Bunun yanı sıra tek ekstremiteye ait girişimlerde periferik sinir blokları iyi bir alternatif olmuş ve son yıllarda popülerlik kazanmıştır. Total diz artroplastisi sonrası femoral 3 in 1 blok, uygulaması kolay basit, güvenilir, yan etkisi az ve etkin bir tekniktir. Periferik sinir stimülatörleri ve ultrasonografik görüntülemenin kullanımı başarı oranının artırmaktadır. Bu derlemede total diz replasmanı sonrası analjezi için kullanılan femoral blok tekniği değerlendirilmiştir.

Femoral nerve block for postoperative pain therapy after knee artroplasthy

The postoperative period after total knee arthroplasty is extremely painful. These kind of surgeries are often performed with elderly patients with systemic comorbid dieases and patients who have to use multible drugs because of these. In these circumstances the appropiate anesthesia technique combined with good postoperative pain management decreases the morbidity and mortality rates. Recent studies show that after total knee artroplasty, epidural block is the most effective analgesia technique. Also procedures performed on a single extremity, peripheral nerve blocks are a good alternative and have gained popularity in the last years. After total knee arthroplasty femoral 3 in 1 block technique is easy to perform, safe and effective with minimal side effects. Using peripheral nerve stimulators and ultrasound imaging techniques improves the success rate. In this review we evaluated the femoral block technique after total knee arthroplasty for postoperative analgesia.

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