Hidayet ÜNAL, SEMİH BAŞKAN, Fahri ACAR, İsmail AYTAÇ

Femoral Boyun Kırığı Olan Hastalarda Pozisyon Ağrısı İçin İki Periferik Blok Yönteminin Karşılaştırılması

Amaç: Kalça kırığı gibi ortopedik patolojiler yaşlı popülasyonda sıklıkla görülmektedir. Hasta sayısındaki artış yüzünden, kalça kırığı nedeni ile tedavi gören hastalarda ağrı yönetimi daha önemli hale gelmektedir. Biz bu çalışmada, spinal anestezi için verilen pozisyon sırasındaki ağrıyı gidermek için kullanılan, 2 farklı periferik blok yöntemini, etkinlik ve hasta memnuniyeti açısından karşılaştırdık. Yöntem: Çalışmamız tek merkezli, prospektif, randomize, çift kör bir çalışma olarak planlandı. Her biri 60 yaşın üstünde, American Society of Anesthesiologists (ASA) skalası 1-3 arası olan 59 hasta çalışmaya dahil edildi. Hastalar, fasya ilyaka kompartman bloğu (FICB) (Grup 1) ve Femoral sinir bloğu (FNB) (Grup 2) olarak iki gruba ayrıldı. Bulgular: Tam duyusal blok gelişen hasta oranı FNB grubunda daha yüksekti (FNB’de %73.3, FICB’de %44.8). Ancak tam blok gelişme sürelerinde istatistiksel olarak anlamlı bir fark yoktu. (FICB grubunda 16.2±3.7 ve FNB’de 14.8±3.6). Çalışmamızda, her 2 grubun da vizüel analog sko- runu (VAS) düşürmede etkili olduğunu bulduk (2 grupta da yaklaşık 5 puan düşüş mevcuttu). Hasta memnuniyeti açısından istatistiksel olarak anlamlı bir fark olmasa da FNB grubunda diğer gruba kıyasla daha yüksek memnuniyet oranı izlendi. Sonuç: FNB de FICB gibi nöroaksiyel blok uygulamaları sırasında ortaya çıkan pozisyon ağrısını gidermek için kullanılabilecek bir yöntemdir.

Comparison of Two Peripheral Block Methods For Position Pain in Femoral Neck Fractures

Objective: Orthopedical pathologies such as hip fracture are more common among advanced aged population. Pain management becomes more important in patients who are being treated for hip fracture due to an increase in the number of patients. In this study, we compared two peripheral nerve block methods that could be used to relieve positional pain in spinal anesthesia, in terms of efficacy and patient satisfaction. Metods: Our study was planned as a randomized, prospective, double-blind, single-centered trial. A total of 59 patients aged over 60 years with an American Society of Anesthesiologists (ASA) physical risk scale I-III were included in the study. Patients divided into two groups as Fascia iliaca compartment block (FICB) (Group 1), and Femoral nerve block (FNB) (Group 2). Results: Complete sensory block developed in higher number of patients in the FNB group (73.3% for FNB, 44.8% for FICB). However, there was no statistically significant difference in the time to the development of complete block between groups (FICB, 16.2±3.7 and FNB, 14.8±3.6). In our study, we found that both blocks were effective at lowering the visual analogue scale (VAS) scores (5 points for both groups). Although there was no statistically significant difference, higher satis- faction level was observed in the FNB group. Conclusion: Just like FICB, FNB can be used to relieve pain during positioning of the patient in neuraxial block applications.

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