Ahmet KÖROĞLU, Müslüm ÇİÇEK, A. Kadir BUT, Hüseyin İ. TOPRAK, M. Özcan ERSOY

İnternal juguler ven kanülasyonunda prilokain-lidokain krem uygulamasının prilokain HCI infiltrasyonu ile karşılaştırılması

Bu çalışmada, internal juguler ven (İJV) kanülasyonu için farklı sürelerde uygulanan prilokain-lidokain kremin analjezi, işlem kalitesine etkisinin değerlendirilmesi ve prilokain HCI infiltrasyonu ile karşılaştırılması amaçlandı. Operasyon öncesi IJV kanülasyonu yapılacak 75 olgu çalışmaya alındı. IJV kanülasyonu öncesi, Grup T e 60, Grup W ye 90, Grup life 120 ve Grup TVe 180 dk süreyle prilokain-lidokain krem uygulandı, Grup V deki olgulara ise prilokain HCI infiltrasyonu yapıldı. Prilokain HCI infiltrasyonu ve İJV kanülasyonu sırasında ağrı seviyesi vizüel analog skala ile değerlendirildi, ayrıca cilt-IJV derinliği ile analjezi ve işlem kalitesi kaydedildi. Bütün olgularda yeterli cilt analjezisi sağlandı. Prilokain-lidokain krem uygulananlarda farklı derinliklerdeki yeterli analjezi elde edilen olgu sayısı; 0.5 cm derinlikte Grup III ve IVde Grup I ve W ye göre, 1 cm derinlikte Grup IV'te Grup I ve IF ye, Grup IIFte Grup I'e göre, 1.5 cm derinlikte ise Grup IV'te Grup I'e göre daha fazlaydı. Analjezi kalitesi Grup IV de Grup I ve II'ye göre daha iyiydi. IJV kanülasyonu sırasında toplam yeterli analjezi elde edilen olgu sayısı Grup IV'te Grup I ve II'ye göre, Grup V'te ise Grup I, II ve UF e göre anlamlı olarak daha fazla, ilave %2 prilokain HCI infiltrasyon gereksinimi daha azdı. Sonuç olarak, İJV kanulasyonunda 3 saat süreyle uygulanan prilokain-lidokain krem daha kısa uygulama sürelerine göre daha etkili analjezi sağladı. Ayrıca 90,120,180 dk süreyle uygulandığında klinik olarak daha iyi işlem kalitesi sağladığından prilokain HCI infiltrasyonuna göre daha iyi bir alternatif olduğu kanaatine varıldı.

Anahtar Kelimeler:

Prilokain, Kateterizasyon, Anestezi, lokal, Lidokain, Juguler venler

Application of prilocaine-lidocaine cream for the internal jugular venous cannulation and comparison with prilocaine HCI infiltration

In this study, it was aimed to evaluate the effects of prilocaine-lidocaine cream applied at different durations on the quality of analgesia and procedure and to compare them with those of prilocaine HCI infiltration for internal jugular venous (IJV) cannulation. Seventy-five cases performing IJV cannulation before operations were included in the study. Prilocaine-lidocaine cream was applied before IJV cannulation in Groups I, II, III, and TV during 60, 90,120 and 180 min, respectively. Prilocaine HCI infiltration was applied in cases of Group V. The level of pain was evaluated with the visual analogue scale during infiltration of prilocaine HCI and IJV cannulation. In addition, the depth ofskin-İJV, the quality of analgesia and procedure were recorded. Adequate skin analgesia was obtained in all cases. Number of cases obtained adequate analgesia at different depths in cases in which prilocaine-lidocaine cream was applied were higher in Groups III and IV than in Groups I and II at 0.5 cm depth, higher in Group IV than in Groups I and II, and in Group III than in Group I at 1 cm depth, and higher in Group IV than in Group I at 1.5 cm depth. The quality of analgesia was better in group IV than in Groups I and II. Total number of s cases obtained adequate analgesia was significantly higher, the requirement of additional 2% prilokain HCI infiltration was lower in Group IV than in Groups I and II, and also in Group V than in Groups I, II, and HI, during İJV cannulation. As a result, we hold the opinion that prilocaine-lidocaine cream applied for 3 h provided more effective analgesia than the shorter duration of application. Also, since when it was applied during 90,120, and 180 min it provided clinically better the quality of procedure it could.be a better alternative to the prilocaine HCI infiltration.

Keywords:

Prilocaine, Catheterization, Anesthesia, Local, Lidocaine, Jugular Veins,

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