ÇİĞDEM YILDIRIM GÜÇLÜ, BAŞAK CEYDA MEÇO, Ali Abbas YILMAZ, Zekeriyya ALANOĞLU, NESLİHAN ALKIŞ

SÜNNET OLAN ÇOCUKLARDA ROPİVAKAİN İLE PENİL BLOK VE KAUDAL BLOĞUN ETKİNLİĞİNİN KARŞILAŞTIRILMASI

Amaç: Sünnetlerde ağrı kontrolü önemlidir. Bu amaçla çeşitli medikal yöntemlerin yanında uygun bloklar da sıklıkla uygulanmaktadır. Bu çalışmanın amacı; ropivakain ile penil blok uygulamasının yeterli olup olmadığını araştırmaktır. Gereç ve Yöntem: Ankara Üniversitesi Hastanesi’nde sünnet planlanan, 2-12 yaş aralığındaki çocuklar çalışmaya dahil edildi. Rutin monitörizasyon sonrasında genel anestezi uygulanan hastalara, zarf usulü ile belirlenen yönteme göre penil blok veya kaudal blok uygulandı. Kaudal blok grubunda, anestezist tarafından 22G kaudal iğne kullanılarak 1 ml kg-1 %0.25’lik ropivakain ile kaudal blok uygulanırken, penil blok grubunda cerrah tarafından 0.1 ml kg-1 %0.75’lik ropivakain ile dorsal penil sinir bloğu yapıldı. ‹ntraoperatif dönemde hemodinamik parametreler ve postoperatif dönemde ise derlenme süresi, belirli zaman aralıklarında gözlemci ağrı skalası (OPS), modifiye pediatrik objektif ağrı skalası (MPOPS) ve yüz skalası (YS) kaydedildi. Komplikasyonlar ve aile memnuniyeti sorgulandı. Bulgular: Her iki grupta demografik veriler ve hemodinamik veriler benzer bulundu. Gruplar arasında ağrı skalaları açısından tüm takip aralıklarında istatistiksel olarak anlamlı fark bulunmadı (yüz skalası için p= 0,70; mpops için p= 0,15; ops için p= 0,76). Komplikasyon açısından iki grup arasında fark bulunmadı (p=0,22). Sonuç: Sünnet uygulanan çocuklarda ağrı kontrolünde ropivakain ile uygulanan penil blok ve kaudal bloğun etkinlikleri benzer olduğu sonucuna varılmıştır.

COMPARISON BETWEEN PENILE BLOCK AND CAUDAL BLOCK WITH ROPIVACAINE IN CHILDREN UNDERGOING CIRCUMCISION

Aim: Pain management is an important issue in children undergoing surgery for circumcision. Besides medical methods, appropriate blocks are also applied for pain management. The aim of this study was to research the efficacy of penile block and caudal block with ropivacaine. Materials and Methods: Children aged 2-12 undergoing circumcision in Ankara University Hospital were included in the study. After routine monitoring, general anesthesia was performed and according to envelope method the patients had penile block or caudal block. In caudal block group, anesthesiologist performed caudal block of 1 ml kg-1 0.25% ropivacaine with 22 G caudal needle and in penile block group, and the surgeon performed penile block of 0.1 ml kg-1 0.75% ropivacaine. At intraoperative period hemodynamic parameters and at postoperative period recovery time, observer’s pain scale (OPS), modified pediatric objective pain scale (MPOPS) and face scale (FS) at determined time periods were recorded. Complications and family satisfaction were questioned. Results: Demographic and hemodynamic data were found similar in both groups. There was insignificant statistical difference between groups regarding pain scales at all time periods. (for face scale p= 0,70; for mpops p= 0,15; for ops p= 0,76). There was no difference in complications between groups (p=0,22). Conclusion: We conclude that penile block and caudal block with ropivacaine showed similar efficacy in pain management in children undergoing circumcision.

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