Venkata Rajesh Kumar KODALİ, Prabavathi SRİNİVASAN, Akilandeswari MANİCKAM, Mahesh VAKAMUDİ, Aruna PARAMESWARİ, Senthil Kumar SUKUMAR, Arul Murugan RAMASAMY

Yarık Damak Onarımı Uygulanan Pediatrik Hastalarda Ultrason Eşliğinde %0,25 Bupivakain veya %0,25 Bupivakain ve Deksmedetomidin ile Bilateral Suprazigomatik Maksiller Sinir Bloğunun Analjezik Etkinliği Üzerine Karşılaştırmalı Bir Çalışma - Randomize

Amaç: Yarık damak onarımı, şiddetli ağrı, yoğun sempatik uyarı ve kanamaya yol açan hem sert hem de yumuşak damak cerrahisini içerir. Çalışmamızda yarık damak onarımı için ultrasonografi eşliğinde uygulanan bilateral suprazigomatik maksiller sinir (SMS) bloğunda tek başına bupivakainin ve deksmedetomidin ile bupivakainin analjezik etkinliğini inceledik. Yöntem: Bu randomize, prospektif, çift kör çalışmada, yarık damak onarımı geçirecek, ASA fiziksel sınıflaması sınıf I ve II olan 46 ço- cuk Grup A ve Grup B’ye randomize edildi. Grup A’da, 23 çocuğa 0,15 mL kg-1 hacimde salin içinde %0,25 bupivakainle SMN bloğu uygulandı ve aynı işlem diğer taraf için de tekrarlandı. Grup B’de, 23 çocuğa her iki tarafa 0,15 mL kg-1 hacimde, 0,5 μg kg-1 deks- medetomidin ve %0,25 bupivakain ile SMN blok uygulandı. Analiz edilen birincil sonuçlar, postoperatif dönemde çocuk ve infantların postoperatif ağrı ölçeği (CHIPPS) ile değerlendirilen ağrı skorları ve analjezi süresiydi. Postoperatif ağrı skorları, anestezi sonrası bakım ünitesinde (PACU) 2 saat boyunca 30 dakika aralıklarla, serviste 24 saat boyunca 2 saatte bir analiz edildi. Bulgular: Grup A ve B, yaş, cinsiyet, ağırlık, ASA ve ameliyat süresi gibi demografik değişkenler açısından benzerdi. Grup B’deki çocuklar, Grup A’ya kıyasla (12±4,73 saate karşı 5,41±3,9 saat) anlamlı olarak daha uzun analjezi süresine sahipti (p=0,003). Grup B’deki çocukların, PACU’da sıfırıncı dakikada (p=0,04), 90 dakikadan sonra (p=0,02), 2. saatte (p

A Comparative Study on the Analgesic Efficacy of Bilateral Suprazygomatic Maxillary Nerve Block Under Ultrasound Guidance with 0.25% Bupivacaine and 0.25% Bupivacaine with Dexmedetomidine in Paediatric Patients Undergoing Cleft Palate Repair - A Randomized Prospective Double Blinded Study

Objective: Cleft palate repair involves surgery on the both hard and soft palate leading to severe pain, intense sympathetic stimulation, and bleeding. In our study we analysed the analgesic efficacy of bupivacaine alone and bupivacaine with dexmedetomidine in ultrasound guided bilateral suprazygomatic maxillary nerve block (SMN) for cleft palate repair. Methods: This study was a randomized prospective double- blinded study. Fourty six children of the ASA class I and II posted for cleft palate repair were randomized into Group A and Group B. In Group A, 23 children had SMN block with 0.15 mL kg-1 of 0.25% bupivacaine with saline and the same procedure was repeated on other side. In Group B, 23 children received SMN block with a volume of 0.15 mL kg-1 of 0.25% bupivacaine with dexmedetomidine 0.5 μg kg-1 on each side. Primary outcomes analysed were pain scores in post operative period by Children and Infants Post-Operative Pain Scale (CHIPPS) and the analgesia duration. Postoperative pain scores were analysed at 30 minutes intervals for 2 hours in Post Anaesthesia Care Unit (PACU) and at every 2 hours interval for 24 hours in the postoperative ward. Results: Group A and B were comparable in demographic variables like age, gender, weight, ASA status, and duration of surgery. Children in Group B had significantly longer duration of analgesia when compared to that of Group A (12±4.73 hours vs 5.41± 3.9 hours) (p=0.003). Children had significantly lower pain scores in Group B at zero min in PACU (p=0.04), after 90 min (p=0.02), at 2 hours (p

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