Çiğdem UNAL KANTEKIN, Sevgi ULUSOY TANGUL, İbrahim ADALI, Gamze TALIH

PEDİATRİK İNGUİNAL HERNİ ONARIMI SONRASI POSTOPERATİF ANALJEZİ: TRANSVERS ABDOMİNİS PLAN BLOĞU VEYA CAUDAL EPİDURAL BLOK

AMAÇ: Çocuklarda inguinal herni sonrası postoperatif analjeziyi sağlamak için ultrasonografi eşliğinde transversus abdominis plan (TAP) bloğu ve kaudal epidural blok kullanılabilir. Bu çalışmanın amacı, bu iki tekniğin pediatrik inguinal herni sonrası analjezi üzerindeki etkisini karşılaştırmaktır. GEREÇ VE YÖNTEM: Çalışmaya, tek taraflı inguinal herni nedeniyle ameliyat edilen 4-12 yaş arasındaki 64 hasta dahil edildi. 33 hastaya kaudal epidural blok (Grup C) ve 31 hastaya TAP blok (Grup T) uygulandı. Çocuk hastalar için postoperatif ağrının rutin takibi Wong- Baker yüz ağrı derecelendirme skalası ile yapıldı. Her hasta için ek analjezi ihtiyacı, işlem sırasındaki komplikasyonlar ve yan etkiler kayıt altına alındı. BULGULAR: Wong-Baker skalasına göre postoperatif 6., 8. ve 12. saatlerde grup C değerleri Grup T’ ye göre anlamlı düşük bulundu (p=0.04, p=0.03, p=0.03). Postoperatif analjezi süresi Grup T için ortalama 248.78±85.01 dk ve Grup C için 329.94 ±105.96 dk idi (p= 0.001). Ek analjezi için ilk gereksinim süresi C grubunda 13±4.8, T grubunda 8±3.5 saat idi (p=0.02). SONUÇ: Pediatrik inguinal herni onarımında kaudal epidural blok, ultrasonografi eşliğinde uygulanan TAP bloktan daha etkili postoperatif analjezi sağlamıştır.

POSTOPERATIVE ANALGESIA FOLLOWING PEDIATRIC INGUINAL HERNIA REPAIR: TRANSVERSUS ABDOMINIS PLANE BLOCK OR CAUDAL EPIDURAL BLOCK

AIM: Transversus abdominis plane (TAP) block under ultrasonography and caudal epidural block are techniques used to provide postoperative analgesia in children. The aim of this study was to compare the effect of these two analgesic techniques in pediatric inguinal hernia operations. MATERIAL AND METHOD: The study included 64 patients aged 4-12 years who underwent surgery for unilateral inguinal hernia. Caudal epidural block was applied to 33 patients (Group C) and TAP block to 31 (Group T). Routine follow-up of postoperative pain for pediatric patients was made with the Wong-Baker faces pain rating scale. A record was made for each patient of the time of requirement for additional analgesia, complications during the intervention and side-effects. RESULTS: In the evaluation of the faces pain rating scale, the scores of Group C were found to be significantly lower than those of Group T at 6, 8, and 12 hours postoperatively (p=0.04, p=0.03, p=0.03). The duration of postoperative analgesia was found to be mean 248.78±85.01 mins for Group T, and 329.94 ±105.96 mins for Group C (p= 0.001). The time of first requirement for additional analgesia was mean 13±4.8 hours in Group C, and 8±3.5 hours in Group T (p=0.02). CONCLUSION: The application of caudal block provided more effective postoperative analgesia than TAP block applied under ultrasonography guidance in pediatric inguinal hernia repair.

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