Torakotomi analjezisi için uygulanan serratus anterior alan ve torakal epidural blok etkinliklerinin karşılaştırılması

Amaç: Post-torakotomi ağrısı için günümüzde rejyonal anestezi yöntemleri sıklıkla kullanılmaktadır. Bu çalışmada torakotomi sonrası ağrı için serratus anterior alan bloğunun (SAPB) ve torakal epidural bloğun etkinliğini karşılaştırmayı amaçladık.Yöntemler: Bu retrospektif çalışmada torakotomi yapılan 120 hasta çalışmaya alındı.Dahil etme kriterlerini karşılayan 70 hasta Grup E (torasik epidural blok) (n=37) ve Grup S (serratus anterior alan blok) (n=33) olmak üzere iki grupta değerlendirildi. Postoperatif 2., 6., 12. ve 24. saatlerde görsel analog skala skorları ve 24 saatlik toplam analjezik tüketimi değerlendirildi. İkincil sonuçlar yan etkiler, ek analjezik ilaç gereksinimi ve komplikasyon olarak belirlendi.Bulgular: Gruplar arasında yapılan karşılaştırmalarda ameliyat sonrası 2. saat (p=0.417), 6. saat (p=0.271), 12. saat (p=0.734) ve 24. saat (p=0.157) görsel analog skala skorları ve 24 saatlik toplam analjezik tüketimi miktarları (p=0.714) karşılaştırıldığında, 2 grup arasında istatistiksel olarak anlamlı fark yoktu. İki grup arasında yan etkiler, bulantı ve kusma (p=0.714), kaşıntı (p=N/A), solunum depresyonu (p=N/A) düzeyleri açısından istatistiksel olarak anlamlı fark yoktu. Sonuç: Bu çalışmanın sonuçları, serratus anterior alan bloğu ve torasik epidural blok uygulamasının torakotomi sonrası analjezi için benzer sonuçlara sahip olduğunu göstermektedir.

Anahtar Kelimeler:

torakotomi, bupivakain, analgezi, ağrı yönetimi, epidural anestez

Comparison of efficiency of serratus anterior plane block and thoracic epidural block for thoracotomy analgesia

Aim: Currently, regional anesthesia methods are frequently used for post-thoracotomy pain. In this study, we aimed to compare the efficacy of serratus anterior plane block and thoracic epidural block for pain after thoracotomy.Methods: This retrospective study included 120 patients who underwent thoracotomy. Seventy patients who met the inclusion criteria were evaluated in two groups as Group E (thoracic epidural block) (n=37) and Group S (serratus anterior plane block) (n=33). Postoperative 2nd, 6th, 12th and 24 hour visual analogue scale scores and total analgesic consumption for 24 hours were evaluated. Secondary outcomes were determined as side effects, additional analgesic drug requirement and complications.Results: In the comparison between the groups, there was no statistically significant difference between two groups in terms of Postoperative 2nd (p=0.417), 6th (p=0.271), 12th (p=0.734) and 24 hour (p=0.157) visual analogue scale scores and the amount of total analgesic consumption for 24 hours (p=0.714). There was no statistically significant difference between two groups with regard to the side effects nausea and vomiting (p=0.714), pruritus (p=N/A), respiratory depression (p=N/A) levels. Conclusion: The results of this study demonstrate that use of serratus anterior plane block and thoracic epidural block administration has similar outcomes for post-thoracotomy analgesia.

Keywords:

thoracotomy, analgesia, bupivacaine, pain management, epidural anesthesia,

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