Adem ÇİFTÇİ, Demet LAFLI TUNAY, Geylan IŞIK, Murat Türkeün ILGINEL

Üst Ekstremite Cerrahisinde Geleneksel Bier Blok ile Önkol Bier Blok Tekniğin Karşılaştırması

Amaç: Bu çalışmada; geleneksel üst kol ile önkol Bier blok tekniklerinin ağrı skorları, analjezi etki başlangıcı, ek analjezi gereksinimi ve yan etki insidansı açısından karşılaştırılması amaçlandı. Gereç ve Yöntem: Bu çalışmaya 18 - 65 yaş arası, ASA I – II grubu, intravenöz rejyonel anestezi altında el bileği ve el cerrahisi uygulanacak 60 erişkin hasta dahil edildi. Hastalar rastgele 2 gruba ayrıldı. Grup 1 (n=30)’e üst kola yerleştirilen çift kaflı turnike ve 3 mg/kg dozunda prilokain ile geleneksel Bier blok, grup 2 (n=30)’ye önkola yerleştirilen tek kaflı turnike ve 2 mg/kg dozunda prilokain ile önkol Bier blok uygulandı. Tüm hastalarda, intraoperatif ve postoperatif kan basınçları, kalp hızları, periferik oksijen saturasyonları, ağrı skorları (VAS), yan etkiler, cerrahi süre, turnike zamanı analjezi başlama zamanı ve ek analjezi ihtiyacı kaydedildi. Bulgular: İki grup arasında cerrahi başlama ile sonlanma süreleri, turnike zamanları ve perioperatif analjezi başlama zamanları açısından istatistiksel olarak önemli bir fark bulunmadı. İntraoperatif ve postoperatif kan basınçları, kalp hızları, periferik oksijen saturasyonları arasında da istatistiksel olarak önemli bir fark saptanmadı. Her iki grubun intraoperatif ağrı skorları benzerdi ve ek analjezi ihtiyaçları arasında fark yoktu. Sonuç: Tek kaflı turnike ile uygulanan önkol Bier blok tekniğinin, ön kol cerrahisinde etkili ve güvenli bir yöntem olduğu ve daha düşük dozda lokal anestezik kullanımı nedeniyle geleneksel Bier bloğa tercih edilebileceği kanısına varıldı. Anahtar Kelimeler: Bier blok, prilokain, rejyonel anestezi.

Anahtar Kelimeler:

Bier blok, prilokain, rejyonel anestezi

Red Cell Distribution Width (RDW) as a Diagnostic Tool for Chronic Venous Insufficiency

Introduction Chronic venous insufficiency (CVI) is a chronic inflammatory disease and biomarkers are defined to be used as predictive biomarkers for CVI patients. Red cell distribution width (RDW) is a measure of heterogeneity of erythrocytes in circulation. With this study we aim to investigate the relationship between RDW and CVI classification Materials and Methods 102 consecutive patients with lower extremity venous Doppler ultrasound were evaluated for the study. The Doppler ultrasound results, hematological and biochemical laboratory results were obtained retrospectively from hospital medical records. The study population was divided to chronic venous insufficiency group and control group according to Doppler ultrasound results. Chronic venous insufficiency group also classified according to clinical findings of CEAP classification Results A total of 102 patients were included in the study. Mean age of the study population was 52.3 ± 14.6 and 54 (52.9%) was male. 25.5% of the patients were included in CVI group and 74.5% of the patients were included in the control group. 21.6% (n=26) of the study population was classified as Class 1, 44.1% (n=45) was classified as Class 2 and 8.8% (n=9) of the patients were classified as Class3 according to the clinical findings of the CEAP classification. RDW was significantly higher in venous insufficiency group compared to control group (p=0.02). The pairwise comparison of Class 1 to Class 2 was 0.150, Class 1 to Class 3 was p=0.125 and Class 2 to Class 3 was 0.05. Conclusion Our results propose that RDW may be used as a diagnostic tool for CVI but severity of CVI cannot be determined by RDW.

Keywords:

Red cell distribution width RDW, Chronic venous insufficiency, Chronic venous insufficiency classification,

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