Kasım TUZCU, Halis CANPOLAT, Günhan GÖKAHMETOĞLU, Emin SİLAY

Our anesthesia experiences with geriatric patients at high risk group undergoing hip surgery under combined psoas compartment-sciatic nerve block

Amaç. Kalça kırığı cerrahisi geçiren yüksek risk grubu yaşlı hastalarda psoas kompartman bloğuve siyatik sinir blok kombinasyonunun hemodinamik parametrelere etkisi araştırıldı. Yöntem. Buçalışmada kalça cerrahisi anestezisi için psoas kompartman bloğu ve siyatik sinir bloğu ikilisiyapılan yüksek risk grubu, yaşlı hastalar retrospektif olarak değerlendirildi. Lokal anestezik olaraklevobupivakain ve lidokain kombinasyonu verilen 14 yaşlı hasta Grup 1 olarak, levobupivakain veprilokain kombinasyonu verilen 10 yaşlı hasta Grup 2 olarak adlandırıldı. Çalışmamızda hastalarıntümünde, gruplar arasında ve 85 yaşın üstünde olanlarla altında olanların kalp atım hızı, ortalamakan basıncı değerleri ve sedasyon ihtiyacı incelendi. Bulgular. Gruplar arasında ve yaş gruplarıarasında ortalama kan basıncı değerleri ve kalp atım hızları karşılaştırıldığında istatiksel olarakanlamlı bir fark saptanmadı (p˃0,05). Grup 1de ortalama kan basıncında %6,18 düşüş olurkenGrup 2de %16,52 düşüş oldu. Tüm hastalar değerlendirildiğinde ortalama kan basıncında %10,06oranında düşüş gözlendi. Sonuç. Kalça cerrahisi uygulanan yaşlı ve yüksek risk grubu hastalardaanestezik yöntem olarak psoas ve siyatik blok kombinasyonunun uygun bir seçenek olabileceğinidüşünüyoruz.

Kalça cerrahisi geçiren yüksek risk grubu yaşlı hastalarda psoas kompartman -siyatik sinir bloğu kombinasyonu ile anestezi deneyimlerimiz

Aim. The effect of psoas compartment and sciatic nerve block combination on hemodynamicparameters in high risk geriatric patients with hip fracture surgeries was evaluated. Methods. Inthis study, high risk old patients who underwent psoas compartment block and sciatic nerve blockfor hip surgery anesthesia were evaluated retrospectively. In Group 1 there were 14 patients withlevobupivacaine and lidocaine combination and in Group 2 there were 10 patients withlevobupivacaine and prilocaine combination. In our study we evaluated the heart rate, systolicblood pressure, diastolic blood pressure, mean arterial blood pressure levels and sedation needbetween groups, between age over and below 85 years and in all patients. Results. There were nostatistically significant difference in heart rate and mean arterial blood pressure levels betweengroups and age groups (p˃0.05). There were a 6.18% and 16.52% decrease in mean arterial bloodpressure in Group 1 and 2 respectively. When we evaluated the whole patients there was a 10.06%decrease in mean arterial blood pressure. Conclusion. We consider that the combination of psoasand sciatic block as an anesthetic method may be a proper option especially in the elderly andhigh-risk patients who were underwent the hip surgery.

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