Dijital Blok Anestezisi ve Genel Anestezi Yöntemleri İle Yapılan El Parmak Replantasyonlarının Karşılaştırılması

Amaç: Bu çalışmada dijital blok anestezisi (DBA) (Group II) ile genel anestezi (GA) (Group I) altında yapılan el parmak replantasyonları; ameliyata alınma süresi, iskemi süresi ve ameliyat sonrası sağ kalım yönünden retrospektif olarak karşılaştırılmıştır. Literatürde DBA altında parmak replantosyonuna ait sadece 2 çalışmaya rastladık. Ancak GA ve DBA altında yapılan el parmak replantasyonalarının karşılaştırılmasına dair bir çalışmaya ise literatürde rastlamadık. Yöntemler: Çalışmaya 2005-2014 yılları arasında kliniğimizde metakarpofalangeal (MF) eklem ve distali seviyesinden el parmak replantasyonu veya revaskülarizasyonu yapılan 50 hasta dahil edildi. Hastalar kullanılan anestezi yöntemine göre GA (Grup I) ya da DBA (Grup II) olarak iki gruba ayrıldı. Dijital blok işlemi için yarı-yarıya hazırlanmış 1-4 ml epinefrinsiz Lidocaine %2 ve Bupivacaine %0.5 kombinasyonu kullanıldı. Çalışmada, hasta dosyalarından, fotoğraflardan ve kliniğimizde düzenlenen replantasyon izlem formlarından her iki gruptaki hastalara ait demografik, ameliyat ve klinik izlem bilgileri elde edildi. Bulgular: Hiçbir hastada GA ya da DBA’ne bağlı komplikasyon gelişmedi. Grup II'deki hastaların operasyona hazırlanma süreleri daha az bulunmuş, bu da ameliyata diğer gruba göre anlamlı derecede daha erken bir zamanda başlanmasını sağlamıştır (p=0.048). Grup II'deki parmakların iskemi sürelerinin anlamlı olarak daha kısa olduğu da gözlendi (p=0.003). Acil servise ulaştırılma (p

Comparison of Finger Replantations Performed with Digital Block Anesthesia and General Anesthesia Methods

Objective: In this study, finger replantations which were performed under digital block anesthesia (DBA) (Group II) or under general anesthesia (GA) (Group I) were retrospectively compared in terms of time to operation, the duration of ischemia and post-operative survival rate. In the literature, we found only 2 studies on finger replantation under DBA. However, we could not find any study in the literature, comparing finger replantations performed under GA and DBA. Method: In our clinic, between the years of 2005 and 2014, a total of fifty patients (with a total of 54 effected fingers) who underwent finger replantation or revascularization at the level of metacarpophalangeal (MF) joint and its distal were enrolled for the study. Patients were divided into two groups that were categorized as GA (Group I) or as DBA (Group II) according to the anesthesia method used. For digital block processing, a combination prepared in half with 1 to 4 ml of epinephrine-free Lidocaine 2% and Bupivacaine 0.5% was used. In this study, the demographics, operative and clinical follow-up information of the patients were obtained from the patient files. Furthermore, photographs and replantation follow-up forms, which were drafted at the clinic, were also utilized as well. Results: There was no complication observed due to the application of GA or DBA in any of the patients. Patients in Group II were found have a lower operation readiness period, which resulted in the operations being performed significantly earlier as compared to the other group (p=0.048). It was also observed that ischemia durations of the fingers in group II were significantly shorter (p=0.003). It was determined that all three variables including delivery to the emergency department (ED) (p

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