Pediatrik Penil Cerrahisinde Preemptif Analjezi Deneyimlerimiz: Kaudal Blok ve Dorsal Penil Bloğun Analjezik Etkilerinin Retrospektif Olarak Karşılaştırılması

Amaç: Sünnet hastalarında postoperatif analjezi kontrolü oldukça önemlidir. Bu amaçla preemptif analjezi yöntemleri yaygın olarak kullanılmaktadır. Bu çalışmanın amacı hastanemizde Ocak 2016-Eylül 2017 dönemleri arasında sünnet hastalarına uygulanmış ve farklı kliniklerde en sık uygulanan preemptif analjezi yöntemlerinden kaudal blok ve dorsal penil bloğun yeterli olup olmadığını retrospektrif olarak karşılaştırmaktır. Yöntemler: Bu çalışma Ocak 2016-Eylül 2017 ayları arasındaki Ermenek Devlet Hastanesinde sünnet operasyonu geçiren ve preemtif analjezi amacıyla kaudal blok veya dorsal penil blok uygulanan 483 vakanın dosyalarının retrospektif olarak değerlendirildiği bir çalışmadır. Hastaların dosyalarındaki anestezi izlem formları ve hemşire gözlem formları incelenerek, hastaların demografik verileri, cerrahi süre, anestezi süresi, intraoperatif ve postoperatif analjezik ilaç ihtiyaçları ile verilme zamanlarına ve kaydedilen komplikasyonlara bakıldı. Hastaların servis gözlem kayıtlarından; ilk analjezik ilaç ihtiyaç süreleri, VAS skoru kaydedildi. Bulgular: Her iki grupta demografik veriler ve hemodinamik veriler benzer bulundu. Her iki grup karşılaştırıldığında kaudal grupta postoperatif analjezi süresi daha uzun, ilk 6 saatlik dönemde ek analjezik ilaç ihtiyacı olan hasta sayısı daha az ve VAS skoru daha düşük bulundu (p0,05). Sonuç: Sünnet operasyonu geçiren çocuklarda preemptif analjezi amacıyla bupivakain ile kaudal blok veya dorsal penil bloğun uygulanması kolay ve güvenlidir. Ancak kaudal blok postoperatif analjezi sağlamada daha etkilidir ve daha çok hasta memnuniyeti sağlamaktadır.

Our Experiences of Pre-emptive Analgesia in Pediatric Penile Surgery: A Retrospective Comparison of the Analgesic Effects of Caudal Block and Dorsal Penile Block

Objective: Postoperative analgesia control is very important in circumcision patients, so preemptive analgesiamethods are widely used for this purpose. The aim of this study was to compare patients undergoing circumcisionapplied with the most commonly used preemptive analgesia methods of caudal block or dorsal penile block, betweenJanuary 2016 and September 2017 in our hospital.Methods: This retrospective study included 483 cases who underwent a circumcision operation at Ermenek StateHospital between January 2016 and September 2017 and were administered caudal block or dorsal penile block aspreemptive analgesia. The anesthesia follow-up forms and nurse observation forms of the patients were examinedand a record was made of demographic data, duration of surgery, duration of anesthesia, intraoperative andpostoperative analgesic requirements and complications. From the clinics observation records of the patients, thetime of first analgesic drug requirement and VAS scores were recorded.Results: Demographic data and hemodynamic data were similar in both groups. When the two groups were compared,in the caudal group, the duration of postoperative analgesia was longer, fewer patients required additional analgesiain the first 6-hour period, and the VAS scores were lower (p 0.05).Conclusion: It is easy and safe to administer caudal block or dorsal penile block with bupivacaine for preventiveanalgesia in children undergoing circumcision. However, caudal block is more effective in providing postoperativeanalgesia

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