Reşit SARUHAN, Levent ŞAHİN, Sıtkı GÖKSU, Süleyman GANİDAĞLI, Ayşe MIZRAK, Vahap SARIÇİÇEK, Zeliha Beyza BAYRAK

İnterskalen brakiyal pleksus blok uygulamalarında ultrason ve sinir stimülatörü tekniklerinin etkinliklerinin karşılaştırılması

İnterskalen brakiyal pleksus bloğu uygulamalarında ultrasonografi ve periferik sinir stimülatörü tekniklerinin uygulanması sırasında potasiyel olarak avantaj ve dezavantajlar bulunmaktadır. Bu çalışmada, ultrasonografi ve periferik sinir stimülatörü kullanımı ile gerçekleştirilen interskalen blok uygulamalarında duyusal ve motor blok oluşma sürelerini ve postoperatif analjezik ihtiyacı sürelerini karşılaştırılması amaçladık. Omuz cerrahisi sebebiyle interskalen blok uygulanacak olan ASA (American Society of Anesthesiologysts) I-II grubu 60 hasta prospektif, çift kör planlanan çalışmaya kabul edildi. Her iki hasta grubuna da 25 ml % 0.5 Levobupivakain uygulandı. Duyusal blok pinpirik testi, motor blok ise Bromage skalası ile değerlendirildi. Duyusal ve motor blok oluşma süreleri ile postoperatif ilk analjezik ihtiyacı süreleri kaydedildi. Gruplar arasında hastaların demografik özellikleri benzerdi. Ultrason kullanılan grupta (Grup-U) duyusal ve motor blok oluşma süreleri periferik sinir stimülatörü kullanılan gruba (Grup-S) göre istatistiksel olarak belirgin bir şekilde daha kısa olup ilk analjezik ihtiyacı süresi daha uzundu. Sonuç olarak; ultrason ve sinir stimülatörü kullanılarak gerçekleştirilen interskalen brakiyal pleksus bloğunda; ultrason tekniği ile duyusal ve motor bloğun daha hızlı geliştiği ve postoperatif ilk analjezik ihtiyaç süresinin daha uzun olduğu gözlenmiştir. Ayrıca, ultrason tekniği ile postoperatif hasta konforunun da daha memnun edici olduğu belirlenmiştir..

The comparison of the effectiveness of the ultrasound and peripheral nerve stimulating techniques during interscalen block

There are potential advantages and disadvantages during ultrasonographic and peripheral nerve stimulating techniques in interscalen plexus blockade. In this study, we aimed to compare the sensory and motor blockade onset time and the duration of postoperative analgesic requirement during interscalen blockade performed with ultrasound and peripheral nerve stimulating techniques. Sixty patients in ASA (American Society of Anesthesiologysts) 1-2 groups were accepted in this prospective and double blind study for the shoulder surgery. Twenty-five ml 0.5% Levobupivacaine was administered to each patient group. The sensory blockade was evaluated with Pinprick test and the motor blockade was evaluated with the Bromage Scale. The duration of the sensorial and the motor blockade and the duration of postoperative first analgesic requirement were noted. The demographic data were similar between the groups. The onset time of sensorial and the motor blockades in group U was significantly shorter than in group S and the first analgesic requirement time in group U was significantly longer than in group S. During the interscalen blockade performed with ultrasound and peripheral nerve stimulator, it was observed that the sensorial and motor blockade was developed faster and the duration of first analgesic requirement was longer with ultrasound technique. Furthermore, it was determined that postoperative patient comfort score was more satisfied by ultrasound technique.

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