Ömer AKTAŞ, Mehrican ŞAHİN, Levent ŞAHİN, Rauf GÜL

Ortopedik cerrahi için pediatrik hastalarda ultrason klavuzluğunda rejyonal anestezi

Ultrasonun (US) kullanıma girmesi pediatrik rejyonal anestezide çok önemli gelişmelere yol açmış ve US kılavuzluğu ile zor rejyonal uygulamalar dahi çocuklarda yapılabilir hale gelmiştir. Biz bu çalışmada kliniğimizde ortopedi ameliyat salonunda son 1 yılda opere edilen yaşları 1 ile 16 arasında değişen 81 pediatrik olguya intraoperatif anestezi, analjezi veya postoperatif analjezi amacıyla yaptığımız US kılavuzluğunda periferik sinir ve pleksus bloklarını literatür bilgileri ışığında tartışmayı amaçladık. Bu çalışma için hastaların anestezi formları, rejyonal anestezi değerlendirme formları, hemşire gözlem formları ve hastane çıkış epikrizleri kullanıldı. Hastaların bireysel özellikleri (yaş, cinsiyet, vücut ağırlığı, boy), ASA skorları, anestezi özellikleri, postoperatif analjezi ve motor blok süreleri, ve komplikasyonlar kaydedildi. Hastaların ortalama analjezi süresi üst ekstremite ve alt ekstremite için sırasıyla 5.8 ± 1.6 saat ve 8.7 ± 2.5 saat, motor blok süresi üst ekstremite ve alt ekstremite için sırasıyla 3.6 ± 0.7 saat ve 5.3 ± 1.8 saat olarak bulundu. Üç hastada başarısız veya yetersiz blok mevcuttu. Ortopedik cerrahi uygulanan pediatrik hastalarda rejyonal bloklar US-kılavuzluğunda etkin ve güvenli bir şekilde uygulanabilir ve yüksek başarı, minimal komplikasyon oranına sahiptir.

Ultrasound-guided regional anesthesia for orthopedic surgery in pediatric patients

Introduction of the use of ultrasound (US) has led to very important developments in pediatric regional anesthesia and made applications, which are hard or even impossible to perform, applicable by the guidance of US. In this study, we aimed to discuss USguided peripheral nerve and plexus blocks that we made for intraoperative anesthesia, analgesia or postoperative analgesia in 81 pediatric patients ranging from ages 1 to 16 who were operated in the last year. For this study, anesthesia forms, evaluation forms of regional anesthesia, observation forms for nurses, and hospital epicrises of patients were used. Demographic data (age, sex, weigh, height), ASA scores, anesthetic properties, postoperative duration of analgesia and motor block and complications of patients were recorded. Estimated mean duration of analgesia for upper and lower extremities were 5.8 ± 1.6 h, and 8.7 ± 2.5 h, respectively, the duration of motor block for upper and lower extremities were 3.6 ± 0.7 h, 5.3 ± 1.8 h, respectively. Failed or insufficient block count was three. In orthopedic surgery applied pediatric patients US-guided regional blocks can be applied effectively and safely and it has high achievement and minimal complication rates.

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