Ürolojik cerrahi geçiren çocuklarda postoperatif ağrı ve analjezik ihtiyacının flacc skoruna göre değerlendirilmesi : retrospektif gözlemsel çalışma

Amaç: Pediatrik ürolojik girişim uygulanmış hastalardan postoperatif ağrı tedavisinde parasetamol ya da rejyonal tekniklerden ka- udal blok kullanılmış olan ve FLACC skalası ile postoperatif analjezi ölçümü yapılmış olan hastaları retrospektif olarak değerlendir- meyi amaçladık. Gereç ve Yöntem: Çalışmada yaşları 0 ile 12 arasında değişen, Nisan 2019 ile Temmuz 2019 tarihleri arasında ürolojik günübirlik cerrahi uygulanmış toplam 55 hastanın dosyaları retrospektif olarak değerlendirilmiştir. Kaudal epidural analjezi yapılan pediatrik hastalar Grup 1 olarak adlandırılırken, iv parasetamol verilen Grup 2 olarak adlandırılmıştır. FLACC skorları 10 dakika da bir olmak üzere 50 dakika boyunca uygulanmış. 10, 20, 30, 40 ve 50. dk’daki skorları hesaplanmıştır. Skor sonucuna göre ek analjezik yapılan hastalar not edilmiştir. Bulgular: Hastaların yaş ortalaması Grup 1’de 5.5±3.4 yıl iken Grup 2’de 6.2±3.6 yıl idi. Ortalama cerrahi süresi Grup 1’de 36.9±25.5, Grup 2’de ise 23.5±17.2 dakika idi. Postoperatif FLACC skorları 10, 20, 30, 40. dakikalarda grup 2’de Grup 1’e göre anlamlı derecede yüksekti ve yine 50. dakikada bile anlamlı derecede yüksek tespit edildi. Postoperatif ek analjezik ihtiyacı Grup 1’de hiçbir hastaya gerekmezken (%0), grup 2’deki 14 hastaya (%50) ek analjezik olarak iv parasetamol 15 mg/kg verilmiştir. Sonuç: Çalışmamızda ağrı ortaya çıkmadan önce önleme konusunda kaudal epidural analjezi tekniğinin uygulanmasının postoperatif ağrı kontrolünü sağlamada etkin olduğunu tespit ettik. İlave olarak kaudal analjezinin postoperatif dönemde ek analjezik ihtiyacını azaltması, analjeziklerden oluşabilecek yan etkilerden sakınma ve maliyeti düşürme açısından avantajları düşünüldüğünde pediatrik grup hastalarda tercih sebebi olması gerektiğini düşünmekteyiz

Evaluatıon of postoperatıve paın and analgesıc requırement ın children undergoıng urologıcal surgery accordıng to flacc score: a retrospectıve observatıonal study

bjective: We aimed to evaluate postoperative analgesia of intravenous paracetamol or caudal block at pediatric patients with using FLACC scale who underwent urologic intervention retrospectively. Material and Methods: The files of 55 patients aged between 0 and 12 who underwent urological surgery between April 2019 and July 2019 were evaluated retrospectively. Pediatric patients undergoing caudal epidural analgesia were referred to as Group 1, while Group 2 was given iv paracetamol. FLACC scores were administered for 50 minutes, once every 10 minutes. Scores at 10, 20, 30, 40 and 50 min were calculated. Patients who underwent additional analgesics based on the score were noted. Results: The mean age of the patients was 5.5 ± 3.4 years in Group 1 and 6.2 ± 3.6 years in Group 2. Mean duration of surgery was 36.9 ± 25.5 minutes in Group 1 and 23.5 ± 17.2 minutes in Group 2. Postoperative FLACC scores were significantly higher in group 2 at 10, 20, 30, 40 minutes compared to Group 1, and again significantly higher at 50 minutes. No additional postoperative analgesic require- ment was required in Group 1 (0%), while 14 patients (50%) in group 2 received iv paracetamol 15 mg / kg as an additional analgesic. Conclusion: We found that the application of caudal epidural analgesia to prevent postoperative pain was effective. Caudal analgesia should be preferred in pediatric patients when it is considered to reduce requirement of additional analgesics in postoperative period, avoiding the side effects and reducing costs

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