Ultrasonografi Kılavuzluğunda Yapılan Perkutan Karaciğer Biyopsilerinde Perikapsüler Lokal Anestezi Uygulamasının Perioperatif Ağrı Üzerine Etkisi

GİRİŞ ve AMAÇ: Perkütan karaciğer biyopsisi, karaciğer hastalığının tanı ve tedavisi için önemli bir prosedür olup sıklıkla ağrı ile ilişkilidir. Bu çalışmada, perkutan karaciğer biyopsisi öncesi perikapsüler alana lokal anestezi uygulamasının işlem sonrası ağrı düzeylerine etkisini araştırmayı amaçladık. YÖNTEM ve GEREÇLER: Çalışmaya ultrasonografi eşliğinde perkutan karaciğer biyopsisi yapılan 79 hasta dahil edildi. İşlem öncesi 20 mL %2 lik prilokainden 5 mL cilt altı dokulara, 15 mL ise perikapsüler alana verildi. Biyopsi sonrası hastaların 0. ve 3. saat ağrı düzeyleri 1-10 arası sayısal derecelendirme ölçeği (SDÖ) ile değerlendirildi. BULGULAR: Hastaların işlemden hemen sonraki ortalama SDÖ skoru 1,75 +/- 2,2 iken, işlemden 3 saat sonraki ortalama SDÖ skoru 1,73 +/- 2,1 bulundu. Hastaların 0. ve 3. saat ortalama ağrı skorları arasında anlamlı fark izlenmedi (p=0,962). Herhangi bir zaman diliminde (0-3. saat), hastaların ağrı düzeyleri ile yaşı, cinsiyeti, biyopsi endikasyonu ve modifiye hepatik aktivite indeksi arasında anlamlı ilişkili saptanmadı (p>0,05). Erkeklerde fibrozis evresi ile ağrı düzeyi arasında anlamlı ilişki bulunmazken, kadınlarda 0. saatte fibrozis evresi arttıkça ağrı düzeyinin arttığı saptandı. TARTIŞMA ve SONUÇ: : Ultrasonografi eşliğinde perkutan karaciğer biyopsisi, perikapsüler alana yeterli miktarda lokal anestezi ile birlikte uygulandığında işlem sonrası ağrı düzeyini önemli ölçüde azaltmaktadır.

The Effect of Pericapsular Local Anesthesia on Perioperative Pain in Ultrasound-guided Percutaneous Liver Biopsies

INTRODUCTION: Percutaneous liver biopsy is an important procedure for the diagnosis and treatment of liver disease and is often associated with pain. In this study, we aimed to investigate the effect of pericapsular local anesthesia before percutaneous liver biopsy on post-procedure pain levels. METHODS: A total of 79 patients who underwent ultrasound guided percutaneous liver biopsy were included in the study. Before the procedure, 5 mL of 2% prilocaine was performed to subcutaneous tissue and 15 mL to the pericapsular area. After the biopsy, the pain levels of the patients at 0 and 3 hours were evaluated with a numerical rating scale (NRS) between 1-10. RESULTS: The NRS scores at 0 and 3 hours were 1.75 +/- 2.2 and 1.73 +/- 2.1, respectively. There was no significant difference between NRS scores at 0 and 3 hours (p=0.962). There was no significant correlation in any time period (0-3 hours) between the pain levels of the patients and age, gender, biopsy indication and modified hepatic activity index (p>0.05). While there was no significant correlation between fibrosis stage and pain level in men, it was found that the level of pain increased as the fibrosis stage increased at 0 hour in women. DISCUSSION AND CONCLUSION: Pericapsular local anesthesia is an effective method that significantly reduces the level of pain after percutaneous liver biopsy under ultrasound guidance..

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