Ömer Fatih Şahin, Yakup Aksoy, Ayhan Kaydu, Erhan GÖKÇEK

Spinal anestezi uygulanan sezaryen operasyonlarında bilateral TAP bloğun analjezik tüketimine etkisi

Amaç: Çalışmamızda spinal anestezi altında uygulanan Transvers Abdominis Plain (TAP) bloğun; sezaryen operasyonlarında postoperatif analjezi ve opioid tüketimine etkisini retrospektif olarak incelemeyi amaçladık.Gereç ve Yöntem: 2016 mayıs-ekim ayları arasında hastanemizde elektif şartlarda spinal anestezi altında sezaryen operasyonu olan hastaların dosyaları retrospektif olarak incelendi. Hastalar medikal tedavi alanlar ile TAP blok uygulananlar olarak iki gruba ayrıldı. Demografik veriler, postoperatif 1, 2, 4, 6, 9, 12 ve 24. saatte bakılan vizüel analog skala (VAS) değerleri, NSAİİ (Nonsteroid Anti inflamatuar İlaç) ve opioid tüketimleri incelendi. Blok uygulanan ve uygulanmayan hastalardaki ilk analjezik ve opioid tüketim saatlerine bakıldı. Bulgular: Kayıtlarına ulaşılabilen 58 hastadan medikal tedavi yapılan hastaların (27 hasta) postoperatif 1. ve 4. saat VAS değerleri TAP blok yapılan hastalara (31 hasta) göre anlamlı derecede yüksek bulundu. Yalnızca medikal tedavi alan hastalarda (Grup 1) opioid ihtiyacının TAP blok uygulanan hastalara (Grup 2) göre yüksek olduğu saptandı (p<0,05). Opioid uygulama süresi ise Grup 1 de ortalama 200,27 dakika, Grup 2 de ise 263,33 dakika olarak bulunmuştur (p<0,05). Opioid uygulanan hasta oranları Grup 1 de %66,66 Grup 2 de ise %29,03 olarak bulundu. Tartışma ve Sonuç: Sezaryen operasyonları gibi alt abdominal cerrahi operasyonları sonrası ağrı kontrolünde TAP blok uygulanmasının opioid tüketimini azalttığını saptadık.

Anahtar Kelimeler:

postoperatif analjezi, transvers abdominis plain blok, Sezeryan

The effect of bilateral TAP block administration on analgesic consumption in cesarean operations under spinal anesthesia

Backround: The purpose of this study was determine the efficacy of ultrasound guided Transverse Abdominis Plane (TAP) block in patients after cesarean operation under spinal anesthesia.Methods: İn this retrospective study, we reviewed the patient files which was elective cesarean operation under spinal anesthesia between 2016 may and october. Fifty-eight patients who were fully informed were included in the study. The patients were divided into two groups as medical treatment subjects (Group 1) and TAP blockers (Group 2). Demographic data, visual analogue scale (VAS) values, NSAID (Nonsteroidal Anti-inflammatory Drug) and opioid consumption were examined at postoperative 1.2, 4, 6, 9, 12 and 24 hours. The time of first analgesic and opioid consumption in the patients was checked.Results: Postoperative 1 and 4 hour VAS values were significantly higher in group 1 patients (27 patients) than in group 2 patients (31 patients) who underwent TAP block. In patients receiving only medical treatment (Group 1), the need for opioids was found to be higher than patients receiving TAP block (Group 2), (p <0.05). The mean duration of opioid application was 200,27 minutes in group 1 and 263,33 minutes in group 2 (p<0,05). In Group 1, 66.66% of the patients were treated with opioid and 29.03% in Group 2. Conclusions: We found that the TAP block decreased the postoperative VAS values and the opioid consumption.after cesarean operation under spinal anesthesia.

Keywords:

Postoperative analgesia, transverse abdominal plain block, cesarean,

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