Sevtap DARCİN, Ayca TAS TUNA, İbrahim AKKOYUN, Melahat KECECİOGLU, Onur PALABİYİK

Çocuk Hastalarda İlioinguinalL/İliohipogastrik Sinir Bloğunda Bupivakain ve Levobupivakainin Postoperatif Ağrıya Etkilerinin Karşılaştırılması: Retrospektif Çalışma

Amaç: Genel anesteziye eklenen ilioinguinal/iliohipogastrik (İİ/İH) sinir bloğu pediyatrik hastalarda postoperatif analjezi için sıklıkla kullanılmaktadır. Daha önce araştırılmadığından dolayı, pediyatrik hastalarda inguinal herni onarımı için İİ/İH sinir bloğunda uygulanan bupivakain ve levobupivakainin postoperatif analjezik etkilerini karşılaştırmayı amaçladık.Gereç ve Yöntem: Bu 2 yıllık retrospektif çalışmada, veriler tek taraflı kasık fıtığı ameliyatı yapılan hastaların tıbbi kayıtlarından elde edildi. 0.2 mL/kg %0.5 bupivakain (Grup B) veya levobupivakain (Grup L) ile İİ/İH sinir bloğu uygulanan hastalar alındı. Elektif olmayanlar, 2 yaş altı hastalar ve birden fazla cerrahi prosedür içerenler çalışma dışı bırakıldı. Hastaların demografik özellikleri (yaş, kilo ve cinsiyet), cerrahi süre ve taraf, ağrı skorları, ek analjezik gereksinimi ve komplikasyonlar kayıt altına alındı. İstatistiksel analiz için Ki-kare testi ve Mann-Whitney U testi kullanıldı. Bulgular: Her iki gruptaki ağrı skorları post-anestezi bakım ünitesinde, 1, 2, 6 ve 24. saatlerde farklı değildi. Bununla birlikte, 4. saatteki ağrı skorları Grup L'de anlamlı derecede düşüktü. Sonuçlar: Genel anesteziye eklenen İİ/İH sinir bloğu, postoperatif ağrı kontrolünde pediyatrik hastaların inguinal bölge cerrahisinde etkilidir ve %0.5 levobupivakain ve bupivakainin benzer analjezik etkisi vardır.

Anahtar Kelimeler:

Bupivakain, levobupivakain, pediyatrik anestezi, ilioinguinal/iliohipogastrik sinir bloğu, postoperatif ağrı

COMPARISON OF BUPIVACAINE AND LEVOBUPIVACAINE ON POSTOPERATIVE PAIN AFTER ILIOINGUINAL/ILIOHYPOGASTRIC NERVE BLOCK IN PEDIATRIC PATIENTS: A RETROSPECTIVE STUDY

Objective: Ilioinguinal/iliohypogastric (II/IH) nerve block added to general anesthesia is frequently used for postoperative analgesia in pediatric patients. We aimed to compare the postoperative analgesic effects of bupivacaine and levobupivacaine for II/IH nerve block for inguinal hernia repair in pediatric patients, which is not investigated previously.Materials and Methods: In this 2-year retrospective study, data were collected from the medical charts of patients that underwent unilateral inguinal hernia repair. Patients were included who received an II/IH nerve block with 0.2 mL/kg 0.5% of either bupivacaine (Group B) or levobupivacaine (Group L). Non-elective cases, age under 2 years and patients with multiple procedures were excluded. Demographic properties of the patients (age, weight, and sex), duration and side of surgery, pain scores, additional analgesic requirement and complications were documented. The chi-square test and the Mann-Whitney U test were used for statistical analysis. Results: In both groups, the pain scores were not significantly different at post anesthesia care unit, 1, 2, 6 and 24th hours; nevertheless, the pain scores at 4th hour were significantly lower in Group L. Conclusion: II/IH nerve block added to general anesthesia is effective in inguinal region surgery of pediatric patients in postoperative pain control, and 0.5% levobupivacaine and bupivacaine had similar analgesic effect.

Keywords:

Bupivacaine, levobupivacaine, pediatric anesthesia, ilioinguinal/iliohypogastric nerve block, postoperative pain,

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