FAST TRACK DİZ ARTROPLASTİSİ: İKİ FARKLI MULTİMODAL ANALJEZİ YÖNTEMİNİN KARŞILAŞTIRILMASI

AmaçBu çalışmanın amacı, Fast track Total Diz Artroplasti(TDA) ameliyatlarında multimodal protokolün, femoralsinir blokajı (FSB) ile lokal infiltrasyon analjezi (LIA)yöntemleri kullanarak pre-emptif analjezideki etkilerinihızlı bir şekilde değerlendirmektir.Gereç ve YöntemBu çalışma tek merkezli, randomize, tek kör kontrollübir çalışma olarak planlandı. Çalışmaya, birincil veyaikincil osteoartrit nedeniyle TDA uygulanan, her ikicinsiyetten 40-80 yaş arası toplam 72 gönüllü hastadahil edildi. Hastalar bir bilgisayar randomizasyonprogramı kullanılarak iki gruba ayrıldı. Grup I: FSByöntemi uygulanan hastalar ve Grup II: LIA yöntemiuygulanan hastalar. Gruplar fonksiyonel puanlar açısındankarşılaştırıldı.BulgularGruplar arasında yaş, cinsiyet, boy, kilo, vücut kitle indeksi,ASA, ameliyat edilen taraf, protez tipi ve ameliyatsüresi açısından istatistiksel olarak anlamlı farksaptanmadı (p> 0,05). Her iki grupta da ölçüm zamanlarıarasında fonksiyon skor değerlerinde istatistikselolarak anlamlı farklılık belirlendi (p <0.05). Hangi zamandaveya zamanlarda bir fark olduğunu belirlemekiçin çoklu karşılaştırma testleri (post-hoc) uygulandı.Her iki grupta da fonksiyon skor değerleri tüm ölçümzamanlarında farklıydı, preoperatif ölçüm en düşük,postoperatif 3 aylık değerler en yüksek bulundu.SonuçÇalışmamız femoral sinir bloğu veya lokal infiltrasyonanaljezisi ile multimodal analjezinin kullanılmasınınFast-track TDA ameliyatlarında etkili analjezi yöntemleriolarak uygulanabileceğini ve birbirlerine alternatifolabileceğini göstermektedir.

Anahtar Kelimeler:

Fast-Track cerrahi, Total diz artroplastisi, Lokal infiltrasyon analjezi, Femoral sinir bloğu, Multimodal analjezi

FAST TRACK KNEE ARTHROPLASTY: COMPARISON OF TWO DIFFERENT MULTIMODAL ANALGESIA METHODS

ObjectiveThe aim of this study was to evaluate the effectsof a multimodal protocol in pre-emptive analgesiafollowing Total Knee Arthroplasty (TKA), usingepidural anesthesia with femoral nerve blockage(FNB) or local infiltration analgesia (LIA) methods infast-track TKA.Material and MethodsThis study was planned as a single-centre,randomized, single-blind, controlled study. The studyincluded 72 voluntary patients, aged 40-80 years,of both genders, who underwent TKA for primary orsecondary osteoarthritis. The patients were dividedinto two groups using a computer randomizationprogram. Group I: FNB application and Group II:LIA methods. Groups were compared in terms offunctional scores.ResultsNo statistically significant difference was determinedbetween the groups in respect of age, gender, height,weight, BMI, ASA, operated side, prosthesis type,and operating time (p>0.05). A statistically significantdifference was determined in the function score valuesbetween the measurement times in both groups(p<0.05). Multiple comparison tests (post-hoc) wereapplied to determine at which time or times there wasa difference. In both groups, the function score valueswere different at all the measurement times, with thepreoperative measurement found to be the lowestand the postoperative 3-month values the highest.ConclusionsOur study show that used multimodal analgesia withfemoral nerve block or local infiltration analgesia canbe applied as effective analgesia methods in fasttrackTKA and can be considered as alternatives foreach other.

Keywords:

Arthroplasty, Analgesia, Local infiltration analgesia, Femoral nerve block, Multi-modal analgesia,

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