Yavuz ENÇ, Tamer AKSOY, Sevim CANİK, Şahin ŞENAY, Pelin KARACA, Oğuzhan CÜCÜ, Okan YÜCEL

Comparison of thoracic paravertebral and epidural blocks for pain relief after thoracotomy

Amaç: Dorsal paravertebral ve epidural bloğun torakotomi sonrası ağrı kontrolü ve solunum fonksiyonları üzerine etkilerini karşılaştırmaktı. Çalışma planı: Çalışmaya 50 hasta (38 erkek, 12 kadın; ort. yaş 49.8±17.7; dağılım 15-78) alındı. Hastalar rasgele epidural (grup 1) ve paravertebral (grup 2) blok uygulanacak şekilde iki gruba ayrıldı. Hastalara, hasta kontrollü analjezi (PCA) cihazıyla ek morfin uygulaması yapıldı. Ameliyat sonrası birinci günkü total morfin kullanımı PCA cihazının hafızasından not edildi. Görsel analog skalası (VAS) kullanılarak ilk 24 saatte, dinlenme sırasında; cerrahi yoğun bakım ünitesine gelişten bir saat sonra ve ardından her iki saatte bir hastalarda ağrı değerlendirilmesi yapıldı.Bulgular: İki grup arasında; VAS skoru ve morfin tüketimi açısından istatiksel olarak anlamlı fark bulunamadı. Ek olarak ameliyat sonrası birinci gündeki FEV1 ve FVC değerleri istatiksel olarak anlamlı derecede farklı değildi.Sonuç: Paravertebral blok torakotomi sonrası ağrı kontrolü için uygun ve etkili bir alternatif olabilir.

Torakotomi sonrası uygulanan dorsal paravertebral ve epidural bloğun ağrı kontrolü açısından karşılaştırılması

Background: The aim was to compare the effects of thoracic paravertebral and epidural blocks on pain relief and respiratory function after thoracotomy. Methods: 50 patients (38 males, 12 females; mean age 49.8±17.7; range 15 to 78 years) were included in the study. Patients were randomly divided into two groups to be applied epidural (group I), paravertebral (group II) block. Patients had supplementary doses of morphine by a patient-controlled analgesia (PCA) device. Postoperative total morphine consumption was noted by the PCA device. During the first 24 hours using visual analoque scale (VAS) patients were asked to assess their pain at rest; 1 hour after being in the intensive care unit and every 2 hoursResults: There were no significant differences between the groups regarding morphine consumption and VAS scores. Additionally, on the first postoperative day FEV1 and FVC measurements were not significantly different.Conclusion: Paravertebral block may be an effective and safe altenative for the pain relief after thoracotomy.

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