Dilek ALTUN, Abdullah DOĞAN, Ahmet ARNAZ, Adnan YÜKSEK, Yusuf Kenan YALÇINBAŞ, Rıza TÜRKÖZ, Sinan AŞAR, Tayyar SARIOĞLU

Pediatrik hastalarda mini-torakotomi ile atriyal septal defekt kapatılması: İnterkostal sinir blokunun ameliyat sonrası analjezik etkisi

Amaç: Bu çalışmada, sağ lateral mini-torakotomi ile atriyal septal defekt kapatılması yapılan pediatrik hastalarda interkostal sinir blokunun ameliyat sonrası ağrı yönetimindeki etkinliği değerlendirildi. Çalışma planı: Ocak 2016 - Ocak 2019 tarihleri arasında sağ lateral minitorakotomi ile atriyal septal defekt kapatılması için düzeltici doğuştan kalp cerrahisi yapılan toplam 63 pediatrik hasta (37 erkek, 26 kız; ort. yaş 34.8±26.8 ay; dağılım, 2-96 ay) retrospektif olarak incelendi. Hastalar interkostal sinir bloku ve genel anestezi verilenler (Grup 1, n=33) ve yalnızca genel anestezi verilenler (Grup 2, n=30) olmak üzere iki gruba ayrıldı. Ramsay Sedasyon Ölçeği skoru >4 ve Doğu Ontario Çocuk Hastanesi Ağrı Ölçeği skoru >7 olan hastalara kurtarma analjezisi olarak 0.03 mg/kg dozunda intravenöz morfin uygulandı. Toplam analjezik gereksinimi, yan etkiler, mekanik ventilasyon süresi ve yoğun bakım ünitesinde kalış süresi kaydedildi. Bulgular: Ortalama mekanik ventilasyon ve yoğun bakım ünitesinde kalış süresi Grup 1’de Grup 2’ye kıyasla daha kısa idi (sırasıyla, 3.6±1.3’e kıyasla 9.4±2.1 saat; 23±2.6’ya kıyasla 30±7.2 saat) (p

Atrial septal defect closure via mini-thoracotomy in pediatric patients: Postoperative analgesic effect of intercostal nerve block

Background: In this study, we evaluated the efficacy of intercostal nerveblock for postoperative pain management in pediatric patients undergoingatrial septal defect closure through a right lateral mini-thoracotomy.Methods: Between January 2016 and January 2019, a total of 63 pediatric patients(37 males, 26 females; mean age 34.8±26.8 months; range, 2 to 96 months) whounderwent corrective congenital heart surgery for atrial septal defect closurethrough a right lateral mini-thoracotomy were retrospectively reviewed. Thepatients were divided into two groups as those (Group 1, n=33) receivingintercostal nerve block and general anesthesia and those (Group 2, n=30)receiving general anesthesia alone. Intravenous morphine at a dose of 0.03 mg/kgwas applied as rescue analgesia to the patients with a Ramsay Sedation Scalescore of >4 and Children’s Hospital of Eastern Ontario Pain Scale score of>7. The total analgesic requirement, adverse effects, duration of mechanicalventilation and length of stay in the intensive care unit were recorded.Results: The mean duration of mechanical ventilation and intensive careunit stay was shorter in Group 1 compared to Group 2 (3.6±1.3 vs. 9.4±2.1 h;23±2.6 vs. 30±7.2 h, respectively) (p

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