Supraklaviküler brakiyal pleksus bloğu uygulanan hastalarda intravenöz deksmedetomidin ve perinöral deksametazonun blok süresine etkisi
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Date
2020
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Amaç: Bu çalışmada supraklaviküler blok yapılan hastalarda intravenöz deksmedetomidin ile perinöral deksametazonun kombine kullanımının blok süresine, blok başlangıcına, hasta memnuniyetine, postoperatif bulantı-kusmaya ve opioid tüketimine etkisinin değerlendirilmesi amaçlandı. Yöntem: Etik kurul onayından sonra, supraklaviküler blok planlanan ASA I-III, 18-75 yaş arası 120 hasta çalışmaya alındı. Çalışma prospektif, randomize, çift kör olarak gerçekleştirildi. Grup 1'e, iv deksmedetomidin infüzyonu, Grup 2'ye iv deksmedetomidin + perinöral deksametazon, Grup 3'e perinöral deksametazon verildi. Dördüncü grup kontrol grubuydu. Postoperatif 48 saat boyunca vital bulgular, komplikasyonlar, morfin tüketimi, hasta memnuniyeti, motor ve sensoriyel blok süreleri kaydedildi. Postoperatif analjezi HKA morfinle sağlandı. Bulgular: Sensoriyel blok süreleri Grup 1 (726,83 ± 50,93 dk), Grup 2 (1126,33 ± 127,32 dk) , Grup 3 (1104,83 ± 120,71 dk), Kontrol (368,67 ± 41,73 dk) gruplarında değerlendirildi. Motor blok süreleri Grup 1 (726,83 ± 50,93 dk), Grup 2 (1126,33 ± 127,32 dk), Grup 3 (1104,83 ± 120,71 dk), Kontrol (368,67 ± 41,73 dk) gruplarında değerlendirildi. Hem motor hem de sensoriyel blok süreleri açısından Grup 2 ve Grup 3 benzer bulundu (p>0,05). Grup 2 ve Grup 3, Grup 1 ve Kontrol gruplarından daha uzun blok sürelerine sahipti (p<0,05). Grup 1 ise Kontrol grubundan daha uzun blok sürelerine sahipti (p<0,05). Sonuç: Hem perinöral deksametazon hem de intravenöz deksmedetomidin tek başlarına kullanıldıklarında blok süresini uzatır. Perinöral deksametazon, iv deksmedetomidinden daha etkin olup, bu iki ajanın kombine kullanımı ile perinöral deksametazonun tek başına kullanımı arasında fark bulunmamıştır. Deksmedetomidin rejyonel anestezide etkin bir sedatif olsa da hipotansiyon ve bradikardiye neden olabileceği unutulmamalıdır.
Background and aim: In this study, it is aimed to evaluate the effect of combined use of intravenous dexmedetomidine and perineural dexamethasone on the duration of block, onset of block, patient satisfaction, postoperative nausea-vomiting and opioid consumption in patients who underwent supraclavicular block. Methods: After the approval of the ethics committee, 120 patients between the ages of 18-75, ASA I-III planned for supraclavicular block were included in the study. The study was prospective, randomized, double-blind. Group 1 received iv dexmedetomidine infusion, Group 2 received iv dexmedetomidine + perineural dexamethasone, and Group 3 received perineural dexamethasone. The fourth group was the control group. Vitals, complications, morphine consumption, patient satisfaction, motor and sensory block times were recorded for postoperative 48 hours. Postoperative analgesia was provided with PCA morphine. Results: Sensory block times Group 1 (726.83 ± 50.93 min), Group 2 (1126.33 ± 127.32 min), Group 3 (1104.83 ± 120.71 min), Control (368.67 ± 41, 73 minutes) were evaluated in groups. Motor block times Group 1 (726.83 ± 50.93 min), Group 2 (1126.33 ± 127.32 min), Group 3 (1104.83 ± 120.71 min), Control (368.67 ± 41, 73 minutes) were evaluated in groups. Group 2 and Group 3 were found to be similar in terms of both motor and sensory block times (p> 0.05). Group 2 and Group 3 had longer block times than Group 1 and Control groups (p <0.05). Group 1 had longer block times than the control group (p <0.05). Conclusion: Both perineural dexamethasone and intravenous dexmedetomidine prolong the block time when used alone. Perineural dexamethasone is more effective than iv dexmedetomidine, and there was no difference between the combined use of these two agents and the use of perineural dexamethasone alone. It should be kept in mind that although dexmedetomidine is an effective sedative in regional anesthesia, it may cause hypotension and bradycardia. Keyword: supraclavicular block, iv dexmedetomidine, perineural dexamethasone
Background and aim: In this study, it is aimed to evaluate the effect of combined use of intravenous dexmedetomidine and perineural dexamethasone on the duration of block, onset of block, patient satisfaction, postoperative nausea-vomiting and opioid consumption in patients who underwent supraclavicular block. Methods: After the approval of the ethics committee, 120 patients between the ages of 18-75, ASA I-III planned for supraclavicular block were included in the study. The study was prospective, randomized, double-blind. Group 1 received iv dexmedetomidine infusion, Group 2 received iv dexmedetomidine + perineural dexamethasone, and Group 3 received perineural dexamethasone. The fourth group was the control group. Vitals, complications, morphine consumption, patient satisfaction, motor and sensory block times were recorded for postoperative 48 hours. Postoperative analgesia was provided with PCA morphine. Results: Sensory block times Group 1 (726.83 ± 50.93 min), Group 2 (1126.33 ± 127.32 min), Group 3 (1104.83 ± 120.71 min), Control (368.67 ± 41, 73 minutes) were evaluated in groups. Motor block times Group 1 (726.83 ± 50.93 min), Group 2 (1126.33 ± 127.32 min), Group 3 (1104.83 ± 120.71 min), Control (368.67 ± 41, 73 minutes) were evaluated in groups. Group 2 and Group 3 were found to be similar in terms of both motor and sensory block times (p> 0.05). Group 2 and Group 3 had longer block times than Group 1 and Control groups (p <0.05). Group 1 had longer block times than the control group (p <0.05). Conclusion: Both perineural dexamethasone and intravenous dexmedetomidine prolong the block time when used alone. Perineural dexamethasone is more effective than iv dexmedetomidine, and there was no difference between the combined use of these two agents and the use of perineural dexamethasone alone. It should be kept in mind that although dexmedetomidine is an effective sedative in regional anesthesia, it may cause hypotension and bradycardia. Keyword: supraclavicular block, iv dexmedetomidine, perineural dexamethasone
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Anestezi ve Reanimasyon, Anesthesiology and Reanimation, supraklaviküler blok, iv deksmedetomidin, perinöral deksametazon, supraclavicular block, iv dexmedetomidine, perineural dexamethasone
