Kalça atroplastisi hastalarında fasia iliaka ve perikapsüler sinir grubu blok kombinasyonunun, devamlı yara yeri lokal anestezi infiltrasyonu ile postoperatif ağrı ve analjezik tüketimine etkisinin karşılaştırılması
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Tarih
2022
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada spinal anestezi altında kalça atroplastisi olan hastalarda ultrasonografi eşliğinde preoperatif uygulanan fasia iliaka kompartman bloğu (FİKB) ve perikapsüler sinir grubu blok (PENG) kombinasyonu, devamlı yara yeri infiltrasyon analjezisi ile postoperatif opioid tüketimlerini ve ağrı skorlarını gibi çeşitli parametrelerle karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Kalça atroplastisi planlanan 18-75 yaş aralığında 60 hasta çalışmaya dahil edildi. Fasia iliaka kompartman bloğu (FİKB) ve perikapsüler sinir grubu blok (PENG) kombinasyonu 30 hastadan oluşan 1. gruba, devamlı yara yeri infiltrasyonu ise diğer 30 hastadan oluşan 2. gruba uygulandı. Devamlı yara yeri infiltrasyonu için cerrahi ekip tarafından intraoperatif kateter yerleştirildi. Olguların tamamına postoperatif morfin içeren hasta kontrollü analjezi (HKA) cihazı takıldı. Postoperatif opioid tüketimleri, ağrı skorları ve ilk mobilizasyona zamanları kaydedildi. Bulgular: Hastaların demografik özellikleri iki grup arasında benzer bulundu. Birinci grupta postoperatif 4., 8., 12., 24., ve 48. saatlerdeki ağrı skorları ikinci gruba göre daha düşük bulundu. 48. saatte elde edilen toplam morfin tüketim miktarlarının grup 1'de (9.47mg), grup 2'ye (17.07mg) göre daha düşük olduğu tespit edildi (p<0,001). Hastaların ilk mobilizasyon zamanları grup 1'de 20.43 saat, grup 2'de ise 25.40 saat olarak kaydedildi ve aralarındaki bu farklılık istatistiksel olarak anlamlı bulundu (p<0,001). Sonuç: Çalışmamızda kalça atroplastisi uygulanan hastalarda fasia iliaka kompartman bloğu (FİKB) ve perikapsüler sinir grubu blok (PENG) kombinasyonu, devamlı yara yeri infiltrasyon grubuna kıyasla daha az postoperatif opioid tüketimi ve daha düşük ağrı skorları meydana getirmiştir.
Objective: In this study, it was aimed to compare fascia iliaca compartment block (FICB) and pericapsular nerve group block (PENG) combination with continuous wound infusion in patients who were operated under spinal anesthesia for hip arthroplasty in terms of postoperative opioid consumption and postoperative pain scores. Materials and Methods: Sixty patients between the ages of 18-75 for hip arthroplasty using spinal anesthesia were prospectively included in this study. The patients were divided equally into 2 groups. Group 1 received fascia iliaca compartment block (FICB) and pericapsular nerve group block (PENG) combination, group 2 received the continuous wound infusion. Intraoperative catheter was placed by the surgical team for continuous wound infiltration. Morphine IV patient controlled analgesia was offered to all patients. Postoperative pain scores and opioid consumption and time to first mobilization were recorded. Results: The demographic characteristics of the patients were similar between the two groups. In the group 1, the pain scores were found to be lower at postoperative 4., 8., 12., 24., and 48. hours. Mean morphine consumption was significantly lower in the group 1 during the first 48 postoperative hours (9.47mg vs 17.07mg) (p<0,001). The first mobilization time was earlier in the group 1 and there was a statistical difference between them: 20.43 hour vs 25.40 hour (p<0.001). Conclusion: As a result of this study, it was shown that fascia iliaca compartment block (FICB) and pericapsular nerve group block (PENG) combination provided less postoperative opioid consumption and lower pain scores compared to continuous wound site infiltration in patients undergoing hip atroplasty.
Objective: In this study, it was aimed to compare fascia iliaca compartment block (FICB) and pericapsular nerve group block (PENG) combination with continuous wound infusion in patients who were operated under spinal anesthesia for hip arthroplasty in terms of postoperative opioid consumption and postoperative pain scores. Materials and Methods: Sixty patients between the ages of 18-75 for hip arthroplasty using spinal anesthesia were prospectively included in this study. The patients were divided equally into 2 groups. Group 1 received fascia iliaca compartment block (FICB) and pericapsular nerve group block (PENG) combination, group 2 received the continuous wound infusion. Intraoperative catheter was placed by the surgical team for continuous wound infiltration. Morphine IV patient controlled analgesia was offered to all patients. Postoperative pain scores and opioid consumption and time to first mobilization were recorded. Results: The demographic characteristics of the patients were similar between the two groups. In the group 1, the pain scores were found to be lower at postoperative 4., 8., 12., 24., and 48. hours. Mean morphine consumption was significantly lower in the group 1 during the first 48 postoperative hours (9.47mg vs 17.07mg) (p<0,001). The first mobilization time was earlier in the group 1 and there was a statistical difference between them: 20.43 hour vs 25.40 hour (p<0.001). Conclusion: As a result of this study, it was shown that fascia iliaca compartment block (FICB) and pericapsular nerve group block (PENG) combination provided less postoperative opioid consumption and lower pain scores compared to continuous wound site infiltration in patients undergoing hip atroplasty.
Açıklama
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation, PENG, FİKB, Devamlı Yara Yeri İnfiltrasyonu, Opioid Tüketimi, PENG, FICB, Continuous Wound Infusion, Hip Athropasty, Opioid Consumption
