Karaciğer nakli vericilerinde postoperatif ağrı kontrolünde epidural blok ve paravertabral bloğun karşılaştırılması
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Dosyalar
Tarih
2010
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Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Karaciğer nakli vericilerinde epidural blok ve paravertebral bloğun postoperatif ağrı kontrolündeki etkinliklerini karşılaştırmak. Gereç ve Yöntem: Karaciğer vericisi olmayı ve ağrı kontrolü için paravertebral veya epidural kateter yerleştirilmesini kabul eden, 18-60 yaş arası, ASA 1-2, 50 hasta dahil edildi. Olgular kapalı zarf yöntemi ile T6-8 düzeyinden paravertebral blok uygulanan olgular (Grup 1) ve epidural blok uygulanan (Grup 2) olgular olarak iki eşit gruba ayrıldı. Olgular operasyondan sonraki 24 saat boyunca, postoperatif ağrı düzeyleri, vital bulgular, sedasyon skorları, hasta memnuniyet düzeyleri, mobilizasyon, ek analjezik ihtiyacı, işleme bağlı yan etkiler açısından karşılaştırıldı. Bulgular: Postoperatif 2. ve 4. saatte Grup 2'ye göre Grup 1'de insizyon bölgesinde görülen ağrı daha şiddetli idi (p<0.05). Ayrıca postoperatif 2. saatte Grup 1'de Grup 2'ye göre ek analjezik kullanımı iki kat fazla idi (Grup 1'de %56, Grup 2'de %28) (p<0.05). Postoperatif 2. saatte ve 4. saatte verilen toplam lokal anestezik miktarı Grup 1'de, Grup 2'ye göre anlamlı derecede yüksekti (p<0.05). Her iki grup arasında hasta memnuniyeti açısından anlamlı fark tespit edilmedi. Her iki grupta birer hastada görülen bulantı-kusma haricinde hiçbir komplikasyona rastlanmadı. Sonuç: Donor hepatektomi olgularında postoperatif ağrı kontrolünde paravertebral blok epidural bloğa iyi bir alternatif olabilir.
Aim: To compare of the thoracal epidural vs paravertebral blockade on the relief of postoperative pain in donor hepatectomy. Methods: 50 patients, aged 18-60 years, ASA I-II undergoing donor hepatectomy operation were enrolled in this study. Patients were randomly allocated into two groups of 25 patients each at the level of T6-8 (Group 1, paravertebral analgesia; and Group 2, epidural analgesia). Postoperative pain, vital signs, sedation score, overall patients? satisfaction, rescue analgesic requirements and side effects were evaluated for 24 hours after surgery. Results: The Group 1 patients had a significantly higher postoperative pain scores than those patients in the group 2 at 2nd and 4th hour postoperatively. In Group 1, rescue analgesic requirements at 2nd hour postoperatively was increased by more than 2 times (56% in group 1, 28% in group 2) (p<0.05). Total local anesthetic consumption at 2nd and 4th hour postoperatively was significantly higher in the Group 1 compared to the Group 2) (p<0.05). There was no difference between groups for patients? satisfaction. There was no complication in both groups except for one patient with nausea and vomiting postoperatively in each groups. Conclusion: Paravertebral analgesia may be a good alternative to thoracic epidural analgesia for postoperative pain control undergoing donor hepatectomy.
Aim: To compare of the thoracal epidural vs paravertebral blockade on the relief of postoperative pain in donor hepatectomy. Methods: 50 patients, aged 18-60 years, ASA I-II undergoing donor hepatectomy operation were enrolled in this study. Patients were randomly allocated into two groups of 25 patients each at the level of T6-8 (Group 1, paravertebral analgesia; and Group 2, epidural analgesia). Postoperative pain, vital signs, sedation score, overall patients? satisfaction, rescue analgesic requirements and side effects were evaluated for 24 hours after surgery. Results: The Group 1 patients had a significantly higher postoperative pain scores than those patients in the group 2 at 2nd and 4th hour postoperatively. In Group 1, rescue analgesic requirements at 2nd hour postoperatively was increased by more than 2 times (56% in group 1, 28% in group 2) (p<0.05). Total local anesthetic consumption at 2nd and 4th hour postoperatively was significantly higher in the Group 1 compared to the Group 2) (p<0.05). There was no difference between groups for patients? satisfaction. There was no complication in both groups except for one patient with nausea and vomiting postoperatively in each groups. Conclusion: Paravertebral analgesia may be a good alternative to thoracic epidural analgesia for postoperative pain control undergoing donor hepatectomy.
Açıklama
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
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WoS Q Değeri
Scopus Q Değeri
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Künye
Koç,E. (2011). Karaciğer nakli vericilerinde postoperatif ağrı kontrolünde epidural blok ve paravertabral bloğun karşılaştırılması.Yayımlanmış Uzmanlık Tezi, İnönü Üniversitesi, Malatya.
