Transversus Abdominis Plane Bloğa EklenenDeksametazonun Etkisi
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Tarih
2015
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Medicine Science
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Öz:Çalışmamızda total abdominal histerektomi (TAH) planlanan olgularda ultrasound eşliğinde yaptığımız transversus abdominis plane (TAP) bloğa ilave edilen deksametazonun postoperatif analjezi üzerine etkisini araştırmayı amaçladık. Etik Kurul ve hasta onayı alındıktan sonra genel anestezi ile TAH planlanan, ASA I-II grubu, toplam 60 olgu çalışmaya alındı. Cerrahi sonlandıktan sonra TAP blok işlemi aynı anestezist tarafından ultrason eşliğinde uygulandı. Olgular zarf yöntemi kullanılarak rasgele iki gruba ayrıldı. Grup B(n=30):bilateral olarak, tek tarafa 19 mL %0,25'lik bupivakain+1 mL SF olacak şekilde, Grup BD(n=30):bilateral olarak, tek tarafa 19 mL %0,25'lik bupivakain+1 mL deksametazon (4mg) enjeksiyonu yapıldı. Postoperatif ağrı skorları VizüelAnalog Skala (VAS) kullanılarak derlenme odasında ve postoperatif 2, 4, 6, 12 ve 24. saatte kaydedildi. İlk analjezik gereksinim zamanı, morfin tüketimi, bulantı-kusma görülme sıklığı ve sedasyon skorları kaydedildi. Grup BD'de derlenme vepostoperatif ikinci saatte dinlenme ve hareketteki VAS skorları Grup B'ye göre anlamlı düşüktü (p<0.05). İlk analjezik ihtiyacı için geçen süre (130 ± 4.5dk) Grup B'ye göre (25±6.2) anlamlı uzundu (p<0.05). Grup BD toplam morfin tüketimi açısından GrupB ile karşılaştırıldığında 24 saatlik morfin gereksinimi Grup BD' de anlamlı derecede daha düşüktü (p<0.05). TAH planlanan olgularda USG eşliğinde yaptığımız TAP bloğa; deksametazon eklenmesinin, derlenme ve postoperatif 2.saatte ağrı skorlarını anlamlı derecede düşürdüğü; ilk analjeziğe gereksinim süresini uzattığı kanısındayız.
Abstract:We aimed to evaluate the effect of dexamethasone added TAP block on postoperative analgesia accompanied by ultrasound in the TAH. After obtaining the Ethics Committee and the patient's consent a total of 60 ASA I-II patients undergoing planned total abdominal hysterectomy with general anesthesia were enrolled in the study. After surgical termination, ultrasound guided TAP block was performed by the same anesthesiologist. The patients were randomly divided into two groups using the envelope method. TAP block was obtained with 19 mL of bupivacaine hydrochloride 0.25%+1 mLsaline 0.9% (Group B, n=30) or 19 mL of bupivacaine hydrochloride 0.25%+1 mLdexamethasone (4 mg) (Group BD, n=30). Postoperatif pain scores were evaluated with Visual Analog Scale (VAS) at the recovery room and postoperative 2, 4, 6, 12 and 24 hours. Time to first analgesic requirement, morphine consumption, incidence of nausea and vomiting, and sedation scores were recorded. VAS scores at rest and on movement in recovery room and postoperative 2 h were significantly lower Group BD than Group B (p<0.05). The time to first analgesic requirement in Group BD (130±4.5 min) was longer compared to Group B (25±6.2) (p<0.05). Total morphine consumption was significantly lower in Group BD compared to Group B (p <0.05). The addition of dexamethasone to ultrasound-guided TAP block was decreased postoperative pain scores and increased the time to first analgesic requirement in patients undergoing total abdominal hysterectomy.
Abstract:We aimed to evaluate the effect of dexamethasone added TAP block on postoperative analgesia accompanied by ultrasound in the TAH. After obtaining the Ethics Committee and the patient's consent a total of 60 ASA I-II patients undergoing planned total abdominal hysterectomy with general anesthesia were enrolled in the study. After surgical termination, ultrasound guided TAP block was performed by the same anesthesiologist. The patients were randomly divided into two groups using the envelope method. TAP block was obtained with 19 mL of bupivacaine hydrochloride 0.25%+1 mLsaline 0.9% (Group B, n=30) or 19 mL of bupivacaine hydrochloride 0.25%+1 mLdexamethasone (4 mg) (Group BD, n=30). Postoperatif pain scores were evaluated with Visual Analog Scale (VAS) at the recovery room and postoperative 2, 4, 6, 12 and 24 hours. Time to first analgesic requirement, morphine consumption, incidence of nausea and vomiting, and sedation scores were recorded. VAS scores at rest and on movement in recovery room and postoperative 2 h were significantly lower Group BD than Group B (p<0.05). The time to first analgesic requirement in Group BD (130±4.5 min) was longer compared to Group B (25±6.2) (p<0.05). Total morphine consumption was significantly lower in Group BD compared to Group B (p <0.05). The addition of dexamethasone to ultrasound-guided TAP block was decreased postoperative pain scores and increased the time to first analgesic requirement in patients undergoing total abdominal hysterectomy.
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Medicine Science
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Künye
GÜLHAŞ N,KAYHAN G. E,ŞANLI M,KITLIK A,DURMUŞ M (2015). Transversus Abdominis Plane Bloğa Eklenen Deksametazonun Etkisi. Medicine Science, 4(4), 2732 - 2742.
