Tek taraflı meme cerrahisinde ultrasonografi eşliğinde yapılan erektör spina plan bloğunun intraoperatif analjezik tüketimine etkisi
Küçük Resim Yok
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Kadınlarda meme kanseri sık görülen kanserlerden biri olduğu için tedavisinde de sıklıkla cerrahi müdahale yapılmaktadır. Son yıllarda ultrasonografinin anestezide sık kullanılmasının avantajıyla erektör spina plan bloğu (ESP) meme cerrahisinde, multimodal analjezinin bir parçası olarak sıklıkla kullanılmaktadır. Çalışmamızda ameliyat öncesinde yapılan erektör spina plan bloğunun ameliyat esnasında ve sonrasında hastanın narkotik analjezik tüketimine etkisine bakmayı amaçladık. Materyal ve Metot: Çalışmamıza tek taraflı meme cerrahisi geçirecek olan 68 kadın hasta dahil edildi. Ameliyat öncesinde ESP blok yapılan 34 hasta GRUP I (n=34), blok yapılmayan kontrol grubuna ise GRUP II (n=34) olarak iki gruba ayrıldı. Her iki gruba ameliyat süresince propofol ve remifentanil infüzyonu ile total intravenöz anestezi (TİVA)si uygulandı. Ameliyat bitiminde her iki gruba morfin ile hasta kontrollü analjezi (HKA) cihazı takılarak, 15,30. dk ve 1, 2, 4, 6, 8, 16, 24. saatlerde vizüel ağrı skoru (VAS ) ile ağrı düzeyi, hasta memnuniyet skoru ile hasta memnuniyeti ve kullanılan toplam narkotik ve ek analjezik tüketimleri kaydedildi. Bulgular: Blok yapılan grupta ameliyat esnasında remifentanil tüketimi daha az olmakla beraber bu fark istatistiksel olarak anlamlı değildi (p>0,05). Ameliyat sonrasında 24. saatin sonunda; blok yapılan grupta VAS skorları daha düşük, morfin tüketimi daha az ve hasta memnuniyet skorları daha yüksek olarak ölçüldü. Bunlar istatistiksel olarak anlamlıydı (p<0,05) Sonuç: Yeni bir periferik sinir bloğu olan ESP blok; komplikasyon ve yan etkilerinin daha az olması nedeniyle, sık yapılan meme cerrahisinde postoperatif ağrı yönetiminde, multimodal analjezinin bir parçası olarak güvenle kullanılacağı kanaatindeyiz. Anahtar Kelimeler: Erektör Spina Plan Bloğu, Hasta Memnuniyeti, Meme Cerrahisi, Morfin, Remifentanil.
The Effects of Ultrasound-guided Erector Spinae Plane Block on Intraoperative Analgesic Usage in Unilateral Breast Surgery Objective: Breast cancer is a common cancer in women and frequently requires surgical intervention for treatment. In recent years, ultrasound has become advantageous for anesthesia and in this regard, erector spinae plane (ESP) block is frequently performed as a part of multimodal analgesia in breast surgery. In our study, we aimed to evaluate the effects of preoperative erector spinae plane block on patients' narcotic analgesic usage during and after the operation. Materials and Methods: Our study consisted of 68 female patients schuduled unilateral breast surgery. The patients were divided into two groups; Group I (n=34) included 34 patients who received ESP block before surgery, while Group II was the control group that did not receive ESP block (n=34). Both groups received total intravenous anesthesia through propofol and remifentanil infusion. Follow the operation, all patients were supplied patient-controlled analgesia machines with morphine. The patients' satisfaction and pain levels were assessed using a patient satisfaction scale and visual analogue scale (VAS) for pain; the evaluations were performed on minutes 15, 30 and hours 1, 2, 4, 6, 8, 16, 24. The total amount of narcotics and additional analgesics used by the patients were recorded. Results: The ESP block group demonstrated a lower remifentanil usage during the operation; however, this was not statistically significant (p>0.05). At the end of the 24th hour following surgery; patients who received an ESP block showed lower VAS scores, reduced morphine usage, and higher patient satisfaction scores; these findings were statistically significant (p<0.05). Conclusion: ESP block is a contemporary peripheral nerve block associated with reduced complications and side effects. For this reason, we believe that it can be safely used as a part of multimodal analgesia in the postoperative pain management of frequently conducted breast surgeries. Keywords: Breast surgery, Erector Spinae Plane Block, Remifentanil, Morphine, Patient Satisfaction
The Effects of Ultrasound-guided Erector Spinae Plane Block on Intraoperative Analgesic Usage in Unilateral Breast Surgery Objective: Breast cancer is a common cancer in women and frequently requires surgical intervention for treatment. In recent years, ultrasound has become advantageous for anesthesia and in this regard, erector spinae plane (ESP) block is frequently performed as a part of multimodal analgesia in breast surgery. In our study, we aimed to evaluate the effects of preoperative erector spinae plane block on patients' narcotic analgesic usage during and after the operation. Materials and Methods: Our study consisted of 68 female patients schuduled unilateral breast surgery. The patients were divided into two groups; Group I (n=34) included 34 patients who received ESP block before surgery, while Group II was the control group that did not receive ESP block (n=34). Both groups received total intravenous anesthesia through propofol and remifentanil infusion. Follow the operation, all patients were supplied patient-controlled analgesia machines with morphine. The patients' satisfaction and pain levels were assessed using a patient satisfaction scale and visual analogue scale (VAS) for pain; the evaluations were performed on minutes 15, 30 and hours 1, 2, 4, 6, 8, 16, 24. The total amount of narcotics and additional analgesics used by the patients were recorded. Results: The ESP block group demonstrated a lower remifentanil usage during the operation; however, this was not statistically significant (p>0.05). At the end of the 24th hour following surgery; patients who received an ESP block showed lower VAS scores, reduced morphine usage, and higher patient satisfaction scores; these findings were statistically significant (p<0.05). Conclusion: ESP block is a contemporary peripheral nerve block associated with reduced complications and side effects. For this reason, we believe that it can be safely used as a part of multimodal analgesia in the postoperative pain management of frequently conducted breast surgeries. Keywords: Breast surgery, Erector Spinae Plane Block, Remifentanil, Morphine, Patient Satisfaction
Açıklama
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
