Elektif kalça operasyonunda post-operatif analjezi amaçlı kullanılan perikapsüler sinir grup bloğu ile tek taraflı erektör spina pl
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Elektif Kalça Operasyonunda Post-operatif Analjezi Amaçlı Kullanılan Perikapsüler Sinir Grup Bloğu ile Tek Taraflı Erektör Spina Plan Bloğu Etkinliklerinin Karşılaştırılması ÖZET Çalışmamızda kalça veya femur ameliyatı geçiren hastalarda postoperatif analjezi yönetiminde yüksek volüm perikapsüller sinir grup (PENG) ile lomber erektör spina plan (L-ESP) bloklarının etkinliğini karşılaştırdık. Çalışmamız prospektif etkinlik çalışmasıdır. 2021 Mayıs - 2022 Aralık tarihlerinde genel anestezi altında elektif kalça operasyonu uygulanan ve kriterleri karşılayan 75 hasta (PENG:25, L-ESP:25, kontrol grubu:25) çalışmaya dahil edildi. Hastaların ağrı yoğunluğu NRS ağrı skoru kullanılarak değerlendirildi. İlk 24 saatte morfin dahil uygulanan analjezik ilaçlar kaydedildi. Memnuniyet değerlendirilmesinde 5'li Likert memnuniyet ölçeği kullanıldı. Gruplar arasında NRS puanlarında; 30.dk (p=0.019), 2.saat (p=0.002), 4.saat (p=<.001) ve 6.saat (p=<.001) anlamlı fark bulundu. İlk 12 saat medyan maksimum NRS puanı kontrol grubunda 4 (3-4), PENG grubunda 2 (2-4), L-ESP grubunda 3 (2-4) saptandı (p=<.001). Kontrol grubunun morfin tüketimi (ort:21.5 mg, SS:9.6 mg) PENG grubundan 10.3mg (ort:11.2 mg, SS:7.5 mg, p=<.001), L-ESP grubundan 8.6mg (ort:12.8 mg, SS:8.8 mg, p=<.001) daha fazlaydı. Kontrol grubunda ilk morfin talep zamanı (ort:3 saat, SS:2.1 saat) PENG grubundan 6.8 saat (ort:9.8 saat, SS:6.3 saat, p=<.001), L-ESP grubundan 5 saat (ort:8 saat, SS:5.6 saat, p=<.001) daha erkendi. Likert memnuniyet puanı en düşük kontrol grubundaydı (p=<.001). Blok uygulanan grup arasındaki değerlerde istatiksel anlamlı fark saptanmadı. PENG grubunun NRS puanları en düşüktü. Kalça cerrahisi geçiren hastalarda yüksek volüm (40 ml) lokal anestezik (LA) ile uygulanan PENG bloğu ve L-ESP bloğu ameliyat sonrası hastaların analjezi gereksinimini azaltmakta ve multimodal analjezinin kalitesini iyileştirmektedir. Çalışmamız literatürde PENG bloğunda yüksek volüm LA'nın uygulandığı ilk prospektif çalışmadır. Anahtar kelimeler: Kalça cerrahisi, Perikapsüler Sinir Grup Blok, Lomber Erektör Spina Plan Blok
Comparison of the Efficiency of Pericapsular Nerve Group Block and Unilateral Erector Spina Plan Block Used for Postoperative Analgesia in Elective Hip Surgery SUMMARY In our study, we compared the effectiveness of high-volume pericapsular nerve group (PENG) or lumbar erector spina plane (L-ESP) blocks in the management of postoperative analgesia in patients undergoing hip or femur surgery. Our study is a prospective efficacy study. Seventy-five patients (PENG:25, L-ESP:25, control group:25) who underwent elective hip surgery under general anesthesia between May 2021 - December 2022 and met the criteria were included in the study. The pain intensity of the patients was evaluated using the NRS pain score. Analgesic drugs, including morphine, administered in the first 24 hours were recorded. A 5-point Likert satisfaction scale was used to evaluate satisfaction. In NRS scores between groups; significant differences were found at 30th min (p=0.019), 2nd hour (p=0.002), 4th hour (p=<.001) and 6th hour (p=<.001). The median maximum NRS score in the first 12 hours was 4 (3-4) in the control group, 2 (2-4) in the PENG group, and 3 (2-4) in the L-ESP group (p=<.001). The morphine consumption of the control group (mean:21.5 mg, SD:9.6 mg) was 10.3 mg more than the PENG group (mean:11.2 mg, SD:7.5 mg, p=<.001) and 8.6 mg more than the L-ESP group (mean:12.8 mg, SD:8.8 mg, p=<.001). The first morphine demand time in the control group (mean:3 hours, SD:2.1 hours) was 6.8 hours earlier than the PENG group (mean:9.8 hours, SD:6.3 hours, p=<.001) and 5 hours earlier than the L-ESP group (mean:8 hours, SD:5.6 hours, p=<.001). Likert satisfaction score was lowest in the control group (p=<.001). There was no statistically significant difference in the values between the blocks applied groups. The NRS scores of the PENG group were the lowest. PENG and L-ESP blocks applied with high volume (40 ml) local anesthetic (LA) in patients undergoing hip surgery reduce the postoperative analgesia requirement of patients and improve the quality of multimodal analgesia. Our study is the first prospective study in the literature in which high volume LA was applied in PENG block. Key words: Hip surgery, Pericapsular Nerve Group Block, Lumbar Erector Spina Plane Block
Comparison of the Efficiency of Pericapsular Nerve Group Block and Unilateral Erector Spina Plan Block Used for Postoperative Analgesia in Elective Hip Surgery SUMMARY In our study, we compared the effectiveness of high-volume pericapsular nerve group (PENG) or lumbar erector spina plane (L-ESP) blocks in the management of postoperative analgesia in patients undergoing hip or femur surgery. Our study is a prospective efficacy study. Seventy-five patients (PENG:25, L-ESP:25, control group:25) who underwent elective hip surgery under general anesthesia between May 2021 - December 2022 and met the criteria were included in the study. The pain intensity of the patients was evaluated using the NRS pain score. Analgesic drugs, including morphine, administered in the first 24 hours were recorded. A 5-point Likert satisfaction scale was used to evaluate satisfaction. In NRS scores between groups; significant differences were found at 30th min (p=0.019), 2nd hour (p=0.002), 4th hour (p=<.001) and 6th hour (p=<.001). The median maximum NRS score in the first 12 hours was 4 (3-4) in the control group, 2 (2-4) in the PENG group, and 3 (2-4) in the L-ESP group (p=<.001). The morphine consumption of the control group (mean:21.5 mg, SD:9.6 mg) was 10.3 mg more than the PENG group (mean:11.2 mg, SD:7.5 mg, p=<.001) and 8.6 mg more than the L-ESP group (mean:12.8 mg, SD:8.8 mg, p=<.001). The first morphine demand time in the control group (mean:3 hours, SD:2.1 hours) was 6.8 hours earlier than the PENG group (mean:9.8 hours, SD:6.3 hours, p=<.001) and 5 hours earlier than the L-ESP group (mean:8 hours, SD:5.6 hours, p=<.001). Likert satisfaction score was lowest in the control group (p=<.001). There was no statistically significant difference in the values between the blocks applied groups. The NRS scores of the PENG group were the lowest. PENG and L-ESP blocks applied with high volume (40 ml) local anesthetic (LA) in patients undergoing hip surgery reduce the postoperative analgesia requirement of patients and improve the quality of multimodal analgesia. Our study is the first prospective study in the literature in which high volume LA was applied in PENG block. Key words: Hip surgery, Pericapsular Nerve Group Block, Lumbar Erector Spina Plane Block
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
