Periferik sinir bloğu uygulamaları ile yapılan üst ekstremite cerrahisinde yara iyileşmesi, mortalite ve enfeksiyon parametrelerinin incelenmesi

Year 2025, Volume: 30 Issue: 3, 477 - 484, 25.09.2025

Veysel Dinç , Döndü Genç Moralar , Erdem Özden , Serpil Sehirlioglu , Fatma Çiğdem Özakın , Kadir Yılmaz

https://doi.org/10.21673/anadoluklin.1757797

Abstract

Amaç: Bu retrospektif çalışmada, üst ekstremite cerrahisi geçiren hastalarda Periferik Sinir Bloğu ile Genel Anestezi uygulananlar arasında yara iyileşmesi, enfeksiyon parametreleri ve sağkalım sonuçlarının karşılaştırılması amaçlandı.

Yöntem: İstanbul Gaziosmanpaşa Eğitim ve Araştırma Hastanesi’nde 2014–2024 yılları arasında üst ekstremite cerrahisi yapılan ve çalışmaya dâhil edilen toplam 5666 hasta incelendi. Hastalar anestezi tipine göre Periferik Sinir Blok (n=1259) ve Genel Anestezi (n=4407) olarak iki gruba ayrıldı. Yaş, cinsiyet, komorbiditeler, ameliyat süresi, hastanede yatış süresi ile sedimantasyon, prokalsitonin, idrar kültürü, CRP, yara yeri kültürü, kan kültürü ve altı ay mortalite parametreleri değerlendirildi.

Bulgular: Yaş ortalaması, kadın cinsiyet, kronik böbrek yetmezliği, Kronik Obstrüktif Akciğer Hastalığı, diyabetes mellitus ve hipertansiyon sıklığı Genel Anestezi grubunda anlamlı derecede daha yüksekti (p<0.05). Ameliyat tipi, ASA skoru, hiperlipidemi, epilepsi, astım, kalp yetmezliği, serebrovasküler olay öyküsü, ameliyat süresi ve yatış süresi açısından gruplar arasında fark anlamlı değildi (p>0.05). Prokalsitonin düzeyi Genel Anestezi grubunda anlamlı olarak daha pozitif bulundu (p<0.05). Sedimantasyon, idrar kültürü, CRP, yara yeri kültürü, kan kültürü ve altı ay mortalite açısından gruplar arasında anlamlı fark yoktu (p>0.05). Anestezi tipi ile bu parametreler arasındaki korelasyonlar istatistiksel olarak anlamlı değildi (p>0.05). Kronik böbrek yetmezliği mortalite üzerinde bağımsız olarak anlamlı etkiliydi (OR=0.331; p<0.01); diğer demografik özellikler ve komorbiditelerin anestezi tipiyle birlikte etkileri anlamlı bulunmadı (p>0.05).

Sonuç: Üst ekstremite cerrahisi yapılan hastalarda yara iyileşmesi, enfeksiyon göstergeleri ve mortalite sonuçları bakımından periferik sinir bloğu ve genel anestezi uygulamaları arasında anlamlı bir fark gözlenmemiştir.

Keywords

Genel anestezi , periferik sinirler , sinir bloğu , yara iyileşmesi

Investigation of wound healing, mortality and infection parameters in upper extremity surgery with peripheral nerve block applications

Abstract

Aim: In this retrospective study, it was aimed to compare wound healing, infection parameters and survival outcomes in patients undergoing upper extremity procedures under Peripheral Nerve Block versus General Anesthesia.

Methods: A total of 5666 patients who underwent upper extremity surgery between 2014 and 2024 at İstanbul Gaziosmanpaşa Training and Research Hospital and included patients were subjected to the study. Patients were grouped according to anesthesia type as Peripheral Nerve Block (n=1259) and general anesthesia (n=4407). Age, gender, comorbidities, operation duration and hospitalization duration, sedimentation, procalcitonin, urine culture, CRP, wound site culture, blood culture and mortality at 6th month parameters of patients were analyzed.

Results: Mean age, female sex, chronic renal failure, Chronic Obstructive Pulmonary Disease, diabetes mellitus and hypertension frequencies were significantly higher in the general anesthesia group (p<0.05). Operation group, ASA score, Hyperlipidemia, epilepsy, asthma, heart failure, Cerebrovascular event, operation duration, and hospitalization duration parameter differences between anesthesia groups were statistically insignificant (p>0.05). Procalcitonin level was significantly higher in general anesthesia group (p<0.05). Sedimentation, urine culture, CRP, wound site culture, blood culture and mortality at 6th month parameter differences between patient groups were statistically insignificant (p>0.05). Correlation between anesthesia type and sedimentation, procalcitonin, urine culture, CRP, blood culture and mortality at 6th month were statistically insignificant (p>0.05). Chronic renal failure (OR=0.331; p<0.01) had significant effect on mortality. Effects of all other demographic and comorbidities with anesthesia type were statistically insignificant (p>0.05)

Conclusion: In patients undergoing upper extremity procedures, wound healing, infection parameters and survival outcomes were similar for both general and peripheral nerve block anesthesia procedures.

Keywords

General anesthesia , nerve block , peripheral nerves , wound healing

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