Korakoid ve lateral sagital infraklavikular blokların karşılaştırması

Abstract

Amaç: Bu çalışmanın amacı korakoid blok (coracoid block, CB) ve lateral sagital infraklavikular blok (lateral sagittal infraclavicular block, LSIB) tekniklerinde blok uygulama sürelerini karşılaştırmak ve CB ile LSIB'in başarı oranlarını karşılaştırmaktı. Çalışma planı: Prospektif çalışma yöntemiyle; üst ekstremite ameliyatı tarihi verilen 100 yetişkin hasta rastgele bir biçimde CB ya da LSIB gruplarına ayrıldı. 5 mg/ml oranında 20 ml levobupivakain ve 20 mg/ml oranında 20 ml lidokain ile 5 µg/ml epinefrin içeren lokal anestezik karışımı (toplamı 40 ml); medyan, ulnar ya da radyal sinir tipi yanıtlardan biri alındıktan sonra uygulandı. Duyusal blok 40 dakika boyunca 10 dakikalık aralıklarla test edildi. Bulgular: Blok uygulama süreleri (CB Grubu: 5.2±1.9 dk, LSIB Grubu: 5.5±1.4 dk) ve blok başarı oranları (CB Grubu: %86, LSIB Grubu: %92) her iki grupta da benzerlik göstermekteydi. LSIB grubunda ulnar sinir duyusal blok 10, 20 ve 30. dakikalarda, radyal sinir ise 20. dakikada CB’den anlamlı şekilde daha yoğundu (p<0.05). LSIB grubunda dört adet vasküler ponksiyon saptandı. Çıkarımlar: Her iki tekniğin de klinik anlamda etkili olduğu ve benzer sürelerde uygulandığı görüldü.

Keywords

• Korakoid blok; lateral sagital infraklavikular blok; sinir uyarımı.

Coracoid versus lateral sagittal infraclavicular block

Abstract

Objective: The aim of this study was to compare block performance time and secondarily success rates of coracoid block (CB) and lateral sagittal infraclavicular block (LSIB).
Methods: This prospective study included 100 adult patients scheduled for upper limb surgery. Patients were randomly allocated to receive either a CB or LSIB. A local anesthetic mixture of 20 ml of levobupivacaine 5 mg/ml and 20 ml of lidocaine 20 mg/ml with 5 μg/ml epinephrine (total 40 ml) was administered after obtaining either a median, ulnar or radial nerve type response. Sensory block was tested at 10-minute intervals for 40 min.
Results: Block performance time (CB Group: 5.2±1.9 min, LSIB Group: 5.5±1.4 min) and block success rate (CB Group: 86%, LSIB Group: 92%) were similar in both groups. In the LSIB group, sensory block of the ulnar nerve at 10, 20 and 30 minutes and at the radial nerve at 20 minutes was significantly more intense than the CB group (p<0.05). There were four vascular punctures in the LSIB group.
Conclusion: Both block techniques were effective and performed in a similar time period.

Keywords

• Coracoid block
• lateral sagittal infraclavicular block
• nerve stimulation

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