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Ortopedik alt ekstremite cerrahisinde spinal anestezi ile kombine siyatik-femoral blok teknikleri

Year 2011, Volume: 45 Issue: 4, 225 - 232, 14.09.2011

Abstract

Amaç: Özellikle eşlik eden hastalıkları bulunan yaşlılarda, alt ekstremitenin ortopedik cerrahilerinde genel anestezi ile birlikte merkezi ve periferik rejyonal anestezi teknikleri kullanılabilir. Bu çalışma, alt ekstremitenin ortopedik cerrahilerinde uygulanan spinal anestezi ile kombine siyatik/femoral blok tekniklerinin hasta-cerrah memnuniyeti açısından etkinliğini incelemektedir.
Çalışma planı: ASA skoru 2 veya 3 olan ve yaşları 50 ila 90 arasında değişen 50 ardışık hasta alt ekstremitelerine ortopedik cerrahi girişimde bulunulmak üzere çalışmaya dahil edildi. Hastalar anestezi türüne göre rastgele iki gruba ayrıldı. Spinal anestezi (SA) uygulanan 25 hasta ile kombine siyatik-femoral blok (KSFB) uygulanan 25 hasta, sırasıyla, Grup 1 ve Grup 2 olarak sınıflandırıldı. Spinal anestezi 3 ml 0.75% ropivakain, kombine siyatik-femoral blok uygulaması 10 ml 0.75% ropivakain ve 10 ml serum fizyolojik (toplamda 20 ml) enjekte edilerek gerçekleştirildi. Anestezinin uygulanması ile etki göstermesi arasındaki zaman aralığı ölçüldü. Sonuçlar hasta-cerrah memnuniyeti açısından değerlendirildi.
Bulgular: Rejyonal anestezi süresi KSFB grubunda anlamlı şekilde daha uzun idi (p<0.0001). Hastaları ameliyata hazırlamak için gereken süre ise SA grubunda istatistiksel ve anlamlı olarak daha kısa idi (p<0.001). Hasta ve cerrah memnuniyeti ilişkisinde ise anlamlı bir korelasyon saptanmadı (p>0.05).
Çıkarımlar: SA ve KSFB tekniklerinin her ikisinin de alt ekstremitenin ortopedik cerrahilerinde başarılı oldukları görüldü. KSFB grubunda cerrahiye hazırlık süresi daha uzun olmasına rağmen, hasta-cerrah memnuniyeti her iki grupta benzerdi.

Spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery

Year 2011, Volume: 45 Issue: 4, 225 - 232, 14.09.2011

Abstract

Objective: In lower extremity orthopedic surgeries, central and peripheral regional anesthesia techniques can be used along with general anesthesia, mainly in elderly patients with accompanying maladies. This study investigates the efficiency of spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery in terms of patientsurgeon satisfaction.
Methods: Fifty consecutive patients (age range: 50-90 years), with an ASA score of 2-3 were scheduled for lower extremity orthopedic surgery. The patients were randomly divided into two groups according to anesthesia type. Group 1 (25 patients) received spinal anesthesia (SA) and Group 2 (25 patients) a combined sciatic/lumbar plexus nerve block (CSLPB). Spinal anesthesia was performed with 3 ml of 0.75% ropivacaine, and the combined sciatic/lumbar plexus nerve block was obtained with 10 ml 0.75% of ropivacaine and 10 ml of normal saline (20 ml in total). We recorded the time elapsed during the administration of the anesthesia and the initiation of its effect. Evaluation was made on patient-surgeon satisfaction.
Results: Regional anesthesia duration was significantly longer in the CSLPB group (p<0.0001). The time required to prepare the patients for surgery was statistically and significantly shorter in the SA group (p<0.001). Values of patient and surgeon satisfaction did not significantly correlate (p>0.05).
Conclusion: Both standard anesthesia and combined sciatic/lumbar plexus nerve block were effective in lower extremity orthopedic surgeries. Although surgery preparation time was longer in the CSLPB group, patient-surgeon satisfaction was similar in both groups.

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Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Suzan Adali This is me

Kerem Erkalp This is me

Veysel Erden This is me

Mevlut Comlekci This is me

Murat Bulbul This is me

Tayfun Aldemir This is me

Publication Date September 14, 2011
Published in Issue Year 2011 Volume: 45 Issue: 4

Cite

APA Adali, S., Erkalp, K., Erden, V., Comlekci, M., et al. (2011). Spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery. Acta Orthopaedica Et Traumatologica Turcica, 45(4), 225-232.
AMA Adali S, Erkalp K, Erden V, Comlekci M, Bulbul M, Aldemir T. Spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery. Acta Orthopaedica et Traumatologica Turcica. September 2011;45(4):225-232.
Chicago Adali, Suzan, Kerem Erkalp, Veysel Erden, Mevlut Comlekci, Murat Bulbul, and Tayfun Aldemir. “Spinal Anesthesia and Combined Sciatic nerve/Lumbar Plexus Block Techniques in Lower Extremity Orthopedic Surgery”. Acta Orthopaedica Et Traumatologica Turcica 45, no. 4 (September 2011): 225-32.
EndNote Adali S, Erkalp K, Erden V, Comlekci M, Bulbul M, Aldemir T (September 1, 2011) Spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery. Acta Orthopaedica et Traumatologica Turcica 45 4 225–232.
IEEE S. Adali, K. Erkalp, V. Erden, M. Comlekci, M. Bulbul, and T. Aldemir, “Spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery”, Acta Orthopaedica et Traumatologica Turcica, vol. 45, no. 4, pp. 225–232, 2011.
ISNAD Adali, Suzan et al. “Spinal Anesthesia and Combined Sciatic nerve/Lumbar Plexus Block Techniques in Lower Extremity Orthopedic Surgery”. Acta Orthopaedica et Traumatologica Turcica 45/4 (September 2011), 225-232.
JAMA Adali S, Erkalp K, Erden V, Comlekci M, Bulbul M, Aldemir T. Spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery. Acta Orthopaedica et Traumatologica Turcica. 2011;45:225–232.
MLA Adali, Suzan et al. “Spinal Anesthesia and Combined Sciatic nerve/Lumbar Plexus Block Techniques in Lower Extremity Orthopedic Surgery”. Acta Orthopaedica Et Traumatologica Turcica, vol. 45, no. 4, 2011, pp. 225-32.
Vancouver Adali S, Erkalp K, Erden V, Comlekci M, Bulbul M, Aldemir T. Spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery. Acta Orthopaedica et Traumatologica Turcica. 2011;45(4):225-32.