Çocuklarda alt batın cerrahisi sonrası postoperative analjezide ultrason yardımlı Transversus abdominis plane blok ile kaudal bloğun karşılaştırılması

Yıl 2020, Cilt: 7 Sayı: 1, 25 - 28, 31.03.2020

Koray Erbüyün , Eralp Çevikkalp , Demet Aydın Tok , Gülay Ok , İdil Tekin

https://doi.org/10.34087/cbusbed.672763

Öz

Giriş ve Amaç: kaudal anestezi çocuklarda alt batın cerrahilerinde postoperative analjezide kullanılan popüler bir tekniktir. Anestezisitler Kaudal bloğun sınırlamalarından ötürü alternatif rejyonel anestezi tekniklerini araştırmak zorunda kalmışlardır. Çalışmamızda; kaudal blok ve ultrason yardımlı TAP bloğun posoperatif analjezide etkinliğini ve güvenilirliğini karşılaştırmayı amaçladık.
Gereç ve Yöntem: Çalışma ASA 1-II, 2-10 yaş aralığında alt batın cerrahisi operasyonu olan hastalarda yapıldı. grup C de (kaudal blok, n: 31), 0,3 mL.kg-1 ve grup T (TAP blok, n: 30), 0,5 mL.kg-1 0,25 % levobupivacaine ameliyat sonrası uygulandı.. Hastalar postoperatif 0., 1., 4., 6. saatlerde revize edilmiş yüzler skalası (FPS-R) kullanılarak ağrı skorları açısından değerlendirildi. Analjezik tüketimi, komplikasyonlar ve yan etkiler kaydedildi. istatistiksel analizlerde Student's t testi, ANOVA, Fisher exact testi kullanıldı.
Bulgular: İki grup arasında demografik verilerde anlamlı bir fark yoktu. TAP bloğu için kullanılan lokal anestezik miktarı kaudal bloktan daha fazlaydı (T: 8,3 ± 4,3> C: 4,1 ± 0,9) (p <0,05). FPS-R'yi 0. saatte karşılaştırdığımızda, TAP bloğu postoperatif ağrıda kaudal bloğa göre daha etkiliydi (p <0,05). Tüm hastaların% 23'ü (n: 14) analjezik gerektiriyordu. İki grup arasında anlamlı fark yoktu
Tartışma ve Sonuç: Sonuç olarak, alt abdominal pediatrik cerrahide postoperatif ağrı yönetiminin erken döneminde TAP bloğu ve kaudal blok basit, güvenli ve etkili analjezik yöntemlerdir

Anahtar Kelimeler

kaudal blok, tap blok, postoperatif analjezi, ultrason, pediatrik

Comparison of Ultrasound-Guided Transversus Abdominis Plane Block vs Caudal Block For Postoperative Analgesia After Lower Abdomen Surgery In Children.

Öz

Introduction. Caudal anesthesia is a very popular postoperative analgesia technique for pediatric lower abdominal surgery. Because of the limitations of caudal block anesthesiologists need to search for alternative regional anesthesia techniques.This study aims to compare the effects and safety of Ultrasound-assisted TAP block and caudal block in postoperative analgesia.
Methods. The study was conducted in ASA grade I-II, 2-10 years aged cases scheduled for lower abdominal surgery. At group C (caudal block , n: 31), 0,3 mL.kg-1 and at group T (TAP block, n: 30), 0,5 mL.kg-1 0,25 % levobupivacaine applied at the end of surgery. Patients were assessed for the quality of pain relief by using faces pain scale-revised (FPS-R) at 0., 1., 4., 6., hours of the postoperative period. Analgesic consumption, complications and adverse effects was recorded. Student’s t-test, ANOVA, Fisher exact test were used for statically analyses.
Results. Between two group there were no significant differences at demographical data. The local anesthetic volume used for TAP block was more than caudal block (T:8,3±4,3 > C: 4,1±0,9) (p<0,05). When we compared the FPS-R at 0. hour, TAP block was more efficient at postoperative pain than caudal block (p<0,05). 23 % off all patients (n:14) required analgesic. There were no significant differences between two groups.
Conclusion: In conclusion TAP block and caudal block are simple, safe and effective analgesic methods in early period of postoperative pain management in lower abdominal pediatric surgery.

Anahtar Kelimeler

caudal block, tap block, pediatric, postoperative analgesia, ultrasound

Kaynakça

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