Distal radius kırıklarının redüksiyonu öncesi analjezi yöntemi olarak hematom bloğu ve sedoanaljezi yöntemlerinin karşılaştırılması

Year 2021, Volume: 46 Issue: 3, 1100 - 1107, 30.09.2021

Melih Bağır Akif Mirioğlu Mustafa Tekin Ömer Biçer Cenk Özkan

https://doi.org/10.17826/cumj.910800

Cited By: 1

Abstract

Amaç: Bu çalışmanın amacı deplase distal radius kırıklarının redüksiyonu sırasında, analjezi amaçlı kullanılan hematom bloğu ve sedoanaljezi tekniklerinin redüksiyon kalitesi, hastanede kalış süresi ve ağrı kontrolü açısından retrospektif olarak karşılaştırılmasıdır.
Gereç ve Yöntem: İzole deplase distal radius kırığı tanısı ile kapalı redüksiyon uygulanan 106 hasta değerlendirildi. Hastaların 45’ine hematom bloğu, 61’ine sedoanaljezi uygulandı. Sedoanaljezik olarak midazolam (0,1mg/kg) ve fentanyl (1 mcg/kg), lokal anestezik olarak da lidokain (10 ml %1) kullanıldı. Demografik veriler, Frykman sınıflamasına göre kırık tipleri ve travma mekanizmaları değerlendirildi. Hastaların ağrı değerlendirmesi Vizüel analog skala (VAS) ile yapıldı. Redüksiyon kalitesi Sarmiento kriterlerine göre değerlendirildi. Analjezi yöntemlerinin maliyet değerlendirilmesi prosedürlerin ücretleri, kullanılan ilaçlar ve medikal malzemeler üzerinden yapıldı.
Bulgular: Her iki grup cinsiyet, yaş, kırık tipi ve etkilenen taraf açısından benzerdi. Hematom bloğu grubunda hastanede kalış süresi daha kısa idi ve VAS skoru belirgin olarak daha düşüktü. Redüksiyon kalitesi her iki grupta benzerdi. Hasta başı maliyet, sedoanaljezi grubunda hematom bloğu ile karşılaştırıldığında dört kat fazla idi.
Sonuç: Hematom bloğu, distal radius kırıklarının redüksiyonu öncesi ağrıyı azaltmak için kullanılan kolay ve etkili bir yöntemdir. Özellikle sedoanaljezi yönteminin yan etkilerine daha hassas olan yaşlı hastalarda, analjezi sağlamak için daha güvenli bir yöntem olan hematom bloğu tercih edilebilir.

Keywords

radius kırığı, hematom bloğu, sedoanaljezi

Comparison of hematoma block and sedoanalgesia for analgesia before reduction of distal radius fractures

Abstract

Purpose: The aim of this study was retrospective assessment of the reduction quality, hospitalization time, and relief of pain in hematoma block assisted closed reduction versus sedoanalgesia assisted closed reduction.
Materials and Methods: There were 106 patients included who diagnosed as isolated displaced distal fracture of radius and treated with closed reduction. Hematoma block was used in 45 patients and sedoanalgesia was used in 61 patients. Midazolam (0,1 mg/kg) and fentanyl (1 mcg/kg) combination was administered as the sedoanalgesic agent, and lidocaine (10 ml, 1%) as the local anaestetic. Demographic data, fracture type according to Frykman classification, and mechanism of trauma were noted. Pain status of patients were recorded by using the Visual analog scale (VAS). Sarmiento criteria was used for the evaluation of the reduction quality. Cost of the analgesic procedure was assessed based on the prices of the analgesia procedures, used pharmaceuticals and medical consumables.
Results: Both groups were similar in terms of gender, age, fracture type and affected side., Hospitalization time was shorter in hematoma block group, and VAS was significantly lower. Quality of reduction was similar in both groups. Cost per patient was four times higher in sedoanalgesia group compare to hematoma block group.
Conclusion: Hematoma block is an effective, easily performed method that can be used prior to the closed reduction of the distal radius fractures to relieve the pain. Older patients can be susceptible to adverse effects of sedoanalgesia and hematoma block can be chosen as a more reliable method to provide the analgesia.

Keywords

radius fracture, hematoma block, sedoanalgesia

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