Lomber Diskektomi Cerrahisi Sonrası Postoperatif Analjezi Amacıyla Uygulanan Posterior Yaklaşımlı Quadratus Lumborum Bloğunun Etkisinin Değerlendirilmesi; Retrospektif Gözlemsel Çalışma

Year 2022, Volume: 5 Issue: 1, 12 - 22, 30.06.2022

Gökhan Sertçakacılar Güneş Özlem Yıldız

Abstract

Lomber disk hernileri intervertebral disk patolojileri içerisinde en sık görülen hastalıklardan birisidir. Lomber diskektomi, bu nedenle beyin cerrahisi girişimlerinin başında gelmektedir. Bu hastaların postoperatif dönemdeki ağrı yönetiminde opioidler sık olarak kullanılmaktadır. Bu ilaçlara ait yan etki insidansından kaçınmak için günümüzde güncel blok teknikleri sıklıkla kullanılır olmuştur. Quadratus lumborum bloğu da (QLB) bu bağlamda gelecek vaad eden bloklardan birisidir. Bu çalışmada, tek seviye lomber diskektomi cerrahisinde ultrason eşliğinde uygulanan QLB’nun postoperatif analjezik etkinliği ve güvenliğinin değerlendirilmesi amaçlanmıştır. Bilateral QLB uygulanan 20 hasta blok grubu olarak ve uygulanmayan 25 hasta ise kontrol grubu olarak çalışmaya dahil edildi. Ameliyat sonrası 1-6-12-24. saatlerde hastaların ağrı skorları ve postoperatif iv opioid tüketimleri değerlendirildi. Ağrı skorları tüm zaman dilimlerinde QLB grubunda anlamlı şekilde düşük saptandı (p0.05). Operasyon sonrası 2. ve 6. saatlerde opioid tüketimi, kontrol grubuna kıyasla blok grubunda anlamlı olarak daha düşük bulundu. (p=0.004 ve p=0.011, sırasıyla) Çalışmamızın sonuçları bilateral quadratus lumborum bloğunun lomber diskektomi operasyonu sonrası analjezi yönetiminde başarılı bir seçenek olarak kullanılabileceğini göstermiştir.

Keywords

lomber diskektomi, quadratus lumborum bloğu, postoperatif analjezi

Evaluation of the Efficacy of Posterior Approach Quadratus Lumborum Block for Postoperative Analgesia after Lumbar Discectomy Surgery; Retrospective Observational Study

Abstract

Lumbar disc hernia is one of the most common diseases among intervertebral disc pathologies. Lumbar discectomy surgery is, therefore, one of the leading neurosurgery interventions. Opioids are frequently used in the postoperative pain management of these patients. However, to avoid side effects of these drugs, current block techniques are frequently used today. Quadratus lumborum block (QLB) is one of the promising blocks in this context. This study aimed to evaluate the postoperative analgesic efficacy and safety of QLB performed under ultrasound guidance in single-level lumbar discectomy surgery. Bilateral QLB applied, 20 patients were included in the study as the block group, and 25 patients who were not applied were included in the study as the control group. Patients were evaluated in pain scores and postoperative intravenous opioid consumption at 2-6-12-24 hours postoperatively. Pain scores were significantly lower in the QLB group in all time periods (p0.05). Opioid consumption at the 2nd and 6th hours after the operation was significantly lower in the block group than in the control group (p= 0.004 and p= 0.011, respectively). The results of our study showed that bilateral QLB can be used as a successful option in the management of analgesia after lumbar discectomy.

Keywords

lumbar discectomy, quadratus lumborum block, postoperative analgesia

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