Kalça Cerrahisinde Perikapsüler Sinir Grubu Bloğunun Postoperatif Analjeziye Etkisinin İncelenmesi

Abstract

ÖZ Amaç: Kalça cerrahisi uygulanan hasta sayısının artmasıyla birlikte postoperatif dönemde hastaların analjezi planlaması da önem kazanmaktadır. Kalça cerrahisi sonrası ağrı akut ve şiddetli ağrı grubundadır ve etkin tedavisi büyük önem arz etmektedir. Çalışmamızda multimodal analjezi kapsamında kalça cerrahilerinde Perikapsüler Sinir Grubu bloğunun (PENG) postoperatif analjeziye etkinliğini, opioid miktarı ve postoperatif bulantı-kusma varlığını araştırmayı amaçladık. Gereç ve Yöntem: Çalışmamız prospektif bir çalışma olup elektif şartlarda kalça cerrahisi planlanan toplam 102 hasta dahil edildi. Hastalar rastgele iki gruba ayrılarak ilk gruba PENG bloğu (Grup P, n=51) yapılırken ikinci gruba (Grup C, n=51) blok uygulanmadı. Hastaların intraoperatif hemodinamik veriler, taburculuk- hastanede kalış süresi ve komplikasyon varlığı, vizüel ağrı skorları (VAS) (istirahat ve dinamik) kaydedildi. Toplam tüketilen tramadol dozu, ek analjezik ihtiyacı ve ilk analjezik saati değerlendirildi. Bulgular: 102 hasta çalışmayı tamamladı. Postoperatif tüm zamanlarda istirahat ve dinamik VAS skorları PENG bloğu yapılan grupta anlamlı bir şekilde daha düşük bulundu (p<0,001). PENG bloğu yapılan grupta total kullanılan tramadol dozları ve ek analjezik yapılma oranı anlamlı bir şekilde daha düşük bulundu (p<0,001). Ayrıca blok yapılmayan grupta PENG bloğu yapılan gruba göre daha erken saatte ek analjezik gereksinim gösterip kurtarma analjezisi yapılma oranları anlamlı bir şekilde daha yüksek olduğu bulundu (p<0,001, p=0,023). Sonuç: PENG bloğu uygulamasının kalça cerrahilerinde hasta ağrı skorlarını azaltarak daha az opioidle daha az ağrı duyacağı opioid nedenli yan etkilerinden koruyacağı kanaatindeyiz.

Keywords

• Kalça cerrahisi
• PENG blok
• Postoperatif analjezi

Investigating the Effect of Pericapsular Nerve Group Block on Postoperative Analgesia in Hip Surgery

Abstract

Purpose: With increasing numbers of patients undergoing hip surgery, postoperative analgesia planning for patients also becomes more important. Post-hip surgery pain is categorized as acute and severe, and its effective treatment is paramount. Our study investigates the effectiveness of Pericapsular Nerve Group (PENG) block in postoperative analgesia, the amount of opioid used, and the presence of postoperative nausea and vomiting in hip surgeries in a multimodal analgesia context. Materials and Method: This is a prospective study that includes 102 patients in total, undergoing elective hip surgery. The patients were randomly divided into two groups, and the first group (Group P, n=51) received a PENG block, while the second group (Group C, n=51) received no block. Intraoperative hemodynamic data, discharge-hospitalization time, presence of complications, visual pain scores (VAS) (rest and dynamic) were recorded. Total tramadol dose consumed, additional analgesic requirement, and time of first analgesic were evaluated. Results: 102 patients completed the study. Rest and dynamic VAS scores were significantly lower in the blocked PENG group at all times postoperatively (p<0.001). Total tramadol dosage and additional analgesic rates were significantly lower in the blocked PENG group (p<0.001). Also, the rate of requiring additional analgesics and receiving rescue analgesia at an earlier time was significantly higher in the non-block group compared to the blocked PENG group (p<0.001, p=0.023). Conclusion: We believe that application of a PENG block in hip surgeries will reduce patient pain scores, allowing for experiencing less pain with fewer opioids, and protection from side effects of opioids.

Keywords

• Hip surgery
• PENG block
• Postoperative analgesia

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