Postoperatif Analjezi İçin Ultrason Kılavuzluğunda Transversus Abdominal Plan Bloğunun Laparoskopik Kolesistektomide Derlenme ve Postoperatif Hemodinamik Parametreler Üzerine Etkilerinin Değerlendirilmesi

Year 2022, , 213 - 221, 31.08.2022

Öztürk Taşkın , Ayşe Yılmaz , Ufuk Demir

https://doi.org/10.36516/jocass.1113668

Abstract

Amaç: Laparoskopik kolesistektomi tüm dünyada oldukça yaygın hale gelmiştir. Laparoskopik işlemlerden sonra da şiddetli ağrı gelişebilir. Ameliyat sonrası ağrı birçok sistemde değişikliğe neden olabilir ve komplikasyon riskini artırabilir. Bu çalışmada, laparoskopik kolesistektomide ultrason eşliğinde yapılan Transversus Abdominis plan bloğunun derlenme ve postoperatif hemodinamik parametrelere etkisini değerlendirmeyi amaçladık.
Yöntemler: Hastalar postoperatif analjezi için parasetamol alanlar ve parasetamol ve TAP blok alanlar olarak 2 gruba ayrıldı. Hastaların postoperatif hemodinamik parametreleri, periferik oksijen satürasyonları, VAS skorları ve Aldrete Skorları hasta dosyalarından kaydedilerek karşılaştırıldı.
Bulgular: TAP bloklu hastalarda VAS skorları ve sistolik-diyastolik arter basınçları istatistiksel olarak anlamlı derecede düşüktü ve Modifiye Aldrete skorları ve oksijen satürasyonları istatistiksel olarak anlamlı derecede yüksekti.
Sonuç: Laparoskopik kolesistektomi yapılan hastalarda konvansiyonel analjezi yöntemlerine ek olarak USG ile uygulanan TAP bloğun postoperatif ağrı kontrolünü kolaylaştırdığını, daha stabil bir hemodinami sağladığını ve hem daha iyi hem de daha erken derlenme sağladığını gösterdik. Özellikle kardiyovasküler sistem bozukluğu olan hastalarda hem iyileşme hem de komplikasyon riski açısından avantaj sağlayacaktır.

Keywords

tap blok, rejyonel anestezi, transversus abdominis plan bloğu, laparoskopik kolesistektomi, postoperatif analjezi

Evaluation of the Effects of Ultrasound-Guided Transversus Abdominal Plane Block for Postoperative Analgesia on Recovery and Postoperative Hemodynamic Parameters in Laparoscopic Cholecystectomy

Abstract

Objectives: Laparoscopic cholecystectomy has become quite common all over the world. Severe pain may also develop after laparoscopic procedures. Postoperative pain can cause changes in many systems and increase the risk of complications. In this study, we aimed to evaluate the effect of ultrasound-guided Transversus Abdominis plane block on recovery and postoperative hemodynamic parameters in laparoscopic cholecystectomy.
Methods: The patients were divided into 2 groups as those who received paracetamol for postoperative analgesia and those who received paracetamol and TAP block. Postoperative hemodynamic parameters, peripheral oxygen saturations, VAS scores and Aldrete Scores of the patients were recorded from the patient files and compared.
Results: VAS scores and systolic-diastolic arterial pressures were statistically significantly lower and Modified Aldrete scores and oxygen saturations were statistically significantly higher in patients with TAP block.
Conclusion: We showed that in addition to conventional analgesia methods in patients who underwent laparoscopic cholecystectomy, TAP block applied with USG facilitates postoperative pain control, provides a more stable hemodynamics and both better and earlier recovery. It will provide an advantage in terms of both recovery and complication risk, especially in patients with cardiovascular system disorders.

Keywords

TAP Block, Regional anesthesia, Transversus Abdominis Plan Block, Laparoscopic cholecystectomy, Postoperative analgesia

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