Transkütan elektriksel sinir stimülasyonunun multipl kaburga kırıklarında ağrı ve komplikasyonları önlemedeki etkinliği

Abstract

Giriş: Künt toraks travmaları sonrası ortaya çıkan kaburga kırıkları şiddetli ağrıya neden olur. Ağrıya bağlı solunum yolu sekresyonlarının atılamaması, atelektazi ve pnömoni gibi ciddi komplikasyonlar ortaya çıkabilir. Bu çalışmamızda izole multiple kaburga kırıklı hastalarda Transkütan Elektriksel Sinir Stimulasyonu’nun (TENS) ağrıyı giderme, akciğer fonksiyonlarını düzeltme ve komplikasyonları önlemedeki etkinliğini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya Mart 2021 ile Aralık 2022 arasında Göğüs Cerrahi Kliniğimizde yatarak tedavi gören, izole toraks travmalı 50 hasta dahil edildi. Hastalar İV (İntravenöz) Analjezi grubu ve TENS (Transcutaneous Electrical Nerve Stimulation) grubu olarak gruplara ayrıldı. Belirlenen analjezi yöntemi uygulandıktan sonra 30. dakikada, tedavinin 1. gününde, 2. gününde ve 3. gününde istirahat halinde VAS değeri ve oda havasında periferik oksijen satürasyonu ölçüldü. Üçüncü gün aynı zamanda istirahat halinde solunum fonksiyon testinde bulunan FEV1 değeri ölçüldü. Bulgular: Çalışmaya katılan 50 hastanın 28’i erkek, 22’si ise bayan idi. Ortalama yaş 55.7 idi. Gruplar arası yapılan istatistiksel çalışmada grup 2’de komplikasyon oranı istatistiksel olarak anlamlı şekilde grup 1’den daha fazla idi. Ayrıca işlem sonrası 1. ve 3. gün VAS değerleri, 3. gün FEV1 değeri, 3. gün O2 saturasyonu ve ilave analjezi ihtiyacı açısından gruplar arasında istatistiksel açıdan anlamlı fark vardı. Diğer parametreler açısından gruplar arasında anlamlı bir fark yoktu. Sonuç: TENS tedavisi komplike olmayan ve az sayıda kaburga kırığı olan hastaların ağrısını kontrol etmede etkili ve güvenilir bir yöntemdir. Ancak çok sayıda kaburga kırığı olan ve şiddetli ağrısı olan hastalarda tek başına kullanıldığında yetersiz kalmakta ve ilave analjezi ihtiyacı artmaktadır.

Keywords

• Kaburga kırığı
• TENS
• Komplikasyon

Transkütan elektriksel sinir stimülasyonunun multipl kaburga kırıklarında ağrı ve komplikasyonları önlemedeki etkinliği

Abstract

Rib fractures following blunt thoracic trauma cause severe pain. Serious complications such as inability to excrete respiratory secretions, atelectasis and pneumonia may occur due to pain. In this study, we aimed to investigate the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) in relieving pain, improving lung function and preventing complications in patients with isolated multiple rib fractures. The study included 50 patients with isolated thoracic trauma who were hospitalised in our Thoracic Surgery Clinic between March 2021 and December 2022. Patients were divided into groups as IV (Intravenous) Analgesia group and TENS group. VAS value at rest and peripheral oxygen saturation in room air were measu-red at 30 minutes after the analgesia method was applied, on 1st, 2nd and 3rd days of the treatment. On the third day, FEV1 value in pulmonary function test at rest was also measured. Of the 50 patients who participated in the study, 28 were male and 22 were female. The mean age was 55.7 years. In the statistical study between the groups, the complication rate in group 2 was statistically significantly higher than in group 1. In addition, there was a statistically significant difference between the groups in terms of post-procedure 1st and 3rd day VAS values, 3rd day FEV1 value, 3rd day O2 saturation and need for additional analgesia. There was no significant difference between the groups in terms of other parameters. TENS therapy is an effective and reliable method to control pain in patients with uncomplicated and few rib fractures. However, when used alone in patients with multiple rib fractures and severe pain, it is inadequate and the need for additional analgesia increases.

Keywords

• Rib fracture
• TENS
• Complication

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