Diz Artroplastisi Uygulanan Hastalarda Femoral, Siyatik Veya Femoral, Siyatik, Obturator Sinir Bloklarının Ameliyat Sonrası Ağrı Üzerine Etkilerinin Değerlendirilmesi

Abstract

Amaç: Total diz artroplastisi, son dönem diz osteoartritinin etkili bir tedavi yöntemi olan ameliyattır. Yapılan bu ameliyat sonrası yetersiz veya uygun olmayan postoperatif ağrı tedavisi hastanede kalış süresini uzatmakta, yoğun bakım ihtiyacını artırmaktadır. Biz de total diz artroplastisi’nde uygulanan femoral, siyatik ve obturator sinir bloklarının postoperatif dönemdeki ağrı ve ek analjezik tüketimlerine, postoperatif bulantı-kusma, hasta memnuniyetine ve hastanede kalış sürelerine etkilerini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya 21.10.2020-21.02.2021 tarihleri arasında tek taraflı diz artroplastisi ve postoperatif analjezi amaçlı periferik sinir bloğu uygulanan 50 hasta dahil edildi. Hastalar rastgele 2 gruba ayrıldı. Grup I femoral ve siyatik sinir bloğu, grup II ise femoral, siyatik ve obturator sinir bloğu yapılacak hastaları içermektedir. Postoperatif 0., 2., 4., 8., 12., 24. saatlerde hastaların istirahat Vizüel Analog Skala skorları ve bulantı, kusma semptomları kaydedildi. Ayrıca hastaların 8., 12., 24. saatlerde dinamik Vizüel Analog Skala skoru, ek analjezi başlama saatleri, 24 saatlik toplam analjezik kullanımı, taburculuk süreleri ve hasta memnuniyet dereceleri değerlendirildi. Bulgular: Femoral ve siyatik sinir bloğu olan hastaların 4. ve 8. saat istirahat Vizüel Analog Skala skoru, femoral, siyatik ve obturator sinir bloğu olan hastaların 4. ve 8. saat istirahat Vizüel Analog Skala skorundan anlamlı olarak daha yüksek bulundu. Femoral ve siyatik sinir bloğu olan hastaların ek analjezik gereksinimi başlama saati, femoral, siyatik ve obturator sinir bloğu olan hastalara göre anlamlı olarak daha erkendir. Sonuç: Total diz artroplastisi operasyonlarında postoperatif ağrı için uygulanan femoral, siyatik ve obturator sinir bloğunun postoperatif Vizüel Analog Skala skoru ve ek analjezik başlama süresine olumlu katkısı olduğu gösterildi.

Keywords

• Sinir bloğu
• total diz artroplastisi
• vizüel analog skala
• hasta memnuniyeti

EVALUATION OF THE EFFECTS OF FEMORAL, SCIATIC OR FEMORAL, SCIATIC, OBTURATOR NERVE BLOCKS ON POSTOPERATIVE PAIN IN PATIENTS UNDERGOING KNEE ARTHROPLASTY

Abstract

Objective: Total knee arthroplasty is an effective treatment for end-stage knee osteoarthritis. Inadequate or inappropriate postoperative pain management after this surgery can prolong hospitalization and increase the need for intensive care. This study investigates the effects of femoral, sciatic, and obturator nerve blocks on postoperative pain, additional analgesic consumption, postoperative nausea-vomiting, patient satisfaction, and length of hospital stay. Material and Methods: The study involved 50 patients who underwent unilateral knee arthroplasty and peripheral nerve block for postoperative analgesia between October 21, 2020, and February 21, 2021. The patients were randomly divided into two groups: group I received femoral and sciatic nerve block, while group II received femoral, sciatic, and obturator nerve block. Resting Visual Analog Scale scores, as well as nausea and vomiting symptoms, were recorded at 0, 2, 4, 8, 12, and 24 hours postoperatively. Additionally, we evaluated dynamic Visual Analog Scale scores at 8, 12, and 24 hours, initiation times for additional analgesia, total analgesic use within 24 hours, discharge times, and patient satisfaction levels. Results: The resting Visual Analog Scale scores at the 4th and 8th hour were significantly higher in patients with femoral and sciatic nerve block compared to those with femoral, sciatic, and obturator nerve block. Additionally, patients with femoral and sciatic nerve block required additional analgesics significantly earlier than those with femoral, sciatic, and obturator nerve block. Conclusion: The use of femoral, sciatic, and obturator nerve block for postoperative pain in total knee arthroplasty operations was found to have a positive impact on postoperative Visual Analog Scale score and the time to initiate additional analgesics.

Keywords

• Nerve block
• total knee arthroplasty
• visual analog scale
• patient satisfaction

Ethical Statement

XXX Health Sciences University Hospital Clinical Research Ethics Committee (No:2011-KAEK-2, 02.10.2020)

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