FAST TRACK DİZ ARTROPLASTİSİ: İKİ FARKLI MULTİMODAL ANALJEZİ YÖNTEMİNİN KARŞILAŞTIRILMASI

Year 2021, , 543 - 549, 30.12.2021

İbrahim Alper Yavuz , Fuad Öken , Semih Başkan , Hakan Tırın , Kevser Dilek Andıç , Oya Kılcı , Ahmet Özgür Yildirim

https://doi.org/10.17343/sdutfd.897132

Abstract

Amaç
Bu çalışmanın amacı, Fast track Total Diz Artroplasti
(TDA) ameliyatlarında multimodal protokolün, femoral
sinir blokajı (FSB) ile lokal infiltrasyon analjezi (LIA)
yöntemleri kullanarak pre-emptif analjezideki etkilerini
hızlı bir şekilde değerlendirmektir.
Gereç ve Yöntem
Bu çalışma tek merkezli, randomize, tek kör kontrollü
bir çalışma olarak planlandı. Çalışmaya, birincil veya
ikincil osteoartrit nedeniyle TDA uygulanan, her iki
cinsiyetten 40-80 yaş arası toplam 72 gönüllü hasta
dahil edildi. Hastalar bir bilgisayar randomizasyon
programı kullanılarak iki gruba ayrıldı. Grup I: FSB
yöntemi uygulanan hastalar ve Grup II: LIA yöntemi
uygulanan hastalar. Gruplar fonksiyonel puanlar açısından
karşılaştırıldı.
Bulgular
Gruplar arasında yaş, cinsiyet, boy, kilo, vücut kitle indeksi,
ASA, ameliyat edilen taraf, protez tipi ve ameliyat
süresi açısından istatistiksel olarak anlamlı fark
saptanmadı (p> 0,05). Her iki grupta da ölçüm zamanları
arasında fonksiyon skor değerlerinde istatistiksel
olarak anlamlı farklılık belirlendi (p <0.05). Hangi zamanda
veya zamanlarda bir fark olduğunu belirlemek
için çoklu karşılaştırma testleri (post-hoc) uygulandı.
Her iki grupta da fonksiyon skor değerleri tüm ölçüm
zamanlarında farklıydı, preoperatif ölçüm en düşük,
postoperatif 3 aylık değerler en yüksek bulundu.
Sonuç
Çalışmamız femoral sinir bloğu veya lokal infiltrasyon
analjezisi ile multimodal analjezinin kullanılmasının
Fast-track TDA ameliyatlarında etkili analjezi yöntemleri
olarak uygulanabileceğini ve birbirlerine alternatif
olabileceğini göstermektedir.

Keywords

Fast-Track cerrahi, Total diz artroplastisi, Lokal infiltrasyon analjezi, Femoral sinir bloğu, Multimodal analjezi

FAST TRACK KNEE ARTHROPLASTY: COMPARISON OF TWO DIFFERENT MULTIMODAL ANALGESIA METHODS

Abstract

Objective
The aim of this study was to evaluate the effects
of a multimodal protocol in pre-emptive analgesia
following Total Knee Arthroplasty (TKA), using
epidural anesthesia with femoral nerve blockage
(FNB) or local infiltration analgesia (LIA) methods in
fast-track TKA.
Material and Methods
This study was planned as a single-centre,
randomized, single-blind, controlled study. The study
included 72 voluntary patients, aged 40-80 years,
of both genders, who underwent TKA for primary or
secondary osteoarthritis. The patients were divided
into two groups using a computer randomization
program. Group I: FNB application and Group II:
LIA methods. Groups were compared in terms of
functional scores.
Results
No statistically significant difference was determined
between the groups in respect of age, gender, height,
weight, BMI, ASA, operated side, prosthesis type,
and operating time (p>0.05). A statistically significant
difference was determined in the function score values
between the measurement times in both groups
(p<0.05). Multiple comparison tests (post-hoc) were
applied to determine at which time or times there was
a difference. In both groups, the function score values
were different at all the measurement times, with the
preoperative measurement found to be the lowest
and the postoperative 3-month values the highest.
Conclusions
Our study show that used multimodal analgesia with
femoral nerve block or local infiltration analgesia can
be applied as effective analgesia methods in fasttrack
TKA and can be considered as alternatives for
each other.

Keywords

Arthroplasty, Analgesia, Local infiltration analgesia, Femoral nerve block, Multi-modal analgesia

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