Çocuk Hastalarda İlioinguinalL/İliohipogastrik Sinir Bloğunda Bupivakain ve Levobupivakainin Postoperatif Ağrıya Etkilerinin Karşılaştırılması: Retrospektif Çalışma

Year 2017, , 120 - 124, 30.09.2017

Sevtap Darcin Ayca Tas Tuna İbrahim Akkoyun , Melahat Kececioglu Onur Palabiyik

https://doi.org/10.31832/smj.318124

Abstract

Amaç: Genel anesteziye eklenen ilioinguinal/iliohipogastrik
(İİ/İH) sinir bloğu pediyatrik hastalarda postoperatif analjezi için sıklıkla
kullanılmaktadır. Daha önce araştırılmadığından dolayı, pediyatrik hastalarda
inguinal herni onarımı için İİ/İH sinir bloğunda uygulanan bupivakain ve
levobupivakainin postoperatif analjezik etkilerini karşılaştırmayı amaçladık.

Gereç ve Yöntem: Bu 2 yıllık retrospektif çalışmada, veriler tek
taraflı kasık fıtığı ameliyatı yapılan hastaların tıbbi kayıtlarından elde
edildi. 0.2 mL/kg %0.5 bupivakain (Grup B) veya levobupivakain (Grup L) ile İİ/İH
sinir bloğu uygulanan hastalar alındı. Elektif olmayanlar, 2 yaş altı hastalar ve
birden fazla cerrahi prosedür içerenler çalışma dışı bırakıldı. Hastaların
demografik özellikleri (yaş, kilo ve cinsiyet), cerrahi süre ve taraf, ağrı
skorları, ek analjezik gereksinimi ve komplikasyonlar kayıt altına alındı.
İstatistiksel analiz için Ki-kare testi ve Mann-Whitney U testi kullanıldı. 

Bulgular: Her iki gruptaki ağrı skorları post-anestezi bakım
ünitesinde, 1, 2, 6 ve 24. saatlerde farklı değildi. Bununla birlikte, 4.
saatteki ağrı skorları Grup L'de anlamlı derecede düşüktü.

Sonuçlar: Genel anesteziye eklenen İİ/İH sinir bloğu,
postoperatif ağrı kontrolünde pediyatrik hastaların inguinal bölge cerrahisinde
etkilidir ve %0.5 levobupivakain ve bupivakainin benzer analjezik etkisi
vardır.

Keywords

Bupivakain, levobupivakain, pediyatrik anestezi, ilioinguinal/iliohipogastrik sinir bloğu, postoperatif ağrı

COMPARISON OF BUPIVACAINE AND LEVOBUPIVACAINE ON POSTOPERATIVE PAIN AFTER ILIOINGUINAL/ILIOHYPOGASTRIC NERVE BLOCK IN PEDIATRIC PATIENTS: A RETROSPECTIVE STUDY

Abstract

Objective: Ilioinguinal/iliohypogastric
(II/IH) nerve block added to general anesthesia is frequently used for
postoperative analgesia in pediatric patients. We aimed to compare the
postoperative analgesic effects of bupivacaine and levobupivacaine for II/IH
nerve block for inguinal hernia repair in pediatric patients, which is not investigated
previously.

Materials and Methods: In this 2-year retrospective study, data were collected from the medical
charts of patients that underwent unilateral inguinal hernia repair. Patients
were included who received an II/IH nerve block with 0.2 mL/kg 0.5% of either
bupivacaine (Group B) or levobupivacaine (Group L). Non-elective cases, age
under 2 years and patients with multiple procedures were excluded. Demographic
properties of the patients (age, weight, and sex), duration and side of
surgery, pain scores, additional analgesic requirement and complications were
documented. The chi-square test and the Mann-Whitney U test were used for
statistical analysis.

Results: In both groups, the
pain scores were not significantly different at post anesthesia care unit, 1,
2, 6 and 24th hours; nevertheless, the pain scores at 4th hour were
significantly lower in Group L.

Conclusion: II/IH
nerve block added to general anesthesia is effective in inguinal region surgery
of pediatric patients in postoperative pain control, and 0.5% levobupivacaine
and bupivacaine had similar analgesic effect.

Keywords

Bupivacaine, levobupivacaine, pediatric anesthesia, ilioinguinal/iliohypogastric nerve block, postoperative pain

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