İnternal Üretrotomide İntraüretral Lidocaine ile Sedoanaljezi Kombinasyonunun Etkinliği

Öz

Amaç: Bu çalışmadaki amacımız, primer anterior üretral darlığı olan ve internal üretrotomi yapılan hastalarda uygulanan intraüretral lidokain ve sedoanaljezi kombinasyonu ile tek başına uygulanan intraüretral lidokainin etkinliğini karşılaştırmaktır. Gereç ve Yöntemler: 2-3 cm uzunluğunda anterior üretral darlığı olan ve internal üretrotomi yapılan 76 hasta analiz edildi.Hastalar iki gruba ayrıldı.Grup 1̓̓ de 36 hasta olup işlem sırasında sadece intraüretral lidokain jel(12.5 g,% 2 ) uygulandı. Grup 2̓ de ise 40 hasta vardı ve operasyon esnasında intraüretral lidokain jel ve intravenöz sedoanaljezi kombinasyonu ( 1 mg/kg Propofol and 1µg/kg Fentanyl) verildi.Gruplar, anatomik lokasyon,üretral darlığın uzunluğu ve etiyolojisi, işlem süresi,takip süreleri ve postoperatif VAS skorlamaları açısından karşılaştırıldı. Bulgular: Gruplar arasında yaş, üretral darlık uzunluğu ve takip süreleri açısından anlamlı farklar yoktu.Üretral darlığın sebebi her iki gruptaki hastalarda çoğunlukla iatrojenikti ve daha çok bulber üretrada idi.Ortalama işlem zamanı ve VAS skoru grup 1 de grup 2 ye göre anlamlı olarak daha yüksekti. (p<0.001). Üretral darlık nüksü ortalama 9.47 ay takip sonucunda grup 1 de 4 hastada ve grup 2 de 9.62 ay ortalaması ile 6 hastada gerçekleşti .Hastalarda herhangi bir ciddi komplikasyon gelişmedi. Sonuç:Anterior üretral darlıkların internal üretrotomi ile tedavisi sırasında uygulanan intraüretral lidokain ve intravenöz sedoanaljezi kombinasyonu hastalarda ağrı kontrolü açısından tek başına uygulanan intraüretral lidokain anestezisine göre çok daha etkili ve memnuniyet vericidir.

Anahtar Kelimeler

• İnternal üretrotomi
• lokal anestezi
• sedoanaljezi
• üretral darlık

Effectiveness of Combined Intraurethral Lidocaine with Sedoanalgesia in Optical Internal Urethrotomy

Öz

Aim: In this study, our aim was to compare the effectiveness of combined intraurethral lidocaine and intravenous sedoanalgesia with intraurethral lidocaine alone in patients with undergoing optical internal urethrotomy(OIU) for primary anterior urethral strictures. Materials and methods: A total of 76 patients who underwent OIU with anterior urethral stricture 2-3 cm long were analysed. Patients were divided into two groups. There were 36 patients in group 1 received only intraurethral lidocaine gel (12.5 g,% 2 ) and there were 40 patients in group 2 operated under intraurethral lidocaine gel anesthesia with intravenous sedoanalgesia (1 mg/kg Propofol and 1µg/kg Fentanyl). Anatomic location, length and etiology of the urethral stricture, procedure time, patients’ follow-up and postoperative VAS scores were compared in two groups. Results: There was no significant differences between the two groups in the length of the urethral stricture,age and in the follow-up time. Most of the patients in two groups had iatrogenic as the cause of urethral stricture and the stricture was most commonly located in the bulbar urethra. The mean procedure time and VAS score in group 1 were significantly higher than group 2 (p<0.001). Recurrence of urethral stricture developed in 4 and 6 patients at a mean follow-up of 9.47 in group 1, 9.62 months in group 2. No serious complication was developed in both groups. Conclusion: Intraurethral lidocaine with sedoanalgesia is effective and satisfactory with better pain control than intraurethral lidocaine alone in OIU for anterior urethral strictures.

Anahtar Kelimeler

• Internal urethrotomy
• local anesthesia
• sedoanalgesia
• urethral stricture

Kaynakça

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