EL CERRAHİSİNDE İNTRAVENÖZ REJYONEL ANESTEZİ VE AKSİLLER SİNİR BLOĞU YÖNTEMLERİNİN HASTA MEMNUNİYETİ VE AMELİYAT KONFORUNA ETKİSİ

Öz

Giriş ve Amaç: El cerrahisinde uygulanan rejyonel anestezi yöntemleri genel anestezi ile kıyaslandığında, hızlı taburculuk süresi, yüksek hasta memnuniyeti ve düşük maliyetleri nedeniyle popüler hale gelmiştir. Günümüzde el cerrahisi için geleneksel olarak birçok bölgesel teknik kullanılmaktadır. Bunlar ikisi intravenöz bölgesel anestezi (RIVA ) ve aksiller brakiyal pleksus bloğu (AB) olarak tanımlanmaktadır. Çalışmamızın amacı bu iki yöntemi hasta memnuniyeti ve cerrahi konfora etkili faktörler yönünden karşılaştırmaktı. Materyal metod: Etik kurul onayı sonrasında ASA I-III sınıfında, 18-75 yaş arasında 80 olgu, prospektif ve randomize olarak bu çalışmaya dahil edildi. Her iki grupta da işlem esnasından başlamak üzere, işlem süresi, bekleme süresi, ameliyat süresi, sensorial ve motor blok bitiş zamanı, sedasyon gereksinimi, analjezik ihtiyacı, taburculuk süresi, taburculuk sonrası hasta memnuniyet düzeyi açısından karşılaştırma yapıldı. Bulgular: İşlem süresi RİVA grubunda aksiller blok grubundan daha uzundu (p<0.05). İşlem sonrasında cerrahi başlayıncaya kadar geçen süre, aksiller blok grubunda daha uzundu (p<0.05). Sensorial ve motor blok bitiş zamanı aksiller blok grubunda daha uzundu (p<0.05). Postoperatif analjezik ihtiyacı aksiller blok grubunda daha düşüktü (p<0.05). Hasta memnuniyeti açısından her iki grup arasında fark bulunamadı. Tartışma ve Sonuç: Aksiller sinir bloğu RIVA ile kıyaslandığında, daha düşük postoperatif analjezik ihtiyacı ve daha uzun motor blok süresi sağlamasına rağmen, hastalar için işlem sonrası daha uzun bekleme süresine neden olur. El ve el bileği cerrahisinde anestezi uzmanının deneyim ve tecrübesine göre aksiller sinir bloğu, RIVA yöntemine tercih edilebilir.

Anahtar Kelimeler

• aksiller blok
• el cerrahisi
• intravenöz anestezi

Proje Numarası

2020/61

Etik Beyan

Before the study, approval from the Ethics Committee of Ömer Halisdemir University Faculty of Medicine numbered 2020/61 was obtained.

EFFECTS OF INTRAVENOUS REGIONAL ANESTHESIA AND AXILLARY NERVE BLOCK METHODS ON PATIENT SATISFACTION AND SURGICAL COMFORT IN HAND SURGERY:

Öz

Aims: Regional anesthesia methods used in hand surgery have become popular due to their rapid discharge time, high patient satisfaction and low costs compared to general anesthesia. Today, many regional techniques are traditionally used for hand surgery. Two of these are defined as intravenous regional anesthesia (RIVA) and axillary brachial plexus block (AB). The aim of our study was to compare these two methods in terms of patient satisfaction and factors affecting surgical comfort. Material Methods: A total of 80 patients between the ages of 18 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were retrospectively included in this randomized study. In both groups, a comparison was made in terms of procedure time, waiting time, surgery time, sensory and motor block end time, sedation requirement, analgesic requirement, discharge time, and patient satisfaction level after discharge, starting from the procedure. Results: Procedure time was longer in the RIVA group than in the axillary block group (p<0.05). The time from the procedure until the start of surgery was longer in the axillary block group (p<0.05). Sensorial and motor block completion times were longer in the axillary block group (p<0.05). Postoperative analgesic requirement was less in the axillary block group (p<0.05). No difference was found between the two groups in terms of patient satisfaction. Conclusion Although axillary nerve block provided lower postoperative analgesic requirement and longer motor block duration compared to RIVA, there was a longer waiting time for patients after the procedure. Axillary nerve block may be preferred to RIVA by anesthesiologists experienced in hand and wrist surgery.

Anahtar Kelimeler

• axillary block
• hand surgery
• intravenous anaesthesia

Proje Numarası

2020/61

Etik Beyan

Before the study, approval from the Ethics Committee of Ömer Halisdemir University Faculty of Medicine numbered 2020/61 was obtained.

Kaynakça

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