Yıl 2015, Cilt 5 , Sayı 2, Sayfalar 41 - 45 2015-06-01

PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ

Mine AKIN [1] , Sibel SAYDAM [2] , Gülsen KESKİN [3] , Sengül ÖZMERT [4] , Yeşim ŞENAYLI [5] , Devrim Tanıl KURT [6] , Feyza SEVER [7] , Atilla ŞENAYLI [8]


Objective: In pediatric surgery, caudal epidural analgesia is reliable, easy to learn regional anesthesia technique in surgical procedures under the umbilicus. Despite its frequent use, excellent analgesic properties, current literature search yielded only a few large series reported. We aimed to present our institutional experience reflecting the collective data in pediatric urological surgical casesMateials and Methods: The anesthesia records of 5536 consecutive pediatric urological surgical cases who underwent caudal epidural anesthesia procedure between January 2008-February 2013 were retrospectively analyzed. Parameters including the type of surgery, demographic findings, need for additional analgesic agents, the complications related to the procedure, the percentage of failed cases were analyzed.Results: Total patients with a median age of 4 years were enrolled. There were 4538 male (82%), 998 female (18%) patients. In four cases the procedure was terminated due to dural puncture. Inadvertent penetration of vascular space was noted in 276 (4,98%) cases. In 221 cases, it was terminated due to the failure of correct placement of the needle despite repeated attempts. The procedure was categorized as failure in 122 (2,2%) cases. 4096 patients were discharged on the same day. In 48 patients (1,5%) additional analgesic dose was needed. In the patients who required prolonged hospitalization additional analgesic was started at postoperative 6th hour.Conclusion: Caudal epidural anesthesia is easy, safe and effective technique in preoperative and postoperative pain control.. The main advantages are high success, low complication rates, lesser analgesic dose requirement. In the light of our study results, we recommend routine use of the caudal epidural procedure in pediatric urological surgery cases

Amaç: Kaudal epidural anestezi, pediatrik hasta grubunda umblikus altı cerrahi girişimlerinde uygula-
nan, öğrenilmesi ve uygulaması kolay, güvenilir bir rejyonal anestezi yöntemidir. Postoperatif dönemde analjezi sağlamada mükemmel sonuç verir, ancak geniş serili yayınlar azdır. Çalışmamızda pediatrik üro- loji vakalarında kaudal epidural blok uygulamasının etkinliğinin değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji-Onkoloji Eğitim Araştırma Hastanesi’nde Ocak 2008-Şubat 2013 tarihleri arasında kaudal epidural blok uygulanmış pediatrik üro- loji vaka kayıtları retrospektif olarak değerlendirildi. Bu hastaların demografik verileri, operasyon türleri, blok uygulaması sırasında gelişen komplikasyonlar ve başarısız kabul edilen olgular kaydedildi. Postope- ratif analjezi etkinliği ve ek analjezik ihtiyacı değerlendirildi.
Bulgular: Toplam 5536 vaka çalışmaya alındı. Hastaların ortanca yaşı 4 yaş (Çeyrekler Arası Aralık:
1-7yaş) bulundu. Hastaların 4538’i (%82) erkek, 998’i (%18) kız idi. Dört (%0.07) olguda dura delinmesi,
276 (%4.98) olguda damar ponksiyonu kaydedilmiştir. İki yüz yirmi bir (%3.9) olguda ise kaudal blok işlemine son verilmiştir. Ayrıca 122 (%2,2) hastanın kaudal blokları başarısız kabul edilmiştir. Çalışmaya alınan 4096 (%73.9) hasta günübirlik vakadır. Taburculuk öncesi 48 (%1.15) hastaya ek analjezik ajan verilmiştir. Günübirlik hasta grubu dışındaki hastalarda postoperatif 6. saatte analjezik ilaç başlanmıştır. Sonuç: Kaudal epidural anestezi peroperatif ve postoperatif ağrı kontrolünde etkili, uygulaması kolay, basit ve güvenli bir anestezi yöntemidir. Operasyon esnasında güçlü analjezi sağlar. Sonrasında ise anal- jezik gereksiniminde azalma ile ciddi hasta konforu sağlar. Umblikus altı pediatrik cerrahi olgularında yüksek başarı ve düşük komplikasyon oranları nedeniyle kullanımı önerilir.
Anahtar Kelimeler: Pediatrik, Epidural anestezi, Ürolojik cerrahi

ABSTRACT
Objective: In pediatric surgery, caudal epidural analgesia is reliable, easy to learn regional anesthesia
technique in surgical procedures under the umbilicus. Despite its frequent use, excellent analgesic properties, current literature search yielded only a few large series reported. We aimed to present our institutional experience reflecting the collective data in pediatric urological surgical cases
Mateials and Methods: The anesthesia records of 5536 consecutive pediatric urological surgical cases who underwent caudal epidural anesthesia procedure between January 2008-February 2013 were retrospectively analyzed. Parameters including the type of surgery, demographic findings, need for additional analgesic agents, the complications related to the procedure, the percentage of failed cases were analyzed.
Results: Total patients with a median age of 4 years (interquartile range: 1-7) were enrolled. There were
4538 male (82%), 998 female (18%) patients. In four cases the procedure was terminated due to dural puncture. Inadvertent penetration of vascular space was noted in 276 (4,98%) cases. In 221 cases, it was terminated due to the failure of correct placement of the needle despite repeated attempts. The procedure was categorized as failure in 122 (2,2%) cases. 4096 patients were discharged on the same day. In 48 patients (1,5%) additional analgesic dose was needed. In the patients who required prolonged hospitalization additional analgesic was started at postoperative 6th hour.
Conclusion: Caudal epidural anesthesia is easy, safe and effective technique in preoperative and postoperative pain control.. The main advantages are high success, low complication rates, lesser analgesic dose requirement. In the light of our study results, we recommend routine use of the caudal epidural procedure in pediatric urological surgery cases.
Key Words: Pediatric, Epidural anesthesia, Urological surgery

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Bölüm Orjinal Çalışma
Yazarlar

Yazar: Mine AKIN

Yazar: Sibel SAYDAM

Yazar: Gülsen KESKİN

Yazar: Sengül ÖZMERT

Yazar: Yeşim ŞENAYLI

Yazar: Devrim Tanıl KURT

Yazar: Feyza SEVER

Yazar: Atilla ŞENAYLI

Tarihler

Yayımlanma Tarihi : 1 Haziran 2015

Bibtex @ { bozoktip564028, journal = {Bozok Tıp Dergisi}, issn = {2146-4006}, eissn = {2148-2438}, address = {}, publisher = {Bozok Üniversitesi}, year = {2015}, volume = {5}, pages = {41 - 45}, doi = {}, title = {PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ}, key = {cite}, author = {AKIN, Mine and SAYDAM, Sibel and KESKİN, Gülsen and ÖZMERT, Sengül and ŞENAYLI, Yeşim and KURT, Devrim Tanıl and SEVER, Feyza and ŞENAYLI, Atilla} }
APA AKIN, M , SAYDAM, S , KESKİN, G , ÖZMERT, S , ŞENAYLI, Y , KURT, D , SEVER, F , ŞENAYLI, A . (2015). PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ. Bozok Tıp Dergisi , 5 (2) , 41-45 . Retrieved from https://dergipark.org.tr/tr/pub/bozoktip/issue/45124/564028
MLA AKIN, M , SAYDAM, S , KESKİN, G , ÖZMERT, S , ŞENAYLI, Y , KURT, D , SEVER, F , ŞENAYLI, A . "PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ". Bozok Tıp Dergisi 5 (2015 ): 41-45 <https://dergipark.org.tr/tr/pub/bozoktip/issue/45124/564028>
Chicago AKIN, M , SAYDAM, S , KESKİN, G , ÖZMERT, S , ŞENAYLI, Y , KURT, D , SEVER, F , ŞENAYLI, A . "PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ". Bozok Tıp Dergisi 5 (2015 ): 41-45
RIS TY - JOUR T1 - PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ AU - Mine AKIN , Sibel SAYDAM , Gülsen KESKİN , Sengül ÖZMERT , Yeşim ŞENAYLI , Devrim Tanıl KURT , Feyza SEVER , Atilla ŞENAYLI Y1 - 2015 PY - 2015 N1 - DO - T2 - Bozok Tıp Dergisi JF - Journal JO - JOR SP - 41 EP - 45 VL - 5 IS - 2 SN - 2146-4006-2148-2438 M3 - UR - Y2 - 2019 ER -
EndNote %0 Bozok Tıp Dergisi PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ %A Mine AKIN , Sibel SAYDAM , Gülsen KESKİN , Sengül ÖZMERT , Yeşim ŞENAYLI , Devrim Tanıl KURT , Feyza SEVER , Atilla ŞENAYLI %T PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ %D 2015 %J Bozok Tıp Dergisi %P 2146-4006-2148-2438 %V 5 %N 2 %R %U
ISNAD AKIN, Mine , SAYDAM, Sibel , KESKİN, Gülsen , ÖZMERT, Sengül , ŞENAYLI, Yeşim , KURT, Devrim Tanıl , SEVER, Feyza , ŞENAYLI, Atilla . "PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ". Bozok Tıp Dergisi 5 / 2 (Haziran 2015): 41-45 .
AMA AKIN M , SAYDAM S , KESKİN G , ÖZMERT S , ŞENAYLI Y , KURT D , SEVER F , ŞENAYLI A . PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ. Bozok Tıp Dergisi. 2015; 5(2): 41-45.
Vancouver AKIN M , SAYDAM S , KESKİN G , ÖZMERT S , ŞENAYLI Y , KURT D , SEVER F , ŞENAYLI A . PEDİATRİK ÜROLOJİK CERRAHİDE KAUDAL EPİDURAL BLOK UYGULAMASI; 5536 OLGU DENEYİMİ. Bozok Tıp Dergisi. 2015; 5(2): 45-41.