Ultrasound guided rectus sheath block vs intravenous tramadol on postoperative analgesia in children undergoing inguinal hernia repair

Ersel Güleç; Mediha Türktan; Zehra Hatipoğlu; Dilek Özcengiz

doi:10.17826/cutf.296419

TR EN

İnguinal herni cerrahisi geçiren çocuklarda ultrason kılavuzluğunda uygulanan rektus kılıf bloğu ile intravenöz tramadol'ün postoperatif ağrı üzerindeki etkilerinin karşılaştırılması

Öz

maç: Rektus kılıf bloğu postoperatif ağrı kontrolünde kullanılan bir rejyonal anestezi tekniğidir. Açık inguinal herni tamiri cerrahisi geçiren çocuklarda ultrason kılavuzluğunda rektus kılıf bloğu ve intravenöz tramadol’ün postoperatif ağrı üzerindeki etkilerini karşılaştırmayı amaçladık.

Gereç ve Yöntem: Genel anestezi altında inguinal herni cerrahisi geçirecek olan 2-7 yaşları arasındaki 40 hasta prospektif randomize çalışmaya dahil edildi. Hastalar iki gruba ayrıldı. Grup UR’ deki (n=20) hastalara cerrahi öncesi 0,2 mg/kg dozunda %0,25 levobupivakain ile ultrason kılavuzluğunda rektus kılıf bloğu uygulandı. Grup T’ deki (n=20) hastalara ise intravenöz 1 mg/kg tramadol uygulandı. Çalışmanın birincil sonucu postoperatif ağrı derecesidir. Postoperatif ağrı skorları, sedasyon seviyesi, ek analjezik gereksinimi ve yan etkiler kaydedildi.

Bulgular: Ağrı skorları 5. dakika (UR 1.90 [95% confidence interval [CI], 1.05–2.74] ; T 5.50 [95% CI, 4.31–6.68; P < 0.001]), 15. dakika (UR 1.00 [95% CI, 0.27–1.72] ; T 4.65 [95% CI, 3.56–5.73; P < 0.001]), 30. dakika (UR 0.85 [95% CI, 0.08–1.61] vs T 3.05 [95% CI, 2.14–3.95; P < 0.001]) ve 60. dakikada (UR 0.20 [95% CI, -0.12–0.52] vs T 0.95 [95% CI, 0.41–1.48; P=0.008]) Grup T’ye göre Grup UR’de daha düşüktü. Ek analjezik ihtiyacını Grup T’de 15 hasta gösterirken Grup UR’de hiçbir göstermedi.

Sonuç: İnguinal herni tamiri geçiren çocuklarda ultrason kılavuzluğunda rektus kılıf bloğu etkili postoperatif analjezi sağlar. Bu etki tramadol ile karşılaştırıldığında özellikle postoperatif ilk 1 saat boyunca daha belirgin ortaya çıkmaktadır.

Anahtar Kelimeler

tramadol,Çocuk,inguinal herni,levobupivakain,ultrason

Ultrasound guided rectus sheath block vs intravenous tramadol on postoperative analgesia in children undergoing inguinal hernia repair

Abstract

Purpose: Rectus sheath block is a regional anesthesia technique for postoperative pain control. We aimed to evaluate the effects of ultrasound-guided rectus sheath block on postoperative pain relief comparing with intravenous tramadol in children undergoing open inguinal hernia repair.

Material and Methods: Forty children, aged between 2-7 years, scheduled for inguinal hernia repair were enrolled into this prospective assessor blinded randomized study. Patients were allocated into one of two groups to receive ultrasound-guided rectus sheath block with a dose of 0.2 ml/kg, levobupivacaine 0.25% (group UR, n=20) or tramadol IV of 1 mg/kg (group T, n=20) under general anesthesia. The primary endpoint was the postoperative pain degree. Postoperative pain scores, sedation levels, supplemental analgesic requirements, and side effects were recorded.

Results: Pain scores were lower in group UR compared to group T at postoperative 5 min (UR 1.90 [95% confidence interval [CI], 1.05–2.74] vs T 5.50 [95% CI, 4.31–6.68; P < 0.001]), 15 min (UR 1.00 [95% CI, 0.27–1.72] vs T 4.65 [95% CI, 3.56–5.73; P < 0.001]), 30 min (UR 0.85 [95% CI, 0.08–1.61] vs T 3.05 [95% CI, 2.14–3.95; P < 0.001]) and 60 min (UR 0.20 [95% CI, -0.12–0.52] vs T 0.95 [95% CI, 0.41–1.48; P=0.008]). Fifteen patients required supplemental analgesic in group T whereas group UR patients did not require it.

Conclusion: Ultrasound-guided rectus sheath block produces an effective postoperative pain relief in children undergoing inguinal hernia repair surgery, noticeably for the first postoperative hour, compared with tramadol.

Keywords

Children,inguinal hernia,levobupivacaine,tramadol,ultrasonography

Kaynakça

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Ayrıntılar

Birincil Dil

İngilizce

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Ersel Güleç
ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ

Mediha Türktan Bu kişi benim
ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ

Zehra Hatipoğlu Bu kişi benim
ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ

Dilek Özcengiz Bu kişi benim
ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ

Yayımlanma Tarihi

30 Eylül 2017

Gönderilme Tarihi

10 Kasım 2016

Kabul Tarihi

23 Aralık 2016

Yayımlandığı Sayı

Yıl 2017 Cilt: 42 Sayı: 3

DOI

https://doi.org/10.17826/cutf.296419

IZ

https://izlik.org/JA96LB88KJ

MLA

Güleç, Ersel, vd. “Ultrasound guided rectus sheath block vs intravenous tramadol on postoperative analgesia in children undergoing inguinal hernia repair”. Cukurova Medical Journal, c. 42, sy 3, Eylül 2017, ss. 459-64, doi:10.17826/cutf.296419.

Bu eser Creative Commons Atıf-Gayriticari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.

İnguinal herni cerrahisi geçiren çocuklarda ultrason kılavuzluğunda uygulanan rektus kılıf bloğu ile intravenöz tramadol'ün postoperatif ağrı üzerindeki etkilerinin karşılaştırılması

Öz

Anahtar Kelimeler

Ultrasound guided rectus sheath block vs intravenous tramadol on postoperative analgesia in children undergoing inguinal hernia repair

Abstract

Keywords

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

DOI

IZ

Kaynak Göster