Suprainguinal fascia iliaka bloğun total diz artroplastisi sonrası iyileşme kalitesi üzerine etkisi: prospektif, randomize kontrollü, çift kör, çok merkezli bir çalışma

Yıl 2025, Cilt: 8 Sayı: 1, 103 - 108, 12.01.2025

Muhammed Halit Satıcı , Mahmut Sami Tutar , Yasin Tire , Betül Kozanhan , Ahmet Erarkadaş , Ahmet Yıldırım , Ahmet Yaşar Dağ , Nuray Altay

https://doi.org/10.32322/jhsm.1595732

Öz

Amaç: Total diz artroplastisi, ileri gonartrozlu hastalar için yaygın bir cerrahi prosedürdür ve genellikle önemli ölçüde postoperatif ağrıya yol açar. Etkili ağrı yönetimi, çevresel sinir blokları ile multimodal analjeziyi içerir ve bu süreçte hayati öneme sahiptir. Suprainguinal fascia iliaka bloğu, dizin duyusundan sorumlu temel sinirleri hedef alan ve lumbar pleksus bloğuna benzer etkiler gösteren bir tekniktir. Bu araştırma, suprainguinal fascia iliaka bloğunun total diz artroplastisi hastalarında Quality of Recovery-15 skorlarını iyileştirip iyileştirmediğini değerlendirmeyi amaçlamaktadır.
Yöntem: Total diz artroplastisi geçiren 60 hasta ile randomize, prospektif, kontrollü ve çok merkezli bir çalışma yürütülmüştür. Katılımcılar, Grup S (lokal anestezik ile SIFIB uygulanan grup) veya Grup C (salin solüsyonu ile SIFIB uygulanan grup) olmak üzere iki gruba ayrılmıştır. Birincil sonuç ölçütü, ameliyat sonrası 24. saatte Quality of Recovery-15 skoruydu. İkincil sonuçlar arasında postoperatif sayısal derecelendirme ölçeği skorları, kurtarma analjezisine olan ihtiyaç, ilk kurtarma analjezisinin zamanı, postoperatif komplikasyonlar (bulantı ve kusma), antiemetik gereksinimi ve hasta memnuniyeti yer almıştır.
Bulgular: Grup S’nin QoR-15 skorları, Grup C’ye kıyasla anlamlı derecede daha yüksekti (124 [121–129] vs. 98 [92–101]; p<0.001). Ayrıca, tüm zaman noktalarında Grup S'nin sayısal derecelendirme ölçeği skorları Grup C’ye kıyasla daha düşüktü (p<0.001). İlk 24 saat içinde tüketilen toplam tramadol miktarı Grup C’de daha yüksekti (145 [80–225] mg vs. 0 [0–0] mg; p<0.001).
Sonuç: Suprainguinal fascia iliaka bloğu, total diz artroplastisi hastalarında postoperatif iyileşmeyi ve ağrı yönetimini önemli ölçüde iyileştirerek, diz cerrahisinde diğer bölgesel bloklara uygulanabilir bir alternatif sunmaktadır.

Anahtar Kelimeler

Multimodal analjezi, postoperatif iyileşme, iyileşme kalitesi-15 skoru, Suprainguinal fasya iliaka bloğu

Effect of suprainguinal fascia iliaca block on recovery quality after total knee arthroplasty: a multicenter, prospective, randomized controlled, double-blind study

Öz

Aims: Total knee arthroplasty is a common procedure for patients with advanced gonarthrosis, often leading to significant postoperative pain. Effective pain management, including multimodal analgesia with peripheral nerve blocks, is essential. The suprainguinal fascia iliaca block is a technique that targets key nerves responsible for knee sensation and is similar in effect to the lumbar plexus block. This research aims to evaluate whether suprainguinal fascia iliaca block improves the Quality of Recovery-15 scores in Total knee arthroplasty patients.
Methods: A randomized, prospective, controlled, multicenter study was conducted with 60 patients undergoing total knee arthroplasty. Participants were allocated to either Group S (received SIFIB with local anesthetic) or Group C (received SIFIB with saline solution). The primary outcome measured was the Quality of Recovery-15 score 24 hours post-surgery. Secondary outcomes included postoperative numeric rating scale scores, the requirement for rescue analgesia, time to first rescue analgesia, postoperative complications (nausea and vomiting), the necessity for antiemetics, and patient satisfaction.
Results: Group S had significantly higher QoR-15 scores (124 [121–129] vs. 98 [92–101]; p<0.001) and lower numerical rating scale scores at all time points compared with Group C (p<0.001). The total amount of tramadol consumed within the first 24 hours postoperatively was higher in Group C (145 [80–225] mg vs. 0 [0–0] mg; p<0.001).
Conclusion: Suprainguinal fascia iliaca block significantly enhances postoperative recovery and pain management in total knee arthroplasty patients, presenting a viable alternative to other regional blocks for knee surgery.

Anahtar Kelimeler

Multimodal analgesia, postoperative recovery, quality of recovery-15 score, Suprainguinal fascia iliaca block

Kaynakça

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