SPİNAL ANESTEZİNİN KOMPLİKASYONLARINDAN BİRİ: SPİNAL CERRAHİ SONRASI BEL AĞRISI VE PREEMPTİF TOPİKAL DİKLOFENAK KULLANIMI

Öz

Giriş: Pre-emptive analjezik ilaçlar post-operatif ve anestetik müdahale ağrısının yönetiminde önemlidir. Bu çalışmada, diklofenak dietilamonyumun spinal anesteziden sonra sırt ağrısının önlenmesinde topik uygulanmasının etkisini araştırmak amaçlandı. Metod: Bu randomize kontrollü klinik çalışma, elektif cerrahi girişim planlanan 18-70 yaş arasındaki 210 diz artroskopi hastasından oluşmaktadır. Hastalar rasgele seçilerek bir kısmı diklofenak dietilamonyum grubuna (Grup D) bir kısmı plasebo grubu (Grup P) olarak tayin edildi. Spinal anestezi uygulanmadan önce, Grup D için topikal diklofenak dietilamonyum jel, Grup P için topikal placebo jel, spinal anestezik uygulanacak lumbar bölgede cilt üzerine sürüldü. Bromage motor skalası (BMS) 3 olduğunda, tüm hastalara addüktor kanal kateteri takıldı. Visual Analog Skala (VAS) kullanılarak hastalara spinal anestezi uygulanan alanda bulunan ağrı sorgulandı. 1, 2, 4, 8, 16 and 24. saatlerde cerrahi sonrası hastaların VAS skorları not edildi. Bulgular: Grupların demografik verileri, spinal anestezi ile ilgili bazı veriler, operasyon süresi ve perioperatif analjezi oranları arasında istatistiksel olarak fark yoktu. Ancak, grupların postoperatif analjezi kullanımları arasında istatistiksel olarak anlamlı farklılık vardı. Operasyondan sonra 1, 2, 4, 8, 16 ve 24 saatlerde, bir hafta ve altı ay sonra tüm grupların VAS değerlerine bakıldığında, istirahat ve hareket halinde Grup D’nin VAS değerlerinin daha düşük olduğu görülmüştür ve her iki grup arasında istatistiksel olarak anlamlı fark vardır. Sonuç: Spinal anesteziden sonra topikal diklofenak kullanılması sırt ağrısı sıklığını azaltabilir.

Anahtar Kelimeler

• Preemptif analjezi
• Topikal analjezi
• post spinal baş ağrısı
• Nonsteroid inflamatuar ilaçlar.

ONE OF THE COMPLICATIONS OF SPINAL ANESTHESIA: POSTSPINAL BACK-ACHE AND PREEMPTIVE USAGE OF THE TOPICAL DICLOFENAC

Öz

interventions' pain. Present study was to examine the effect of the topical application of diclofenac diethylammonium on the prevention of backache after spinal anaesthesia. Methods: This randomized, controlled clinical study consisted of 210 knee arthroscopy patients aged 18–70 years who were scheduled to undergo elective surgery. The patients were randomly assigned to a diclofenac diethylammonium group (Group D) or a placebo group (Group P). Before administration of spinal anaesthesia, diclofenac diethylammonium gel for Group D, plasebo gel for Group P was rubbed onto the skin in the lumbar region where the spinal anaesthetic was to be applied. When the Bromage motor scale (BMS) was 3, an adductor canal catheter was inserted. Using the Visual Analog Scale (VAS), the patients were asked about pain in the area where the spinal anaesthetic had been administered. VAS values were recorded 1, 2, 4, 8, 16 and 24 h after the surgery. Results: There wasn’t statistically difference between the groups’ demographic datas, some datas about spinal anesthesia, duration of the operation and ratios of perioperative analgesia. But there was a statistically differences between the groups’ postoperative analgesia. When the groups’ 1, 2, 4, 8, 16 and 24-h VAS values and VAS values one week and six months after the surgery were evaluated, there was a statistically significant difference between the two groups in rest and dynamic. Conclusion: The use of topical diclofenac after spinal anaesthesia can significantly reduce the incidence of backache.

Anahtar Kelimeler

• Analgesia
• Anesthesia
• Spinal
• Backache
• NSAIDs
• Nerve block

Kaynakça

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