The effect of ultrasonography guided preemptive paravertebral blocking in thoracic surgery

Yıl 2017, Cilt: 8 Sayı: 4, 160 - 167, 01.12.2017

Gülçin Aydın , Işın Gençay , Selim Çolak , Nesimi Günal , Berkant Özpolat

https://doi.org/10.18663/tjcl.289117

Cited By: 1

Öz

Objective: Currently, thoracic
paravertebral block (TPVB) is one of the regional anesthesia methods frequently
used in the acute treatment of thoracotomy pain. In this clinical study, it was
aimed to investigate the effects of TPVB on opioid drug consumption, postoperative
pain, complications and patient satisfaction during surgery.

Material and Methods: Twenty-five patients
aged 18-65 years who underwent elective thoracic surgery were included in the
study. Thoracotomy (TH group) was performed in 14 patients and videothoracoscopy
(VATS group) was performed in 11 patients. Additional opioid drug requirements
and the operation time of the groups were recorded during the surgery.
Furthermore, Visual Analogue Scale (VAS) values ​​at the 0-1-2-6-12-24 hours,
nausea-vomiting, hypotension and other complications within 24 hours were
recorded, postoperatively. In addition, "Patient Satisfaction Scale"
(PSS) was applied in the postoperative period.

Results: The values of the amount of
opioid drug use, VAS score, PSS score, postoperative complication type were not
different between thoracotomy and thoracoscopy patients in the study. However,
the duration of the operation was found to be shorter in the TH group. On the
other hand, a negative correlation was found between all VAS score values ​​and
the PSS scores.

Conclusion: At the end of this study,
it was thought that TPVB procedure could be a good option for reduction of
postoperative pain, patient comfort and reduction of complications in patients
who will undergo either thoracotomy or videothoracoscopy.

 

Anahtar Kelimeler

Thoracal paravertebral blok, pain, thoracotomy, thoracoscopy

Toraks cerrahisinde ultrasonografi eşliğinde yapılan preemptif torakal paravertebral bloğun etkinliği

Öz

Amaç: Günümüzde
torakotomi ağrısının akut tedavisinde sık kullanılan bölgesel anestezi
yöntemlerinden biri torakal paravertebral blok (TPVB) uygulamasıdır. Bu klinik
çalışmada, toraks cerrahisinde ultrasonografi eşliğinde “preemptif” yapılan TPVB’un, ameliyat esnasında opioid ilaç tüketimi,
ameliyat sonrası ağrı, komplikasyon ve hasta memnuniyeti üzerine etkilerini
araştırması amaçlandı.

Gereç ve
Yöntemler: Elektif
toraks cerrahisi geçirecek 18-65 yaş arası 25 hasta çalışmaya alındı ve 14
hastaya torakotomi (TKT grubu), 11 hastaya torakoskopi (TKS grubu) uygulandı. Grupların
operasyon süreleri ve ameliyat esnasında ek opioid ilaç ihtiyaçları
kaydedildi.  Ameliyat sonrası dönemde ağrıya
yönelik 0-1-2-6-12-24. saatlerdeki “Görsel Analog Ölçeği” (VAS) değerleri, 24
saat içindeki bulantı-kusma, hipotansiyon ve diğer komplikasyonlar kaydedildi.
Ayrıca hastalara ameliyat sonrası dönemde “Hasta Memnuniyet Ölçeği” (HMÖ) uygulandı.

Bulgular:
Çalışmada
torakotomi ile videotorakoskopi uygulanan hastalar arasında opioid ilaç
kullanımı miktarı, VAS puanı, HMÖ puanı, ameliyat sonrası komplikasyon türü bakımından
anlamlı bir fark bulunmadığı saptandı. Ancak operasyon süresi bakımından TKS
grubunda sürenin daha kısa olduğu bulundu. Diğer yandan tüm VAS puanı değerleri
ile HMÖ sonuçları arasında da negatif korelasyon tespit edildi.

Sonuçlar: Çalışma
sonunda TPVB işleminin gerek torakotomi gerekse videotorakoskopi yapılacak hastalarda
ameliyat sonrası ağrının azaltılmasında, hasta konforunun sağlanmasında ve
komplikasyonların azaltılmasında oldukça iyi bir seçenek olabileceği düşünüldü.

 

Anahtar Kelimeler

Torakal paravertebral blok, ağrı, torakotomi, videotorakoskopi

Kaynakça

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