Meme Cerrahisi Geçiren Hastalarda Uygulanan PECS II (pektoral sinir) Bloğunun İntraoperatif ve Postoperatif Etkileri

Öz

Meme cerrahisinde uygulanan PECS II (Pektoral Sinir) bloğun preoperatif ve postoperatif uygulanmasının, intraoperatif anestezik tüketimi ve postoperatif analjezik ihtiyacı ve komplikasyonların sıklığının değerlendirilmesini amaçladık. Meme cerrahisi geçirmiş 75 hastanın anestezi dökümlerinin retrospektif olarak incelenmesiyle ve verilerin analiziyle düzenlenmiştir. Verileri elde edilen hastalar üç gruba kategorize edilmiştir. Grup I (n25:genel anestezi uygulanan kontrol grubu), Grup II (n25:preoperatif PECS II blok ve genel anestezi) ve Grup III (n25: postoperatif PECS II blok ve genel anestezi). Verilerin analizi sonrası preoperatif PECS II blok uygulanan hastalarda intraoperatif desfluran MAC (minimum alveolar konsantrasyon) değerlerinin diğer gruplara göre belirgin olarak düştüğü bulunmuştur. İntraoperatif ve postoperatif PECS II blok uygulanan çalışma gruplarında, kontrol grubuna göre postoperatif analjezik tüketiminde ve ağrı skorlarında (erken dönem, postoperatif 0, 2, 4 ve 8. saat) anlamlı düşüşler görülmüştür. Preoperatif PECS II blok uygulanan grupta postoperatif ilk analjezik uygulama zamanı, sadece genel anestezi uygulanan ve Postoperatif PECS II blok uygulanan gruplardan anlamlı olarak daha geç bulunmuştur. Sadece genel anestezi uygulanan ve Postoperatif PECS II blok uygulanan gruplarda postoperatif ilk analjezik uygulama zamanı benzer bulunmuştur. Meme cerrahisi geçirecek hastalarda PECS II bloğun preoperatif veya postoperatif dönemde genel anesteziye eklenmesi hastalarda daha az ağrı ile seyreden postoperatif analjezi elde edilmesini sağlamaktadır. PECS II bloğun preoperatif uygulanmasının en önemli avantajı ise intraoperatif anestezik tüketimini azaltmasıdır.

Anahtar Kelimeler

• Pektoral sinir bloğu
• postoperatif analjezi
• meme cerrahisi
• rejyonal blok

Effects of PECS II (Pectoral Nerve) Block on Intraoperative Inhaled Anesthetic and Postoperative Analgesic Consumption in Patients Undergoing Breast Surgery

Öz

We aimed to evaluate the preoperative and postoperative application of PECS II (Pectoral Nerve) block in breast surgery, intraoperative anesthetic consumption, postoperative analgesic requirement and frequency of complications. A retrospective review of the anesthesia records of 75 patients who underwent breast surgery and analysis of the data was performed. The patients whose data were obtained were categorized into three groups. Group I (n25: control group with general anesthesia), Group II (n25: preoperative PECS II block and general anesthesia) and Group III (n25: postoperative PECS II block and general anesthesia). After analysis of the data, it was found that intraoperative desflurane MAC (minimum alveolar concentration) values were significantly lower in patients who underwent preoperative PECS II block compared to the other groups. Significant decreases in postoperative analgesic consumption and pain scores (early period, postoperative 0, 2, 4 and 8 hours) were observed in the study groups who underwent intraoperative and postoperative PECS II block compared to the control group. The first postoperative analgesic administration time was significantly later in the preoperative PECS II block group than in the general anesthesia only and postoperative PECS II block groups. The time to first postoperative analgesic administration was similar in the general anesthesia only and postoperative PECS II block groups. Adding PECS II block to general anesthesia preoperatively or postoperatively in patients undergoing breast surgery provides postoperative analgesia with less pain. The most important advantage of preoperative application of PECS II block is to reduce intraoperative anesthetic consumption.

Anahtar Kelimeler

• pectoral nerve block
• postoperative analgesia
• breast surgery
• regional block

Kaynakça

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