Video yardımlı torakoskopik cerrahilerde yüzeyel ve derin serratus anterior plan bloğunun analjezik etkinliğinin değerlendirilmesi
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Tarih
2022
Yazarlar
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Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kliniğimizde genellikle VATS cerrahileri için blok yapılmasını kabul eden hastalara postoperatif analjezi amacıyla ultrasonografi (USG) eşliğinde preempitif (hasta uyutulup cerrahiye teslim edilmeden önce) Yüzeyel veya Derin Serratus Anterior Plan Bloğu uygulanmaktadır. Bu çalışmamızda hastaların verilerini inceleyerek, yüzeyel ve derin SAPB yapılmış olan hastaların intraoperatif analjezik ihtiyaçlarını, postoperatif analjezik etkinliğini, ek analjezik ihtiyaçlarını, taburculuk sürelerini, hasta memnuniyetlerini, VAS değerlerini retrospektif olarak değerlendirmeyi amaçladık. Çalışmaya Ocak 2019-Aralık 2021 arasındaki VATS cerrahisi geçiren toplam 60 hasta dahil edildi. Hastalar yüzeyel SAPB yapılmış ve derin SAPB yapılmış olmak üzere 2 gruba ayrıldı. Hasta bilgilerine geçmiş kayıtlarından ulaşıldı. Hastalar karşılaştırmalı olarak değerlendirildi. Gruplar arası karşılaştırmada, demografik veriler açısından istatistiksel olarak anlamlı fark yoktu (p>0,05). Hastaların postoperatif ekstübasyon sonrası 0., 1., 2., 4., 6., 8., 12., 24. saatlerdeki VAS skorları, postoperatif analjezik ihtiyacı, intraoperatif kullanılan opioid miktarı, taburculuk süreleri ve hasta memnuniyeti açısından gruplar arasında derin blok grubu lehine anlamlı farklılık olduğu görüldü (p<0,05). Bu çalışma ile, elektif olarak VATS cerrahisi geçirecek olan hastalarda preemptif olarak ultrasonografi eşliğinde yapılan derin SAPB'nin postoperatif dönemde ağrıyı azalttığını ve kullanılan analjezik miktarını anlamlı derecede düşürdüğünü gözlemledik. Ayrıca bloğun hastanede kalış süresini kısalttığı, hasta konforunu olumlu yönde etkilediği ve hasta memnuniyetini oldukça arttırdığını tespit ettik. Hasta supin pozisyondayken ultrasonografi eşliğinde toplam tek enjeksiyonda uygulanabilir basit bir alan bloğu olan derin SAPB'nin, VATS cerrahisinde etkin ve güvenilir bir postoperatif analjezi sağladığı sonucuna vardık.
In our clinic, preemptive Superficial and Deep Serratus Anterior Plan Block (SAPB) is usually applied under ultrasonography (USG) for VATS surgeries. These procedures are performed for the purpose of postoperative analgesia in patients who accept blocks. In this study, we retrospectively analyzed the data of the patients. We aimed to evaluate the intraoperative analgesic needs, postoperative analgesic effectiveness, additional analgesic needs, discharge times, patient contentment, and VAS values of patients who had superficial and deep SAPB. A total of 60 patients who underwent VATS surgery were included in the study. These patients had surgery between January 2019 and December 2021. The patients were divided into 2 groups as superficial SAPB and deep SAPB. Patient information was obtained from past records. The patients were evaluated comparatively. In the comparison between the groups, there was no statistically significant difference in terms of demographic data (p>0.05). The patients' VAS scores at 0th, 1st, 2nd, 4th, 6th, 8th, 12th, and 24th hours after postoperative extubation, postoperative analgesic requirement, amount of opioid used intraoperatively, discharge times and patient contentment were statistically significant in the deep SAPB group. (p<0.05). In this study, we observed that in patients who undergo elective VATS surgery, deep SAPB performed preemptively with ultrasonography reduced pain in the postoperative period and significantly reduced the amount of analgesic used. In addition, we found that the block shortens the discharge time, positively affects patient comfort and increases patient contentment considerably. We concluded that deep SAPB, which is a simple plane block that can be performed in a total of one injection with the patient in the supine position, provides effective and reliable postoperative analgesia in VATS surgery.
In our clinic, preemptive Superficial and Deep Serratus Anterior Plan Block (SAPB) is usually applied under ultrasonography (USG) for VATS surgeries. These procedures are performed for the purpose of postoperative analgesia in patients who accept blocks. In this study, we retrospectively analyzed the data of the patients. We aimed to evaluate the intraoperative analgesic needs, postoperative analgesic effectiveness, additional analgesic needs, discharge times, patient contentment, and VAS values of patients who had superficial and deep SAPB. A total of 60 patients who underwent VATS surgery were included in the study. These patients had surgery between January 2019 and December 2021. The patients were divided into 2 groups as superficial SAPB and deep SAPB. Patient information was obtained from past records. The patients were evaluated comparatively. In the comparison between the groups, there was no statistically significant difference in terms of demographic data (p>0.05). The patients' VAS scores at 0th, 1st, 2nd, 4th, 6th, 8th, 12th, and 24th hours after postoperative extubation, postoperative analgesic requirement, amount of opioid used intraoperatively, discharge times and patient contentment were statistically significant in the deep SAPB group. (p<0.05). In this study, we observed that in patients who undergo elective VATS surgery, deep SAPB performed preemptively with ultrasonography reduced pain in the postoperative period and significantly reduced the amount of analgesic used. In addition, we found that the block shortens the discharge time, positively affects patient comfort and increases patient contentment considerably. We concluded that deep SAPB, which is a simple plane block that can be performed in a total of one injection with the patient in the supine position, provides effective and reliable postoperative analgesia in VATS surgery.
Açıklama
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
