TORAKOTOMİ SONRASI AĞRI KONTROLÜNDE TORASİK PARAVERTEBRAL BLOK İLE lN'l'RATEKAl. MORFlN UYGllLAMALARlNlN KARŞILAŞTIRILMASI
Küçük Resim Yok
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızda genel anestezi altında posterolateral torakotomi ve lobektomi uygulanan hastalarda torasik paravertebralblok ile intratekal morfin uygulamalarının cerrahi sonrası ağrı kontrolünde etkinliklerinin karşılaştırılması amaçlandı. Yöntem: Elektif lobektomi uygulanan 18-65 yaşlarındaki 40 hasta iki gruba ayrıldı. Paravertebral blok (PVB) grubunda(n=20) torakotomi kapatılmadan önce cerrah tarafından paravertebral bölgeye epidural kateter yerleştirilerek cerrahi bitiminde20 mL %0.25 bupivakain bolusu ve postoperatif ilk 24 saat %0.25 bupivakain (0.1 mL kg-1h-1) infüzyonu uygulandı. İntratekalmorfin (ITM) grubunda (n=20) cerrahi bitiminde hastalara intratekal 10 µg kg-1morfin verildi. Postoperatif dönemde tümolgulara morfin ile hasta kontrollü analjezi uygulandı. Sistolik ve diyastolik kan basınçları, kalp atım hızı, solunum sayısı, oksijensatürasyonu, arteriyel kan gazı, pik ekspiratuvar akım hızı, ağrı ve sedasyon skorları kaydedildi. Bulgular: Demografik veriler, hemodinamik ve solunumsal parametreler ve VAS skorları her iki grupta benzer bulundu.Postoperatif 24. saatteki morfin tüketimi ve ilk 4 saat içerisindeki sedasyon skorları ITM Grubunda diğer gruba oranla anlamlıyüksek bulundu (p< 0.05). Her iki gruba ait 12. ve 24. saatlerdeki sedasyon skorları benzer bulundu. Sonuç: Posterolateral torakotomi uygulanan hastalarda ağrı kontrolünde torasik paravertebral blok ve intratekal morfinuygulamalarının her ikisi de etkin olup, postoperatif 24. saatteki morfin tüketimi ve ilk 4 saat içerisindeki sedasyon skorları PVBgrubunda diğer gruba oranla anlamlı olarak düşük bulunmuştur
Objective: This study aimed to compare the analgesic efficacies of thoracic paravertebral block and intrathecal morphine inpatients undergoing posterolateral thoracotomy and lobectomy under general anesthesia. Method: Forty patients, aged 18-65 yrs, undergoing elective lobectomies were randomized into two groups: In the paravertebralblock group (PVB, n=20), an epidural catheter was inserted into the paravertebral space by the surgeon before thoracotomyclosure; 20 mL 0.25% bupivacaine bolus was given at the end of surgery and 0.25% bupivacaine (0.1 mLkg-1h-1) infusion wasgiven for 24thhour after surgery. In the intrathecal morphine group (ITM, n=20), intrathecal 10 µg kg-1morphine was given at theend of surgery. Patient controlled analgesia using morphine was administered postoperatively for all patients. Systolic and diastolic arterial pressures, heart rate, respiratory rate, oxygen saturation, arterial blood gases, peak expiratory flows and sedationscores were recorded. Results: Demographic data and postoperative hemodynamic, respiratory parameters and pain scores were similar in bothgroups. Postoperative 24thhour morphine consumption and sedation scores during the initial 4thhour after surgery were higher inthe ITM group (p< 0.05), while sedation scores at 12thand 24thhour were similar between groups. Conclusion: Although both techniques were effective in controlling pain after posterolateral thoracotomy, morphine consumptionat 24thhour was lower and sedation scores during the initial 4thhour after surgery were improved in patients who were administered athoracic paravertebral block when compared to patients who were given intrathecal morphine
Objective: This study aimed to compare the analgesic efficacies of thoracic paravertebral block and intrathecal morphine inpatients undergoing posterolateral thoracotomy and lobectomy under general anesthesia. Method: Forty patients, aged 18-65 yrs, undergoing elective lobectomies were randomized into two groups: In the paravertebralblock group (PVB, n=20), an epidural catheter was inserted into the paravertebral space by the surgeon before thoracotomyclosure; 20 mL 0.25% bupivacaine bolus was given at the end of surgery and 0.25% bupivacaine (0.1 mLkg-1h-1) infusion wasgiven for 24thhour after surgery. In the intrathecal morphine group (ITM, n=20), intrathecal 10 µg kg-1morphine was given at theend of surgery. Patient controlled analgesia using morphine was administered postoperatively for all patients. Systolic and diastolic arterial pressures, heart rate, respiratory rate, oxygen saturation, arterial blood gases, peak expiratory flows and sedationscores were recorded. Results: Demographic data and postoperative hemodynamic, respiratory parameters and pain scores were similar in bothgroups. Postoperative 24thhour morphine consumption and sedation scores during the initial 4thhour after surgery were higher inthe ITM group (p< 0.05), while sedation scores at 12thand 24thhour were similar between groups. Conclusion: Although both techniques were effective in controlling pain after posterolateral thoracotomy, morphine consumptionat 24thhour was lower and sedation scores during the initial 4thhour after surgery were improved in patients who were administered athoracic paravertebral block when compared to patients who were given intrathecal morphine
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Anestezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
24
Sayı
3
