Ayak cerrahisinde kullanılan periferal sinir blok uygulamasında iki metodun karşılaştırılması: USG yardımlı ve anatomic landmark yardımlı.

Year 2023, Volume: 7 Issue: 1, 98 - 104, 21.06.2023

Mesut Uluöz , Ümmühan Eren Herdem

https://doi.org/10.30565/medalanya.1199764

Abstract

Amaç: Ayak bileği periferik sinir bloğu iki yöntemle uygulanır. Bunlar; USG yardımlı periferik blok ve USG kullanımına ihityaç duymayan anatomik landmark’lar kullanılarak yapılan periferik bloktur. Biz de çalışmamızda ayak ameliyatlarında uygulanan bu iki yöntemi retrospektif olarak karşılaştırmayı amaçladık.

Yöntem : 2017 yılından itibaren ayak bileği periferik blok ile ameliyat edilen hastaların bilgilerine ulaşıldı. USG yardımıyla yapılan periferik blok hastaları (grup 1) 20 kişi, USG kullanılmadan, anatomik landmarklara göre yapılan periferik blok hastaları (grup 2) 20 kişiydi. Her iki grupta 40 cc’lik karışım kullanıldı (bupivakain+lidocain). Hastaların kayıt altına alınan bilgileri şunlardı: demografik bulgular, blok uygulanma süresi (BUS), operasyona hazır olma süresi (OHOS), operasyon süresi (OS), blok anestezi süresi (BAS) ve intraoperatif-postoperatif VAS skoru. Ameliyat sonrası hastalara uygulanan vizüel analog skalası (VAS) sonuçlarına ulaşıldı. Hastalara telefonla ulaşılıp anesteziden memnun olup olmadıkları soruldu.

Bulgular : Grup 1’deki hastaların BUS ve BAS değerleri yüksekti. Grup 2’deki hastaların OHOS ve VAS 6 değerleri yüksekti. Diğer parametrelerde gruplar arasında anlamlı bir farklılığa rastlanılmadı. İntraoperatif dönemde grup 1’de ek doz anestezik maddeye ihtiyaç olmamıştır. Grup 2’de ise 3 hastada intraoperatif hafif ağrı hissetmeleri üzerine lokal ek doz uygulanmıştır.

Sonuç : USG kullanılarak uygulanan periferik blok hazırlığı uzun sürmektedir. Anestezistlerin tecrübesi arttıkça bu sürenin kısalacağı kanaatindeyiz. Ancak cerrahi sırasında daha konforludur. Ameliyat süresinin herhangi bir sebepten uzama ihtimali ve postoperatif erken dönem ağrı kontrolü göz önüne alınınca USG eşliğinde yapılan periferik blok daha avantajlıdır.

Keywords

anastezi, ayak bileği, periferal sinir bloğu, ultrasonografi

Comparison of two methods in the peripheral nerve block application used in foot surgery: USG-guided and anatomical landmark-guided.

Abstract

Aim: Ankle peripheral nerve block is applied by two methods. These are peripheral block that is performed using USG-assisted and anatomical landmarks that do not require the use of Ultrasonography (USG). In our study, we aimed to compare these two methods applied in foot surgeries retrospectively.

Methods :Peripheral block patients performed with the USG-guided (group 1) were 20, anatomical landmarks- guided (group 2) were 20. In both groups, 40 cc of anesthetic mixture was used (bupivacaine + lidocaine). The recorded information of the patients were as follows: Block application time (BAT), surgery readiness time (SRT), duration of surgery (DoS), duration of block anesthesia (DBA) and intraoperative-postoperative Visual Analogue Scale (VAS). The results of the VAS applied to the patients postoperatively were obtained. Patients were contacted by phone and asked if they were satisfied with the anesthesia.

Results : The BAT and DBA values of the patients in Group 1 were high. SRT and VAS 6 values of the patients in group 2 were high. No significant difference was found between the groups in other parameters. No additional dose of anesthetic was needed in group 1 during the intraoperative period. In group 2, local additional dose was administered to 3 patients.

Conclusion: Peripheral block preparation USG-guided takes a long time. However, it is more comfortable during surgery. The USG-guided peripheral nerve block is more advantageous when considering the possibility of prolonging the duration of surgery for any reason and early postoperative pain control after surgery.

Keywords

anesthesia, ankle, peripheral nerve block, ultrasonography

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