Torakotomi sonrası ağrı tedavisinde interkostal sinir Blokajının etkisi
Küçük Resim Yok
Tarih
2008
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Aves Yayıncılık
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İntravenöz hasta kontrollü analjezi (HKA) ile birlikte interkostal sinir blokajı torakotomi sonrası ağrıyı azaltmada kolay ve güvenilir bir yöntem olabilir. Yaptığımız prospektif randomize kontrollü çalışmamızda interkostal sinir blokajının torakotomi sonrası ağrıya etkisini araştırmayı amaçladık. Mayıs 2006-Ocak 2007 tarihleri arasında torakotomi uygulanan 40 hastayı çalışmaya aldık. Hastalar iki gruba ayrıldı. Grup I’e (n=20) dolantin (50 mg bolus, 5 mg HKA, 15 dk kilit süresi) ile HKA ve tenoksikam (20 mg) uygulandı. Grup II’ye (n=20) dolantin (50 mg bolus + 5 mg HKA, 15 dk kilit süresi) ile HKA ve tenoksikam (20 mg) tedavisine ilaveten intraoperatif 5 segment interkostal sinir blokajı (%0,5 bupivakain 3 ml) yapıldı. İstirahatte ve öksürürken visüel analog skala (VAS) değerleri, solunum sayısı, nabız/dk, oksijen satürasyonu ve kan basıncı 0, 1, 2, 4, 8, 16, 24. saatlerde izlendi. Yirmidört saat sonunda toplam kullanılan dolantin miktarı, analjezik istem sayısı ve oluşan komplikasyonlar kaydedildi. İki grup arasında hastaların demografik verileri, solunum sayıları, nabız sayısı, oksijen satürasyonu, komplikasyonlar ve istirahatta-öksürürken VAS değerleri açısından istatiksel olarak anlamlı fark bulunamadı (p<0,05). Ancak kullanılan dolantin miktarı (p=0,0043) HKA’ daki analjezik istem sayısı (p=0,0128) grup II’de grup I’e göre anlamlı derecede düşüktü (p<0,05). Sonuç olarak torakotomi sonrası ağrı tedavisinde interkostal blokaj ile birlikte daha düşük dozda narkotik analjezik kullanarak yeterli seviyede analjezi sağlanabildiği kanaatine vardık.
Intercostal nerve blockage together with intravenous pain control analgesia (PCA) can be an easy and reliable method in diminishing post thoracotomy pain. In this prospective, randomized, controlled study, we aimed to investigate the effect of intercostal nerve blockage on post thoracotomy pain. We investigated 40 patients who had undergone thoracotomy in the period between May 2006-January 2007. Patients were divided into two groups. Group I (n=20) was dosed with dolantin (50 mg bolus, 5 mg PCA, 15 min. lock time) with PCA and tenoxicam (20 mg). Group II (n=20) was treated with intraoperative 5 segment intercostal nerve blockage (%0,5 bupivacaine 3 ml) in addition to (n=20) dolantin (50 mg bolus + 5 mg PCA, 15 min. lock time) with PCA . Tenoxicam visual analog scale (VAS) values at rest and duringcoughing, respiration rate, pulse rate, oxygen saturation, and blood pressure were observed at 0, 1, 2, 4, 8, 16, 24 hours. Total dolantin quantity used, analgesic demand amount and complications were recorded. No statistical significant difference (p<0,05) could be found between the two groups from the demographical data such as respiration rate, pulse rate, oxygen saturation, complications, visual analog scale (VAS) values while at rest and coughing. However, the quantity of dolantin used (p=0,0043) and analgesic demand amount (p=0,0128) with PCA were significantly lower for group II in comparison to group I (p<0,05). In conclusion, we are of the opinion that satisfactory analgesia could be obtained by applying intercostal blockage together with lower doses of narcotic analgesics in the treatment of post thoracotomy pain.
Intercostal nerve blockage together with intravenous pain control analgesia (PCA) can be an easy and reliable method in diminishing post thoracotomy pain. In this prospective, randomized, controlled study, we aimed to investigate the effect of intercostal nerve blockage on post thoracotomy pain. We investigated 40 patients who had undergone thoracotomy in the period between May 2006-January 2007. Patients were divided into two groups. Group I (n=20) was dosed with dolantin (50 mg bolus, 5 mg PCA, 15 min. lock time) with PCA and tenoxicam (20 mg). Group II (n=20) was treated with intraoperative 5 segment intercostal nerve blockage (%0,5 bupivacaine 3 ml) in addition to (n=20) dolantin (50 mg bolus + 5 mg PCA, 15 min. lock time) with PCA . Tenoxicam visual analog scale (VAS) values at rest and duringcoughing, respiration rate, pulse rate, oxygen saturation, and blood pressure were observed at 0, 1, 2, 4, 8, 16, 24 hours. Total dolantin quantity used, analgesic demand amount and complications were recorded. No statistical significant difference (p<0,05) could be found between the two groups from the demographical data such as respiration rate, pulse rate, oxygen saturation, complications, visual analog scale (VAS) values while at rest and coughing. However, the quantity of dolantin used (p=0,0043) and analgesic demand amount (p=0,0128) with PCA were significantly lower for group II in comparison to group I (p<0,05). In conclusion, we are of the opinion that satisfactory analgesia could be obtained by applying intercostal blockage together with lower doses of narcotic analgesics in the treatment of post thoracotomy pain.
Açıklama
Anahtar Kelimeler
Torakotomi, Postoperatif ağrı, Analjinezi, Thoracotomy, Postoperative pain, Analgesia
Kaynak
Toraks Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
9
Sayı
2
Künye
Kapıcıbaşı, H. O., Meydan, B., Koşar, A., Sönmez, H,. Kır, A. ve Atasalihli, A. (2008). Torakotomi sonrası ağrı tedavisinde interkostal sinir blokajının etkisi / Efficacy of intercostal nerve blockage for pain treatment after thoracotomy. Toraks Dergisi. 9(2), s. 57-59.
