Öz
Amaç:
Bu çalışmanın amacı perkütan kifoplasti (PKP) cerrahisi uygulanan hastalarda uygulanan anestezi yöntemi ile preoperatif özelliklerinin, postoperatif sonuçlar ve komplikasyonlar üzerindeki etkisini incelemektir.
Yöntem:
Anestezi yöntemlerine göre hastalar; 1: Genel anestezi (sedasyon), 2: Santral blok (spinal ve epidural anestezi), 3: Periferik blok (erector spina düzlem bloğu ve paravertebral blok) şeklinde 3 gruba ayrıldı. Hastaların preoperatif özellikleri, belirlenen zamanlarda visual ağrı skalası (VAS) ile kaydedilen ağrı değerleri, hemodinamik parametreleri, ek sedasyon gereksinimi, perioperatif ve postoperatif komplikasyonları prospektif olarak kaydedildi.
Bulgular:
Grup 1’de 22, grup 2’de 20 ve grup 3’te 24 hasta yer aldı. Grup 1’de ortalama parasetamol, tramadol dozları, postoperatif VAS skorları ve ek sedasyon ihtiyacı, diğer gruplara göre istatistiksel olarak anlamlı derecede daha yüksek düzeyde bulundu (tümü için p<0,001). Postoperatif ilk mobilizasyon ve taburculuk zamanı grup 3’te diğer gruplara kıyasla istatistiksel olarak anlamlı düzeyde daha düşük izlendi (her ikisi için de p<0,001). Grup 3’te hasta memnuniyeti grup 1’e göre istatistiksel olarak anlamlı düzeyde daha yüksek gözlendi (p<0,001). Postoperatif bakım ünitesi oranı grup 1’de diğer gruplara göre daha yüksek ve grup 3’te diğer gruplara kıyasla anlamlı düzeyde daha düşüktü (p<0,001). Perioperatif bulantı oranı ise istatistiksel olarak anlamlı düzeyde daha düşük gözlendi (p=0,008). Çalışma grupları ile ortalama arter basıncı, kalp atış hızı, SpO2, operasyon süresi, perioperatif ve postoperatif komplikasyon oranları bakımından istatistiksel olarak anlamlı bir fark görülmedi.
Sonuç:
İleri yaş ve komorbiditeleri çok olan hastalarda PKP cerrahilerinde anestezi yöntemi olarak santral ve özellikle periferik blok yöntemlerinin daha güvenle ve daha yüksek hasta memnuniyeti ile tercih edilebileceğini düşünmekteyiz.
Anahtar Kelimeler: Erektör spina plan bloğu, paravertebral blok, perkütan kifoplasti, sedoanaljezi, vertebroplasti
Kaynakça
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