Öz
Ortopedik alt ekstremite cerrahilerinde periferik sinir blokları, perioperatif analjezi sağlama, opioid tüketimini azaltma ve erken mobilizasyona olanak tanıma açısından anestezi pratiğinde önemli bir yer edinmiştir. Kalça, diz, ayak bileği ve ayak cerrahileri sırasında hem motor hem de duyu fonksiyonlarını hedefleyen çeşitli sinir blokları, cerrahi alanın anatomisine ve hastanın özelliklerine göre bireyselleştirilerek uygulanmaktadır. Femoral sinir bloğu, perikapsüler sinir grup bloğu ve suprainguinal ve infrainguinal fascia iliaca blokları kalça ve proksimal femur girişimlerinde sık tercih edilirken, diz cerrahilerinde adductor kanal bloğu ile popliteal arter ile posterior diz kapsülü arasındaki boşluk bloğunun kombinasyonu öne çıkmaktadır. Ayak bileği ve ayak cerrahilerinde ise tibial, peroneal, sural ve safen sinirlerin yüzeyel olarak bloke edilmesiyle etkili bir anestezi ve analjezi sağlanabilmektedir. Ultrasonografi kılavuzluğunda gerçekleştirilen sinir blokları, anatomik varyasyonlara bağlı başarısızlık riskini azaltmakta ve komplikasyon oranlarını düşürmektedir. Bu derlemede, alt ekstremite ortopedik cerrahilerinde kullanılan başlıca periferik sinir blokları; anatomik temelleri, endikasyonları, komplikasyonları ve uygulama teknikleri güncel literatür eşliğinde değerlendirilmektedir.
Anahtar Kelimeler: Alt ekstremite, analjezi, ortopedik prosedürler, periferik sinir bloğu, postoperatif ağrı yönetimi, ultrason rehberliğinde rejyonal anestezi
Kaynakça
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