ÖZET
Amaç:
Sezeryanlarda multimodal analjezi amacıyla postoperatif periferik gövde blokları kullanılmaktadır. Bu araştırma spinal anestezi altında sezeryan operasyonu olan hastalarda transversalis fasya plan blok (TFPB) ve transversus abdominis plan bloğunun (TAPB) postoperatif analjezide etkinliğini karşılaştırmak amacıyla planlandı.
Yöntem:
Prospektif tasarıma sahip bu araştırmada spinal anestezi altında elektif sezeryan operasyonu planlanan 20-50 yaş aralığında ASA II-III risk grubundaki hastalar değerlendirildi. Demografik verileri, operasyon süreleri, intraoperatif ve postoperatif bulantı & kusma, kaşıntı varlığı, ilk analjezi gereksinim süresi, postoperatif 24 saat boyunca görsel analog ölçeği (VAS) değerleri, parasetamol, diclofenac sodyum, toplam kullanılan Steroid olmayan anti-enflamatuvar ilaçlar (NSAII) miktarı kaydedildi.
Bulgular:
Hastalar TFPB (75, %50) ve TAPB (75, %50) grubu olmak üzere iki gruba randomize edildi. İki grup arasında demografik veriler, komorbidite, ASA sınıflaması ve operasyon sürelerinde anlamlı farklılık görülmedi (p>0,05). Hastaların postoperatif ilk analjezi ihtiyaç süreleri değerlendirildiğinde TFPB grubunda daha yüksekti (p<0,05). Yirmi dört saat boyunca ağrı skorları (VAS 6. saat ve vas 12. saat) TFPB grubunda daha düşüktü (p<0,05). Kullanılan parasetamol, diklofenak ve toplam kullanılan NSAII miktarına bakıldığında ise TAPB grubunda daha fazlaydı (p<0,05).
Sonuç:
Sezeryanlarda USG eşliğinde bilateral uygulanan TFPB, postoperatif analjezide TABP’den daha etkindir.
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