Comparison of different analgesia methods in shoulder surgery Omuz cerrahisinde postoperatif analjezi saǧlama yöntemlerinin karşilştirilmasi


Koltka K., Batmaz M., Atalar A. C., Demirhan M., Küçükay S., ŞENTÜRK N. M., ...Daha Fazla

Revista Espanola de Cirugia Ortopedica y Traumatologia, cilt.52, sa.1, ss.38-44, 2008 (Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 52 Sayı: 1
  • Basım Tarihi: 2008
  • Dergi Adı: Revista Espanola de Cirugia Ortopedica y Traumatologia
  • Derginin Tarandığı İndeksler: Scopus
  • Sayfa Sayıları: ss.38-44
  • Anahtar Kelimeler: Interscalene catheter, Postoperative analgesia, Shoulder surgery, Subacromial catheter
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Aim: Postoperative pain is a problem after shoulder surgery. The aim was to compare the postoperative analgesic efficacies of subacromial infusion after single shot interscalene block (ISB) to a continuous ISB. Material and Methods: After ethical committee approval and informed consent 36 ASA I-II patients were randomly divided into two groups. Preoperalively all patients received an ISB with 30 mL 0.5 % bupivacaine. Catheters were inserted to the interscalene sheath in Group I and to the subacromial space in Group II. In the postoperative period patients received an analgesia using patient controlled analgesia (PCA) device. The PCA parameters were 5 mL h-1 bupivacaine 0.125%, a bolus of 5 mL bupivacaine 0.125 % in GI and 2.5 mL h-1 bupivacaine 0.125%, a bolus of 2.5 mL bupivacaine 0.125 % in GII a with a lock out time of 20 minutes. Pain relief was assessed using a visual analog scale (VAS, 0-10 cm) at the postoperative at 0, 4th, 8th, 12th and 24 th hours. Additional analgesics were noted and at the end of 24 h patients rated their satisfaction. Results: All patients had adequate analgesia (VAS< 4). GI had lower VAS scores during the study period accept for the 0 and 4th hour compared to GII. Two patients (11 %) in GI and 8 patients (44 %) in GII had additional analgesics, which was not significant. Patient satisfaction: 9±0.8 in GI and 8±0.7 in GII with significant differences (p<0.001). Conclusion: Subacromial catheters can be applied without serious side-effects and complications. Although less effective than continuous ISB; it is a suitable method with adequate analgesia.