Analgetski efekat blokade grupe perikapsularnih nerava kod starijih osoba koje su podvrgnute zameni kuka

  • Min Zhou Wuhan University of Science and Technology, Puren Hospital, Department of Anesthesiology, Wuhan, China
  • Qiuping Xu Wuhan University of Science and Technology, Puren Hospital, Department of Anesthesiology, Wuhan, China
  • Dong Zuo Airborne Troops Hospital, Department of Anesthesiology, Wuhan, China
  • Zhiyi Wang Wuhan University of Science and Technology, Puren Hospital, Department of Anesthesiology, Wuhan, China
  • Maohua Zhang Wuhan University of Science and Technology, Puren Hospital, Department of Anesthesiology, Wuhan, China
  • Tingting Liu Wuhan University of Science and Technology, Puren Hospital, Department of Anesthesiology, Wuhan, China
  • Renqi Liu Wuhan University of Science and Technology, Puren Hospital, Department of Anesthesiology, Wuhan, China
DOI: https://doi.org/10.2298/VSP220429002Z
Ključne reči: stare osobe, analgezija, anestezija, provodna, kuk, artroplastika, metode

Sažetak


Uvod/Cilj. Blokada grupe perikapsularnih nerava (BGPN) ne utiče na motorni nerv a blokira opturatorne i femoralne nerve. Cilj rada bio je da se utvrdi vrednost primene BGPN tokom zamene kuka kod starijih osoba. Metode. Ukupno 90 starijih osoba, podvrgnutih zameni kuka od marta 2019. do oktobra 2020, nasumično su podeljene u grupu bolesnika kojima je izvršena blokada odeljka ilijačne fascije (BOIF) i grupu onih kojima je izvršena BGPN. BOIF i BGPN izvedene su pre subarahnoidnog bloka (SAB). Upoređivani su osnovni podaci bolesnika, uslovi operacije, incidenca neželjenih reakcija, skor na vizuelnoj analognoj skali (VAS), brzina otkucaja srca (BOS), srednji arterijski pritisak (SAP), nivoi kortizola u plazmi (KOP) i epinefrina (E). Rezultati. Skor VAS, nivoi E i KOP bili su niži kod bolesnika u grupi BGPN nego u grupi BOIF, u vremenskim terminima T2–T4 (T2: 10 min posle bloka nerva; T3: pri promeni položaja; T4: posle promene položaja) (p < 0,001). Nije bilo značajnih razlika u vrednostima BOS i SAP između dve grupe ispitanika ni u jednoj od vremenskih tačaka (p > 0,05). U grupi BGPN, vreme ultrazvučnog snimanja bilo je kraće, moment u kome  je prvi put korišćena analgezije koju kontroliše bolesnik (patient controlled analgesia – PCA) se desio kasnije, a broj korišćenja PCA bio je manji u poređenju sa grupom BOIF (p < 0,001). Nakon blokade nerva nije došlo do toksičnog efekta lokalne anestezije, ni do stvaranja hematoma na mestu uboda, povrede nerva, mučnine i povraćanja, vrtoglavice i delirijuma. Zaključak. I BOIF i BGPN primenjeni pre SAB-a bili su veoma bezbedni tokom procesa zamene kuka kod starijih osoba, ali BPGN ima kraće vreme ultrazvučnog snimanja, bolji analgetički efekat i blaži oksidativni stres, stoga ga vredi primeniti klinički.

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Objavljeno
2023/08/28
Broj časopisa
Vol. 80 Br. 08 (2023): Vojnosanitetski pregled
Rubrika
Originalni članak