Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: ORIGINAL RESEARCH
Rejyonel İntravenöz Anestezide Lidokain-Tenoksikam ve Lidokain-Deksketoprofenin Etkinliklerinin Karşılaştırılması: Analitik Araştırma
Comparison of the Efficacy of Lidocaine-Tenoxicam and Lidocaine-Dexketoprofen in Regional Intravenous Anesthesia: Analytical Research
Tolga TERZİa , Gülşen BOSNAa , Asu ÖZGÜLTEKİNa , Osman EKİNCİa
aHaydarpaşa Numune Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye
Turkiye Klinikleri J Anest Reanim. 2023;21(3):98-103
doi: 10.5336/anesthe.2023-99497
Article Language: TR
Full Text
ÖZET
 Amaç: Rejyonel intravenöz anestezi (RİVA), ekstremite operasyonlarında yaygın şekilde yıllardır kullanılan, basit ve güvenilir bir yöntemdir. Çalışmamızda, RİVA tekniği ile kullanılan ilaçların operasyona başlangıç süresi, peroperatif analjezi ve postoperatif analjezi süreleri açısından karşılaştırmasını yapmayı amaçladık. Gereç ve Yöntemler: Çalışmamız üst ekstremite operasyonu öncesinde RİVA tekniği uygulanan hastaları içeren retrospektif kohort çalışmasıdır. Grup T'ye, %2 lidokain 3 mg/kg'a ek olarak tenoksikam 20 mg; Grup D'ye ise %2 lidokain 3 mg/kg'a ek olarak deksketoprofen 50 mg uygulanmıştır. Kayıtlardan preoperatif, peroperatif ve postoperatif dönemde kalp atım hızı, ortalama arter basıncı, oksijen saturasyonu, görsel analog skala [visual analogue scale (VAS)], motor blok başlangıç süresi ve ilk analjezik gereksinim zamanları karşılaştırıldı. Bulgular: Gruplar arasında preoperatif, peroperatif ve postoperatif değerlendirmeler sonucunda kalp atım hızları, oksijen saturasyonları ve ortalama arter basıncı değerleri arasında anlamlı fark yoktu. Gruplar arasında motor blok başlama süresi ve ilk analjezik ihtiyaç süresi arasında istatistiksel olarak anlamlı fark gözlenmedi. Grup D ve Grup T arasında VAS değerlerinde preoperatif ve peroperatif 30. dk'larda istatistiksel olarak anlamlı bir fark gözlenmese de postoperatif 60. dk'da Grup T'nin Grup D'ye göre daha etkili olduğu saptandı. Sonuç: RİVA'da adjuvan olarak kullanılan tenoksikamın, deksketoprofene göre postoperatif dönemde daha etkin bir analjezi sağladığı görüldü. Sonuç olarak, RİVA'da lidokaine tenoksikam 20 mg ve deksketoprofen 50 mg ilave edilmesi arasında preoperatif ve peroperatif analjezi kalitesinde anlamlı bir fark yoktur, ancak postoperatif dönemde tenoksikam daha etkili bir analjezi sağlar.

Anahtar Kelimeler: Deksketoprofen trometamol; lidokain hidroklorür; tenoksikam; bölgesel; sinir bloğu
ABSTRACT
 Objective: Regional intravenous anesthesia (RIVA) is a widely used, simple, and reliable method in extremity surgeries for many years. In our study, we aimed to compare the drugs used with the RIVA technique in terms of the onset time of the operation, perioperative analgesia, and postoperative analgesia durations. Material and Methods: Our study is a retrospective cohort study including patients who underwent the RIVA technique before upper extremity surgery. In Group T, 2% lidocaine 3 mg/kg was administered in addition to tenoxicam 20 mg, while in Group D, 2% lidocaine 3 mg/kg was administered in addition to dexketoprofen 50 mg. Heart rate, mean arterial pressure, oxygen saturation, visual analogue scale (VAS), motor block onset time, and the time to first analgesic requirement were compared during the preoperative, perioperative, and postoperative periods based on records. Results: There was no significant difference between the groups in terms of heart rate, oxygen saturation, and mean arterial pressure values in the preoperative, perioperative, and postoperative assessments. No statistically significant difference was observed in motor block onset time and the time to the first analgesic requirement between the groups. Although there was no statistically significant difference in VAS values between Group D and Group T in the preoperative and perioperative 30th minutes, Group T was found to be more effective than Group D in the postoperative 60th minute. Conclusion: Tenoxicam, used as an adjuvant in RIVA, provided more effective analgesia in the postoperative period compared to dexketoprofen. In conclusion, there is no significant difference in the quality of preoperative and perioperative analgesia between adding tenoxicam 20 mg and dexketoprofen 50 mg to lidocaine in RIVA, but tenoxicam provides more effective analgesia in the postoperative period.

Keywords: Dexketoprofen trometamol; lidocaine hydrochloride; tenoxicam; regional; nerve block
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