RESUMO
BACKGROUND: The lateral sagittal brachial plexus block is the most used method for pediatric upper extremity surgery, whereas the applications of costoclavicular brachial plexus block are limited. This study aimed to compare the lateral sagittal and costoclavicular approaches for the ultrasound-guided infraclavicular block in pediatric patients. METHODS: Sixty pediatric patients aged 5-15 years undergoing hand or forearm surgery were randomly assigned to two groups. Group LS (n = 30) received ultrasound-guided lateral sagittal block, and Group CC (n = 30) received ultrasound-guided costoclavicular block. The block performing time, needling time, imaging time, needle visibility, number of passes, sensorial/motor block time, and postoperative pain scores were evaluated. RESULTS: The needling time (82.90 ± 28.17 seconds vs. 64.77 ± 28.11 seconds respectively, p = 0.004) and total block performance time (109.53 ± 29.75 seconds vs. 89.70 ± 29.98 seconds respectively, p = 0.005) were significantly longer in Group LS than in Group CC. However, there was no significant difference between the groups in imaging time, needle visibility, number of passes, sensorial/motor block time, and postoperative pain scores (p > 0.05). CONCLUSIONS: Costoclavicular and lateral sagittal brachial plexus blocks resulted in similar anesthetics effects. Moreover, the costoclavicular method can be a better alternative to lateral sagittal as it has a shorter block performance time.
RESUMO
Abstract Introduction: Hip surgery is a major surgery that causes severe postoperative pain. Although pain during rest is usually considerably reduced mobilization is important in terms of thromboembolic complications. The quadratus lumborum block is a regional analgesic technique that blocks T6-L3 nerve branches. This block may provide adequate analgesia and reduce opioid consumption after hip surgery. Case report: We performed continuous quadratus lumborum type 3 block in two patients who underwent hip arthroplasty. Postoperative 24-h pain scores, local anesthetic consumptions on patient-controlled analgesia and additional analgesic requirement were recorded. In two patients, postoperative pain scores were less than 6 during rest and physiotherapy. Patient was mobilized in the early postoperative period without additional opioid analgesic requirement and without muscle weakness. Discussion: Continuous quadratus lumborum block may be used to relieve postoperative acute pain in hip surgery because it provides one-sided anesthesia without muscle weakness.
Resumo Introdução: A cirurgia de quadril é uma cirurgia de grande porte que causa dor intensa no pós-operatório. Embora a dor durante o repouso seja consideravelmente reduzida, a mobilização é importante em termos de complicações tromboembólicas. O bloqueio doquadrado lombar é uma técnica analgésica regional que bloqueia os ramos nervosos de T6-L3. Esse bloqueio pode fornecer analgesia adequada e reduzir o consumo de opioides após cirurgiasde quadril. Relato de caso: Realizamos o bloqueio contínuo do quadrado lombar tipo 3 em dois pacientes submetidos à artroplastia de quadril. Durante as 24 hs de pós-operatório foram registrados os escores de dor, o consumo de anestésicos locais em analgesia controlada pelo paciente e a necessidade de analgésicos adicionais. Em dois pacientes, os escores de dor pós-operatória foram < 6 durante o repouso e fisioterapia. O paciente foi mobilizado no período pós-operatório imediato, sem precisar de analgésico opioide adicional e sem fraqueza muscular. Discussão: O bloqueio contínuo do quadrado lombar pode ser usado para aliviar a dor aguda no pós-operatório de cirurgia de quadril porque fornece anestesia unilateral sem fraqueza muscular.
Assuntos
Humanos , Masculino , Feminino , Idoso , Dor Pós-Operatória/prevenção & controle , Artroplastia de Quadril/métodos , Anestésicos Locais/administração & dosagem , Bloqueio Nervoso/métodos , Medição da Dor , Analgesia Controlada pelo Paciente/métodos , Músculos AbdominaisRESUMO
INTRODUCTION: Hip surgery is a major surgery that causes severe postoperative pain. Although pain during rest is usually considerably reduced mobilization is important in terms of thromboembolic complications. The quadratus lumborum block is a regional analgesic technique that blocks T6-L3 nerve branches. This block may provide adequate analgesia and reduce opioid consumption after hip surgery. CASE REPORT: We performed continuous quadratus lumborum type 3 block in two patients who underwent hip arthroplasty. Postoperative 24-h pain scores, local anesthetic consumptions on patient-controlled analgesia and additional analgesic requirement were recorded. In two patients, postoperative pain scores were less than 6 during rest and physiotherapy. Patient was mobilized in the early postoperative period without additional opioid analgesic requirement and without muscle weakness. DISCUSSION: Continuous quadratus lumborum block may be used to relieve postoperative acute pain in hip surgery because it provides one-sided anesthesia without muscle weakness.
Assuntos
Anestésicos Locais/administração & dosagem , Artroplastia de Quadril/métodos , Bloqueio Nervoso/métodos , Dor Pós-Operatória/prevenção & controle , Músculos Abdominais , Idoso , Analgesia Controlada pelo Paciente/métodos , Feminino , Humanos , Masculino , Medição da DorRESUMO
OBJECTIVES: In addition to its roles in the stimulation of growth hormone secretion and the regulation of appetite and metabolism, ghrelin exerts immunomodulatory, anti-inflammatory and antioxidant actions in several organ systems. In this study, we investigated the effects of ghrelin on the healing of experimental colonic anastomoses. METHODS: Wistar rats were randomly divided into two groups (n = 10 in each). A segment of colon was excised, and an end-to-end anastomosis was performed in the distal colon. The Ghrelin Group received 10 ng/kg/day IP ghrelin for seven days postoperatively, whereas the Control Group received an identical volume of saline. On the seventh postoperative day, the anastomotic bursting pressures and hydroxyproline levels were measured, and adhesion formation around the anastomoses was examined. Histopathological analyses were performed to evaluate inflammatory cell infiltration, fibroblast infiltration, collagen density and neovascularization. RESULTS: In the Ghrelin Group, the bursting pressure and hydroxyproline levels were significantly higher than in the Control Group. The adhesion formation scores were lower in the Ghrelin Group than in the Control Group. Although the inflammatory cell infiltration was diminished in the Ghrelin Group, the degrees of fibroblast infiltration, collagen density and neovascularization were not significantly different between the groups. CONCLUSION: Our results indicate that ghrelin improves the healing of colonic anastomoses in rats.
Assuntos
Colo/cirurgia , Grelina/uso terapêutico , Cicatrização/efeitos dos fármacos , Anastomose Cirúrgica , Animais , Colágeno/biossíntese , Colágeno/efeitos dos fármacos , Modelos Animais de Doenças , Fibroblastos/fisiologia , Masculino , Distribuição Aleatória , Ratos , Ratos Wistar , Aderências Teciduais , Resultado do TratamentoRESUMO
OBJECTIVES: In addition to its roles in the stimulation of growth hormone secretion and the regulation of appetite and metabolism, ghrelin exerts immunomodulatory, anti-inflammatory and antioxidant actions in several organ systems. In this study, we investigated the effects of ghrelin on the healing of experimental colonic anastomoses. METHODS: Wistar rats were randomly divided into two groups (n = 10 in each). A segment of colon was excised, and an end-to-end anastomosis was performed in the distal colon. The Ghrelin Group received 10 ng/kg/day IP ghrelin for seven days postoperatively, whereas the Control Group received an identical volume of saline. On the seventh postoperative day, the anastomotic bursting pressures and hydroxyproline levels were measured, and adhesion formation around the anastomoses was examined. Histopathological analyses were performed to evaluate inflammatory cell infiltration, fibroblast infiltration, collagen density and neovascularization. RESULTS: In the Ghrelin Group, the bursting pressure and hydroxyproline levels were significantly higher than in the Control Group. The adhesion formation scores were lower in the Ghrelin Group than in the Control Group. Although the inflammatory cell infiltration was diminished in the Ghrelin Group, the degrees of fibroblast infiltration, collagen density and neovascularization were not significantly different between the groups. CONCLUSION: Our results indicate that ghrelin improves the healing of colonic anastomoses in rats.