Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi University, Tıp Fakültesi, Turkey
Approval Date: 2010
Thesis Language: Turkish
Student: SİNEM HÜRSEN GÜNAY
Supervisor: ÖMER KURTİPEK
Abstract:The aim of this study was to observe the effect of interscalen brachial plexus block on postthoracotomy ipsilateral shoulder pain. 40 patients with postoperative ipsilateral shoulder pain who will undergo elective thoracotomy operation and under risk group ASA I-III were included in the study. The patients were divided into 2 groups randomly as Group I (interscalen block, n=20) and Group II(NSAID, n=20). By applying interscalen block with 25ml 0.25% levobupivacain to one group and by administring 75 mg diclofenac sodium to the other group. We compared the effect of both methods on the shoulder pain. Following the anesthetic induction, the invazive blood pressure had been monitored and later, HR, SAP, DAP, MAP, EtCO2 values were noted on 3th, 5 th, 15 th, 30 th, 45 th, 60 th, 120 th, 180 th minute after induction and during extubation. Incision area pain and shoulder pain of the patients, taken to the postoperative intensive care, were evaluated with VNS score and after that interscalen block or NSAID were applied randomly. Postoperative HR, SAP, DAP, MAP, SPO2values in 30th minute, 2nd hr, 4th hr, 6 th hr, 12 th hr and 24 th hr; postoperative initial morphine requirement time, total morphine requirement, patient satisfaction, interscalen block application time/non-steroid application time, postoperative blood gas parameters in 2nd hr and 24 th hr were all noted. While a significant decrease of the VNS scores were observed in 30 th min, 2nd, 4 th, 6 th, 12 th and 24 th hr with respect to the initial values on the patients with interscalen block, the decrease was only observed in 12 th and 24 th hr on the patients who were given im diklofenac sodium (p<0.05). Between these two groups, the significant decrease of the VNS scores had been found in the group with interscalen block (p<0.05). No significant difference was observed on initial analgasia requirement between these two groups. However total analgesia consumption was less on the group with interscalen block. (p<0.05). As a result, we found that the interscalen block with 20ml 0.25% levobupivacain may be used as an effective treatment for the patients with ipsilateral shoulder pain after thoracotomy in the first 24 hours.