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OBJECTIVE: Patent ductus arteriosus is an important cause of morbidity and mortality, especially in very low birth weight infants. The aim of the study is to report our single-centre short-term results of preterm patients who underwent ligation through left anterior mini-thoracotomy . METHODS: Data of 27 preterm infants operated by the same surgeon who underwent Patent ductus arteriosus (PDA) closure with left anterior mini-thoracotomy technique between November 2020 and January 2022 at a single institution were reviewed. The patients were divided into two groups according to their weight at the time of surgery. Data on early postoperative outcomes and survival rates after discharge were collected. RESULTS: Twenty-seven patients with a mean (±SD) gestational age of 25.8 (±2.0) weeks and a mean birth weight of 1027 (±423) g were operated using left anterior mini-thoracotomy technique. The lowest body weight was 480 g. Complications such as bleeding, abnormal healing of incision, or pneumothorax were not seen. There were 8 mortalities after the operation (29,6 %). The causes of the deaths were sepsis, necrotising enterocolitis, hydrops fetalis, hepatoblastoma, and intracranial bleeding. There was no statistically significant difference in the rates of complication between the groups. CONCLUSIONS: Left anterior mini-thoracotomy technique can be performed as the first choice when transcatheter intervention cannot be applied in preterm infants. It provides easy access to the PDA, a good exposure, minimal contact with the lungs, good cosmetic results in early and mid-term and shortens the operation time, especially in very low birth weight preterm babies. However, early ligation may be helpful to minimise the complications related to PDA.
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AIM: To compare the effect of ultrasound-guided modified thoracolumbar interfascial plane (TLIP) block versus local anesthetic infiltration on the wound site for post-operative analgesia in patients undergoing lumbar disc surgery with spinal anesthesia. MATERIAL AND METHODS: This prospective and observationally planned study included 42 patients from the ages of 18 to 75 years, American Society of Anesthesiologists classes I?III, who underwent lumbar disc surgery. In Group L, bupivacaine infiltration was performed on the surgical incision line. In Group T, TLIP block was performed with ultrasound. In the postoperative period, visual analogue scale (VAS) values were also investigated and recorded on the 10 < sup > th < /sup > day after discharge. Nausea, vomiting, and sedation score values and analgesic doses used by all patients in the postoperative period were recorded. RESULTS: During any of the postoperative follow-up hours, the VAS score was ? 3 (mild pain), and those who did not need tramadol were 80.9% (n=17) in Group T and 71.4% (n=15) in Group L. VAS scores at the 1 < sup > st < /sup > , 4 < sup > th < /sup > , and 8 < sup > th < /sup > hours were statistically lower in Group L than those in Group T (p values: 0.011, 0.028, and 0.029). The average amounts of tramadol consumption per patient were determined as 19.04 mg ± 40.23 in Group T and 27.38 ± 44.65 mg in Group L in the first 24 hours postoperatively. There was no statistically significant difference between groups (p=0.519). CONCLUSION: In this study, it was determined that the modified TLIP block application performed for the purpose of post-operative analgesia in lumbar disc surgery was not superior to local anesthetic infiltration in terms of postoperative opioid consumption and VAS scores.
Asunto(s)
Anestesia Local , Degeneración del Disco Intervertebral/cirugía , Desplazamiento del Disco Intervertebral/cirugía , Bloqueo Nervioso , Dolor Postoperatorio , Adolescente , Adulto , Anciano , Analgésicos Opioides , Anestésicos Locales , Bupivacaína , Humanos , Persona de Mediana Edad , Dolor Postoperatorio/tratamiento farmacológico , Estudios Prospectivos , Adulto JovenRESUMEN
PURPOSE: In this study, we evaluated the hypothesis that preoperative bilateral infraoptic nerve (ION) and infratrochlear nerve (ITN) blocks under general anesthesia with sevoflurane and remifentanil reduced the incidence of emergence agitation (EA), pain scores, and the analgesic consumption after the septorhinoplasty. PATIENTS AND METHODS: Our study was conducted as a prospective randomized, double-sided blind study. Fifty-two patients whose septorhinoplasty operation was planned under general anesthesia were included in the study. Patients were randomly distributed to either the ION and ITN blocks were performed. Group 1: Bilateral ION and ITN blocks were performed; Group 2: ION and ITN blocks were not performed. Duration of the surgery and anesthesia, Riker Sedation-Agitation Scale (RSAS) score, EA presence, duration of postoperative analgesia, numerical rating scale (NRS) scores, and cumulative dexketoprofen consumption were recorded. RESULTS: The RSAS score, NRS score and cumulative dexketoprofen consumption of the patients in Group 1 were statistically significantly lower than the patients in Group 2 (p<0.05). It was also found that patients in Group 1 (n: 8/26) had less EA compared to patients in Group 2 (n: 16/26) and this difference was statistically significant (p: 0.026). Postoperative analgesia duration of patients in Group 1 was found to be statistically significantly higher than patients in Group 2 (p: <0.001). In addition, the number of patients given postoperative dexketoprofen in Group 1 (n: 8/26) was found to be statistically significantly lower than patients in Group 2 (n: 25/26). (p: <0.001). CONCLUSION: Bilateral ION and ITN blocks in septorhinoplasty operation is an effective, reliable and simple technique in the treatment of postoperative pain.