FEMORAL BLOK UYGULANMIŞ KALÇA KIRIKLI OLGULARDA BLOĞUN SPİNAL ANESTEZİNİN FARKLI POZİSYONLARI ÜZERİNE ETKİNLİĞİNİN DEĞERLENDİRİLMESİ Evaluation of the Effectiveness of the Block on Different Positions of Spinal Anesthesia in Patients with Hip Fractures Treated with Femoral Block

OZET Amac: Tek doz femoral sinir blokajinin (FNB) kalca kirigi cerrahisinde ultrasonografik kilavuzluk altinda sedyeden ameliyat masasina transfer sirasinda, lateral dekubit veya spinal anesteziden once oturma pozisyonlarinda etkinligini degerlendirmeyi amacladik Yontem ve Gerecler: Sedye uzerinde ultrasonografik rehberlik altinda tek doz FNB uyguladik. Gorsel Analog Skala (VAS) skorlari sedyeden ameliyat masasina transfer sirasinda ve spinal anestezi oncesi lateral dekubit pozisyonunda (grup I) veya oturma pozisyonunda (grup II) degerlendirildi Bulgular: Grup I'de 2.96 ± 0.55 transfer sirasindaki VAS skorlari ve lateral dekubit pozisyonda 3.33 ± 0.54, baslangic 7.47 ± 0.68, P <0.001 VAS skorlarindan anlamli olarak dusuktu. Ancak, transfer sonrasi hastalar lateral dekubit pozisyonuna gectiklerinde VAS skorlarinda anlamli bir artis vardi II. Grupta 3.06 ± 0.52 transfer sirasindaki VAS skorlari ve 2.96 ± 0.49 oturma pozisyonunda baslangic 7.56 ± 0.62, V <0.001 VAS skorlarindan anlamli olarak dusuktu. Hastalarin transfer sonrasi oturma pozisyonuna gecerken VAS skorlarinda anlamli bir artis olmadi P <0.001 Tartisma ve Sonuc: Kalca kirikli hastalarda agri yonetimi icin FNB yapilmasi, hasta transferi sirasinda ve spinal anestezi oncesi hem oturma hem de lateral dekubit pozisyonlarinda etkiliydi. Bununla birlikte, lateral dekubit pozisyona kiyasla VAS skorlarinin oturma pozisyonunda daha az yukselmesi oturma pozisyonunun daha az agrili oldugunu gostermistir. Anahtar Kelimeler: Femoral sinir blogu; Spinal anestezi; Femur kirigi ABSTRACT Introduction: We aimed to evaluate the efficacy of single-dose femoral nerve blockade (FNB) under ultrasonographic guidance in hip fracture surgery during transfer from the stretcher to the operating table, in lateral decubitis or sitting positions before the spinal anesthesia Methods: We performed single-dose FNB under ultrasonographic guidance on the stretcher. Visual Analogue Scale (VAS) scores were calculated during transfer from the stretcher to the operating table and in lateral decubitus position (group I) or in sitting position (group II) before spinal anesthesia Results: In group I, VAS scores during transfer 2.96±0.55 and in lateral decubitis position 3.33±0.54 were significantly lower than the VAS scores at the beginning 7.47±0.68, P<0.001. However, there was a significant increase in VAS scores when the patients moved to lateral decubitis position after transfer. In group II, VAS scores during transfer 3.06±0.52 and in the sitting position 2.96±0.49 were significantly lower than the VAS scores at the beginning 7.56±0.62, P<0.001. There was no significant increase in VAS scores when the patients moved to sitting position after transfer P<0.001 Conclusion: Performing FNB for pain management in hip fracture patients was effective during patient transfer and in both sitting and lateral decubitis positions before spinal anesthesia. However, the lesser elevation of VAS scores in sitting position when compared to lateral decubitis position indicated that sitting position was less painful Keywords: Femoral nerve block; Spinal anesthesia; Femur fracture