Özet:

Target: Torax surgery is considered one of the most painful surgical procedures. The pain that develops after the torace surgery can lead to negative consequences such as respiratory complications such as atelectasis and pneumonia, longer hospitalization periods, a decrease in quality of life, and the pain becomes postoperative chronic pain. We aimed at examining our postoperative analgesic practices and their results retrospectively in patients who suffered Toraks surgery. Tools and Methods: Our study was done with a retrospective examination of the data of 563 patients who suffered toral surgery and followed postoperative analgesics between June 2019 and June 2021. The postoperative analgesic method applied to patients, visual analog scale (VAS) scores, supplementary analgesic treatment applied and developing complications were evaluated. The findings: 28.42 percent of patients were women, and the most frequently performed surgery was lung resections with 64.30 percent. Patient-controlled analgesia (HKA) was administered in 458 (81.35) patients intravenously and in 105 (18.65) patients epidurally. The VAS score for intravenous HKA was 4.1 in postoperative 1 hour, 2.0 in 24 hours and 1.2 in 48 hours. For Epidural HKA, it was estimated at 3.9 in 1 hour, 2.0 in 24 hours and 1.4 in 48. Intravenous HKA patients with side effects were estimated at 6.9%, and epidural HKA patients with side effects at 37.14%. In our clinic, malignity surgery is often performed. Similar analgesic results were obtained in these patients with torasic paravertebral block (TPVB) and an intravenous analgesic combination with elastomeric infusion in torasic epidural analgesic. Although the complications rates were lower in the group of TPVB and intravenous analgesic combinations, both groups were at clinically acceptable limits. We believe that the analysis protocols and algorithms will provide effective analysis based on the clinical experience and the implemented surgical process.

Anahtar Kelimeler:

Özet:

Aim: BThoracic surgery is one of the most painful surgical procedures. Pain after thoracic surgery can cause respiratory complications, such as atelectasis and pneumonia; longer hospital stays; reduced quality of life and chronic persistent postoperative pain. We aimed to retrospectively analyze our postoperative analgesia practices and results in patients undergoing thoracic surgery through anesthesia and pain follow-up forms. Material and Methods: In our study, we retrospectively scanned 563 patients who underwent thoracic surgery and were followed up with postoperative analgesia between June 2019 and June 2021. Postoperative analgesia method applied to the patients, visual analog scale (VAS) scores, additional applied analgesia and complications were evaluated. Results: 28.42% of the patients were women. The most common surgery was lung resections with a rate of 64.30%. Patient-controlled analgesia (PCA) was administered thoracic paravertebral block (TPVB) + intravenously in 458 (81.35%) patients and by epidural route in 105 (18.65%) patients. The VAS scores were 4.1 at the postoperative 1st hour, 1.9 at 24th hour and 1.1 at 48th hour for TPVB + intravenous PCA. For epidural PCA, VAS scores were 3.9 at the first hour, 1.9 at 24th hour, and 1.4 at 48th hour. Side-effect rates were evaluated as 6.99% in patients who underwent TPVB + intravenous PCA and 37.14% in patients who underwent epidural PCA. Conclusion: Malignancy surgery is frequently performed in our clinic. In these patients, similar analgesic results were obtained for the combination of TPVB and intravenous analgesia, and thoracic epidural analgesia (TEA) administered with elastomeric infusion. Although the complication rates were lower in the group treated with TPVB and intravenous analgesia, they were found to be within clinically acceptable limits in both groups. We think that the choosing analgesia protocols and algorithms according to the experience of the clinicians and the surgical procedure will provide effective analgesia