Clinical Research
Vertebral Kompresyon Kırıklarının Perkütan Kifoplasti ile Tedavisinde Anestezi Yöntemlerinin Etkinliğinin Karşılaştırılması
Abstract
Amaç: Kifoplasti , vertebral kompresyon kırıklarında ağrıyı hafifletmeye ve yapısal bütünlüğü güçlendirmeye yardımcı olabilen perkütan girişimsel bir prosedürdür. Bu işlem için farklı anestezi teknikleri kullanılmaktadır. Bu çalışmada PKP için ideal anestezi tekniğinin araştırılması amaçlanmıştır.
Materyal ve Metot: Prospektif, randomize olmayan çalışmamız Ocak 2022-Haziran 2022 arasında gerçekleştirildi. Hastalar genel anestezi grubu, lokal anestezi grubu, epidural anestezi grubu olarak üç gruba ayrıldı. Perioperatif ağrı ve komplikasyonlar değerlendirildi.
Bulgular: Merkezimizde vertebral kompresyon kırığı nedeniyle peruktan kifoplasti uygulanan 40 hasta çalışmaya alındı. Genel anestezi altında operasyon geçiren hasta sayısı çok az olduğundan ilgili hasta grubu sadece tanımlayıcı istatistiklerde gösterilip karşılaştırma istatistiklerinde değerlendirmeye alınmadı. Lokal anestezi grubunda tüm zamanlama noktalarında katlanılabilir ağrı yaşanırken %25 oranında ciddi komplikasyon yaşandı. 4 hastanın ameliyat sonrası yoğun bakım takibi ihtiyacı oldu. Epidural anestezi grubunda trokar girişi sırasında ağrı yaşanırken (ort görsel analog skala=2), diğer zamanlamalarda ağrı yaşanmadı. Komplikasyon oranı lokal anestezi grubundan düşük, yoğun bakım takip ihtiyacı yoktu.
Sonuç: Epidural anestezi, peruktan kifoplasti için güvenli bir anestezi tekniğidir. Postoperatif analjezi, düşük komplikasyon oranı ve ameliyat sonrası yoğun bakım ünitesi ihtiyacı ile ilgili olarak lokal anesteziden avantajlıdır. Fakat anestezi uygulama süresi ve maliyet açısından dezavantajlıdır. Komorbidetesi yüksek, tek seviye peruktan kifoplasti operasyonlarında uygun bir anestezi tekniği olarak düşünülebilir.
Supporting Institution
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Project Number
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Thanks
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References
- 1- Chandra RV, Maingard J, Asadi H, et al. Vertebroplasty and kyphoplasty for osteoporotic vertebral fractures: what are the latest data?. American Journal of Neuroradiology. 2020;39(5):798-806.
- 2- Cook DJ, Guyatt GH, Adachi JD, et al. Quality of life issues in women with vertebral fractures due to osteoporosis. Arthritis Rheum. 1993; 36(6):750-756.
- 3- Denaro V, Longo UG, Maffulli N, et al. Vertebroplasty and kyphoplasty. Clinical Cases in Mineral and Bone Metabolism. 2009;6(2):125-130.
- 4- Fuentes S, Metellus P, Fondop J,et al. Percutaneous pedicle screw fixation and kyphoplasty for management of thoracolumbar burst fractures. Neuro-chirurgie. 2007;53(4): 272-276.
- 5- Wardlaw D, Cummings SR, Van Meirhaeghe J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. The Lancet. 2009;373(9668): 1016-1024.
- 6- Ma XL, Xing D, Ma JX,et al. Balloon kyphoplasty versus percutaneous vertebroplasty in treating osteoporotic vertebral compression fracture: grading the evidence through a systematic review and meta-analysis. European Spine Journal. 2012;21(9):1844-1859.
- 7- Wiles MD, Nowicki RW, Hancock SM, et al. Anaesthesia for vertebroplasty and kyphoplasty. Current Anaesthesia & Critical Care. 2009;20(1): 38-41.
- 8- Ge C, Wu X, Gao Z, et al. Comparison of different anesthesia modalities during percutaneous kyphoplasty of osteoporotic vertebral compression fractures. Scientific Reports.2021; 11(1): 1-7. 9- Alfahel WS, Dabbous AS, Thompson ME. Epidural analgesia for percutaneous kyphoplasty in a patient with multiple medical comorbidities. Avicenna Journal of Medicine.2019; 9(02):75-77.
- 10- Souvatzis X, Katonis PG, Licoudis SA, et al. Subarachnoid anesthesia for kyphoplasty: is anesthesia adequate?. Anesthesia & Analgesia.2010; 111(1):238-240.
- 11- Hannallah M, Gibby E, Watson V. Fluoroscopy-guided, small-dose spinal anesthesia for kyphoplasty: A collaborative effort between the anesthesiologist and interventional radiologist. Anesth Analg. 2008;106:1329–30.
- 12- Ergün MO, Güvenç Y . Comparison of the Effectiveness of Anesthesia Methods on Percutaneous Kyphoplasty: Erector Spinae Plane Block Versus Local Anesthesia. Istanbul Medical Journal. 2022; 23(2): 149-53.
- 13- Liu J, Wan L, Chai M, et al. Analysis of anesthesia methods in percutaneous kyphoplasty for treatment of vertebral compression fractures. J Healthc Eng. 2020;(1) 9;2020:3965961.
- 14- Ge C, Wu X, Gao Z, et al. Comparison of different anesthesia modalities during percutaneous kyphoplasty of osteoporotic vertebral compression fractures. Scientific Reports.2021; 11(1), 1-7.
- 15- Zhang LG, Gu X, Zhang HL, et al. Unilateral or bilateral percutaneous vertebroplasty for acute osteoporotic vertebral fracture: a prospective study. Clinical Spine Surgery.2015; 28(2), 85-88.
- 16- Luginbühl M. Percutaneous vertebroplasty, kyphoplasty and lordoplasty: implications for the anesthesiologist. Current Opinion in Anesthesiology. 2008;21(4), 504-513.
- 17- Vasconcelos C, Gailloud P, Beauchamp NJ, et al. Is percutaneous vertebroplasty without pretreatment venography safe? Evaluation of 205 consecutives procedures. American Journal of Neuroradiology.2002; 23(6), 913-917.
- 18- Ohara T, Takahashi M, Yamamoto Y, et al. Use of propofol for painful procedures in cancer pain management. Masui. The Japanese Journal of Anesthesiology.2003; 52(7), 740-743.
- 19- Civelek E, Cansever T, Yilmaz C, et al. The retrospective analysis of the effect of balloon kyphoplasty to the adjacent-segment fracture in 171 patients. Clinical Spine Surgery.2014; 27(2), 98-104. 20- Apan A., Apan ÖC, Köse EA. Segmental epidural anesthesia for percutaneous kyphoplasty: Comparison with general anesthesia. Turkish Journal of Medical Sciences.2016; 46(6), 1801-1807.
- 21- Guay J, Choi PT, Suresh S, et al. Neuraxial anesthesia for the prevention of postoperative mortality and major morbidity: an overview of cochrane systematic reviews. Anesth Analg. 2014; 119(3), 716-725.
- 22- Wang W, Ni BB, Shen H, et al. Comparison of surgical outcomes of lumbar disc herniation using local anesthesia and epidural anesthesia: A meta-analysis. Medicine. 2020;99(33),18958.
- 23- Albayrak S, Demırel I, Ayden O, et al. Lumbar disc surgery with epidural anesthesia: review of 700 cases. Turkish Neurosurgery. 2016;26(3).399-403.
Year 2022,
Volume: 5 Issue: 2, 241 - 249, 31.08.2022
Abstract
Project Number
yok
References
- 1- Chandra RV, Maingard J, Asadi H, et al. Vertebroplasty and kyphoplasty for osteoporotic vertebral fractures: what are the latest data?. American Journal of Neuroradiology. 2020;39(5):798-806.
- 2- Cook DJ, Guyatt GH, Adachi JD, et al. Quality of life issues in women with vertebral fractures due to osteoporosis. Arthritis Rheum. 1993; 36(6):750-756.
- 3- Denaro V, Longo UG, Maffulli N, et al. Vertebroplasty and kyphoplasty. Clinical Cases in Mineral and Bone Metabolism. 2009;6(2):125-130.
- 4- Fuentes S, Metellus P, Fondop J,et al. Percutaneous pedicle screw fixation and kyphoplasty for management of thoracolumbar burst fractures. Neuro-chirurgie. 2007;53(4): 272-276.
- 5- Wardlaw D, Cummings SR, Van Meirhaeghe J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. The Lancet. 2009;373(9668): 1016-1024.
- 6- Ma XL, Xing D, Ma JX,et al. Balloon kyphoplasty versus percutaneous vertebroplasty in treating osteoporotic vertebral compression fracture: grading the evidence through a systematic review and meta-analysis. European Spine Journal. 2012;21(9):1844-1859.
- 7- Wiles MD, Nowicki RW, Hancock SM, et al. Anaesthesia for vertebroplasty and kyphoplasty. Current Anaesthesia & Critical Care. 2009;20(1): 38-41.
- 8- Ge C, Wu X, Gao Z, et al. Comparison of different anesthesia modalities during percutaneous kyphoplasty of osteoporotic vertebral compression fractures. Scientific Reports.2021; 11(1): 1-7. 9- Alfahel WS, Dabbous AS, Thompson ME. Epidural analgesia for percutaneous kyphoplasty in a patient with multiple medical comorbidities. Avicenna Journal of Medicine.2019; 9(02):75-77.
- 10- Souvatzis X, Katonis PG, Licoudis SA, et al. Subarachnoid anesthesia for kyphoplasty: is anesthesia adequate?. Anesthesia & Analgesia.2010; 111(1):238-240.
- 11- Hannallah M, Gibby E, Watson V. Fluoroscopy-guided, small-dose spinal anesthesia for kyphoplasty: A collaborative effort between the anesthesiologist and interventional radiologist. Anesth Analg. 2008;106:1329–30.
- 12- Ergün MO, Güvenç Y . Comparison of the Effectiveness of Anesthesia Methods on Percutaneous Kyphoplasty: Erector Spinae Plane Block Versus Local Anesthesia. Istanbul Medical Journal. 2022; 23(2): 149-53.
- 13- Liu J, Wan L, Chai M, et al. Analysis of anesthesia methods in percutaneous kyphoplasty for treatment of vertebral compression fractures. J Healthc Eng. 2020;(1) 9;2020:3965961.
- 14- Ge C, Wu X, Gao Z, et al. Comparison of different anesthesia modalities during percutaneous kyphoplasty of osteoporotic vertebral compression fractures. Scientific Reports.2021; 11(1), 1-7.
- 15- Zhang LG, Gu X, Zhang HL, et al. Unilateral or bilateral percutaneous vertebroplasty for acute osteoporotic vertebral fracture: a prospective study. Clinical Spine Surgery.2015; 28(2), 85-88.
- 16- Luginbühl M. Percutaneous vertebroplasty, kyphoplasty and lordoplasty: implications for the anesthesiologist. Current Opinion in Anesthesiology. 2008;21(4), 504-513.
- 17- Vasconcelos C, Gailloud P, Beauchamp NJ, et al. Is percutaneous vertebroplasty without pretreatment venography safe? Evaluation of 205 consecutives procedures. American Journal of Neuroradiology.2002; 23(6), 913-917.
- 18- Ohara T, Takahashi M, Yamamoto Y, et al. Use of propofol for painful procedures in cancer pain management. Masui. The Japanese Journal of Anesthesiology.2003; 52(7), 740-743.
- 19- Civelek E, Cansever T, Yilmaz C, et al. The retrospective analysis of the effect of balloon kyphoplasty to the adjacent-segment fracture in 171 patients. Clinical Spine Surgery.2014; 27(2), 98-104. 20- Apan A., Apan ÖC, Köse EA. Segmental epidural anesthesia for percutaneous kyphoplasty: Comparison with general anesthesia. Turkish Journal of Medical Sciences.2016; 46(6), 1801-1807.
- 21- Guay J, Choi PT, Suresh S, et al. Neuraxial anesthesia for the prevention of postoperative mortality and major morbidity: an overview of cochrane systematic reviews. Anesth Analg. 2014; 119(3), 716-725.
- 22- Wang W, Ni BB, Shen H, et al. Comparison of surgical outcomes of lumbar disc herniation using local anesthesia and epidural anesthesia: A meta-analysis. Medicine. 2020;99(33),18958.
- 23- Albayrak S, Demırel I, Ayden O, et al. Lumbar disc surgery with epidural anesthesia: review of 700 cases. Turkish Neurosurgery. 2016;26(3).399-403.
There are 21 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Anaesthesiology |
| Journal Section | Articles |
| Authors | |
| Project Number | yok |
| Early Pub Date | August 18, 2022 |
| Publication Date | August 31, 2022 |
| Acceptance Date | August 17, 2022 |
| Published in Issue | Year 2022 Volume: 5 Issue: 2 |
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