Kalça Kırığı Olan Hastalarda Rejyonel Blok Tekniklerine Güncel Yaklaşım
Özet
Yaşlı hastalarda kalça kırıkları önemli morbidite ve mortalite ile ilişkilidir. Bu hastaların tedavisinde erken başlatılan multimodal analjezik stratejinin bir parçası olarak periferik sinir bloklarının dahil edilmesi, önemli faydalar sağlar. Bu faydalar arasında ağrıda ve deliryum riskinde azalma, pulmoner komplikasyonlarda azalma ve mobilizasyona kadar geçen sürede azalma sayılabilir. Büyük popülasyona dayalı çalışmalar, blokla ilgili advers olaylarda önemli artışlar olmaksızın hastanede kalış süresinin azaldığını da göstermektedir. Fasya iliaka bloğu, femoral blok ve perikapsüler sinir grubu bloğu olmak üzere üç ana periferik sinir bloğundan herhangi birinin kullanımını destekleyen iyi kanıtlar vardır ve bu nedenle kalça kırığı olan tüm uygun hastalarda düşünülmelidir. Periferik sinir bloğu tekniğinin seçimi, kontrendikasyonların varlığı, blokla ilgili hedefler, motor veya kutanöz blokaj potansiyeli ve ayrıca teknik ve hasta anatomisi ile operatör deneyimi gibi blok performansının teknik yönlerini göz önüne alarak yapılmalıdır.
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