Meme kanseri nedeniyle opere edilen hastalarda postoperatif analjezi amacıyla yapılan erektör spina plan bloğunun nötrofil/lenfosit oranı ve platelet/lenfosit oranı üzerine etkisinin karşılaştırılması
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Tekirdağ Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kadın meme kanseri tüm dünyada en sık tanı konulan kanserdir. Meme kanseri cerrahisi sonrası görülen nüks ve metastazın, konağın immün yanıtıyla ilişkili olduğu gösterilmiştir. Anestezik ajanlar, cerrahi stres yanıtı modüle ederek veya doğrudan immün sistem hücrelerinin fonksiyonlarını bozar. Çalışmamızda Tekirdağ Namık Kemal Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı 'nda meme kanseri cerrahisi geçiren hastalarda postoperatif analjezi için kullandığımız yöntemlerden nonsteroid antiinflamatuar ilaçlar ve erektör spina plan bloğunun, stres yanıt biyobelirteçleri olan nötrofil/lenfosit oranı ile platelet/lenfosit oranı üzerine etkilerini karşılaştırmayı amaçladık. Çalışmamıza 18-75 yaş arası, tek taraflı meme kanseri cerrahisi planlanan, kadın cinsiyette ve çalışmaya katılmayı kabul eden 100 olgu dahil edildi. Bu olgular analjezi yöntemine göre, erektör spina plan bloğu yapılanlar (Grup E) ve nonsteroid antiinflamatuar ilaç uygulananlar (Grup N) şeklinde 50 'şer kişilik 2 gruba ayrıldı. Hastaların operasyon öncesi ve postoperatif 2. saatte alınan hemogram örneklerinde beyaz küre, lökosit, lenfosit, trombosit, hemoglobin, hematokrit, ortalama gövde hacmi ve ortalama trombosit hacmi değerleri kaydedildi. Çıkan sonuçlara göre preoperatif ve postoperatif nötrofil/lenfosit oranı ve platelet/lenfosit oranı değerleri hesaplanarak kaydedildi. Hastaların postoperatif 0., 2., 4. ve 6. saat vizüel analog skala puanları kaydedildi. Her iki grupta beyaz küre, lökosit, nötrofil/lenfosit oranı ve platelet/lenfosit oranı postoperatif dönemde istatistiksel olarak anlamlı yüksek bulunurken, lenfosit, trombosit, hemoglobin ve hematokrit değerleri anlamlı düşük bulundu. Gruplar arası laboratuvar parametrelerinin preoperatif ve postoperatif ölçüm değişimleri kıyaslandığında ise istatistiksel olarak anlamlı bir fark saptanmadı. Postoperatif 0., 2., 4. ve 6. saat VAS skorları Grup E 'de istatistiksel olarak anlamlı düşük bulundu. Postoperatif 0. saate göre 4. ve 6. saat VAS skoru değişimi, Grup N 'de istatistiksel olarak anlamlı yüksek bulundu. Sonuçta meme kanseri cerrahisinde postoperatif analjezi yönetiminde erektör spina plan bloğu ve nonsteroid antiinflamatuar ilaç kullanımı kıyaslandığında, nötrofil/lenfosit oranı ve platelet/lenfosit oranı üzerine etkilerinin birbirlerine üstünlük sağlamadığı, ancak etkin ağrı kontrolü için erektör spina plan bloğunun üstün olduğu kanısına vardık.
Female breast cancer is the most frequently diagnosed cancer worldwide. It has been shown that recurrence and metastasis seen after breast cancer surgery are related to the immune response of the host. Anesthetic agents modulate the surgical stress response or directly impair the functions of immune system cells. In our study, we aimed to compare the effects of nonsteroidal anti-inflammatory drugs and erector spinae plane block, which are among the methods we use for postoperative analgesia, on the neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients undergoing breast cancer surgery in Tekirdag Namık Kemal University Faculty of Medicine, Department of Anesthesiology and Reanimation. One hundred female patients aged 18-75 years, scheduled for unilateral breast cancer surgery, and who agreed to participate were included in our study. These cases were divided into two groups of 50 people according to the analgesia method: Those with erector spinae plane block (Group E) and those who were administered nonsteroidal anti-inflammatory drugs (Group N). The values of white blood cell, leukocyte, lymphocyte, thrombocyte, haemoglobin, hematocrit, mean corpuscular volume and mean platelet volume were recorded in the haemogram samples taken before the operation and at the 2nd hour postoperatively. According to the results, preoperative and postoperative neutrophil/lymphocyte ratio and platelet/lymphocyte ratio values were calculated and recorded. Postoperative 0th, 2nd, 4th and 6th hour visual analogue scale scores of the patients were recorded. While white blood cell, leukocyte, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were statistically higher in both groups in the postoperative period, lymphocyte, thrombocyte, haemoglobin and hematocrit values were found to be significantly lower. No statistically significant difference was foundwhen the preoperative and postoperative measurement changes of the laboratory parameters between the groups were compared. Postoperative 0th, 2nd, 4th and 6th hour VAS scores were statistically significantly lower in Group E. The change in VAS score at the 4th and 6th hours compared to the postoperative 0th hour was found to be statistically significantly higher in Group N. As a result, we concluded that when erector spinae plane block and nonsteroidal anti-inflammatory drug use were compared in the managing postoperative analgesia in breast cancer surgery, their effects on neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were not superior to each other. However, erector spinae plane block was superior for adequate pain control.
Female breast cancer is the most frequently diagnosed cancer worldwide. It has been shown that recurrence and metastasis seen after breast cancer surgery are related to the immune response of the host. Anesthetic agents modulate the surgical stress response or directly impair the functions of immune system cells. In our study, we aimed to compare the effects of nonsteroidal anti-inflammatory drugs and erector spinae plane block, which are among the methods we use for postoperative analgesia, on the neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients undergoing breast cancer surgery in Tekirdag Namık Kemal University Faculty of Medicine, Department of Anesthesiology and Reanimation. One hundred female patients aged 18-75 years, scheduled for unilateral breast cancer surgery, and who agreed to participate were included in our study. These cases were divided into two groups of 50 people according to the analgesia method: Those with erector spinae plane block (Group E) and those who were administered nonsteroidal anti-inflammatory drugs (Group N). The values of white blood cell, leukocyte, lymphocyte, thrombocyte, haemoglobin, hematocrit, mean corpuscular volume and mean platelet volume were recorded in the haemogram samples taken before the operation and at the 2nd hour postoperatively. According to the results, preoperative and postoperative neutrophil/lymphocyte ratio and platelet/lymphocyte ratio values were calculated and recorded. Postoperative 0th, 2nd, 4th and 6th hour visual analogue scale scores of the patients were recorded. While white blood cell, leukocyte, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were statistically higher in both groups in the postoperative period, lymphocyte, thrombocyte, haemoglobin and hematocrit values were found to be significantly lower. No statistically significant difference was foundwhen the preoperative and postoperative measurement changes of the laboratory parameters between the groups were compared. Postoperative 0th, 2nd, 4th and 6th hour VAS scores were statistically significantly lower in Group E. The change in VAS score at the 4th and 6th hours compared to the postoperative 0th hour was found to be statistically significantly higher in Group N. As a result, we concluded that when erector spinae plane block and nonsteroidal anti-inflammatory drug use were compared in the managing postoperative analgesia in breast cancer surgery, their effects on neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were not superior to each other. However, erector spinae plane block was superior for adequate pain control.
Açıklama
Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
