Tek-port, Bilateral ve Supin Pozisyonda ID Uygulanan Video-Yardımlı Torakoskopik Sempatektomi Ameliyatları Sonrası İV Morfin Yeterli midir?

Objective: The method of operation carried out by clip application in the supine position and using a single port for thoracoscopic sympathectomy has been defined in recent years. Since lesser tissue damage occurs with this method, lower perception of pain may be anticipated. The aim of this study is to investigate whether intravenous morphine alone provides effective postoperative analgesia in thoracoscopic sympathectomy performed with clips method using a single port with the patient in the supine position. Method: Files of 28 patients who underwent thoracoscopic sympathectomy between January 2017-December 2019 were retrospectively screened . Intrathecal morphine was administered to a group at a dose of 0.6 mg in 3 mL physiologic saline (Group ITM, n=14), and the other group received IV morphine in the same doses only by the PCA method (Group PCA, n=14). Both groups received postoperative Patient Controlled Analgesia (PCA) with IV morphine, as 1 mg bolus within 30 min-lock- in time. VAS values and postoperative IV total morphine consumption were recorded at the time of extubation and at the 6th, 24th and 48th hours postoperatively Results: Any statistically significant difference was not detected between patient groups as for demographic, and operative data. After extubation and at postoperative 6th hour, pain scores were statistically significantly lower in Group ITM than the Group PCA. Total IV morphine consumption at the postoperative 24th and 48th hours was statistically significant in the Group that did not receive ITM. In the postopoperative 48-hour follow-up, no VAS>4 value was observed in any one of the patients. Any intergroup difference was not detected as for length of hospital stay and complications associated with the method of analgesia used. Conclusion: In conclusion, even though an adequate analgesia is ensured through ITM in thoracoscopic sympathectomy operations realized using clips method and a single port with the patient in the supine position,we think that admiinistration of morphine using IV PCA method may provide clinically acceptable analgesic efficacy, and a regional administration may not be required in patients who will be operated with this surgical technique. [ABSTRACT FROM AUTHOR]