Comparison of postoperative tramadole consumption, clinical effect and side effects of peng block applicable and NON-applicablepatients in partial hip prosthesis operations

Objective: The aim of this study is to compare the postoperative tramadol consumption, clinical and side effects of patients who underwent PENG (pericapsular nerve group) block in partial hip replacement operations and those who did not. Materials and Methods: After the approval of the ethics committee of our hospital and the written consent of the patients, partial hip replacement (PKP) surgery was planned, between the ages of 18-75, PENG block was applied after general anesthesia (GA) (Group P). A total of 48 patients, 24 patients and 24 patients without PENG block (Group K), were included in the study. Demographic data (age, gender, body mass index, ASA score) of the patients were recorded. Patients in Group P underwent PENG block after GA with 20 ml of 0.5% bupivacaine accompanied by ultrasonography and only GA was applied to patients in Group K. Postoperative BIS score, first 24-hours VAS and NRS scores, vital signs, amount of tramadol and remifentanil used, additional analgesia need, mini mental test score, Riker agitation and sedation score, patient comfort score, modified aldrete recovery score and intraoperative and postoperative complications (tachycardia, bradycardia, hypertension, hypotension, pruritus, nausea-vomiting, arrhythmia) were recorded. Results: There was no statistically significant difference between the intraoperative and postoperative complications of Group P and Group K who underwent partial hip replacement (PKP) surgery; however, while remifentanil iv infusion was at an average of 0.13 mcg/kg/min in Group K, it was administered at 0.05 mcg/kg/min in Group P and a statistically VIII significant difference was found (p<0.01) . Group P, BIS score values show a statistically significant difference when preoperative measurement and last measurement of the surgery (after awakening) are compared (p=0.01). Group K, BIS score values show a statistically significant difference when preoperative measurement and last measurement of the surgery (post-awakening) are compared (p=0.01). When the BIS score values were compared between Group P and Group K, no statistically significant difference was found (p=0.14). Postoperative MAP and pulse values were lower in Group P compared to group K and there was a statistically significant difference when MAP (p<0.01) and pulse (p<0.01) values were compared (p<0.05). VAS (p<0.01) and NRS (p<0.01) evaluated postoperatively at 0. min, 10. min, 30. min, 60. min, 2nd hour, 4th hour, 6th hour, 12th hour and 24th hour scores were lower in Group P in both groups and there was a statistically significant difference (p<0.05). There was a statistically significant difference between Group P and Group K when postoperative tramadol use was compared (p=0.04). There was a statistically significant difference between Group P and Group K in modified aldrete recovery scoring (p<0.01). There was a statistically significant difference between Group P and Group K in the comparison of patient comfort score (p=0.04). Conclusion: VAS and NRS scores, amounts of tramadol and remifentanil used, patient comfort score, postoperative MAP and pulse values of patients who underwent PENG block for intraoperative and postoperative analgesic purposes in patients who underwent PKP surgery show a statistically significant difference compared to the control group who did not receive PENG block. This shows that PENG block application is a good option as part of intraoperative and postoperative multimodal analgesia in patients scheduled for PKP. Keywords: VAS and NRS scores, BİS score.