Öz
İki yıl önce sivil bir ateşli silah yaralanması sonrası L2 vertebrasında şarapnel parçaları bulunan 28 yaşındaki erkek hasta kronik bel ağrısı ile başvurdu. Hastaya daha önce NSAİİ’ler, gabapentinoidler, antidepresanlar ve opioidler dâhil olmak üzere çeşitli farmakolojik tedaviler uygulanmasına rağmen yeterli ağrı kontrolü sağlanamamıştı. Omurgada yabancı cisim bulunması nedeniyle epidural girişimlerden kaçınıldı. Alternatif bir yöntem olarak T12 seviyesinde ultrason eşliğinde erektör spina plan bloğu (ESPB) uygulandı. İşlem sonrası hastada hızlı ve belirgin ağrı azalması sağlandı; ağrı skorlarında, mobilitede ve yaşam kalitesinde kalıcı iyileşme gözlendi. Bir yıllık takip süresince komplikasyon ya da semptom nüksü izlenmedi ve hasta ek analjezik girişimlere ihtiyaç duymadı. Bu olgu, omurgada retansiyonlu yabancı cisim bulunan ve geleneksel girişimsel yöntemlerin kontrendike olduğu hastalarda ESPB’nin kronik post-travmatik bel ağrısı tedavisinde güvenli ve etkili bir seçenek olabileceğini göstermektedir.
Anahtar Kelimeler: spinal ateşli silah yaralanması, kronik post-travmatik ağrı, rejyonal anestezi, erektör spina plan bloğu, ağrı tedavisi
Kaynakça
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