Effects of preoperative lornoxicam versus tramadol on postoperative pain and adverse effects in adult tonsillectomy patients
Amaç: Erişkin hastalarda ameliyat öncesi uygulanan lornoksikam ile tramadolün tonsillektomi ağrısı üzerine etkinliği değerlendirildi. Gereç ve Yöntem: Prospektif, çift kör, randomize ve klinik çalışma, Gazi Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Cerrahisi Ameliyathanesinde ASA I-II, 18-55 yaş arası, kadın ve erkek 40 olguda gerçekleştirildi. Tonsillektomi hastaları iki gruba ayrıldı. Grup L’deki hastalara 8 mg lornoksikam ve Grup T’deki hastalara 50 mg tramadol genel anestezi indüksiyonundan hemen önce intravenöz yolla uygulandı. Anestezi indüksiyonu ve kontrollü ventilasyon altında sürdürülen anestezi idamesi (propofol, atraküryum, nitroz oksit ve sevoflurane) ve cerrahinin tipi standardize edildi. Bulgular: Anestezi sırasında arter basıncı ve kalp atım hızı monitorize edildi. Ameliyattaki kanama miktarı aynı operatör tarafından 5 nokta skalası kullanılarak ameliyat sonunda değerlendirildi. Ameliyattan sonra yutkunma sırasındaki ağrı hastanın hangi gruba dahil olduğunu bilmeyen araştırmacı tarafından postanestzi bakım odasına gelişte (T0), 30. dakikada (T1), 1. saatte (T2), 2. saatte (T3), 3. saatte (T4), 4. saatte (T5), 5. saatte (T6) ve 6. saatte (T7) değerlendirildi. Ameliyat sonrası ilk 6 saatte VRS ≥2 olduğunda 1mg.kg-1 im meperidin ilave analjezik olarak yapıldı. Ameliyat sonrası ilk 6 saatteki yan etkiler (bulantı kusma ve ameliyat sonrası kanama) kaydedildi. T1 ve T2 ağrı skorları Grup T’de Grup L’den yüksek bulundu (sırasıyla p=0.049, p=0.007). İlk 6 saatte ilave analjezik gereksinimi olan olgu sayısı Grup L’de Grup T’den düşük bulundu. Bulantı kusma, ameliyattaki ve ameliyat sonrası kanama verilerinde gruplar arasında fark bulunmadı. Sonuç: Erişkin hastalarda, posttonsillektomi ağrısı üzerine ameliyat öncesi uygulanan 8 mg lornoksikam 50 mg tramadolden daha etkin, yan etkileri ise benzerdir.
Tonsillektomilerde preoperatif uygulanan lornoksikamın analjezik etkinliğinin ve yan etkilerinin tramadol ile karşılaştırılması
Objectives: This study assessed the efficacy and adverse effects of preoperatively administered lornoxicam versus tramadol in adults, for post-tonsillectomy pain. Methods: This prospective, double blind, randomized, clinical research was performed in the Ear, Nose and Throat Surgery Room in the Department of Anesthesia and Reanimation, Gazi University Faculty of Medicine. Forty American Society of Anesthesiologists (ASA) status I-II patients of both gender, aged 18-55 years, were included. Results: Tonsillectomy patients were divided into two groups: Those in Group L received 8 mg lornoxicam and in Group T received 50 mg tramadol intravenously just before induction of general anesthesia. Induction and maintenance of anesthesia (propofol, atracurium, nitrous oxide and sevoflurane) were standardized. Heart rate and systolic and diastolic arterial pressure data were monitored during the anesthesia. Intra-operative bleeding was scored by the same operator using a 5-point scale at the end of the surgery. Postoperative pain on swallowing was scored by a blinded anesthesiologist using Verbal Rating Scale (VRS) on arrival in the Post Anesthesia Care Unit (T0), at 30 min (T1), 1h (T2), 2h (T3), 3h (T4), 4h (T5), 5h (T6), and 6h (T7) thereafter. During the first postoperative 6 hours, when VRS ≥2, 1mg.kg-1 im meperidine was used as a rescue analgesic. Adverse effects in the postoperative 6h period were noted. T1 and T2 pain scores in Group T were higher than in Group L (p=0.049, p=0.007, respectively). The number of patients requiring rescue analgesics during the first 6 hours in Group L was lower than in Group T. Nausea-vomiting, bleeding and postoperative hemorrhage values were similar between Group L and Group T. Conclusion: Preoperative 8 mg lornoxicam was more effective than 50 mg tramadol with respect to early postoperative tonsillectomy pain in adult patients, and side effects were similar.
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- ISSN: 1300-0012
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 2018
- Yayıncı: Ali Cangül
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