Gül Köknel TALU, N.Süleyman ÖZYALÇIN, Rukiye BALSAK, MELTEM SAVRAN KARADENİZ

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Ketamin ve ropivakainin pediatrik hastalarda etkinliği: Plasebo kontrollü, çift kör çalışma

Ketamin ve Ropivakainin pediatrik hastalarda etkinliği Randomize, plasebo kontrollü ve çift kör olarak düzenlenen bu çalışmada, ropivakainle kaudal blok altında elektif herni tamiri yapılacak pediatrik hastalarda preemptif intravenöz ketamin ve plasebonun etkilerinin karşılaştırılması ve değerlendirilmesi yapılmıştır. MATERYAL-METOD: planlı herni tamiri operasyonu geçirecek olan 1- 12 yaşları arasında, ASA I-II grubu 60 hasta çalışmaya dahil edilmiştir. Hastalar randomize olarak 3 gruba ayrılmıştır. Grup K hastalara anestezi indüksiyonundan önce intravenöz yolla 0.5 mg/kg ketamin, Grup R hastalara kaudalden 0.7 mg/kg %0.2 ropivakain ve intravenöz yoldan 2 ml normal salin, Grup RK hastalara kaudalden 0.7 mg/ml %0.2 ropivakain ve intravenöz 0.5 mg/kg ketamin verilmiştir. Anestezi süresince hastaların kalp hızı, end-tidal CO2, pulse oksimetri, kan basınçları ve BIS(bispektral indeks) takibi yapılmıştır. Postopertif analjezi etkinliği Objektif Ağrı Skalası (OPS) ile değerlendirilmiş ve analjezik ihtiyacı operasyon sırasında ve sonrasında kayıt edilmiştir. BULGULAR: Grup R ve Grup RK arasında fentanil tüketiminde faklılık görülmedi, anestezi sırasında Grup K hastalardaki fentanil tüketimi önemli derecede yüksekti, Grup R ve Grup RK, Grup K ile karşılaştırıldığında OPS değeri önemli derecede yüksek olarak görüldü. SONUÇ: Elektif herni tamiri yapılan pediatrik hasta grubunda kaudal uygulamalarda uygun dozlarda ropivakain ile peroperatif ve postoperatif dönemlerde tatmin edici analjezi sağlanabilmiş ve yan etki görülmemiştir. Uygulanan ketamin dozlarında ise preemptif etki elde edilememiştir.

The efficacy of preemptive ketamine and ropivacaine in pediatric patients: A placebo controlled, double-blind

OBJECTIVE: We have evaluated and compared the preemptive efficacy of intravenous ketamine with placebo and caudal ropivacaine in pediatric patients going under elective hernia repair. METHODS: 60 ASAI-II pediatric patients ages between 1-12. The patients were divided into 3 groups randomly. Group K patients had 0.5mg/kg ketamine by intravenous route before induction,Group R patients had 0.7 mg/kg 0.2% ropivacaine caudally and 2ml normal saline intravenously,Group RK patients had 0.7 mg/kg 0.2% ropivacaine caudally and 0.5mg/kg ketamine by intravenous routeAll patients had standard anesthesia technique. Heart rate (HR), pulse oximetry, and systolic and diastolic blood pressure (BP), and BIS (bispectral index) were obtained during anesthesia, In addition, end-tidal carbon dioxide concentration was monitored. The efficacy of postoperative analgesia was documented by objective pain scale (OPS). Analgesic requirements during and after the surgery documented RESULTS: While there was no significant differences in fentanyl consumption between the groups GR and GRK, fentanyl consumption was found to be significantly higher in group K during anesthesia.When compared with GR and GRK, GK had significantly higher OPS values. During postoperative period Group K patients demanded for additional analgesics in significantly shorter time than group R and Group K patients. GK patients had consumed significantly higher amounts of acetaminophen after surgery CONCLUSION: Caudal application of ropivacaine in appropriate doses provides satisfactory peroperative and postoperative analgesia with no side effects in pediatric patient group going under elective hernia repair where as ketamine with the applied doses has no preemptive effect.
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Ağrı-Cover
  • ISSN: 1300-0012
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2018
  • Yayıncı: Ali Cangül
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