TOLGA KOYUNCU, GONCA OĞUZ, Seda AKBEN, Sevinç NAS, SÜHEYLA ÜNVER

Modifiye radikal mastektomi ameliyatlarında perioperatif kullanılan pregabalinin ameliyat sonrası ağrı ve opioid tüketimi üzerine etkisi

Amaç: Bu çalışmada, modifiye radikal mastektomi (MRM) ameliyatı uygulanan hastalarda perioperatif kullanılan pregabalinin ameliyat sonrası ağrı ve opioid tüketimi üzerine etkileri araştırıldı. Gereç ve Yöntem: Çalışmaya MRM ameliyatı planlanan ASA 1-2 60 kadın hasta dahil edildi. Hastalar rastgele ikiye ayrılarak her gruba 30’ar hasta alındı. Pregabalin grubuna ameliyattan bir saat önce 150 mg oral pregabalin, plasebo grubuna içi boş kapsül verildi. Anestezi indüksiyonu her iki grupta da pentotal, fentanil ve roküronyum, idame ise sevofluran, N2O ve O2 ile sağlandı. Ameliyattan 12 saat sonra pregabalin grubundaki hastalara 75 mg pregabalin verilirken, plasebo grubuna tekrar boş kapsül verildi. Tüm hastalara cerrahi bitiminden bir saat önce 8 mg iv lornoksikam, 30 dk önce 4 mg ondansetron yapıldı. Her iki gruba da ameliyat sonrası analjezi için morfinle hazırlanmış hasta kontrollü analjezi cihazı bağlandı. Ameliyat sonrası VAS ağrı skorları, hemodinamik parametreler, morfin tüketimi, bulantı, kusma, sedasyon ve baş dönmesi gibi yan etkiler takip edilerek kaydedildi. Bulgular: Demografik parametreler benzerdi. VAS ağrı skorları pregabalin grubunda birinci dk, 30. dk, bir, dört, sekiz ve 12 saatlerde anlamlı olarak düşüktü (p

The effects of pregabaline on postoperative pain and opioid consumption used perioperatively in patients undergoing modified radical mastectomy

Objectives: In this study, effects of pregabaline on postoperative pain and opioid consumption used perioperatively in patients under- going modified radical mastectomy(MRM) were investigated. Methods: Sixty ASA 1-2 patients scheduled for MRM were included. Patients were randomly divided into two and 30 patients were allocated into each group. Group Pregabaline was given pregabaline 150mg 1hr before operation and Group Placebo empty capsule. In both groups, anesthesia induction was obtained by penthotal, fentanyl and rocuronium and maintainence by sevoflurane, N2O and O2. Twelve hr after operation, Group Pregabaline was administered pregabaline 75mg while Placebo group received empty capsule again. All patients received lornoxicam 8mg iv 1hr before end of surgery and ondansetrone 4mg 30min before. Patient-controlled analgesia device prepared with morphine was connected to both groups for postoperative analgesia. Postoperative VAS pain scores, he- modynamic parameters, morphine consumption, side-effects like nausea-vomiting, sedation and dizziness were followed and recorded. Results: Demographic parameters were similar. VAS scores were significantly lower in Group Pregabaline at 1, 30min, 1,4,8 and 12hr (p<0.05). There was no significant difference in postoperative morphine consumption and need for additional dose, although they were higher in Placebo group. The patients in Placebo group had higher bothersome scores for side-effects. Hemodynamic param- eters and other side-effects were similar. Conclusion: In our study, we showed that pregabalin administered perioperatively increased postoperative analgesic efficacy in MRM operations without making significant side effect, but did not change opioid consumption. We think that further studies about this topic must be held with different dose and patient groups.

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