Postoperatif ağrı tedavisinde intravenöz hasta kontrollü analjezi yöntemi ile kullanılan tramadol, tramadol-metamizol ve tramadol lornoksikamın karşılaştırılması
Bu çalışmada, alt abdominal cerrahide intravenöz HKA yöntemi ile kullanılan tramadol, tramadol-metamizol ve tramadol-lornoksikam kombinasyonlarının postoperatif analjezik etkilerinin karşılaştırılması amaçlandı. Alt abdominal cerrahi girişim uygulanacak 60 erişkin kadın hasta çalışmaya dahil edildi. Hastalar randomize olarak üç gruba ayrıldılar. Grup I (tramadol) için, 50 ml izotonik NaCl içinde 500 mg tramadol (10 mg/ml tramadol); Grup II (tramadol- metamizol) için, 50 ml izotonik NaCl içinde 250 mg tramadol + 3000 mg metamizol (5 mg/ml tramadol + 60 mg/ml metamizol) ve Grup III (tramadol- lornoksikam) için ise, 50 ml izotonik NaCl içinde 250 mg tramadol + 20 mg lornoksikam (5 mg/ml tramadol + 0,4 mg/ml lornoksikam ) içeren solüsyonlar hazırlandı. Her üç grupta da operasyon bitiminden 30-40 dakika önce başlanarak, 10 ml, 30 dakikada gidecek şekilde yükleme dozu uygulandı. Hasta ağrıdan ilk yakındığı zaman HKA uygulaması başlatıldı. Ağrı VAS ile ilk 1 saatte 15 dak. ara ile daha sonra ise 2., 4., 8., 12., 18. ve 24. saatlerde değerlendirildi. Eş zamanlı olarak vital parametreler, yan etkiler, sedasyon skorları ve total analjezik tüketimleri de değerlendirildi. Toplam tramadol ve antiemetik tüketimi ile postoperatif bulantı kusma insidansı, sadece tramadol kullanılan grup I’ de, diğer iki gruba göre belirgin derecede yüksek olarak tesbit edildi. Sonuç olarak; HKA yöntemi ile tramadol-metamizol ve tramadol-lornoksikam kombinasyonları uygulandığında, daha az yan etki ile etkin bir postoperatif analjezi sağlandı.
Anahtar Kelimeler:
Dipiron, İlaç kombinasyonları, Ağrı, ameliyat sonrası, Tramadol, Analjezi, hasta kontrollü
Comparison of tramadol, tramadol-metamizol and tramadol-lornoxicam administered by intravenous PCA in management of postoperative pain
Comparison of tramadol, tramadol-metamizol and tramadol-lornoxicam administered by intravenous PCA in management of postoperative pain. The aim of the present study was to compare of the postoperative analgesic effects of tramadol, combinations of tramadol-metamizol and tramadol-lornoxicam administered by intravenous Patient Control Analgesia (PCA) in lower abdominal surgery. Sixty adult, female patients who undergoing lower abdominal surgery, were included in this study. Patients were randomized to three groups. The solutions were prepared containing 500 mg tramadol in 50 ml saline (10 mg/ml tramadol) for Group I, 250 mg tramadol+3000 mg metamizol in 50 ml saline (5 mg/ml tramadol+60 mg/ml metamizol) for Group II and 250 mg tramadol+20 mg lornoxicam in 50 ml saline (5mg/ml tramadol + 0.4mg/ml lornoxicam) for Group III. Loading dose 10 ml was administrated within 30 min 30 to 40 min before the end of the surgery. PCA was started at the first complaint of pain. Pain was evaluated by VAS in every 15 minute intervals at the first hour and later at 2nd, 4th, 8th, 12th, 18th and 24th hours postoperatively. Vital parameters, side-effects, sedation scores and total analgesic consumptions were also recorded concurrently.. Total tramadol and anti-emetic consumption, the incidence of postoperative nausea and vomiting (PONV) were significantly higher in group I than the other groups (p<0.05). In conclusion; Tramadol-metamizol and tramadol-lornoxicam combinations administered by intravenous PCA provide efficient postoperative analgesia with less side effects.
Keywords:
Dipyrone, Drug Combinations, Pain, Postoperative, Tramadol, Analgesia, Patient-Controlled,
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- ISSN: 1300-0012
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 2018
- Yayıncı: Ali Cangül
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