MEHMET AKSOY, İLKER İNCE, Ali AHISKALIOĞLU, Sadullah KELEŞ, Ömer DOYMUŞ

Şaşılık cerrahisi uygulanan hastalarda preoperatif ve postoperatif uygulanan intravenöz parasetamolün postoperatif bulantı ve kusma üzerine etkisi: Bir prospektif randomize çalışma

Amaç: Bu prospektif randomize çalışma, şaşılık cerrahisi uygulanan çocuklarda preoperatif ve postoperatif uygulanan intravinöz parasetamolün postoperatif bulantı ve kusma üzerine olan etkinliğini karşılaştırmayı amaçladı.Gereç ve Yöntem: Doksan altı hasta randomize olarak 3 eşit gruba ayrıldı (n=32). Preoperatif parasetamol grubunda, ameliyattan bir saat önce 20 dakika sürecek şekilde 15 mg kg-1 parasetamol (1.5 ml kg-1) intravenöz (IV) infüzyon ve iyileşme odasında ise serum fizyolojik IV infüzyonu (1.5 ml kg-1) uygulandı. Postoperatif parasetamol grubunda ameliyattan bir saat önce 20 dakika boyunca serum fizyolojik (1.5 ml kg-1) IV infüzyonu ve sonra iyileşme odasında 15 mg kg-1 parasetamol (1.5 ml kg-1) verildi. Kontrol grubunda, hastalar preoperatif ve postoperatif dönemde serum fizyolojik (1.5 ml kg-1) IV infüzyonu aldı. Postoperatif ağrı durumu ilk 24 saat boyunca Yüz Ağrı Ölçeği kullanılarak değerlendirildi. İyileştirme odasında bir gözlemci postoperatif 24 saat süresince ağrı skorunu, bulantı ve kusma şikayetlerini, analjezik ihtiyacını ve antiemetik ilaç ihtiyacını kaydetti.Bulgular: Ameliyattan sonraki ilk 0-6 saatteki bulantı ve kusma insidansı preoperatif parasetamol grubunda kontrol grubuna (p

Effect of intravenous preoperative versus postoperative paracetamol on postoperative nausea and vomiting in patients undergoing strabismus surgery: A prospective randomized study

Objectives: This prospective randomized study aimed to compare the efficacy of preoperative versus postoperative paracetamol on postoperative nausea and vomiting (PONV) in children undergoing strabismus surgery.Methods: Ninety-six patients were randomly divided into three equal groups (n=32). In the preoperative paracetamol group, patients received intravenous (IV) infusion of paracetamol [15 mg kg−1 (1.5 ml kg−1)] 1 h before surgery over 20 min and that of saline (1.5 ml kg−1) in the recovery room. In the postoperative paracetamol group, patients received IV infusion of saline (1.5 ml kg−1) 1 h before surgery over 20 min and that of paracetamol [15 mg kg−1 (1.5 ml kg−1)] in therecovery room. In the control group, patients received the IV infusion of saline (1.5 ml kg−1) pre- and postoperatively. Postoperative pain condition was evaluated using the Faces Pain Scale. In the recovery room, an observer recorded the pain score, complaints of nausea and vomiting, the need for rescue analgesics, and the need for antiemetic drug during 24 h postoperatively.Results: The incidence of nausea and vomiting during the first 0–6 h postoperatively was significantly lower in the preoperative paracetamol group than in the control and postoperative paracetamol groups (p

PDF

___

1. Klockgether-Radke A, Neumann S, Neumann P, Braun U, Mühlendyck H. Ondansetron, droperidol and their combination for the prevention of post-operative vomiting in children. Eur J Anaesthesiol 1997;14(4):362–7.
2. van den Berg AA, Lambourne A, Clyburn PA. The oculoemetic reflex. A rationalisation of postophthalmic anaesthesia vomiting. Anaesthesia 1989;44(2):110–7.
3. Kaufman S, Martin-Sheridan D. Postoperative nausea and vomiting after strabismus surgery: mechanisms, treatment, and implications for practice. CRNA 1996;7(3):139–43.
4. Elder M, Steven D, Beasley S, Wium D. Unplanned overnight hospital admission after strabismus surgery. N Z Med J 2007;120(1260):U2681.
5. Ebrahim Soltani AR, Mohammadinasab H, Goudarzi M, Arbabi S, Mohammadinasab A, Mohammadinasab F, et al. Comparing the efficacy of prophylactic p6 acupressure, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery. Acta Med Iran 2011;49(4):208–12.
6. Bicer C, Aksu R, Ulgey A, Madenoglu H, Dogan H, Yildiz K, et al. Different doses of palonosetron for the prevention of postoperative nausea and vomiting in children undergoing strabismus surgery. Drugs R D 2011;11(1):29–36.
7. Shastri N. Intravenous acetaminophen use in pediatrics. Pediatr Emerg Care 2015;31(6):444-8; quiz 449–50.
8. Pickering G, Loriot MA, Libert F, Eschalier A, Beaune P, Dubray C. Analgesic effect of acetaminophen in humans: first evidence of a central serotonergic mechanism. Clin Pharmacol Ther 2006;79(4):371–8.
9. Cok OY, Eker HE, Pelit A, Canturk S, Akin S, Aribogan A, et al. The effect of paracetamol on postoperative nausea and vomiting during the first 24 h after strabismus surgery: a prospective, randomised, double-blind study. Eur J Anaesthesiol 2011;28(12):836–41.
10. Unal SS, Aksoy M, Ahiskalioglu A, Erdem AF, Adanur S. The effect of intravenous preemptive paracetamol on postoperative fentanyl consumption in patients undergoing open nephrectomy: a prospective randomized study. Niger J Clin Pract 2015;18(1):68–74.
11. Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs 1988;14(1):9–17.
12. Lenth RV. Java Applets for Power and Sample Size [Computer software] 2006. Available at: http://www.stat.uiowa. edu/~rlenth/Power. Accessed Apr 14, 2016.
13. Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg 2011;9(8):672–7.
14. Arici S, Gurbet A, Türker G, Yavaşcaoğlu B, Sahin S. Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. Agri 2009;21(2):54–61.
15. Apfel CC, Turan A, Souza K, Pergolizzi J, Hornuss C. Intravenous acetaminophen reduces postoperative nausea and vomiting: a systematic review and meta-analysis. Pain 2013;154(5):677–89.
16. Awad IT, Moore M, Rushe C, Elburki A, O’Brien K, Warde D. Unplanned hospital admission in children undergoing day-case surgery. Eur J Anaesthesiol 2004;21(5):379–83.
17. Kovac AL. Management of postoperative nausea and vomiting in children. Paediatr Drugs 2007;9(1):47–69.
18. Howard R, Carter B, Curry J, Morton N, Rivett K, Rose M, et al; Association of Paediatric Anaesthetists of Great Britain and Ireland. Postoperative pain. Paediatr Anaesth 2008;18 Suppl 1:36–63.
19. Uysal HY, Takmaz SA, Yaman F, Baltaci B, Başar H. The efficacy of intravenous paracetamol versus tramadol for postoperative analgesia after adenotonsillectomy in children. J Clin Anesth 2011;23(1):53–7.
20. Alhashemi JA, Daghistani MF. Effects of intraoperative i.v. acetaminophen vs i.m. meperidine on post-tonsillectomy pain in children. Br J Anaesth 2006;96(6):790–5.
21. Loewen PS, Marra CA, Zed PJ. 5-HT3 receptor antagonists vs traditional agents for the prophylaxis of postoperative nausea and vomiting. Can J Anaesth 2000;47(10):1008–18.
22. Graham GG, Scott KF. Mechanism of action of paracetamol. Am J Ther 2005;12(1):46–55.
23. Högestätt ED, Jönsson BA, Ermund A, Andersson DA, Björk H, Alexander JP, et al. Conversion of acetaminophen to the bioactive N-acylphenolamine AM404 via fatty acid amide hydrolase-dependent arachidonic acid conjugation in the nervous system. J Biol Chem 2005;280(36):31405–12.
24. Sharkey KA, Darmani NA, Parker LA. Regulation of nausea and vomiting by cannabinoids and the endocannabinoid system. Eur J Pharmacol 2014;722:134–46.