Sema TUNCER, Gökhan AYSOLMAZ, Ruhiye REİSLİ, Atila EROL, Naime YALÇIN, Alper YOSUNKAYA

Sezaryen cerrahisinde ON-Q ağrı pompa sistemi ile uygulanan subfasiyal levobupivakain infüzyonunun postoperatif analjezi ve tramadol tüketimine etkisi

Amaç: Bu çalışmada, sezaryen operasyonlarında ON-Q ağrı pompa sistemi ile uygulanan subfasiyal levobupivakainin, postoperatif ağrı kontrolü ve tramadol kullanımına etkileri araştırıldı. Gereç ve Yöntem: Sezaryen operasyonu geçirecek ASA I-II grubu 50 hasta çalışmaya dahil edildi ve randomize olarak iki gruba ayrıldı. Bütün olgulara standart genel anestezi uygulandı. Grup I’e, ON-Q ağrı pompa sistemi uygulanmadı ve kontrol grubu olarak kabul edildi. Grup II’ye ON-Q ağrı pompa sistemi ile %0.25’lik levobupivakain infüzyonu 4 ml/sa hızda 24 saat uygulandı. Cerrahinin sonunda tüm olgulara hasta kontrollü analjezi cihazı ile i.v. tramadol uygulandı. Ağrı skorları 2., 6., 12. ve 24. saatlerde değerlendirildi. Çalışma sonunda tramadol tüketimi ve yan etkiler kaydedildi. Bulgular: Ağrı skorları ve tramadol tüketimi levobupivakain grubunda, kontrol grubuna göre daha düşük bulundu (p

The effects of the administration of subfacial levobupivacaine infusion with the ON-Q pain pump system on postoperative analgesia and tramadol consumption in cesarean operations

Objectives: In this study, the effects of administration of subfacial levobupivacaine infusion with the ON-Q pain pump system were investigated in elective cesarean operations for postoperative pain control and tramadol-sparing effect. Methods: Fifty ASA I-II patients scheduled for cesarean operation were enrolled into this study. Patients were randomly divided into two groups: Group I served as a control group, without the ON-Q pain pump system, whereas Group II received the ON-Q pain pump system with subfacial 0.25% levobupivacaine infusion for 24 hours at 4 ml/hour. All patients received a standard anesthetic protocol. At the end of the surgery, all patients received tramadol i.v. via a PCA (Patient Controlled Analgesia) device. Pain scores were assessed at 2, 6, 12 and 24 hours postoperatively. Tramadol consumption and adverse effects were noted in the first 24 hours following surgery. Results: The pain scores were significantly lower in the levobupivacaine group when compared with the control group (p<0.05). The cumulative tramadol consumption was lower in the levobupivacaine group than in the control group (p<0.05). Group II used less antiemetic and had less postoperative nausea and vomiting, and the difference was statistically significant (p<0.05). Conclusion: No complication occurred as a result of the ON-Q pain pump system. Subfacial levobupivacaine infusion with the ON-Q pain pump system diminished postoperative pain and the need for tramadol use following cesarean operations.

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