Perihan EKMEKÇİ, ZÜLEYHA KAZAK BENGİSUN, BATURAY KANSU KAZBEK, SALİH ERPULAT ÖZİŞ, Huri TAŞTAN, Arif Hikmet SÜER

The efficacy of adding dexketoprofen trometamol to tramadol with patient controlled analgesia technique in post-laparoscopic cholecystectomy pain treatment

Amaç: Giderek artan sayıda yapılan günübirlik bir cerrahi girişim olan laparoskopik kolesistektomide ağrı tedavisi önemli bir sorun - dur. Her ne kadar laparoskopik cerrahi günübirlik bir girişim olarak kabul edilse de, hastalar sıklıkla ağrı nedeniyle hospitalize edil- mekte ve bu da opioid tüketimini ve opioidlerin sebep olduğu yan etkileri arttırmaktadır. Bu çalışmanın amacı, laparoskopik kolesis- tektomi sonrasında ağrı tedavisi için hasta kontrollü analjezi (PCA) yönteminde tramadole deksketoprofen trometamol eklenmesi - nin etkinliğini araştırmaktır. Gereç ve Yöntem: Çalışmaya 18-65 yaşları arasında ASA I-II risk grubundan 40 hasta alındı ve kapalı zarf yöntemi ile randomi - ze edildi. Grup TDde 600 mg tramadol ve 100 mg deksketoprofen, Grup Tde ise 600 mg tramadol 100 ml %0.9 normal saline ek- lenerek PCA hazırlandı. Postoperatif dönemde VAS >40 olması durumunda 8 mg lornoksikam iv verildi. Bulgular: Yan etki profli açısından (hipotansiyon, bradikardi, sedasyon) iki grup arasında istatistiksel olarak anlamlı bir fark yok- tu, fakat Grup Tde 4 hasta bulantıdan, 3 hasta ise kusmadan yakındı. Grup TDde opioid tüketimi daha düşük ve hasta memnu - niyeti daha yüksekti. Sonuç: Bu çalışma laparoskopik kolesistektomi sonrasında tramadole deksketoprofen trometamol eklenmesinin hasta kontrollü analjezi yönteminde VAS skorlarını düşürdüğünü, hasta memnuniyetini arttırdığını ve opioid tüketimini azalttığını göstermiştir.

Laparoskopik kolesistektomi sonrası ağrı tedavisinde hasta kontrollü analjezi yönteminde tramadole deksketoprofen trometamol eklenmesinin etkinliği

Objectives: Pain treatment in laparoscopic cholecystectomy, which is performed in increasing numbers as an ambulatory procedure, is an important issue.Although laparoscopic cholecystectomy is regarded as an ambulatory procedure, patients are often hospitalized due to pain and this increases opioid consumption and side efects caused by opioids. Tis study aims at evaluating the efcacy of adding dexketoprofen trometamol to tramadol with patient controlled analgesia (PCA) in post- laparoscopic cholecystectomy pain treatment. Methods: 40 patients in ASA I-II risk groups aged between 18-65 years were enrolled in the study and were randomized using closed envelope method. In Group TD 600 mg tramadol and 100 mg dexketoprofen trometamol, in Group T 600 mg tramadol was added to 100 ml 0.9% normal saline for PCA. 8 mg lornoxicam iv was given if VAS >40 in the postoperative period. Results: Tere was no statistically signifcant diference in terms of adverse efects (hypotension, bradycardia, sedation) but in Group T 4 patients complained of nausea and 3 complained of vomiting. Opioid consumption was lower and patient satisfac - tion was higher in group TD. Conclusion: Tis study has shown that adding dexketoprofen trometamol to tramadol in patient controlled analgesia follow - ing laparoscopic cholecystectomy lowers VAS scores, increases patient satisfaction and decreases opioid consumption. Key words: Dexketoprofen trometamol; laparoscopic cholecystectomy; patient controlled analgesia; postoperative pain.

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