MUSTAFA ARSLAN, Ramazan ÇİÇEK, Bahadır CELEP, Hüseyin YILMAZ, Hülya ÜSTÜN KALENDER

Tiroidektomi sonrası postoperatif ağrıda intravenöz parasetamolün analjezik etkinliğinin lornoksikamla karşılaştırılması

GİRİŞ: Bu çalışmanın amacı iv parasetamol ve lornoksikamın postoperatif ağrıda ne derece etkili olduğunu ve tramadol kullanımını ne oranda azalttığını ortaya koymaktır. GEREÇ-YÖNTEM: Çalışmaya elektif tiroidektomi ameliyatı yapılan ASA I-II grubundan, 18-72 yaş arasında, 60 hasta, randomize olarak kabul edildi. GrupL’deki hastalara operasyon bitiminde iv lornoksikam 8mg, Grup P’deki hastalara iv parasetamol 1g ve GrupK’daki hastalara iv 100cc SF uygulandı. Tüm hastalara standart genel anestezi uygulandı Ek analjezi ihtiyacı olup olmaması 0-6, 6-12, 12-24 saatlik periyotlarda takip edildi. Ağrı skoru Visual Analog Skala(VAS) ile postoperatif 15.dk, 1, 2, 4, 6, 8, 12, 18 ve 24.saatlerde kaydedildi. BULGULAR: İlk analjezik gereksinim zamanı GrupL’de ortalama 127.5 dakika, GrupP’de 162.3 dakika ve Grup K’da 35.5 dakika bulundu, süre her iki grupta anlamlı şekilde artmıştı(p

Comparison of the analgesic effects of intravenous paracetamol and lornoxicam in postoperative pain following thyroidectomies

BACKGROUND: The purpose of the present study was to determine the efficacy of lornoxicam and IV paracetamol on postoperative analgesia and the reduction in tramadol consumption. METHODS: Sixty patients following thyroidectomy were enrolled in to the study who were ASA class 1-2, and aged between 18-72 years, and were randomized into three groups: GroupL receiving 8mg of iv lornoxicam, GroupP receiving iv 1g paracetamol and, GroupC receiving 100cc of iv saline solution. All patients received standard general anesthesia. The postoperative salvage analgesic consumption was recorded at 0-6, 6-12 and 12-24 hour intervals. Pain scores were evaluated with a visual analogue scale at 15min, and 1, 2,4,6,8,12,18, and 24h postoperatively. RESULTS: The time to first analgesic requirement was approximately 127.5min in GroupL, 162.3 in GroupP and 35.5min in GroupC, and found to be significantly prolonged in GroupL and GroupP. Pain scores were significantly lower in GroupP and GroupL at 15 min, 1, 8, 12, and 18hours. Twenty four hour analgesic consumption was significantly lower in GroupP and GroupL compared to GroupC. Supplemental analgesics requirement was as follows: 100% in GroupC, 50% in GroupL and 55% in GroupP. The degree of satisfaction of postoperative pain management was exellent 90% in both GroupsL and P, and 30% in GroupC. CONCLUSION: Administration of lornoxicam and iv paracetamol following thyroid surgery decreased the postoperative pain scores and opioid requirement, as well as the incidence of nausea and vomiting; while prolonging the time to the first analgesic supplement.

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