NURTEN İNAN, SUNA AKIN TAKMAZ, Serkan İLTAR, Işın YAZICI, Hülya BAŞAR

Total kalça protezi operasyonlarında iki multimodal analjezi yönteminin etkinliği

Amaç: Total kalça protezi operasyonlarında uygulanan iki farklı multimodal analjezi protokolünün ameliyat sonrası ağrı üzerine etkisi, hasta kontrollü analjezi ile uygulanan tramadol miktarı ve yan etki insidansı incelendi. Gereç ve Yöntem: Grup F’ye (n=18) genel anestezi öncesi sadece 3-1 femoral sinir (3-1 FS) bloğu uygulandı. Grup FD’ye (n=18) genel anestezi öncesi 40 ml %0,25’lik bupivakain ile 3-1 FS bloğu ve oral deksketoprofen uygulandı. Tüm hastalara operasyon sonunda intravenöz HKA yöntemi ile tramadol uygulandı. Grup FD’ye tramadole ek olarak, ameliyat sonrası 48 saat boyunca deksketoprofen 75 mg/gün uygulandı. Ağrı değerlendirmesi istirahat ve harekette vizüel analog skala (VAS) kullanılarak ameliyat sonrası 0., 1/2., 1., 4., 8., 12., 24. ve 48. saatte yapıldı. Aynı saatlerde yan etki de sorgulandı. Gruplar hasta memnuniyeti yönünden işlem sonunda sorgulandı ve karşılaştırıldı. Bulgular: Total tramadol miktarı grup FD’de (377,7±137,4) grup F’den (593,9±132,3) daha düşük olarak bulundu (p

The effects of two different multimodal analgesic regimens in total hip replacement surgery

Objectives: This study evaluated the effectiveness of two different multimodal analgesia protocols in terms of postoperative pain relief, tramadol consumption during patient-controlled analgesia (PCA) and side effects after total hip replacement surgery. Methods: Group F (n=18) received general anesthesia after a 3-in-1 femoral nerve block (FNB) was applied using 40 ml of bupivacaine 0.25%. Group FD (n=18) received general anesthesia after the same block and dexketoprofen p.o. was given. All patients received intravenous tramadol at the end of surgery via a PCA device. Group FD was given dexketoprofen 75 mg/day for 48 hours postoperatively. Pain scores were evaluated at 0, 1/2, 1, 4, 8, 12, 24 and 48h at rest and on movement of the hip. Side effects and global satisfaction scores in both groups were also evaluated in this setting. Results: Total tramadol consumption was lower in Group FD (377.7±137.4) than in Group F (593.9±132.3) (p<0.05). Visual analogue scale (VAS) scores were ≤3 in all follow-up periods in both groups. While in Group FD, 6 patients had nausea, 3 vomiting and 1 sedation, in Group F, 5 patients had nausea, 3 vomiting and 2 sedation. Patient global satisfaction scores in Group F were very good in 14 patients and good in 4 patients, and in Group FD were very good in 13 patients and good in 5 patients. Conclusion: Both analgesia protocols were effective in pain relief in total hip replacement patients, with similar side effects. The effect of additional dexketoprofen was to reduce postoperative tramadol consumption.

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