Osman Nuri AYDIN, Feray GÜRSOY, KAMİL VARLIK EREL

Batın operasyonları sonrası ağrı sağaltımında fentanil ve tramadol ile intravenöz-hasta kontrollu analjezi

Bu çalışmada; major abdominal cerrahi sonrası ağrı sağaltımında tramadol ile fentanilin intravenöz hasta kontrollü analjezide (HKA) etkinliklerinin, komplikasyonlarının ve maliyetlerinin karşılaştırılması amaçlandı. Çalışma; Etik Kurul onayından sonra intraabdominal major elektif cerrahi geçirecek 60 olgu iki eşit gruba ayrılarak çift kör, randomize, prospektif olarak gerçekleştirildi. HKA amacıyla fentanil uygulanan grupta (Grup F); yükleme dozu 1µg kg-1, bolus dozu 15 µg iv ve kilitli kalma süresi 10 dk, tramadol uygulanan grupta (Grup T) ise; yükleme dozu 1.5 mg kg-1, bolus dozu 20 mg iv ve kilitleme kalma süresi 15 dk olarak uygulandı. Vizüel analog skala (VAS) skorları, sedasyon skorları ve komplikasyonlar kaydedildi. Hasta, doktor ve hemşire memnuniyeti postoperatif dönemin 2, 6 ve 24. saatlerinde tespit edildi. Her iki ilacın total maliyetleri hesaplandı. Sedasyon skorları ve VAS 24 saat içinde devamlı olarak azaldı. Postoperatif ikinci saatte VAS değeri tramadol grubunda fentanil grubundan istatistiksel olarak anlamlı derecede yüksek bulundu (p

Anahtar Kelimeler:

Masraflar ve maliyet analizi, Cerrahi işlemler, elektif, Tramadol, İleriye dönük çalışma, Ameliyat sonrası dönem, Ameliyat sonrası komplikasyonlar, Çift kör metot, Analjezi, hasta kontrollü, Fentanil, Ağrı, ameliyat sonrası, Sindirim sistemi cerrahi işlemleri

Intravenous-patient controlled analgesia with fentanyl or tramadol in postoperative pain therapy

The purpose of this study was to evaluate the effects, complications and cost of fentanyl and tramadol in postoperative pain therapy after major intraabdominal surgery. After approval of local ethic committe, the double-blind, randomized and prospective study was performed in 60 patients undergoing elective intraabdominal surgery. The effects of intravenous (IV) fentanyl (Group F) were compared with tramadol (Group T), (Loading dose was 1 µg kg<sup>-1</sup> and 1.5mg kg<sup>-1</sup> bolus dose was 15 mg and 20 mg, lock out time was 10 and 15 minutes respectively). Visual analog scale (VAS) scores, sedation scores and complications were recorded. Patients', doctors' and nurses' satisfaction rates were inquired at 2nd, 6th and 24th hours. Total cost of the both drugs were calculated. Sedation scores and VAS scores decreased continuously in 24 hours. VAS was significantly higher in the Group T than the Group F at 2nd hours postoperatively (p<0,05). Sedation scores, satisfaction rates of patients, doctors and nurses, and complications were similar in both groups. The total cost of fentanyl was three times lower than tramadol (p<0.05). Postoperative pain therapy with fentanyl has similar efficiency when compared with tramadol except postoperative second hour. Major advantage of using fentanyl is the lower cost of therapy.

Keywords:

Costs and Cost Analysis, Surgical Procedures, Elective, Tramadol, Prospective Studies, Postoperative Period, Postoperative Complications, Double-Blind Method, Analgesia, Patient Controlled, Fentanyl, Pain, Postoperative, Digestive System Surgical Procedures,

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