Comparison of intravenous paracetamol and tramadol for postoperative analgesia in patients with septo-rhinoplasty

Amaç: Bu çalışmada septo-rinoplasti ameliyatı sonrası postoperatif analjezi amacıyla intravenöz yoldan verilen parasetamol ile tramadolün etkilerinin karşılaştırılması amaçlandı. Yöntem: Septorinoplasti ameliyatı olan ASA /-// risk grubuna giren yaşları 18 ile 50 arasında değişen 50 hasta çalışmaya dahil edildi. Hastalar postoperatif analjezi amacıyla rastgele iki gruba ayrıldı. Grup I'de operasyon bitimine 30 dk kala lgr i.v. parasetamol infüzyon şeklinde uygulandı. Grup II'de ise operasyon bitimine 20 dk kala i.v. 1 mg kg'1 tramadol verildi. Kör bir çalışmacı ağrı düzeyi, analjezik ihtiyacı, hasta memnuniyeti ve ilaçların yan etkilerini postoperative 1., 6., ve 24. saatlerde kaydetti. Bulgular: Postoperatif 1. saatte VAS değerleri her iki grupta benzerdi, istatistiksel olarak anlamlı bir fark bulunamadı (p> 0,05). Grup II deki VAS skoru postop 6. ve 24. saatlerde grup I den anlamlı olarak daha düşük bulundu (p< 0,05). Çalışma süresince ciddi bir yan etki gözlenmedi. Grup II de en sık görülen yan etki ilk 24 saatte bulantıydı (%25). Kusma açısından her iki grupta anlamlı bir fark görülmedi (p> 0,05), buna rağmen Grup I de Grup II ye göre anlamlı olarak bulantı daha azdı. Kortizol seviyesi postoperative dönemde her iki grupta anlamlı olarak düşüktü. Sonuç: Perioperatif intravenöz olarak verilen parasetamol' ün özellikle erken postoperatif dönemdeki hafif-orta şiddetli ağrıların tedavisi için, opioidlerle eşit derecede analjezi sağladığı görüldü.

Septo-rinoplasti ameliyatlarında postoperatif analjezi amacıyla intravenöz parasetamol ile tramadol'ün karşılaştırılması

Objective: The aim of the study was to compare the efficacy ofi.v. tramadol and i.v. paracetamol for postoperative analgesia after septo-rhinoplasty operation. Method: Fifty American Society of Anesthesiology (ASA) physical status I-II patients, aged between 18-50, receiving septo-rhinoplasty operation are included in the study. The patients were randomly divided into two groups for postoperative analgesia. In Group I; i.v. paracetamol 1 gr was infused 30 minutes before the end of the operation. In Group II; i.v. tramadol 1 mg kg1 was given 20 minutes before the end of the operation. A blinded observer recorded the pain intensity, analgesic need, patient satisfaction and side effects of drugs for postoperative at 1 h, 6 h and 24 h hours. Results: The VAS values are similar in both groups at postoperative 1st hour, no statistically significant differences were found (p> 0.05). VAS values for group II were significantly lower than group I at 6 h and 24 h postoperatively (p< 0.05). No serious side-effects were recorded during the study. The most frequent adverse effect was nausea (25%) in group II. No significant difference was found between groups in terms of vomiting (p>0.05), whereas the rate of nausea was significantly lower in group I than group II. Cortisol levels significantly decreased in both groups at postoperative period. Conclusion: Intravenous paracetamol administration provided adequate analgesia as opioids especially at early postoperative period for mild-moderate pain therapy in perioperative period.

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