Ela ERTEN, Ferruh BİLGİN, Nedim ÇEKMEN, Mehmet Özgür ÖZHAN, Mehmet Emin ORHAN, Ercan KURT

Elektif laminektomi operasyonu geçirecek hastalarda preoperatif verilen gabapentînin farklı dozlarının postoperatif analjeziye etkisi

Amaç: Çalışmamızda, elektif laminektomi operasyonu geçirecek hastalarda preemptif analjezi sağlamak için preoperatif verilen farklı dozlardaki gabapentinin postoperatif ağrı, tramadol tüketimi ve ek analjezik gereksinimi üzerine olan etkisi araştırılmıştır. Yöntem: 59 ASA I-II hasta randomize şekilde operasyondan 1 saat önce plasebo kapsül verilen kontrol grubu (Grup 1, n=20), preemptif analjezi sağlamak için 900 mg gabapentin verilen (Grup 2, n=20) ve 1200 mg gabapentin verilen (Grup 3, n=19) 3 gruba ayrıldı. Ameliyatın sonunda her 3 gruptaki hastalara hasta kontrollü analjezi (HKA) cihazı ile intravenöz (i.v.) tramadol verildi. Postoperatif dönemde hastaların 1., 2., 3., 4., 6., 8., 12. ve 24. saatlerde ağrıları vizüel ağrı skalası (VAS) ile değerlendirildi. Total tramadol kullanımı, bolus butonunu kullanma sayıları ve ek analjezik kullanımları kaydedildi. Bulgular: 1,2,3. saatlerde VAS skoru Grup 1 ve 2'de Grup 3'e göre belirgin yüksek olarak gözlenirken, Grup 1 ve 2 arasında anlamlı farklılık tespit edilmedi (sırasıyla 1., 2., 3. saat; p=0.02, p-0.01, p=0.01). Total tramadol tüketimi Grupl ve 2'de (sırasıyla 390.5 ± 75.3 mg, 356.3 ± 64.3 mg) benzerken Grup 3'de en azdı (267.5 ± 97.8 mg). Ek analjezik ihtiyacı en çok Grup 1 ve 2'de gözlendi ve bu iki grup arasında analjezik ihtiyacı istatistiksel olarak benzer bulundu (p=0.93). En az ek analjezik ihtiyacı Grup 3' de gözlendi (1.63 ± 0.68) ve Grup 1 ve 2'ye göre istatistiksel olarak fark anlamlı yüksekti (p

The analgesic effect of different doses of preemptive gabapentin preoperatively on patients undergoing elective laminectomy during postoperative period

Objective: In our study the effect of different doses of gabapentin, given preoperatively in order to obtain preemptive analgesia to the patients undergoing an elective laminectomy operation, has been investigated for postoperative pain, tramadol consumption and the necessity of an additional analgesic. Methods: 59 ASA I-II patients were divided into three groups randomly: (Group 1: "The control group", n=20) was given placebo capsule an hour before the operation; 900 mg gabapentin was given to the second group in order to obtain a preemptive analgesia (Group 2, n= 20), and the third group (Group 3, n=19) was given 1200 mg gabapentin with the same manner. At the end of the operations we gave tramadol intravenously (i.v.) via patient controlled analgesia device (PCA) to all the patients. In the postoperative period, the pain scores of the patients at the 1st, 2nd, 3rd, 4,h, 6th, 8'h, 12th and the 24"' hours were evaluated by visual analog scale (VAS). Their cumulative usage of tramadol, bolus button-usage numbers and their usages of additional analgesic consumption were recorded. Results: VAS scores for the first 3 hours were meaningfully different among the groups. Although the Group 1 and the Group 2 had the highest VAS scores during the Is', 2nd and the 3rd hours, no significant difference was established between these two groups. While the cumulative tramadol consumptions were similar among Group 1 and 2 (390.5 ± 75.3 mg and 356.3 ± 64.3 mg, respectively), it was the lowest in Group 3 (267.5 ± 97.8 mg). The necessity of an additional analgesic was observed higher in the Group 1 and the Group 2 and it was found similar among them (p=0.93). The need for analgesic was less in group 3 and the difference was significant compared to group 1 and 2 (p<0.001). Regarding to demand numbers on PC A device, no difference was observed between group 1 and 2. However, there was a significant difference between group 1 and 3 as well as between group 2 and 3 (p<0.001 and p=0.003), respectively. Nausea and vomiting were the most observed side effects. In Group 1 and 2, they were highly observed, but in the Group 3 it was less. Conclusion: In conclusion, it has been think that the preoperative use of single dose of 1200 mg gabapentin in elective laminectomy operations given to the patients an hour before the operation provided an effective analgesia in the early postoperative period.

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