Amaç: Bu çalışmada, postoperatif ağrı tedavisinde hasta kontrollü analjezide kullanılan morfin ile kombine edilen intravenöz parasetamolün analjezik etkinliği, yan etkiler ve morfin tüketimine etkisi değerlendirildi. Gereç ve yöntem: Çalışmaya inguinal herni operasyonu geçirecek, ASA I-II grubu 20-77 yaş arası 40 hasta dahil edildi. Randomize olarak iki gruba [Grup I (Kontrol, n=20) ve Grup II (Parasetamol, n=20)] ayrılan olgulara, standart genel anestezi protokolü uygulandı, iki gruba da operasyon sonlanmadan 15 dakika önce intravenöz 0.05 mg kg'1 morfin uygulandı. Grup II' ye operasyon sonlanmadan 15 dakika önce ve postoperatif ilk 24 saat süresince 6 saat aralıklarla, 1 gr parasetamol 100 mL içinde 10 dakikada intravenöz infüzyon şeklinde verildi. Postoperatif her iki grubada Hasta Kontrollü Analjezi (HKA) cihazı ile intravenöz morfin uygulandı. Ağrı ve sedasyon skorları 15 ve 30 dakika ile 1, 2, 4, 6, 8,12, 16 ve 24. saatlerde değerlendirildi. Çalışma sonunda total morfin tüketimi ve yan etkiler kaydedildi. Bulgular: Morfin tüketimi Grup IF de daha düşük bulundu (p0.05). Sonuç: Inguinal herni operasyonlarında intravenöz parasetamol ile morfinin birlikte kullanımı, postoperatif ilk 24 saate kullanılan morfin tüketimini azaltmakta fakat yan etkilerde azalmaya neden olmamaktadır.
Objective: In this study, the effects of intravenous paracetamol, combined with patient controlled intravenous morfin analgesia, were investigated postoperative analgesia and morfin consumption. Method: Fourty, ASA I-II, 20-77 aged patients scheduled for inguinal hernia operation were enrolled to this study. All patients received a standardized anesthetic protocol and were randomly divided into two groups Group I [(Control, n=20) and Group II (Parasetamol, n=20)]. Both of the groups received 0.05 mg kg'1 morphin 15 min before the end of the surgery. Group II patients received 1 gr parasetamol in 100 mL as intravenous infusion 15 min before end of the surgery and repeated at every 6 hours during postoperatively first 24 hours. Both of the groups received morphin intravenously at the end of the surgery via a patient controlled analgesia (PCA) device. Pain and sedation scores were assessed at 15, 30th minutes and 1,2, 4, 6, 8, 12, 16, 24th hours after surgery. Morphine consumption and adverse effects were noted after the study. Results: The morphine consumption was lower in the Group II than Group I (p<0.05). No significant difference was observed in sedation scores, pain scores and advers effects between the groups (p>0.05). Conclusion: Intravenous paracetamol usage with morphine decreases morphine consumption at first 24 hours but does not decrease side effects in inguinal hernia operations.
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