Seval İZDEŞ, Elvin KESİMCİ, Saliha CAN, Orhan KANBAK

Lomber epidural anestezide %0.75 ropivakainin epidural veya intravenöz tramadol ile kombinasyonunun etkinliği

Amaç: Epidural ropivakain ile epidural veya intravenöz tramadolün kombine edilerek kullanılmasının, epidural anestezinin süresi ve kalitesine etkisini araştırmaktır. Yöntem: ASA I-II, 18-65 yaşında 45 olgu çalışmaya dahil edilip, randomize olarak üç eşit gruba ayrıldı. Grup Ve 17 mL % 0.75 ropivakain ile 2 mL % 0.9 NaCl epidural ve 2 mL % 0.9 NaCl İV, Grup W ye 17mL% 0.75 ropivakain ile 2 mL tramadol epidural ve 2 mL % 0.9 NaCl İV, Grup IH'e ise 17 mL % 0.75 ropivakain ile 2 mL% 0.9 NaCl epidural ve 2 mL tramadol İV olarak uygulandı. Vital bulgular epidural anesteziden önce ve sonra belirli aralıklarla kaydedildi. Duyusal blok epidural enjeksiyon sonrası 2, 5, 10, 15, 20, 25, 30. dk'da, daha sonra 2. saate kadar 15 dk'da bir, 6. saatin sonuna kadar 30 dk'da bir test edildi. Duyusal bloğun T10 dermatomuna ulaşma, operasyon bölgesinde ağrıyı hissetme, ilk analjezik alma, duyu fonksiyonlarının tam dönme zamanları ve yan etkiler kaydedildi. Bulgular: Duyusal bloğun başlama ve kalış süreleri ile operasyon bölgesinde ağrıyı hissetme zamanı gruplar arasında farklı değilken, ilk analjezik alma zamanı Grup II ve III'de Grup I'e göre anlamlı uzundu (p

Anahtar Kelimeler:

Anestezi, epidural, Anestezikler, birlikte kullanım, Tramadol, Anestezikler, lokal

The efficacy of epidural or intravenous tramadol combined with ropivacaine 0.75% in lumbar epidural anesthesia

Objective: The aim of the study is to investigate whether the administration of epidural ropivacaine combined with epidural or intravenous tramadol administration enhances the efficacy of epidural ropivacaine. Method: Fourty-five ASA I-II patients, aged 18-65 years, scheduled for lower limb surgery were randomly divided into three equal groups. Group I received 17 mL of epidural ropivacaine 0.75% with 2 mL of epidural NaCl 0.9% and 2 mL of IV NaCl 0.9%; Group II received 17 mL of epidural ropivacaine 0.75% with 2 mL of epidural tramadol and 2 mL of IVNaCl 0.9%; Group III received 17 mL of epidural ropivacaine 0.75% with 2 mL of epidural NaCl 0.9% and 2 mL of IV tramadol. Vital signs were recorded at certain intervals before and after epidural anesthesia. Sensory block was tested at the 2nd, 5th, 10th, 15th, 20th, 25th, 30th minutes after epidural injection, then every 15 minutes up to the 2nd hour and at every 30 minutes up to the end of the 6th hour. The time required for the onset of anesthesia at T10 dermatome, the postoperative sensation of first pain, the first analgesic requirement, the complete reversal of sensory block as well as side effects were recorded. Results: All groups were similar with respect to onset time, duration of sensory block and time of first pain sensation. The time before the first analgesic requirement was significantly longer in groups II and III compared to group I ( p < 0.05, p<0.01). Contusion: Epidural or intravenous tramadol combined with epidural anesthesia prolongs analgesia duration, while providing a similar clinical profile.

Keywords:

Anesthesia, Epidural, Anesthetics, Combined, Tramadol, Anesthetics, Local,

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