Selim TURHANOĞLU, Alper KARARMAZ, Sedat KAYA, M. Ali ÖZYILMAZ, Nurettin BAYHAN

Operasyon sonunda tramadol veya meperidin uygulamasının postoperatif erken dönem derlenme ve analjezi üzerine etkileri

Çalışmamızda; tramadol ve meperidinin, postoperatif erken dönem uyanma ve analjezi üzerine etkileri 60 olguda araştırıldı. Tüm olgularda fentanil 1.5 µg kg -1 ve propofol 2 mg kg -1 ile anestezi indüksiyonu sağlandıktan sonra, süksinilkolin 1.5 mg kg -1 verilerek entübasyon gerçekleştirildi. Anestezi idamesi %50 azot protoksit/oksijen içinde sevofluran %1.5-3 ile sağlandı, kas gevşemesi için gerektikçe cisatraküryum 0.05 mg kg -1 dozda iv uygulandı. Olgular rasgele üç eşit gruba ayrılarak, anestezinin şartlandırılmasına yaklaşık on dakika kala, Grup I'e (n=20) tramadol 1.5 mg kg -1 ve Grup II'ye (n=20) meperidin 1.5 mg kg -1, serum fizyolojik ile 10 mL'ye tamamlanarak iv en az 1 dakika içinde uygulandı, Grup III'e (n=20) ise sadece 10 mL serum fizyolojik verildi ve kontrol grubu olarak alındı. Spontan solunumun başlaması, hastanın gözünü aç komutuna yanıt vermesi, ekstübasyon süreleri ile yanıtı operasyon öncesinde öğrenilen bir soruya (doğum tarihi gibi) yanıt verme süresi saptanarak kaydedildi. Postoperatif 90 dakika izlenen olgulara gerektiğinde analjezik olarak 0.1 mg kg -1 morfin im yoldan yapılarak, uygulanan zaman kaydedildi. Uyanma ve derlenme süresi Grup II'de diğer gruplara göre anlamlı olarak uzun bulundu (p

Anahtar Kelimeler:

Anestezi, genel, Tramadol, Anesteziden uyanma dönemi, Meperidin, Ağrı, ameliyat sonrası

The effects of tramadol or meperidine administered at the end of surgery on postoperative recovery and analgesia

In our study, we investigated the effects of tramadol and meperidine on postoperative recovery and analgesia in sixty patients. Anesthesia induction was performed with fentanyl 1.5 µg kg -1, propofol 2 mg kg -1 and succinylcholine 1.5 mg kg -1. Sevoflurane 1.5-3% in 50% nitrous oxide and oxygen and when necessary cisatracurium 0.05 mg kg -1 was used for maintenance of anesthesia. Patients were randomly allocated into three identical groups. Approximately ten minutes before the end of anesthesia, patients in group I (n=20) received tramadol 1.5 mg kg -1, patients in group II (n=20) received meperidine 1.5 mg kg -1 and the drugs were diluted to 10 mL. Patients in group III (n=20) received isotonic saline and were accepted as control. The onset times of spontaneous ventilation, extubation, the response to command for opening eyes and also the response to questions were determined and recorded. If necessary, morphine 0.1 mg kg -1 im as analgesic was administered to the patients who were followed for 90 minutes postoperatively and the morphine administration time was recorded. The times of awakening and recovery were significantly longer in group II than the other groups (p<0.05). Postoperative analgesic requirement was significantly higher in control group than the groups of tramadol and meperidine (p<0.05). There were no differences between the groups of tramadol and meperidine in the requirements of postoperative analgesics. We concluded that tramadol 1.5 mg kg -1 iv bolus dose administered ten minutes before the end of anesthesia provided sufficient postoperative analgesia without delay of extubation and respiratory depression.

Keywords:

Anesthesia, General, Tramadol, Anesthesia Recovery Period, Meperidine, Pain, Postoperative,

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