Postoperatif analjezide ropivakain, ropivakain-fentanil ve ropivakain-tramadolün devamlı epidural infüzyonunun etkilerinin karşılaştırılması

Amaç: Postoperatif analjezi amacıyla uygulanan devamlı epidural ropivakain infüzyonu ile ropivakainin fentanil ve tramadol ile kombinasyonlarının duyusal/motor blok başlama zamanlarına, analjezi kalitesine ve analjezik tüketimine etkilerini karşılaştırmayı amaçladık. Yöntem: Etik kurul ve hasta izni alındıktan sonra, artroplasti uygulanacak 45 olgu çalışmaya dahil edildi. Postoperatif dönemde rastgele yöntemle üç eşit gruba ayrılan olgulardan Grup R’dekilere % 0.2’lik ropivakain, Grup RF’dekilere % 0.2’lik ropivakain ile 2 µg mL-1 fentanil, Grup RT’dekilere % 0.2’lik ropivakain ile 1 mg kg-1 tramadol hazırlandı ve epidural kateterden hasta kontrollü analjezi cihazı ile infüzyon hızı 4 mL sa-1 olarak başlandı. Gereğinde infüzyon hızı 6, 8, 10 mL sa-1 ’e çıkılarak 24 saat süreyle uygulandı. Bulgular: Duyusal bloğun başlama zamanının ve T10'a ulaşma süresinin, Görsel Analog Skala değerlerine göre Grup RF’de anlamlı olarak düşük olduğu saptandı (p

Comparison of continuous epidural infusion of ropivacaine, ropivacaine plus fentanyl and ropivacaine plus tramadol for postoperative analgesia

Objective: The aim of this study was to compare the effects of ropivacaine alone, and those of fentanyl and tramadol when added to ropivacaine for continuous epidural analgesia in postoperative analgesia on the onset of motor and sensory block, the quality of analgesia and analgesic consumption. Method: After institutional approval and informed consent, 45 patients scheduled for arthroplasty were randomly assigned to one of three groups for administration of either 0.2 % ropivacaine in Group R, 0.2 % ropivacaine with 2 µg mL-1 fentanyl in Group RF, or 0.2 % ropivacaine with 1 mg kg-1 tramadol in Group RT via epidural catheter in the postoperative 24 hours with an infu- sion rate of 4 mL hr-1 . The infusion rate was increased to 6, 8, 10 mL hr-1 according to the analgesic requirement. Results: Sensory block onset time, time to reach T10 and VAS scores were significantly decreased in Group RF (p<0.05). Mean arterial pressure and total drug consumption were higher in Group R (p<0.05). No significant difference was recorded in side effects among the groups. Conclusion: Continuous epidural postoperative analgesia with ropivacaine and fentanyl or tramadol improves postoperative analgesia; however, fentanyl combined with ropivacaine provides advantage on quality of analgesia, onset of sensory block, analgesic consumption and side effects.

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Anestezi Dergisi-Cover
  • ISSN: 1300-0578
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1993
  • Yayıncı: Betül Kartal
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