Aygün GÜLER, Bilge ÇELEBİOĞLU, Altan ŞAHİN, MEHMET SİNAN BEKSAÇ

Preemptif olarak kullanılan lornoksikam ve tramadolün postoperatif analjeziye katkılarının karşılaştırılması

Amaç: Anestezi indüksiyonunda verilen intravenöz (iv) tramadol ve farklı iki doz lornoksikamın postoperatif ağrı üzerine etkilerinin karşılaştırılmasıdır. Yöntem: Çalışmaya total abdominal histerektomi uygulanacak olan ASA I-II risk grubundan, 80 hasta, çift kör ve randomize olarak dahil edildi. Hastalar indüksiyonda 4 gruba ayrıldı; Grup L1e lornoksikam 8 mg, Grup L2e lornoksikam 16 mg, Grup Te tramadol 100 mg ve Grup Ka eş değer miktarda serum fizyolojik iv olarak uygulandı. Tüm hastalara standart genel anestezi uygulandı. Hastalar ekstübe olduktan ve ayılma odasına geldikten sonra postoperatif analjezi için morfin içeren hasta kontrollü analjezi cihazı uygulandı. Hastaların postoperatif ağrı değerlendirilmeleri uyandıklarında (0.), 6., 12. ve 24. saatlerde Visüel Analog Skalası (VAS) ve toplam morfin kullanımları ile değerlendirildi. Bulgular: lk analjezik gereksinim zamanı (efektif analjezi zamanı) Grup L1de ortalama 2 ± 1 dakika (dak), Grup L2de 4 ± 3 dak, Grup Tde 4 ± 4 dak ve Grup Kda 2 ± 1 dak bulunmuştur. Grup K ve Grup L1 değerleri birbirine benzer olup, her iki grup da Grup L2 ve Grup Te göre anlamlı şekilde farklılık göstermiştir (p

Comparison of preemptive administration of lornoxicam and tramadol on postoperative analgesia

Objective: The purpose of the study was to determine the efficacy of preeoperative intravenous (iv) tramadol and two different doses of lornoxicam on postoperative analgesia. Method: Eighty ASA I-II patients undergoing total abdominal hysterectomy were enrolled in the study, and were randomized into four groups: Group L1 received 8 mg of iv lornoxicam, Group L2 received 16 mg of iv lornoxicam, Group T received 100 mg of iv tramadol and Group K received normal saline of the same volume before the surgery. All patients received standard general anaesthesia. In the recovery room, patient controlled iv morphine was initiated for postoperative analgesia after they were extubated. Postoperative pain was assessed by measuring morphine consumption and visual analog pain scores (VAS) at the extubation (0) and postoperative 6, 12 and 24 hours. Results: The time to first analgesic requirement (effective analgesia times) was approximately 2 ± 1 minute (min) in Group L1, 4 ± 3 min in Group L2, 4 ± 4 min in Group T and 2 ± 1 min in Group K. When compared to Group L2 and Group T, effective analgesia times were significantly higher in Group K and Group L1 , which had similar values between themselves (p<0.05). VAS scores after the extubation were significantly higher in Group K and Group L1 (p<0.05). VAS scores at the 6 th hour were significantly different among Group L1, Group K and Group T (p<0.05). There was no significant difference among the groups regarding total morphine consumption. Conclusion: Administration of iv 8 mg lornoxicam before the total abdominal hysterectomies for preempive analgesia was found to be insufficient, and no difference has been found between Group L2 and Group T with respect to effective analgesic period. However, there has been a comparable preemptive analgesic effect of iv 16 mg lornoxicam and tramadol 100 mg administration till the first 6 hours after the surgery.

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