Sezaryen operasyonlarında deksketoprofen trometamol ile lornoksikamın postoperatif analizi ve tramadol tüketimi üzerine etkilerinin karşılaştırılması

Amaç: Prospektif, randomize ve çift kör olarak planlanan çalışmamızda sezaryen operasyonlarında intravenöz hasta kontrollü analjezi (HKA) yöntemi ile kullanılan tramadolün, intravenöz deksketoprofen trometamol ve lornoksikam ile kombinasyonunun postoperatif analjezi, postoperatif yan etkiler ve hasta memnuniyeti açısından karşılaştırılması amaçlandı. Yöntem: Sezaryen ameliyatı olacak ASA I-II 60 hasta çalışmaya dâhil edildi. Hastalar randomize olarak 2 gruba ayrıldı. Bebek çıkartıldıktan hemen sonra ve 12. saatte 1.grup hastalara (Grup D) 50 mg iv deksketoprofen trometamol, 2.grup hastalara (Grup L) 8 mg iv lornoksikam uygulandı. Hastalar uyanma odasına alındıktan hemen sonra yükleme dozu 1 mg kg-1, bolus doz 15 mg, kilitli kalma süresi 15 dk, 4 saat limiti 125 mg olacak şekilde HKA cihazı ile iv tramadol başlandı. Postoperatif ağrı değerlendirmesi VAS skoru kullanılarak 1.,2.,4.,6.,8.,12.,16.,18. ve 24.saatlerde yapıldı. Toplam tramadol tüketimi, gastrointestinal ve diğer yan etkiler ile hasta memnuniyeti kaydedildi. Bulgular: Toplam tramadol tüketimi, hastaların HKA cihazından analjezik talep sayısı, cihazın analjezik verme sayısı gruplar arasında benzerdi. Görsel ağrı skalası (VAS) değerleri arasında anlamlı bir farklılık yoktu. Hasta memnuniyet oranları karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmadı (p=0,202). Dispepsi, bulantı ve kusmada gruplar arasında istatistiksel olarak anlamlı fark saptanmadı. Tartışma ve Sonuç: Sonuç olarak sezaryen ameliyatlarında deksketoprofen trometamol ve lornoksikam uygulamasının postoperatif analjezi, hasta memnuniyeti ve yan etkiler bakımından karşılaştırıldığında benzer etkileri olduğu gözlenmiştir.

A comparative study of the effect of dexketoprofen trometamol and lornoxicam on postoperative analgesia and tramadol requirement in patients underwent cesaren section

Objective: In this prospective, randomized, double-blind clinical study, we aimed to compare the effects of combination of dexketoprofen trometamol and lornoxicam with regard to postoperative pain, adverse events and patients’ satisfaction in patients underwent cesarean section. Method: Sixty patients underwent cesarean/section (C/S) as ASA class I-II, were included to the study. Patients were randomized into two groups. Immediately after delivery, dexketoprofen trometamol 50 mg iv and lornoxicam 8 mg iv were administered for Group I and II, respectively, and repeated after 12 h. Loading dose 1 mg kg-1, bolus dose 15 mg, lock out time 15 min, tramadol IV was started via PCA in recovery room. Postoperative pain was evaluated by visual analog scale (VAS) at 1-2-4-6-8-12-16-18 and 24 h. Total tramadol requirement, gastrointestinal and other adverse effects and patients’ satisfaction were recorded. Results: Total tramadol consumption, the number of patients’ analgesic request from PCA and the number of analgesic dose given by the PCA were all similar for both groups (p=0.202). There were no statistically significant differences between groups regarding to VAS and patients’ satisfaction. Discussion: As a result, dexketoprofen trometamol and lornoxicam were similar with regard to postoperative pain management, adverse effects and patients’ satisfaction, after C/S operations.

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