Güldeniz ARGUN, Sinem GEVENKİRİŞ, SÜHEYLA ÜNVER

The Effects of Adding Opioids to Anesthesia on the Recovery of Patients with Gynecological Cancer Receiving Brachytherapy

Objective: The aim of this retrospective study was to investigate the effects of using propofol alone and in combination with fentanyl on postoperative analgesic consumption, duration of recovery and discharge for brachytherapy in patients with gynecological cancer. Method: After obtaining the study approval from the local ethics committee, 67 patients who underwent brachytherapy within 5 months were included in the study. All patients received mida- zolam for premedication and propofol (in case of need together with fentanyl) for induction. Patients were categorised into two groups as those using (Group I, n=37) and not using opioids (Group II, n=30). The duration of the procedure, drug doses, hemodynamic data, time to recovery and discharge were obtained from records and evaluated. Results: The duration of operation was similar in both groups. Propofol consumption was 1.865 mg kg -1 in Group I and 2.03 mg kg -1 in Group II (p>0.05). The average fentanyl consumption in the opioid group was 1.12 mg kg -1 and the average age was significantly lower in this group. No dif- ference was detected between the groups in terms of the analgesic consumption and the time to recovery and discharge. Conclusion: Anesthetics with shorter half-life are preferred in daily interventions. This study showed that the average age of the patients who required fentanyl during anesthesia for brachytherapy was lower; and the fentanyl that is administered additionally did not lead to sig- nificant prolongation of recovery time.

Brakiterapi Alan Jinekolojik Kanserli Hastalarda Anestezi Uygulamasına Opioid Eklenmesinin Derlenme Üzerine Etkileri

Bu çalışmada, jinekolojik kanserli hastalarda brakiterapi için günübirlik anestezi uygula- malarında tek başına propofol kullanımı ile propofole ilaveten fentanil kullanımının, anesteziden derlenme süresi, postoperatif analjezik tüketimi ve taburculuk sürelerine etkilerini retrospektif olarak araştırmayı planladık. Yöntem: Yerel Etik Kuruldan çalışma onayı alındıktan sonra, 5 aylık sürede brakiterapi yapılan 67 hasta çalışmaya dahil edildi. Bütün hastalara premedikasyon amaçlı midazolam, indüksiyon için propofol ve gerektiğinde fentanil uygulanmıştı. Kayıtlardan ulaşılan hastalar, opioid kullanılan (Grup I, n=37) ve kullanılmayan (Grup II, n=30) olmak üzere 2 gruba ayrıldı. İşlem süreleri, kulla- nılan ilaç dozları, hemodinamik veriler, derlenme süreleri, taburculuk süreleri kayıtlardan ulaşıla- rak değerlendirildi. Bulgular: Operasyon süresi 2 grupta benzerdi. Propofol tüketimi Grup I’de ortalama 1.865 mg kg -1 , Grup II’de 2.03 mg kg -1 idi (p>0.05). Ortalama fentanil tüketimi opioid grubunda 1.12 mcg kg -1 idi ve yaş ortalaması bu grupta anlamlı olarak düşüktü. Postoperatif analjezik tüketimi, der- lenme zamanı ve taburculuk zamanı bakımından 2 grup arasında fark yoktu. Sonuç: Günübirlik girişimlerde hastanın anesteziden kısa sürede derlenmesi için yarılanma ömrü kısa anestetikler tercih edilmektedir. Çalışmamızda, brakiterapi için anestezi uygulamasında fen- tanil gereksinimi olan hastaların yaş ortalamasının daha düşük olduğunu ve ilave verilen fentani- lin derlenme süresinde anlamlı uzamaya neden olmadığını bulduk.

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