Refika Kılıçkaya, Tuna Şahin, Ersel Güleç, Mehtap Balcı, Fatih Balcı

İnguinal herni tamiri sonrası postoperatif ağrı üzerinde intratekal fentanil ve intratekal morfinin etkilerinin karşılaştırılması

Amaç: Çalışmamızın amacı inguinal herni onarımı geçiren hastalarda intratekal fentanil ve intratekal morfin ile uygulanan spinal anestezinin postoperatif ağrı etkilerini karşılaştırmaktır.Gereç ve Yöntem: Elektif inguinal herni onarımı geçirecek olan 18-60 yaşları arasında, Amerikan Anesteziyologları Derneği fizik durum I-II’ye sahip olan 50 hasta, prospektif, randomize çift kör çalışmamıza dahil edildi. Hastalara 12.5 mg heavy bupivakaine ilave olarak bir grupta 25 mcg fentanil (grup F, n=25) ve diğer grupta 0,1 mg morfin (grup M, n= 25) intratekal yolla uygulandı. Hemodinamik ölçümler, postoperatif ilk analjezik gereksinimi için geçen süre, postoperatif ağrı skorları, analjezik gereksinim sayısı ve yan etkiler 24 saat içinde kaydedildi.Bulgular: Postoperatif 24 saatte ağrı skorları, grup F ile karşılaştırıldığında grup M’de belirgin olarak düşüktü. Postoperatif ilk analjezik gereksinim için geçen süre, grup M’de grup F’ye göre belirgin yüksekti. Postoperatif 24 saat için kümülatif analjezik gereksinim sayısı grup F’de grup M’e göre belirgin yüksekti. Sonuç: İnguinal herni tamiri geçirecek hastalarda spinal anestezi amacıyla intratekal 12,5 mg heavy bupivakaine 0,1 mg morfin eklenmesi, 25 mcg fentanil eklenmesine göre özellikle postoperatif 12 saat sonra daha etkili analjezi oluşturmuştur.

Anahtar Kelimeler:

Spinal anestezi, morfin, fentanil, postoperatif ağrı

Comparison of the effects of intrathecal fentanyl and intrathecal morphine on postoperative pain for inguinal hernia repair

Purpose: The aim of this study was to compare the effects of intrathecal fentanyl and intrathecal morphine combined with spinal anesthesia on postoperative pain control for inguinal hernia repair.Materials and Methods: Fifty patients aged 18-60 years with American Society of Anesthesiologists physical status I-II scheduled for elective inguinal hernia repair surgery were enrolled in this prospective randomized double-blinded study. Patients received spinal anesthesia with either 25 mcg fentanyl plus 12.5 mg heavy bupivacaine intrathecally (group F, n=25) or 0.1 mg morphine plus 12.5 mg heavy bupivacaine intrathecally (group M, n=25).Hemodynamic parameters, time to first analgesic requirement, postoperative pain scores, the number of analgesic requirements and side effects over postoperative 24 h were recorded.Results: Pain scores were significantly lower in group M compared with group F in the postoperative 24 h. The time to first analgesic requirement was higher in group M than group F. Analgesic requirement was higher in group F than group M for postoperative 24 h. Conclusion: We concluded that the addition of 0.1 mg morphine intrathecally to 12.5 mg heavy bupivacaine provides improved postoperative analgesia, especially after postoperative 12 h than 25 mcg fentanyl for inguinal hernia repair under spinal anesthesia.

Keywords:

spinal anesthesia; morphine; fentanyl; postoperative analgesia,

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