Seda KİŞİ, Ersel GÜLEÇ, Mediha TÜRKTAN, Zehra HATİPOĞLU, Yasemin GÜNEŞ

Meme Kanseri Cerrahisinde Gabapentin Uygulamasının Preoperatif Anksiyete ve Postoperatif Analjezi Üzerine Etkisi

Amaç: Bu çalışmada meme kanseri nedeniyle opere olacak olgularda preemptif amaçlı uygulanan oral gabapentinin preoperatif anksiyete ve postoperatif ağrı kontrolü üzerindeki etkilerinin karşılaştırılması amaçlanmıştır. Materyal ve Metod: Çalışmaya yaşları 18-60 yaş arasında değişen ASA I-II grubu toplam 62 meme kanserli olgu alınmış olup çalışma prospektif, randomize ve çift kör olarak yürütülmüştür. Olgular iki gruba ayrılmış ve hepsine preoperatif Sürekli Kaygı Ölçeği uygulanmıştır. Birinci gruptaki olgulara operasyondan bir saat öncesi gabapentin 600 mg tablet oral yoldan verilmiş, cerrahiden hemen önce Durumluluk Kaygı Ölçeği uygulanırken 2. gruptaki olgulara yalnızca operasyon öncesi Durumluluk Kaygı Ölçeği uygulanmıştır. Her iki gruba da postoperatif analjezi amacıyla operasyon bitiminden 30 dk önce 1mg/kg i.v. tramadol uygulanmıştır. Postoperatif ağrıyı değerlendirmek amacıyla postoperatif Vizüel Analog Skala değerleri ile total tramadol tüketimi değerlendirilmiştir. Bulgular: Her iki grubun demografik özellikleri, operasyon süreleri, hemodinamik değerleri ve anksiyete skorları birbirine benzer olup intraoperatif 10. ve 60. dakikalarda ölçülen kalp atım hızı değerleri, postoperatif 24 saatte toplam tramadol tüketimi, postoperatif 5., 10. dk ve 6. saat dışındaki VAS değerleri gabapentin verilen grupta kontrol grubuna göre anlamlı düzeyde düşük bulunmuştur (p

Anahtar Kelimeler:

Anksiyete, Gabapentin, Hasta kontrollü analjezi, Preemptif analjezi

The Effect of Gabapentin on Preoperative Anxiety and Postoperative Analgesia in Breast Cancer Surgery

Purpose: The goal of this study was to evaluate the effect of pre-emptive gabapentin administration on anxiety and on postoperative tramadol requirement in patients undergoing breast cancer surgery. Material and Methods: After obtaining the local ethics committee approval and written informed consent, sixty-two patients with ASA physical status I-II aged 18-60 years and scheduled for breast cancer surgery were included into our study. They were randomly allocated into two groups. As control group did not receive premedication, the other group received 600 mg gabapentin per orally. We performed STAI-2 (The State-Trait Anxiety Inventory-2) and preoperatively STAI-1 (The State-Trait Anxiety Inventory-1) in both groups. Heart rate, systolic and diastolic blood pressure were recorded intraoperatively. 30 minutes before the end of surgery, 1mg.kg-1 tramadol was administered intravenously for postoperative analgesia. Patient controlled analgesia device was used intravenously to provide postoperative analgesia. Postoperative VAS scores and postoperative tramadol requirement at 5, 10, 15, 30, 45th and 60th minutes and at 4, 8, 12, 24th hours were recorded. Results: Demographic data, hemodynamic values during the surgery, and anxiety scores were not different between two groups. Heart rate at 10th and 60th minutes intraoperatively, tramadol requirement and VAS scores postoperatively were significantly reduced in gabapentin group compared with control group (p

Keywords:

Anxiety, Gabapentin, Patient controlled analgesia, Pre-emptive analgesia,

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Yazışma Adresi / Address for Correspondence: Dr. Ersel Güleç Çukurova Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı 01330, Balcalı Hastanesi Sarıçam/Adana Tlf: 0 322 338 6060/3289
Email: gulecersel@yahoo.com geliş tarihi/received :09.12.2013 kabul tarihi/accepted:13.01.2014