Ahmet Cemil İSBİR, Haluk KAFALI, Caner MİMAROĞLU, Cevdet DÜGER, İclal Özdemir KOL, Kasım TUZCU, Sinan GÜRSOY, Kenan KAYGUSUZ

Alt batın cerrahilerinde postoperatif analjezik yöntemlerin gastrointestinal sistem fonksiyonlarına etkisi

Amaç. Bu çalışmanın amacı, genel anestezi altında yapılan sezaryen veya abdominal histerektomi operasyonlarında, postoperatif analjezi tekniklerinin, gastrointestinal sistem fonksiyonlarına etkilerinin karşılaştırılmasıdır. Yöntem. Etik kurul ve hastaların onayı alındıktan sonra genel anestezi altında sezaryen veya abdominal histerektomi yapılacak 75 hasta rasgele 5 gruba ayrıldı. Postoperatif dönemde Grup I’e 6 saat ara ile 1mg/kg meperidin intramusküler uygulandı. Grup II’ye 1 mg/kg meperidin ve 75 mg diklofenak sodyum kombinasyonu intramusküler yöntemle 12 saat ara ile uygulandı. Grup III’e hasta kontrollü analjezi ile morfin hidroklorür 3 mg yükleme dozunda, bolus doz 1 mg ve kilitli kalma süresi 20 dakika olacak şekilde intravenöz uygulandı. Grup IV’e epidural kateterden 7 mL %0,5’lik bupivakain ile birlikte 2 mg morfin bolus dozda verildi. Bupivakainin %0.1’lik konsantrasyonunun ve morfinin 0,03 mg/mL’lik konsantrasyonundan oluşan kombinasyon 6-8 mL/saat dozunda sürekli infüzyon şeklinde uygulandı. Grup V’e epidural kateterden 3mg morfin bolus verildi. Morfinin 0,05 mg/mL’lik solüsyonundan 6-8 mL/saat dozunda sürekli infüzyon şeklinde uygulandı. Postoperatif hemodinamik veriler, sedasyon ve VAS skorları, ilk barsak hareketi, gaz-gayta çıkım zamanı, oral alım zamanları, ek analjezik gereksinimi ve yan etkiler kaydedildi. Bulgular. Gruplar arasında demografik özellikler ve hemodinamik veriler yönünden fark yoktu (p>0,05). Grup IV ve V de VAS skorları diğer gruplardan daha düşüktü. Sedasyon skorları grup III, IV, V de diğer gruplara göre daha yüksek gözlenmiştir (p

The effects of postoperative analgesia techniques on gastrointestinal system functions after lower abdominal surgery

Aim. The aim of this study was to compare the effects of postoperative analgesia techniques on gastrointestinal system functions at caesarean section or abdominal hysterectomy under general anesthesia. Method. After the permission of patients and Ethical committee, 75 patients that will undergo cesarian sectio or abdominal hysterectomy under general anesthesia, divided randomly into five groups. Group I patients were given intramuscular meperidine 1 mg/kg/6h postoperatively. Group II patients were given intramuscular meperidine 1 mg/kg/12h combined with 75 mg diclofenac sodium. Group III patients were given intravenous patient controlled analgesia with morphine hydrochlorur 3 mg initial bolus dose and 1 mg maintenance dose with 20 minutes lock out time. Group IV patients were applied epidural 7 mL 0.5% bupivacaine and 2mg morphine then given an infusion of 0.1% bupivacaine and 0.03 mg/mL morphine with rate of 6-8 mL/h. Group V patients were applied epidural 3 mg morphine then given an infusion of 0.05 mg/mL morphine. Postoperative hemodynamic data, sedation and VAS scores, the first bowel movement, time of gas and feces output, time of oral intake, additional analgesic requirements and side effects were recorded. Results. The demographic characteristics and hemodynamic data did not differ between groups (p> 0.05). Group IV and V, had the lower VAS scores than the others (p

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