Pre-emptif uygulanan intravenöz, spinal ve epidural morfinin erken postoperatif analjezi ve stres yanıt üzerine etkileri

Bu çalışmada, preemptif uygulanan iv, spinal ve epidural morfinin erken postoperatif dönemdekianaljezik tüketimi ve stres yanıt üzerine etkilerini belirlemek amaçlandı. Alt batın operasyonuuygulanacak ASA I-II grubuna giren 60 hasta rasgele üç gruba ayrıldı. Grup Ie indüksiyondan 5dk. önce 5 mg iv morfin, Grup IIye indüksiyondan 5 dk önce 0,5 mg intratekal morfin, Grup IIIeindüksiyondan 30dk önce 5mg epidural morfin uygulandı. Anestezi indüksiyonu 0,1 µg kg-1 fentanil ve 4-7 mg kg-1tiopental sodyum ile sağlandı. Kas gevşemesi ise 0,1mg/kg vekuronyum ilesağlandı. İdamede %1-2 sevofluran ve %50 N2O kullanıldı. Pre ve postoperatif dönemde hastalarınhemodinamik parametreleri ve postoperatif dönemde hemodinamik parametreler, VAS (VisualAnalog Ağrı Skala) değerleri, ilk analjezik ihtiyaç zamanları ve total analjezik tüketimi kaydedildi.Ayrıca stres yanıtı değerlendirmek için preoperatif dönemde ilaçlar uygulanmadan önce,peroperatif 30uncu dakika ve postoperatif 2nci saatte olmak üzere üç kan örneği alındı.Çalışmamızda VAS değerleri açısından postoperatif tüm zamanlarda iv grup ile spinal grup ve ivgrup ile epidural grup arasındaki farklılık anlamlı (P

Effects of pre-emptive intravenous, spinal and epidural morphine on early p ostop eratıve analgesia and stress resp onse

In this study, it was aimed to determine the effects of preemptive intravenous, spinal and epiduralmorphine on analgesic consumption, and stress response in the early postoperative period. SixtyASA I-II patients who were undergoing lower abdominal surgery were randomly divided intothree groups. Group I patients were admisnistered 5 mg iv morphine 5 minutes before induction,Grup II patients were administered 0.5 mg of intrathecal morphine 5 minutes before induction,Group III patients were administered 5 mg epidural morphine 30 min before induction ofanesthesia. Induction of anesthesia, was performed with 0.1 mg kg-1fentanyl and 4-7 mg kg-1 thiopental sodium. For muscle relaxation 0.1 mg kg-1vecuronium were given. Anaesthesia wasmaintained with 1-2% sevoflurane and 50% N2O. Pre and postoperative hemodynamic parameters,VAS (Visual Analog Pain Scale) scores, time to first analgesic requirement, total analgesicconsumption were recorded. In addition, to evaluate the stress response blood samples were takenthree times before the administration of preoperative medications, preoperative 30th minute, andpostoperative and 2nd hour. In our study, postoperative VAS scores between groups wassignificantly different at all times for the iv group and the spinal group and iv group and epiduralgroup (P

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