Laparoskopik kolesistektomi sonrası postoperatif bulantı ve kusmanın önlenmesinde tropisetron ve palonosetron'un karşılaştırılması: Randomize, çift-kör çalışma

Amaç: Postoperatif bulantı-kusma (POBK) anestezi sonrası en sık ortaya çıkan yan etkilerden biridir. POBK hastanın ameliyat sonrası derlenmesini ve hastanede kalış süresini uzatır. Bu çalışmada, intraoperatif uygulanan tropisetron ve palonosetronun, laparoskopik kolesistektomi sonrası postoperatif bulantı kusma üzerine etkilerinin karşılaştırılması amaçlandı.Yöntemler: Laparoskopik kolesistektomi planlanan, ASA I-II grubu, 18-65 yaş arası 142 hasta çalışmaya dahil edildi. Endotrakeal entübasyon sonrası iv yoldan Palonosetron Grubuna (Grup P) 0.075 mg palonosetron, Tropisetron Grubuna (Grup T) iv 5 mg tropisetron verildi. Hastaların postoperatif 0-72 saatlik zaman diliminde bulantı-kusma skorları, antiemetik kullanımları ve VAS skorları kaydedildi. Bulgular: Vakaların postoperatif 0-24 ve 48-72 saatlik dönemdeki bulantı-kusma skorları arasında gruplar arasında istatistiksel fark bulunmazken (p > 0.05), 24-48 saatlik dönemde ise Grup P'de, Grup T'ye göre bulantı-kusma skorları daha düşük bulundu (p < 0.024) (Tablo 3). Postoperatif antiemetik kullanımı açısından 72 saatteki her bir dönemde gruplar arasında fark yoktu (p > 0.05). 72 saatlik toplam ek antiemetik tüketimi ise Grup T'de, Grup P'ye göre istatistiksel olarak anlamlı yüksek bulundu (p = 0.025) (Tablo 4). Sonuç: POBK profilaksisinde antiemetik olarak kullanılan palonosetron, postoperatif 24-48 saatler arasında POBK şiddet skorunu ve toplam postoperatif 72 saatteki ek antiemetik ihtiyacını tropisetrona göre daha fazla azaltmıştır.

Comparison of palonosetron and tropisetron used for postoperative nausea and vomiting prophylaxis after laparoscopic cholecystectomy: A Randomized, double blinded study

Objective: Postoperative nausea-vomiting (PONV) is one of the most common side effects after anesthesia. PONV extends the duration of hospital stay and recovery time of the patient after the surgery. In this study, we compared the effects of tropisetron on palonosetron on postoperative nausea and vomiting after laparoscopic cholecystectomy. Methods: After endotracheal intubation, Palonosetron Group (Group P) received iv 0.075 mg of palonosetron and Tropisetron Group (Group T) received iv 5 mg of tropisetron. VAS scores, antiemetic use and nausea-vomiting scores were recorded in 0-72 hours interval. Results: In the 0-24 and 48-72 hour intervals, there were no statistical difference between the groups with respect to nausea-vomiting scores, but, in the 24-48 hour interval, nausea-vomiting score was lower in Group P than Group T (p < 0.024) (Table 3). There was no statistical difference in all 72 hour intervals with respect to antiemetic use (p > 0.05). 72 hours total antiemetic use was statisticaly higher in Group T than Group P (p = 0.025) (Tablo 4). Conclusion: For PONV prophylaxis, palonosetron decreased the PONV score and antiemetic need more than tropisetron in the first 72 hours.

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