S. KAMURAN, İ. GÜMÜŞEN, A. Ceylan, C. EYİGÖR, A. SARGIN

Major jinekolojik cerrahide deksketoprofen trometamol'ün postoperatif analjezi ve morfin tüketimine etkisi

Amaç: Postoperatif ağrıda, opioid ve nonsteroid antiinflamatuar ilaçların birlikte kullanımı oldukça yaygındır. Bu randomize, çift kör, kontrollü çalışmada, major jinekolojik cerrahi uygulanan hastalarda deksketoprofen trometamol'ü postoperatif dönemde analjezik etkinliği, opioid tüketimi ve yan etkiler açısından kontrol grubuyla karşılaştırmayı amaçladık. Gereç ve Yöntem: Bu çalışmaya major jinekolojik operasyon planlanan ASA I-II grubu 56 hasta dahil edildi ve randomize olarak 2 gruba ayrıldı. Operasyon bitiminden 15-20 dk önce ve 8 saat aralıklarla toplam 3 kez Grup I'e intravenöz 50 mg deksketoprofen trometamol Grup II'ye serum fizyolojik verildi. Her iki grup hastaya da standart genel anestezi uygulandı. Postoperatif dönemde hemodinamik parametreler, ağrı ve sedasyon skorları, morfin tüketimi, yan etkiler ve hasta memnuniyeti değerlendirildi. Bulgular: Deksketoprofen grubunda ağrı skorları ve total morfin tüketimi (Grup I: 34.8±11.7 mg, Grup II: 60.0±18.5 mg) daha düşük bulunurken yan etkiler açısından gruplar arasında benzerdi. Grup I'de kullanılan total morfin miktarı 2., 4., 6., 12. ve 24. saatte belirgin olarak düşük, sedasyon skorları 2. ve 12. saatte Grup II de daha yüksek bulundu. Sonuç: Major jinekolojik operasyonlarda, deksketoprofen trametamol'ün postoperatif dönemde etkin bir analjezi sağladığı ve morfin tüketimini azalttığı saptanmıştır.

The effect of dexketoprofen trometamol on postoperative analgesia and morphine consumption in major gynecologic surgery

Aim: The use of opioids and non-steroidal anti-inflammatory drugs in combination for postoperative pain is common. In this randomized, double-blind, placebo-controlled study, we aimed to evaluate the analgesic efficacy, the effects on opioid consumption and postoperative side effect of intravenous dexketoprofen trometamol, in comparison with a placebo, in patients undergoing major gynecologic surgery. Materials and Methods: This study was performed on 56 patients (ASAI-II) planned for major gynecologic surgery. The patients who were randomly allocated into two equal groups received intravenous dexketoprofen trometamol 50 mg (Group I) or serum physiologic (Group II) 15-20 min before the end of surgery and at every 8 h for 24 h postoperatively. All patients received standard general anesthesia. Hemodynamic parameters, pain and sedation score, morphine consumption, side effects and patient satisfaction were recorded postoperatively. Results: Although the pain scores and total morphine consumption (Group I: 34.8±11.7 mg, Group II: 60.0±18.5 mg) in the dexketoprofen group was lower, the side effects were similar between the groups. The amount of morphine use at 2, 4, 6, 12 and 24 h was significantly lower in Group I, sedation scores at 2 and 12 h were higher in Group II. Conclusion: Dexketoprofen trometamol is associated with a decrease in morphine consumption and superior analgesic efficacy in major gynecologic surgery.

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