The efficacy of patient controlled thoracic epidural analgesia for the treatment of RIB fracture pain in intensive care unit
Kot kırıklarına bağlı ağrı kardiyopulmoner fonksiyonları olumsuz etkilemektedir. Bu çalışmanın amacı toraks travmalı hastalarda ağrı tedavisi için kullanılan hasta kontrollü torasik epidural analjezinin etkinliğini araştırmaktır. 10 hasta çalışmaya alındı. Kalp atım hızı, ortalama arter basıncı, istirahat, öksürük ve hareket sırasında Vizüel Analog Skala (VAS) ile belirlenen ağrı skorları, solunum sayısı, arteriyel oksijen parsiyel basıncı ve vital kapasite ölçümleri epidural analjezi öncesi ve sonrasında yapıldı. Hastalar analjezik tedavi sırasında 72 saat takip edildiler. Epidural kateter takıldıktan sonra PCA cihazı bağlandı. Yükleme dozu olarak 10 mL 0,125% bupivakain ve fentanil sitrat (2$/mu$g/ mL) verildi, aynı analjezik karışımla bazal infüzyon 5 mL/saat, PCA bolus dozu 10 mL ve kilitli kalma süresi 30 dk olarak belirlendi. VAS skorları 4 saat arayla, vital kapasite ve PaO2 değerleri önceden belirlenen aralar ile belirlendi.
Yoğun bakımda kot kırıklarının ağrısının tedavisinde hasta kontrollü torakal epidural analjezinin etkinliği
Pain from rib fractures may affect cardiopulmonary functions. The aim of this study is to evaluate the efficacy of patient controlled thoracic epidural analgesia (PCTEA) for pain relief in chest trauma patients. Ten patients were included. Heart rate, mean arterial pressure, pain scores by Visual Analogue Scale (VAS) at rest, cough and movement, respiratory rate, PaO2 and vital capacity (VC) were measured before and after PCTEA. The patients were monitored for 72 h during analgesic treatment. After the placement of the epidural catheter, a PCA pump was used for PCTEA. 10 mL of 0,125% bupivacaine plus fentanyl citrate (2$/mu$g/mL) was delivered as a loading dose and the same analgesic mixture was used for the maintenance at the following dosages: basal infusion rate 5 mL/hr, PCA bolus dose 10 mL and lockout time 30 min. VAS scores were recorded at 4-hour intervals, VC and PaO2 was measured before PCTEA and at predetermined intervals. VAS scores (at rest, cough and movement), VC and PaO2 were improved during 72 h follow-up period. PCTEA could be applied safely and successfully for pain relief in chest trauma patients
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