POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI

Özet : Çalışmamızda genel anestezi altında tiroidektomi operasyonu geçirecek hastalarda (n=40) postoperatif bulantı-kusma (POBK)’nın önlenmesinde tropisetronun etkinliği metoklopramid ile karşılaştırıldı. Randomize çift-kör çalışmamızda; American Society of Anesthesiologists (ASA) I-II sınıflandırmasına göre 18- 70 yaş arası 40 hasta 20’şer kişilik iki gruba ayrıldı. Metoklopramid grubu (Grup M)’na indüksiyondan önce iv 10 mg metoklopramid ve tropisetron grubu (Grup T)’na iv 2 mg tropisetron verildi. Bütün hastalara standart genel anestezi uygulandı. İlaçların antiemetik etkileri ve yan etkileri, her iki gruptaki antiemetik gereksinimi 24 saat boyunca değerlendirildi. Grupların bulantı-kusma skoru açısından karşılaştırılmasında Grup T’de Grup M’ye göre bulantı-kusma skoru sıfır olan hasta sayısı istatistiksel olarak anlamlı şekilde yüksekti (p=0.027), diğer skorlar için gruplar arası istatistiksel olarak anlamlı fark bulunmadı. Bulantıkusma görülme sıklığı her iki grupta benzerdi. Yan etkiler açısından gruplar arası istatistiksel olarak anlamlı fark belirlenemedi. Tiroidektomi geçiren hastalarda POBK’yı önlemede genel anestezi indüksiyonu öncesi 2 mg iv tropisetron uygulandığında 24 saat boyunca POBK riskinin metoklopramide göre daha az olduğu, dolayısıyla tropisetronun uzun etkili bir antiemetik ajan olarak POBK’nın önlenmesinde kullanılabileceği sonucuna varıldı.

Comparison of the Effects of Tropisetron and Metoclopramid in Prevention of Postoperative Nausea and Vomiting

Summary: This study compared the efficacy of tropisetrone and metoclopramide in preventing postoperative nausea-vomiting (PONV) of the patients (n=40) who underwent thyroidectomy under general anesthesia. In our randomized double-blind study, 40 patients (between the age 18-70 years) who were classified in American Society of Anesthesiologists (ASA) I and II groups were classified into two groups, with 20 patients in each. Before induction, 10 mg metoclopramide was administered to metoclopramide group (Group M), while 2 mg tropisetrone was administered to tropisetrone group (Group T) intravenously. All patients had standard general anesthesia. Antiemetic and side effects of the drugs, and the antiemetic requirements of the patients in both groups were followed up for 24 hours. When postoperative nausea-vomiting scores of the groups were compared, the number of the patients with a score of 0 was statistically significantly higher in Group M than in Group T (p=0.027), and no differences were detected among the other scores. The frequency of nausea-vomiting was almost the same in both groups. There were no statistically significant differences between the groups for side effects. The results of this study indicated that 2 mg intravenous tropisetron application before induction of general anesthesia in thyroidectomy patients prevents postoperative nausea-vomiting better than metoclopramide in 24-hour period. In conclusion, tropisetrone may be used as a long-lasting antiemetic drug to prevent postoperative nausea-vomiting

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