Ali KOÇMAN, Ümit FİĞANÇİÇEK, Filiz ALKAYA SOLMAZ, Pakize KIRDEMİR

EPİDURAL KATETER UYGULANAN TOTAL ABDOMİNAL HİSTEREKTOMİ OPERASYONU GEÇİREN HASTALARDA DEKSMEDETOMİDİNİN POSTOPERATİF ANALJEZİK KULLANIMINA ETKİLERİ

Amaç Çalışmanın amacı, total abdominal histerektomi geçiren hastalarda, epidural kataterden verilen deksmedetomidinin postoperatif aneljezik kullanımına etkilerini araştırmak. Gereç ve Yöntem Çalışmaya ASA I-II, 30-60 yaş arası, operasyon süresi 150 dakikayı geçmeyen genel anestezi uygulanmış hastalar alındı. Çalışma kriterlerini sağlayan ve postoperatif aneljezi sağlamak için preoperatif epidural katater takılmış hastaların verileri değerlendirildi. Dosya kayıtları incelenen hastalar, ameliyat sonrası analjeziyi sağlamak için cerrahi cilt kapanması sırasında epidural kateter yolu ile bolus olarak Bupivakain (Grup B) (5 ml% 0.5 bupivakain + 11 ml% 0.9 sodyum klorür) veya Bupivakain + Deksmedetomidin (Grup D) (5 ml% 0.5 bupivakain + 1 ml deksmedetomidin (0.5 μg / kg) +10 ml% 0.9 sodyum klorür) verilen hastalar olarak iki gruba ayrıldı.Dosya kayıtları incelenen hastalar iki gruba ayrıldı. Bupivakain (Grup B) 5 ml %0,5 bupivakain + 11 ml %0,9 sodyum klorür) veya bupivakain + deksmedetomidin (Grup D) 5 ml% 0.5 bupivakain + 1 ml deksmedetomidin (0.5 μg / kg) +10 ml% 0.9 sodyum klorür ameliyat sonrası analjeziyi sağlamak için cerrahi cilt kapanması sırasında epidural kateter yolu ile bolus olarak verilmiş. Her iki gruptaki hastalara postoperatif 24 saat boyunca epidural analjezi için hsata kontrollü analjezi cihazı ile morfin + bupivakain uygulanmış. Anestezi takip fişlerinden; demografik ve hemodinamik veriler, algoloji takip formlarından; postoperatif 24 saatlik analjezik talep sayıları, analjezik tüketimleri, VAS skorları, Ramsey sedasyon skoru değerleri ve ilaç yan etkileri kaydedildi.Bulgular Demografik veriler, hemodinamik parametreler, VAS skorları, Ramsey sedasyon skoru değerleri ve ilaç yan etkileri açısından gruplar arasında fark bulunmadı. Postoperatif 30.dakikadan itibaren Grup D’ de, Grup B’ ye göre daha az analjezik talebi, daha az bupivakain ve morfin tüketimi olduğu görüldü ve istatiksel olarak anlamlı bulundu (p

THE EFFECTS OF DEXMEDETOMIDINE ON POSTOPERATIVE ANALGESIC USE IN THE TOTAL ABDOMINAL HYSTERECTOMY OPERATIONS APPLIED WITH EPIDURAL CATHETER

Objectıve The aim of the present study was to evaluate the effects of dexmedetomidine administration by epidural route for postoperative analgesia administration in patients who had undergone total abdominal hysterectomy. Materıal And Methods ASA I-II patients aged between 30 to 60 years old who had been operated under general anesthesia for less than 150 minutes were enrolled to the present study. Data of the patients who met the study criteria and who had pre-operatively placed epidural catheter for post-operative analgesia were evaluated in the study. Patients whose file records are being examined are divided into two groups. Epidural bupivacaine (Group B: 5 ml 0.5% bupivacaine + 11 ml 0.9% sodium chloride) or bupivacaine + dexmedetomidine combination (Group D: 5 ml 0.5% bupivacaine + 1 ml dexmedetomidine (0.5 μg / kg) +10 ml 0.9% sodium chloride) were given as a bolus via catheter during the surgical wound closure to provide the post-operative analgesia. The patients in both groups received post-operative morphine + bupivacaine by PCA during the post-operative 24 hours for epidural analgesia. According anesthesia forms; demographic and hemodynamic data, algology forms; analgesic demand rate, analgesic consumption, VAS scores, Ramsay sedation scales and side effects were recorded during the post-operative 24 hours. Results There was no statistically significant difference between the groups in terms of demographic data, hemodynamic parameters, VAS scores, Ramsay sedation scales and side effects. After the post-operative 30th minutes, Group D showed less analgesic demand, bupivacaine and morphine consumption than group B with a statistically significance (p

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