Alparslan TURAN, Zafer PAMUKÇU, Dilek MEMİŞ, Beyhan KARAMANLIOĞLU

Transdermal nitrogliserin kullanan hastalarda propofol enjeksiyon ağrısının önlenmesi

Çalışmamızda propofol enjeksiyon ağrısının önlenmesinde transdermal nitrogliserinin iki farklı dozunu plasebo ile karşılaştırmayı amaçladık. Transdermal nitrogliserin kullanılan 150 ASA II sınıf elektif ameliyat planlanan olgular rasgele üç gruba ayrıldı. I. grup hastalara önceden içi boşaltılmış transdermal nitrogliserin, II. grup hastalara transdermal nitrogliserin-TTS 5 ve III. grup hastalara transdermal nitrogliserin-TTS 10 propofol enjeksiyonundan 2 saat önce el sırtına İV kanülün üzerine yapıştırıldı. Propofolün ilk 5 mL'si 10 mg/5 saniye hızla uygulandıktan sonra hastaların reaksiyonları ve yan etkileri değerlendirildi. II. grup hastalarının % 58'nde ve III. grup hastalarının % 64'nde propofol enjeksiyon ağrısı izlenmezken, plasebo hastalarının tamamında değişik derecelerde ağrı izlenmiştir. III. grup hastalarının % 2'de ve II. grup hastalarının % 10'da orta ve ciddi derecede ağrı izlenirken, plasebo grubunda % 96 hastada orta ve ciddi derecede ağrı izlendi. Propofol ağrısının azaltılmasında transdermal nitrogliserinin TTS 5 ve 10 dozları arasında istatistiksel fark bulunmazken, plasebo grubu ile karşılaştırıldıklarında anlamlı fark bulunmuştur. Transdermal nitrogliserin kullanılan hastaların propofol enjeksiyon ağrısı plasebo ile karşılaştırıldığında belirgin olarak azalmıştır. Transdermal nitrogliserin, analjezide adjuvan etkiler göstermesi açısından ve kullanıldığında alınan sonuçtan dolayı propofol enjeksiyon ağrısının önlenmesinde yararlı olabileceğini düşünüyoruz.

Prevention of propofol infection pain in patients using transdermal nitroglycerine

In our study, we aimed to compare two different dosages of transdermal nitroglycerine with placebo in prevention of propofol injection pain. 150 patients from ASA II class who were to undergo various elective operations and who use transdermal nitroglycerine were assigned randomly in to three groups. In Group I pre-emptied transdermal nitroglycerine tape, in Group ll transdermal nitroglycerine TTS 5 tape and in Group III transdermal nitroglycerine TTS 10 tape was applied 2 hours before the propofol injection, over the dorsum of the hand at the tip of intravenous cannula. After application of first 5 mL of propofol with a speed of 10 mg/5 sec, patients reaction and side effects were assessed. There was no propofol injection pain in 58 % of group II patients and in 64 % of group III patients, while different degrees of pain was seen in all the patients in placebo group. In 2 % of group lll patients and 10 % of group II patients moderate to severe pain was seen, while moderate to severe pain was seen in 96 % of patients in placebo group. There was no statistical difference between TNG-TTS 5 and TNG-TTS 10 dosages in reducing propofol pain, when compared with placebo significant difference was found. Propofol injection pain in patients using transdermal nitroglycerine used patients was significantly reduced when compared with placebo. Transdermal nitroglycerine can be useful in preventing propofol injection pain.

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