Cengiz KARA, Ömer Faruk BOZKURT, İzzet ÇİÇEKBİLEK, Ali ÜNSAL

Parenteral parasetamol ve diklofenakin transüretral prostat rezeksiyonu sonrası akut postoperatif ağrının tedavisinde karşılaştırılması

Bu çalışmanın amacı transüretral prostat rezeksiyonu (TUR-P) sonrası erken postoperatif ağrı üzerinde intravenöz parasetamol ile intramuskuler diklofenakın analjezik etkinliği ve yan etkilerini değerlendirmektir. Çalışmaya spinal anes-tezi altında TUR-P ameliyatı yapılan ASA I-II grubundan, 55-70 yaş arasında, 50 hasta, randomize edilerek iki gruba ayrıldı. Grup 1 (n=25) hastalara 1 gr parasetamol intravenöz yolla, Grup 2 (n=25) hastalara 75 mg diklofenak intramuskuler yolla operasyondan sonraki ilk analjezik ihtiyacı olduğunda verildi. Ağrı skoru Vizuel Analog Skala (VAS) ile analjezik öncesi ve analjezik sonrası 30. dk, 1., 2., 4. ve 6. saatlerde ölçüldü. Analjezik sonrası VAS ≥5olan hastalara meperidin 1 mg/kg im olarak uygulandı. İlk analjezik gereksinim zamanı, postoperatif bulantı, kusma, kaşıntı, enjeksiyon yerinde ağrı, allerjik reaksiyon, hipotansiyon ve hipertansiyon gibi yan etkiler kaydedildi. Demografik veriler ve yan etki-ler her iki grupta benzer olarak saptandı. Parasetamol ve diklofenak gruplarında analjezik etkinlik açısından anlamlı bir fark yoktu.

Anahtar Kelimeler:

Ağrı, ameliyat sonrası, Transüretral prostat rezeksiyonu, Karşılaştırmalı çalışma, Diklofenak

A comparison between parenteral paracetamol and diclofenac for postoperative pain treatment in patients after transurethral resection of prostate

The aim of this study was to assess the analgesic efficacy and adverse effects of intravenous paracetamol in comparison with intramuscular diclofenac in patients with postoperative pain after transurethral resection of prostate (TUR-P). Fifty patients of ASA class I-II, 55-75 years of age, undergoing TUR-P under spinal anesthesia were assigned in a randomized manner into two groups. In Group 1 (n=25), 1 gr paracetamol intravenously, in Group 2 (n=25) 75 mg diclofenac intramuscularly was given at the time to first analgesic requirement after the operation. Postoperative pain scores were evaluated before medicine and at 30 min., 1, 2, 4, and 6 hours after the administration of the analgesic. 1 mg/kg meperidine was given in patients whom VAS ≥5 after the analgesic. First analgesic time and adverse effects such as nausea, vomiting, pruritis, injection site pain, allergic reaction, hypotension and hypertension were recorded. The demographic data, and adverse effects were similar in all groups. No significant differences were found between paracetamol and diklofenac for measures of analgesic activity.

Keywords:

Pain, Postoperative, Transurethral Resection of Prostate, Comparative Study, Diclofenac,

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