Dilatasyon ve küretajda propofol ile birlikte kullanılan tramadol, diklofenak ve fentanil’in etkinliklerinin karşılaştırılması
Yükleniyor...
Dosyalar
Tarih
2006
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objektif: Küretaj operasyonlarında postoperatif ağrı, derlenme ve sedasyon düzeyi ile intravenöz anestetik ilaç kullanımı ve hemodinamiye etkileri açısından diklofenak, tramadol ve fentanilin karşılaştırılması amaçlandı. Planlama: Randomize prospektif klinik çalışma. Ortam: Üniversite hastanesi Hastalar: Fraksiyone küretaj planlanan 63 hasta Girişim: Hastalar 3 gruba ayrıldı. Grup 1’de indüksiyondan 30 dk önce im diklofenak 1 mg/kg, grup 2’de indüksiyondan 15 dk önce iv tramadol 1 mg/ kg, grup 3’de indüksiyonda iv fentanil 1 μg/ kg dozunda uygulandı. İndüksiyon için propofol 2 mg/ kg ile yüz maskesi uygulanarak % 50 hava ve O2 ile devam edildi, idame ihtiyacı olduğunda propofol indüksiyon dozunun % 20 si olarak tekrarlandı. Değerlendirme Parameteleri: Peroperatif ve postoperatif SKB, DKB, OKB, KAH ve SpO2 kaydedildi. Postoperatif olarak 1, 5, 15, 30 ve 120. dakikalarda; Visual Analog Skala 0-10 cm, sedasyon skoru 0-4 puan, Aldrete derlenme skoru 1-10 puan arasında değerlendirildi. SONUÇ: İndüksiyon için fentanil kullanılan grupta indüksiyon öncesi tramadol ya da diklofenak kullanılan gruplara göre anlamlı olarak daha az propofol ihtiyacı izlendi ( p= 0.012 ve p=0.013). YORUM: Fentanil kullanımı, tramadol ve diklofenak kullanımına göre propofol tüketimini azaltmıştır. Buna rağmen, postoperatif ek analjezik ihtiyacının daha az olması ve narkotik analjezik olmamaları nedeniyle tramadol ve diklofenak’ın daha avantajlı olduğunu düşünmekteyiz.
OBJECTIVE: To compare the value of three agents in terms of providing postoperative analgesia in patients having dilation and curettages. Their effects on hemodynamic parameters were evaluated. Recovery and sedation properties were also assessed. Design: Prospective, randomized trial Setting: University hospital Patients: Sixty three patients who underwent fractional curettage. Interventions: Diclofenac 1 mg/kg intramuscularly 30 minutes before induction and tramadol 1 mg/kg intravenously 15 minutes before induction were given in group 1 and 2, respectively. The third group received fentanyl 1 μg/ kg intravenously for induction. Then, induction was provided with propofol 2 mg/kg and % 50 air and % 50 oxygen given with face mask. For anesthesia management 20% of the induction dose of propofol was used intermittently. Main outcome measures: Peroperative and postoperative haemodynamic parameters and SPO2 were recorded. Visual Analog Scale 0-10 cm, sedation score 0-4 point, Aldrete recovery scores 1-10 were assessed postoperatively at the 1, 5, 15, 30, and 120th minutes. RESULTS: Peroperative and postoperative hemodynamic parameters showed no difference. The scores obtained by using Visual Analog Scale were also similar in all groups. There were no differences in sedation and Aldrete recovery scores in the three groups. On the other hand, propofol consumption was significantly lower in the fentanyl group when compared with the other two groups. CONCLUSION: Fentanyl usage decreased the amount of propofol when compared with diclofenac and tramadol administration. However, both tramadol and diclofenac were associated with lower amount of supplementary analgesic agents. They are both nonnarcotic analgesics. Therefore, preference of these two agents may be regarded more favorable.
OBJECTIVE: To compare the value of three agents in terms of providing postoperative analgesia in patients having dilation and curettages. Their effects on hemodynamic parameters were evaluated. Recovery and sedation properties were also assessed. Design: Prospective, randomized trial Setting: University hospital Patients: Sixty three patients who underwent fractional curettage. Interventions: Diclofenac 1 mg/kg intramuscularly 30 minutes before induction and tramadol 1 mg/kg intravenously 15 minutes before induction were given in group 1 and 2, respectively. The third group received fentanyl 1 μg/ kg intravenously for induction. Then, induction was provided with propofol 2 mg/kg and % 50 air and % 50 oxygen given with face mask. For anesthesia management 20% of the induction dose of propofol was used intermittently. Main outcome measures: Peroperative and postoperative haemodynamic parameters and SPO2 were recorded. Visual Analog Scale 0-10 cm, sedation score 0-4 point, Aldrete recovery scores 1-10 were assessed postoperatively at the 1, 5, 15, 30, and 120th minutes. RESULTS: Peroperative and postoperative hemodynamic parameters showed no difference. The scores obtained by using Visual Analog Scale were also similar in all groups. There were no differences in sedation and Aldrete recovery scores in the three groups. On the other hand, propofol consumption was significantly lower in the fentanyl group when compared with the other two groups. CONCLUSION: Fentanyl usage decreased the amount of propofol when compared with diclofenac and tramadol administration. However, both tramadol and diclofenac were associated with lower amount of supplementary analgesic agents. They are both nonnarcotic analgesics. Therefore, preference of these two agents may be regarded more favorable.
Açıklama
Anahtar Kelimeler
Diklofenak, Fentanil, Küretaj, Postoperatif Analjezi, Tramadol, Curettage, Diclofenac, Postoperative Analgesia
Kaynak
Uzmanlık Sonrası Eğitim ve Güncel Gelişmeler Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
3
Sayı
3
