Abdominoplasti operasyonu sonrası intravenöz ibuprofen kullanımının postoperatif ağrı ve opioid tüketimi üzerine etkisinin değerlendirilmesi
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bolu Abant İzzet Baysal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Abdominoplasti aynı zamanda abdominal lipektomi olarak da adlandırılan, deri altı yağ ve karın derisinin çıkarılması ve ardından karın kaslarının sıkılaştırılmasıyla oluşan kozmetik prosedürdür. Estetik cerrahinin en ağrılı işlemlerden biri olup son yıllarda sayısı giderek artmaktadır. İbuprofen, anti-enflamatuar, antipiretik ve analjezik etkileri olan bir non-steroid antiinflamatuar ilaç (NSAID)'dir. Oral formu uzun süredir güvenle kullanılmakta olup en çok tercih edilen NSAID'lerden biridir. Bu çalışmada, abdominoplasti uygulanan hastalarda ibuprofenin intravenöz (IV) formunun postoperatif ağrı kontrolü ve opioid gereksinimi üzerindeki etkinliğini değerlendirmeyi amaçladık. Yerel Etik Kurul ve hasta yazılı onamı sonrasında elektif Abdominoplasti Operasyonu planlanan 18-65 yaş aralığında ASA I-II riskinde 60 hasta çalışmaya dahil edildi. Hastalar operasyon öncesi randomize, prospektif ve kapalı zarf metodu ile Grup 1 (Tramadol), Grup 2 (İbuprofen) ve Grup 3 (İbuprofen+tramadol) olmak üzere 3 gruba ayrıldı. Grup 1 (Tramadol)'de operasyon bitiminden 30 dakika önce İV Hasta Kontrollü Analjezi ile Tramadol HCL (Tramosel 100 mg/2 ml Haver Pharma İlaç A.Ş, İstanbul) 4mg/ml konsantrasyonda sürekli infüzyon verildi. Grup 2 (İbuprofen)'de operasyon bitiminden 30 dakika önce İV ibuprofen (Dorifen 800mg/8ml VEM İlaç San. Ve Tic. A.Ş. Türkiye) 800 mg IV uygulandı. 24 saat boyunca her 6 saatte bir 800 mg IV ibuprofen uygulanarak takip edildi. Grup 3 (İbuprofen+tramadol)'de operasyon bitiminden 30 dakika önce HKA ile tramadol (Tramosel 100 mg/2 ml Haver Pharma İlaç A.Ş, İstanbul) 4mg/ml konsantrasyonda sürekli infüzyon ve 800 mg IV ibuprofen 4x1(Dorifen 800mg/8ml VEM İlaç San. Ve Tic. A.Ş. Türkiye) uygulandı. Postoperatif 30.dk 1,2,4,8,12,18. ve 24. saatlerde sistolik arter basıncı (SAB), diyastolik arter basıncı (DAB), ortalama arter basıncı (OAB), kalp atım hızı (KAH), vizüel analog skala (VAS), 0-1, 1-12, 12-24 saat dilimlerindeki analjezik tüketimi, bulantı, kusma, hasta memnuniyeti değerlendirilerek kaydedildi. Demografik verilerde, SAB, DAB, OAB, KAH ve bulantı-kusmada gruplar arasında anlamlı fark bulunmadı. Hastaların VAS değerlendirmesinde Grup 3, Grup 2'ye oranla her saat diliminde, Grup 1'e göre ise 4. saatte VAS değerleri anlamlı düşük tespit edildi. Total analjezik tüketiminde Grup 3, tüm saat dilimlerinde Grup 1'e oranla anlamlı düşük tespit edildi. Sonuç olarak; Abdominoplasti operasyonu sonrasında tramadole ek olarak verilecek IV Ibuprofenin, etkili analjezi sağladığını ve analjezik tüketimini azalttığını tespit ettik.
Abdominoplasty, also called abdominal lipectomy, is a common cosmetic procedure that involves removing subcutaneous fat and abdominal skin followed by tightening the abdominal muscles. It is one of the most painful procedures in aesthetic surgery and has been used increasingly in recent years. Ibuprofen is a non-steroidal anti-inflammatory (NSAID) with anti-inflammatory, antipyretic and analgesic effects. Its oral form has been used safely for a long time and is one of the most preferred NSAIDs. In this study, we aimed to evaluate the effectiveness of the intravenous IV form of ibuprofen on postoperative pain control and opioid requirement in patients who underwent abdominoplasty. After the ethics committee and the written consent of patients was obtained, 60 patients at risk of ASA I-II between the ages of 18-65 who were scheduled for elective Abdominoplasty were included in the study. The patients were divided into 3 groups as Group 1 (Tramadol), Group 2 (Ibuprofen) and Group 3 (Tramadol+Ibuprofen) by the randomized, prospective and closed envelope method before the operation. In Group 1 (Tramadol), 30 minutes before the end of the operation, Tramadol HCL (Tramosel 100 mg / 2 ml Haver Pharma Drugs Inc , Istanbul) was given continuous infusion at a concentration of 4mg / ml via IV Patient Controlled Analgesia. 800 mg IV ibuprofen (Dorifen 800mg/8ml VEM Drugs Inc , Turkey) was administered to Group 2 (Ibuprofen) 30 minutes before the end of the operation. Patients were followed up by administering 800 mg IV every 6 hours for 24 hours. In Group 3 (Tramadol+Ibuprofen), 30 minutes before the end of the operation, tramadol (Tramosel 100 mg / 2 ml Haver Pharma Drugs Inc , Istanbul) was administered via PCA with continuous infusion at a concentration of 4mg / ml and 800 mg IV ibuprofen (Dorifen 800mg/8ml VEM Drugs Inc , Turkey) was administered as 4x1. Postoperative systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR) values at 30 minutes, 1st hour, 2nd hour, 4th hour, 8th hour, 12th hour, 18th hour; visual analog scale (VAS), analgesic vii consumption, nausea, vomiting, and patient satisfaction at at 0-1, 1-12, 12-24 hours were evaluated and recorded. In demographic data, no significant difference was found between groups in terms of SAB, DAB, MAP, CAD and nausea and vomiting. In the VAS evaluation of the patients, VAS values were found to be significantly lower in Group 3 compared to Group 2 at every hour and at the 4th hour compared to Group 1. Group 3 was found to be significantly lower than Group 1 in total analgesic consumption in all time zones. As a result; We think that IV Ibuprofen, which will be given in addition to tramadol after abdominoplasty operation, can provide effective analgesia and reduce analgesic consumption.
Abdominoplasty, also called abdominal lipectomy, is a common cosmetic procedure that involves removing subcutaneous fat and abdominal skin followed by tightening the abdominal muscles. It is one of the most painful procedures in aesthetic surgery and has been used increasingly in recent years. Ibuprofen is a non-steroidal anti-inflammatory (NSAID) with anti-inflammatory, antipyretic and analgesic effects. Its oral form has been used safely for a long time and is one of the most preferred NSAIDs. In this study, we aimed to evaluate the effectiveness of the intravenous IV form of ibuprofen on postoperative pain control and opioid requirement in patients who underwent abdominoplasty. After the ethics committee and the written consent of patients was obtained, 60 patients at risk of ASA I-II between the ages of 18-65 who were scheduled for elective Abdominoplasty were included in the study. The patients were divided into 3 groups as Group 1 (Tramadol), Group 2 (Ibuprofen) and Group 3 (Tramadol+Ibuprofen) by the randomized, prospective and closed envelope method before the operation. In Group 1 (Tramadol), 30 minutes before the end of the operation, Tramadol HCL (Tramosel 100 mg / 2 ml Haver Pharma Drugs Inc , Istanbul) was given continuous infusion at a concentration of 4mg / ml via IV Patient Controlled Analgesia. 800 mg IV ibuprofen (Dorifen 800mg/8ml VEM Drugs Inc , Turkey) was administered to Group 2 (Ibuprofen) 30 minutes before the end of the operation. Patients were followed up by administering 800 mg IV every 6 hours for 24 hours. In Group 3 (Tramadol+Ibuprofen), 30 minutes before the end of the operation, tramadol (Tramosel 100 mg / 2 ml Haver Pharma Drugs Inc , Istanbul) was administered via PCA with continuous infusion at a concentration of 4mg / ml and 800 mg IV ibuprofen (Dorifen 800mg/8ml VEM Drugs Inc , Turkey) was administered as 4x1. Postoperative systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR) values at 30 minutes, 1st hour, 2nd hour, 4th hour, 8th hour, 12th hour, 18th hour; visual analog scale (VAS), analgesic vii consumption, nausea, vomiting, and patient satisfaction at at 0-1, 1-12, 12-24 hours were evaluated and recorded. In demographic data, no significant difference was found between groups in terms of SAB, DAB, MAP, CAD and nausea and vomiting. In the VAS evaluation of the patients, VAS values were found to be significantly lower in Group 3 compared to Group 2 at every hour and at the 4th hour compared to Group 1. Group 3 was found to be significantly lower than Group 1 in total analgesic consumption in all time zones. As a result; We think that IV Ibuprofen, which will be given in addition to tramadol after abdominoplasty operation, can provide effective analgesia and reduce analgesic consumption.
Açıklama
Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
