ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
Comparison Of Postope Rative Analgesia Methods ınlower Abdominal Surgery
Dr. Sinan GÜRSOY,a Dr. Kenan KAYGUSUZ, a Dr. Yeltekin DEMİREL, b Dr. Bülent DURAN, c Dr. Haluk KAFALI, a Dr. Caner MİMAROĞLUa
aAnesteziyoloji ve Reanimasyon AD, bAile Hekimliği, cKadın Hastalıkları ve Doğum AD, Cumhuriyet Üniversitesi Tıp Fakültesi, SİVAS
Objective: The present study aimed to determine the advantage and disadvantage of different postoperative analgesia methods in patients undergoing cesarean section or hysterectomy under general anesthesia.
Material and Methods: Following ethics committee approval and patient informed consents, 120 patients were recruited from the ASA I-III groups. Patients were divided randomly into 6 groups. IM-D group received intramuscular diclofenac sodium (75 mg) every 12 hours. IM-ME group received intramuscular meperidine (1 mg kg-1) every 6 hours. IM-DME group received intramuscular meperidine (1 mg kg-1)-diclofenac sodium (75 mg) combination every 12 hours. EP-MO group received epidural morphine (bolus of 3 mg and 0.06 mg mL-1 morphine; 6 ml h-1) infusion. EP-MOB group received epidural infusion of morphine-bupivacaine combination (bolus of 2 mg morphine + 35 mg bupivacaine combination, 2 mg ml-1 bupivacaine + 0.03 mg mL-1 morphine combination; 6 ml h-1). IV-MO group received intravenous morphine via patient-controlled analgesia (loading dose of 3 mg, bolus of 1 mg and 20 minutes lockout interval). Heart rate, mean arterial pressure, SpO2 , pain and sedation levels were recorded at 2, 6,12, 24 and 48 hours. Furthermore, additional analgesic consumption and side effects were also recorded.
Results: Effective analgesia was in groups IM-DME, EP-MO, EP-MOB, and IV-MO. However, the lowest pain scores were obtained in groups EP-MO and EP-MOB. Sedation scores were higher in groups EP-MO and IV-MO. While the highest additional analgesic consumption was in groups IM-D and IM-ME, there was no additional analgesic consumption in groups EP-MO, EP-MOB and IV-MO. Side effects were not observed in any groups that required treatment. The highest incidence of side effects were in group IV-MO whereas the lowest incidence of side effects were observed in groups IM-DME and EP-MOB.
Conclusion: While there was effective analgesia in groups IM-DME, EP-MO, EP-MOB, and IV-MO, IM diclofenac + meperidine combination and epidural bupivacaine + morphine combination seemed more advantageous when the side effects were considered.Keywords: Analgesia, epidural, surgery, diclofenac, morphineTurkiye Klinikleri J Med Sci 2006, 26:146-152
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