Gabapentinin spinal anestezide postoperatif analjezik etkisi
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Date
2009
Authors
Kaymak, Serdar
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Çalışmamızda bupivakain ile spinal anestezi altında inguinal herni operasyonu planlanan olgularda, preoperatif 1 saat önce uygulanan tek doz oral 800 mg gabapentinin; hemodinamik yanıtlar, spinal anestezi karakteristikleri, postoperatif analjezi ve taburculuk süreleri üzerine etkisini değerlendirmeyi amaçladık.Prospektif, plasebo kontrollü ve çift kör olarak planlanan çalışmaya etik kurul onayı alındıktan sonra ASA I-II grubu, 18-70 yaş arası 50 olgu alındı. Olgular randomize olarak eşit iki gruba ayrıldı; Grup Gabapentin (n=25) ve Grup Kontrol (n=25). Monitörizasyon sonrası oturur pozisyona alınan olgulara 3 ml %0.5 bupivakain ile spinal anestezi uygulandı. Tüm olguların belirli aralıklarla hemodinamik parametreleri (kalp hızı, kan basıncı, SpO2, EtCO2), spinal anestezi karakteristikleri (duyusal ve motor blok seviyesi, duyusal blok iki segment gerileme zamanı, motor blok süresi), intraoperatif ve postoperatif komplikasyonları, operasyon sonrası postoperatif ağrının şiddeti, tüketilen morfin miktarları, ilk analjezik gereksinim zamanı ve taburculuk zamanları kaydedildi.Hemodinamik parametreler, spinal anestezi karakteristikleri ve postoperatif ağrının şiddeti gruplar arası benzer bulunurken, tüm ölçüm dönemlerinde postoperatif morfin tüketimi Grup Gabapentin'de daha düşük bulundu (p<0.05). Ayrıca Grup Gabapentin'de, ilk analjezik gereksinim zamanı daha uzun ve taburculuk süresi daha kısa bulundu (p<0.05, p<0.05).Spinal anestezi altında inguinal herni operasyonu planlanan olgularda; operasyon öncesi alınan 800 mg gabapentinin, spinal anestezi karekteristiklerini etkilemeksizin, postoperatif morfin tüketimini azalttığını ve hastanede kalış süresini kısalttığını saptadık.
In this study, the aim was to evaluate the effects on hemodynamic responses, spinal anesthesia characteristics, postoperative analgesia, and times to discharge of single dose oral 800 mg Gabapentin administered preoperatively one hour before the surgery to cases, for whom inguinal hernia surgery under spinal anesthesia with bupivacaine was planned.After obtaining the approval of the ethics committe, 50 ASA I-II group cases between the ages of 18 and 70 were included in this prospective, placebo controlled, and double blind study. The patients were randomly divided into two equal groups, Gabapentin Group (n=25) and the Control Group (n=25). Spinal anesthesia with 0.5% bupivacaine 3 ml was induced in cases that were placed in the sitting position following monitorization. Hemodynamic parameters (hearth rate, blood pressure, SpO2, EtCO2) at regular intervals, characteristics of spinal anesthesia (sensory and motor block levels, time to two segment regression from peak sensory block, duration of motor block), intraoperative and postoperative complications, severity of postoperative pain, amounts of morphine consumed, time to first analgesic requirement, and times to discharge of all the cases were recorded.While the hemodynamic parameters, characteristics of spinal anesthesia, and severity of postoperative pain were similar between the groups, postoperative morphine consumption at all measurement periods was lower in the Gabapentin Group (p<0.05). In addition, time to first analgesic requirement was longer and time to discharge was shorter in the Gabapentin Group (p<0.05, p<0.05).We have found that 800 mg Gabapentin administered preoperatively to patients that will undergo inguinal hernia surgery under spinal anesthesia reduces postoperative morphine consumption and shortens duration of hospital stay without altering the characteristics of spinal anesthesia.
In this study, the aim was to evaluate the effects on hemodynamic responses, spinal anesthesia characteristics, postoperative analgesia, and times to discharge of single dose oral 800 mg Gabapentin administered preoperatively one hour before the surgery to cases, for whom inguinal hernia surgery under spinal anesthesia with bupivacaine was planned.After obtaining the approval of the ethics committe, 50 ASA I-II group cases between the ages of 18 and 70 were included in this prospective, placebo controlled, and double blind study. The patients were randomly divided into two equal groups, Gabapentin Group (n=25) and the Control Group (n=25). Spinal anesthesia with 0.5% bupivacaine 3 ml was induced in cases that were placed in the sitting position following monitorization. Hemodynamic parameters (hearth rate, blood pressure, SpO2, EtCO2) at regular intervals, characteristics of spinal anesthesia (sensory and motor block levels, time to two segment regression from peak sensory block, duration of motor block), intraoperative and postoperative complications, severity of postoperative pain, amounts of morphine consumed, time to first analgesic requirement, and times to discharge of all the cases were recorded.While the hemodynamic parameters, characteristics of spinal anesthesia, and severity of postoperative pain were similar between the groups, postoperative morphine consumption at all measurement periods was lower in the Gabapentin Group (p<0.05). In addition, time to first analgesic requirement was longer and time to discharge was shorter in the Gabapentin Group (p<0.05, p<0.05).We have found that 800 mg Gabapentin administered preoperatively to patients that will undergo inguinal hernia surgery under spinal anesthesia reduces postoperative morphine consumption and shortens duration of hospital stay without altering the characteristics of spinal anesthesia.
Description
Keywords
Gabapentin, Spinal anestezi, Postoperatif analjezi, Spinal anaesthesia, Postoperative analgesia
Citation
Kaymak, S. (2009). Gabapentinin spinal anestezide postoperatif analjezik etkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.