İntravenöz parasetamolün torakoskopik cerrahi sonrası postoperatif analjezi üzerine etkinliği
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Date
2010-05-07
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Uludağ Üniversitesi
Abstract
Çalışmamızda, torakoskopik cerrahi sonrası intravenöz parasetamol uygulamasının postoperatif analjezi üzerine etkinliğini değerlendirmeyi amaçladık. ASA I-II grubu 40 hasta, anestezi indüksiyonundan önce ve postoperatif 24 saat içinde her 6 saatte bir intravenöz 1 gr parasetamol veya 100 ml serum fizyolojik verilmek üzere randomize olarak ayrıldı. Dinlenme ve hareket sırasındaki ağrı skorları, sedasyon skorları, hemodinamik parametreler, morfin kullanımı, hasta/hemşire memnuniyeti ve yan etkiler değerlendirildi. İlk analjezik gereksinim zamanı, ilk mobilizasyon ve hastaneden çıkış zamanları kaydedildi. Parasetamol grubunda; morfin tüketimi postoperatif 2., 4., 8., 12. ve 24. saatlerde daha düşük (p=0.017, p=0.021, p<0.001, p<0.001, p<0.001), bulantı ve kusma sıklığı daha az (p=0.001, p<0.001); ilk analjezi gereksinim zamanı daha uzun (p=0.0032), ilk mobilizasyon ve hastaneden çıkış süreleri daha kısa bulundu (p=0.0031, p=0.0015). Analjezi açısından hasta/hemşire memnuniyeti anlamlı olarak fazlaydı (p<0.001, p<0.001). Sonuç olarak, parasetamol kullanımı daha az yan etki ile postoperatif morfin gereksinimini azalttı ve hasta/hemşire memnuniyetini artırdı. Bu yaklaşım torakoskopik cerrahi sonrası erken postoperatif mobilizasyona da katkıda bulunabilir.
In our study, we aimed to assess the efficacy of the intravenous paracetamol administration on postoperative analgesia after thoracoscopic surgery. Fourthy patients with an ASA physical status I-II were randomly assigned to receive intravenous administration of either 1 gr paracetamol or 100 ml saline, before induction of anesthesia and then every 6 h postoperatively for 24 h. Pain scores at rest and on movement, sedation scores, hemodynamic parameters, morphine usage, patient/nurse satisfaction, and side effects were evaluated. Time to first analgesic requirement, first mobilization and hospital discharge were recorded. In the paracetamol group; morphine consumption was lower at 2nd, 4th, 8th, 12th and 24th hours (p=0.017, p=0.021, p<0.001, p<0.001, p<0.001), the incidence of nausea and vomiting was lower (p=0.001, p<0.001), time to first analgesic requirement was longer (p=0.0032) postoperatively, and first mobilization and hospital discharge were faster (p=0.0031, p=0.0015). Patient/nurse satisfaction with the analgesia were significantly greater (p<0.001, p<0.001). As a result, the use of paracetamol reduced the postoperative morphine requirement and increased patient and nurse satisfaction with fewer side effects. This approach may also contribute to earlier postoperative mobilization after thoracoscopic surgery.
In our study, we aimed to assess the efficacy of the intravenous paracetamol administration on postoperative analgesia after thoracoscopic surgery. Fourthy patients with an ASA physical status I-II were randomly assigned to receive intravenous administration of either 1 gr paracetamol or 100 ml saline, before induction of anesthesia and then every 6 h postoperatively for 24 h. Pain scores at rest and on movement, sedation scores, hemodynamic parameters, morphine usage, patient/nurse satisfaction, and side effects were evaluated. Time to first analgesic requirement, first mobilization and hospital discharge were recorded. In the paracetamol group; morphine consumption was lower at 2nd, 4th, 8th, 12th and 24th hours (p=0.017, p=0.021, p<0.001, p<0.001, p<0.001), the incidence of nausea and vomiting was lower (p=0.001, p<0.001), time to first analgesic requirement was longer (p=0.0032) postoperatively, and first mobilization and hospital discharge were faster (p=0.0031, p=0.0015). Patient/nurse satisfaction with the analgesia were significantly greater (p<0.001, p<0.001). As a result, the use of paracetamol reduced the postoperative morphine requirement and increased patient and nurse satisfaction with fewer side effects. This approach may also contribute to earlier postoperative mobilization after thoracoscopic surgery.
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Keywords
Postoperatif analjezi, Postoperative analgesia, Parasetamol, Paracetamol, Opioid analgesic, Thoracoscopic surgery, Opioid analjezik, Torakoskopik cerrahi
Citation
Çınar, V. A. vd. (2010). "İntravenöz parasetamolün torakoskopik cerrahi sonrası postoperatif analjezi üzerine etkinliği" Uludağ Üniversitesi Tıp Fakültesi Dergisi, 36(2),43-48.