Laparoskopik kolesistektomide ağrı yönetiminin derlenme parametreleri üzerine etkisi

Year 2018, , 216 - 220, 30.09.2018

Betül Güven Aytac İsmail Aytaç Ayşe Lafçı , Aysun Postacı Bayazit Dikmen

https://doi.org/10.18663/tjcl.445926

Cited By: 1

Abstract

Amaç: Laparoskopik
kolesistektomi ameliyatı geçiren hastalarda intraoperatif kullanılan
analjeziklerin postoperatif ağrı ve derlenme üzerine etkilerini gözlemlemeyi
amaçladık.

 

Gereç ve Yöntemler: ASA I-III risk grubunda,
20-85 yaş arası, LK geçiren hastalar çalışmaya dahil edildi. Kullanılan
analjeziklerin isimlerine göre gruplar adlandırıldı: İntraoperatif analjezi
uygulanmayan hastalar kontrol grubu (Grup C); tramadol (Grup T); metamizol
(Grup M); diklofenak (Grup D); parasetamol (Grup P); tramadol + metamizol (Grup
TM); tramadol + diklofenak (Grup TD); tramadol + parasetamol (Grup TP). Görsel
analog skala (VAS) ≤  4 sağlayabilen analjezikler etkili olarak kabul
edildi. Derlenme odasında VAS 4’den büyük 
olan hastalara ek analjezikler uygulandı. Hastaların derlenmesi Aldrete
Skoru ile belirlendi.

 

Bulgular: Kontrol grubunda 31 hasta,
tramadol grubunda 35 hasta, metamizol grubunda 36 hastada, diklofenak grubunda
32 hasta, parasetamol grubunda 31 hasta, Tramadol + metamizol grubunda 56
hasta,  tramadol + diklofenak grubunda 31
hasta  ve tramadol + parasetamol grubunda
 32 hasta bulunmaktaydı. Analjezik kullanan tüm gruplarda, intraoperatif
analjezikler ile ilk saatte VAS≤4 sağlanamadı. Hastalarda tek analjezik veya
iki analjezik birlikte kullanıldığında ilk bir saat içinde, en düşük ek
analjezik gereksinimi GP ve GTP grubunda  idi. İntraoperatif analjezik
uygulanmayanlarda Aldrete skorları  en düşük düzeyde gözlendi.

 

Sonuç: Laparoskopik
kolesistektomide ağrının erken postoperatif dönemde yapılması gerektiğini düşünüyoruz.
Tüm analjezikler, farmakokinetik profillerinin bilgisi temelinde
uygulanmalıdır.   

Keywords

laparoskopik kolesistektomi, postoperatif ağrı, non-steroid analjezikler

The effect of pain management in laparoscopic cholecystectomy on recovery parameters

Abstract

Aim: We aimed to observe
the effects of analgesics used intraoperatively on the postoperative pain and
recovery in patients underwent LC .

 

Material and
Methods: ASA
I-III group, aged 20-85 patients, who underwent LC surgery were included in the
study. We denominated
as groups the distribution of analgesics used in eight groups: control
group(Group C) for patients without intraoperative analgesia; tramadol (Group
T); metamizole (Group M); diclofenac (Group D); paracetamol (Group P);
tramadol+metamizol (Group TM); tramadol+diclofenac (Group TD);
tramadol+paracetamol (Group TP).   Analgesics that can provide visual
analog scale (VAS) ≤ 4 was considered effective. Additional analgesics were
administered to the patients whom VAS was above 4 in recovery room.
 Recoveries of patients was determined with Aldrete Score.

 

Results:  31 patients control
group, in 35 patients tramadol, in 36 patients, metamizole, in 32 patients
diclofenac and in 31 patients paracetamol,  in 56 patients
tramadol+metamizol, in 31 patients 
tramadol+diclofenac  and in 32 patients  tramadol+paracetamol were used. In all groups
used analgesics, VAS≤ 4 could not be provided in first hour. In the patients
used one analgesic alone and two analgesics together, lowest need for
additional analgesics was in GP and GTP group 
within the first one hour. Aldrete scores were lowest in whom did not
receive analgesics intraoperatively.

 

Conclusion: We consider that
the management of pain in laparoscopic cholecystectomy should be done early
postoperative period. All analgesics should be administered on the basis of the
knowledge of their pharmacokinetic profiles.

Keywords

laparoscopic cholecystectomy, postoperative pain, non-steroid analgesics

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