Comparison the Different Opioids with Propofol for Sedoanalgesia in D&C Operation

Yıl 2016, Cilt: 7 Sayı: 25, 10 - 18, 12.04.2016

Sedat Hakimoğlu , Işıl Davarcı Kasım Tuzcu Murat Karcıoğlu İlay Gözükara Çağla Buket Özbakış Akkurt Selim Turhanoğlu

https://doi.org/10.17944/mkutfd.26572

Öz

Aim: Dilatation and curettage (D&C) is a common day-care
procedure in obstetrics and gynecology. In this study we
aimed to investigate the effect of different opioids with
propofolon recovery and its effects on hemodynamic
parameters combination for sedoanalgesia.
Materials and Methods: This study was conducted in 105
patients who undergoing D & C operations. Anesthesia
induction were ensured with 1.5 mg/kg propofol+1 mcg/kg
remifentanil in Group PR, 1.5 mg/kg propofol+1 mcg/kg
fentanyl in Group PF and 1.5 mg/kg propofol+1 mg/kg
pethidine in Group PP. Duration of anesthesia, Modified
Aldrete Score (MAS), hemodynamic parameters (after
induction 5., 10., 15. minutes and postoperative 0, 5, and 10
minutes) and the number of patients receiving additional
propofol were recorded. Also surgeon satisfaction, side
effects and complications were recorded at the end of
surgery.
Results: Heart rate was significantly lower in Group PR than
other groups (p<0.05). Group PR and Group PP showed
similar effects on heart rate postoperative period but in
Group PR more was suppressed than Group PF (p<0.05).
There was no difference in the postoperative period while
mean arterial pressure (MAP) was significantly lower in
Group PR than Group PF in intraoperative period (p<0.05).
There was no difference between the groups at other times,
while MAP was significantly lower in Group PP than Group
PF in postoperative 0. minute (p<0.05). According to the
group PP surgeon satisfaction were better in both Group PR
and Group PF. Also compared with other groups in Group
PR were provided earlier recovery and the number of those
who need additional propofol was less than (p<0.05).
Conclusion: In our study propofol plus remifentanil ensured
earlier recovery and higher surgeon satisfaction when
compared with fentanyl and pethidine.

Anahtar Kelimeler

Fentanyl, curettage, propofol, remifentanil

D&C operasyonlarında sedoanaljezi için propofol ile kullanılan farklı opioidlerin karşılaştırılması

Öz

Amaç: Dilatasyon ve uterus küretajı (D&C) yaygın bir günübirlik obstetrik ve jinekolojik prosedürdür. Biz bu çalışmada sedoanaljezi için propofol ile kullanılan farklı opioidlerin derlenme ve hemodinamik parametreler üzerine etkilerini araştırmayı amaçladık

Gereç ve Yöntem: Bu çalışma D&C operasyonu yapılacak hastalarda gerçekleştirildi. Anestezi indüksiyonu Grup-PR’de 1.5 mg/kg propofol+1 mcg/kg remifentanil ile, Grup-PF’de 1.5 mg/kg propofol+1 mcg/kg fentanil ile ve Grup-PP’de 1.5 mg/kg propofol+1 mg/kg petidin ile sağlandı. Anestezi süresi, Modifiye Aldret Skoru (MAS), hemodinamik parametreler (indüksiyon sonrası 5.,10., 15. dakikalar ve postoperatif 0., 5., ve 10.dakikalarda) ve ek propofolverilen hastaların sayısı kaydedildi. Ayrıca operasyon sonunda cerrah memnuniyeti, yan etki ve komplikasyonlar kayıt edildi.

Bulgular:Çalışmamızda kalp hızı indüksiyon sonrası Grup PR’de diğer gruplardan daha düşüktü(p<0.05). Postoperatif dönemde Grup PR, kalp hızı üzerine Grup PP ile benzer etki gösterdi fakat Grup PR’de Grup PF’den daha çok baskılandı(p<0.05). Ortalama arter basıncı (OAB) Grup PR’de Grup PF’ye göre intraoperatif dönemde daha düşük iken postoperatif dönemde fark yoktu (p<0.05).OAB açısından Grup PF ile Grup PP karşılaştırıldığında postoperatif 0. dakikada Grup PP’de daha düşük olduğu görülürken diğer zamanlarda fark yoktu (p<0.05). Cerrah memnuniyeti Grup PP’deki hastalara göre hem Grup PR ve hem de Grup PF’de daha iyiydi (p<0.05). Ayrıca Grup PR’de diğer gruplar ile karşılaştırıldığında daha erken derlenme sağlandı ve ek propofol ihtiyacı olanların sayısı diğer gruplardan daha azdı (p<0.05).

Sonuç: Çalışmamızda propofol ile remifentanil; fentanil ve petidine göre daha erken derlenme ve yüksek cerrahi memnuniyet sağlamıştır.

Anahtar Kelimeler

Fentanil, küretaj, propofol, remifentanil

Kaynakça

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