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İNTRAARTİKÜLER SUFENTANIL, MORFİN VE PLASEBONUN POSTOPERATİF AĞRI VE ANALJEZİK KULLANIMI ÜZERİNE ETKİLERİ

THE EFFECTS OF INTRAARTICULAR ADMINISTRATION OF SUFENTANIL, MORPHINE AND PLASEBO ON POSTOPERATIVE PAIN AND ANALGESIC REQUIREMENTS

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Abstract (2. Language): 
Aim: The aim of this study was to evaluate the effects of intraarticular administration of sufentanil and morphine on postoperative pain and analgesic requirements after artroscopic knee procedures. Material and Method: Sixty patients scheduled for artroscopic knee surgery were randomised into three groups. A standart general anesthesia was used for all patients At the end the surgery , before the artroscope was removed the following solutions were administerd in 20 ml of normal saline. Group l:(n:20) 20 ml normal saline, Group ll:(n:20) 10mg sufentanil, Group lll:(n:20) 2 mg mor¬phine. Awaken time of the patients was estimated as time 0 and Visual Analog Scale (VAS) scores were assesed. IV PCA (Patient Controlled Analgesia) was given as tramadol. The PCA deliveries at 30 min, 2 hours, 12 hours and 24 hours and total tramadol requirements for 24 hours were noted. Result: VAS scores were significantly lower in group ll(p< 0.05). The consumption of tramadol at 30 min was also lower in group ll when compared to group l and group lll (p<0.05). lntraarticular sufentanil significantly reduced the postoperative consumption of analgesics (p<0.05). Conclusion: As a result we concluded that intraarticular sufentanil using in artroscopic knee procedures is sim¬ple, effective, safe and well tolerated analgesic techinique. This study showed that the onset of anal¬gesia was faster and stronger with intraarticular sufentanil.
Abstract (Original Language): 
Amaç: Bu çalışmada intraartiküler sufentanil ve morfinin postoperatif agrı ve analjezik kullanımı üze¬rine olan etkilerinin araştırılması amaçlandı. Gereç ve Yöntem: Artroskopik diz cerrahisi geçirecek 60 olgu üç gruba ayrıldı. Hastalara standart anestezi uygulandı. Operasyon sonunda artroskop çek¬ilmeden, ilaçlar toplam verilecek mayi 20 cc olacak şekilde serum fizyolojik ile sulandırılarak, Grup I'de 20 cc izotonik (n:20), Grup Il'de 10 mg sufentanil (n:20), Grup IlI'de 2mg morfin (n:20) intraar¬tiküler uygulandı. Hastaların uyandıkları saat 0. dk kabul edilerek VAS'ları değerlendirildi. Tramadol 1 mg/kg yükleme, 20 mg bolus ve 7 dk kilitli kalma süresi olacak şekilde hasta kontrollü analjezi (HKA) ile uygulandı. Bu andan itibaren 30. dk, 2.saat, 12. saat ve 24. saat larda hastaların HKA istekleri ve bir günlük tramadol tüketimleri kaydedildi. Bulgular: Sufentanil grubunda 0. dk VAS değerleri diger gruplara göre anlamlı derecede düşüktü (p< 0.05). 30. dk kullanılan tramadol miktarı Grup Il'de Grup I ve lll'e göre anlamlı derecede azdı (p<0.05). intraartiküler verilen sufentanilin postoperatif tra¬madol kullanımını azalttıgı gözlendi. Sonuç: Sonuç olarak; intraartiküler sufentanil kullanımı artroskopik diz cerrahisinde kolay uygulanan, efektif, güvenilir ve iyi tolere edilen bir analjezik teknik¬tir. Bu çalışmada intraartiküler sufentanil ile etki başlangıcının daha kısa ve güçlü oldugu gösteril¬miştir.

REFERENCES

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