Artroskopik diz cerrahisi sonrasında intraartiküler tekoksikam ile postoperatif ağrı kontrolü
Küçük Resim Yok
Tarih
2002
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada artroskopik diz cerrahisi geçirecek hastalarda intraartiküler yolla uygulanacak tenoxicamin postoperatif analjezik etkinliğini göstermeyi amaçladık. Fakülte etik kurul onayı alındıktan sonra fizik durumu ASA-I-II' ye giren, yaşları 16-55 arasında değişen 30 hasta çalışmaya dahil edildi. Hastalar rastgele 15' er kişilik 2 gruba ayrıldı. Premedikasyon uygulanmaksızın tüm hastalara Standard genel anestezi protokolü uygulandı. Indüksiyonda atropine 0.01 mg.kg'1 propofol 2 mg.kg'1, fentanil 2mcg. kg'1 ve vekuronyum 0.1 mg.kg"1 IV uygulanıp takiben trakeal entübasyon sonrası anestezi idamesi %50 O2/N2O ve isofluran (0.8-2.0 %) ile sağlandı. Operasyonun sonunda artroskop intraartiküler aralıktan çıkarılmadan tüm hastalara çift kör, randomize şekilde çalışma ilacı verildi. Grup T'ye: 20 ml salin içinde 20 mg tenoksikam, Grup K'ya: sadece 20 ml salin uygulandı. Postoperatif analjeziğe ihtiyaç duyulduğunda intravenöz HKA ile morfin uygulandı. Operasyondan sonra ağrı ve sedasyon skorları; Vizüel Analog Skala (VAS), Verbal Rating Skala (VRS) ve Ramsey Sedasyon Skorları O, 20, 40. dakikalarda ve 1, 2, 4, 12, 24. saatlerde kaydedildi. Postoperatif ilk 24 saat süresince toplam morfin tüketimi ve yan etkiler kaydedildi. Veriler Anova, Chi-kare testleri ile karşılaştırıldı iki grup arasında VAS, VRS, sedasyon skorları ve özellikle de toplam morfin tüketimi açısından istatiksel olarak anlamlı fark yoktu (p> 0.05). Bu çalışmada tenoksikamın intraartiküler analjezik etkisiyle ilgili daha önce yapılmış çalışmaların tersine 20 mg intraartiküler tenoksikamın artroskopik diz cerrahisinde kontrol grubuna göre üstünlüğünün olmadığı bulunmuştur.
In this study we tried to find out the postoperative analgesic efficacy of tenoxicam applied by intraarticular route in patients undergoing arthroscopic knee surgery. Thirty patients ASAI-II and 16-55 years of age were enrolled. Patients received no premedication. General anesthesia was maintained with 50 % O/AfcO and isoflurane (0.8-2.0 %) after induction with atropine 0.01 mg.kg'1, propofol 2 mg.kg'1 and fentanyl 2mcg. kg'1 intravenously, vecuronium 0.1 mg.kg'1 was administered for trachéal intubation. Standard monitoring was used. At the end of the surgery and before the removal of arthroscope, the studied drug was given intraarticulariy in a double-blinded randomized manner, such that; 20 mg Tenoxicam in 20 mL saline (Group T) or 20 mL Saline only, as control group (Group K). Postoperatively analgesic rescue medication was provided by intravenous PCA morphine. Pain and sedation scores were assessed by Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), Ramsey Sedation Scores at'O, 20, 40 minutes and 1, 2, 4, 12, 24 hours after the operation. Total morphine consumption and side effects were the measured parameters in first 24 hours. Statistical analysis was performed by Anova, Chi-square tests.(p<0,05). There were no significant differences in the presence of VAS, VRS, sedation scores and especially morphine consumption between the two groups. In this study, the analgesic efficacy of 20 mg tenoxicam applied intraarticularly in arthroscopic knee surgery hasn't been found to be superior to the control group; in contrast to the previous studies showing intraarticular analgesic effect of this agent.
In this study we tried to find out the postoperative analgesic efficacy of tenoxicam applied by intraarticular route in patients undergoing arthroscopic knee surgery. Thirty patients ASAI-II and 16-55 years of age were enrolled. Patients received no premedication. General anesthesia was maintained with 50 % O/AfcO and isoflurane (0.8-2.0 %) after induction with atropine 0.01 mg.kg'1, propofol 2 mg.kg'1 and fentanyl 2mcg. kg'1 intravenously, vecuronium 0.1 mg.kg'1 was administered for trachéal intubation. Standard monitoring was used. At the end of the surgery and before the removal of arthroscope, the studied drug was given intraarticulariy in a double-blinded randomized manner, such that; 20 mg Tenoxicam in 20 mL saline (Group T) or 20 mL Saline only, as control group (Group K). Postoperatively analgesic rescue medication was provided by intravenous PCA morphine. Pain and sedation scores were assessed by Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), Ramsey Sedation Scores at'O, 20, 40 minutes and 1, 2, 4, 12, 24 hours after the operation. Total morphine consumption and side effects were the measured parameters in first 24 hours. Statistical analysis was performed by Anova, Chi-square tests.(p<0,05). There were no significant differences in the presence of VAS, VRS, sedation scores and especially morphine consumption between the two groups. In this study, the analgesic efficacy of 20 mg tenoxicam applied intraarticularly in arthroscopic knee surgery hasn't been found to be superior to the control group; in contrast to the previous studies showing intraarticular analgesic effect of this agent.
Açıklama
Anahtar Kelimeler
Cerrahi
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Ege Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
41
Sayı
4
