Intrethecal Morphine for Postoperative Palu Relief in Patients with Hemorrholdectomy

Year 1984, Volume: 37 Issue: 4, 243 - 252, 31.12.1984

Handan Cuhruk

Abstract

Our study was performed to evaluate postoperative analgesia and side effects of intrathecally injected morphine in the patients with hemorrhoidectomy. 75 adult patients were divided into three groups. Each group consisted of 25 patients. Group I consisted of control and Group II, Group III intrathecally injected morphine group. Surgical intervention of Group I and Group III were induced with general anesthesia, but Group II under spinel anesthesia. In morphine administred patients, following subarachnoid puncture, 1 mg morphine chlorur was injected into subarachnoid space before surgical procedures. Patients were carefully observed until the first postoperative 72 hours for the severity of pain at the site of surgery none, mild ,moderate, severe, very severe), time of onset of severe postoperative pain, the additional need of analgesics (dose, time of administration) and side effects (nausea-vomiting, hypotension, respiratory depression, miyosis, somnolans, urine retension, pruritus). The data were evaluated statistically. Results indicate that intrathecally administred morphine is effective in postoperative pain relief and reduces the need of postoperative analgesic. However, this practice may cause some side effects. The most frequent side effects were urine retension and nausea-vomiting. Regarding these complications, it appears that using intrathecal morphine should be only performed in the specific units.

Keywords

analgesia , surgical , postoperative

Ethical Statement

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Hemoroid Ameliyatlarında Postoperatif Ağrı İçin Intratekal Morfin Kullanılması

Abstract

Çalışmamız hemoroidektomili hastalarda intratekal olarak enjekte edilen morfinin postoperatif analiezisi ve yan etkilerini saptamak amacı ile yapilmistir. 75 eriskin hasta üç gruba ayrilmistir. Her grup 25 hastadan olusmaktadir. Bu hastalardan I. Grup kontrol grubu, II ve III. Grup intratekal morfin yapilan hastaları icermektedir. I. Grup
ve IIL. Grubun cerrahi girigimleri genel, II. Grubun ise spinal anestezi altinda yapilmistir. Cerrahi girisimden önce intrateral morfin yapilacak hastalara subaraknoid ponksiyon yapilarak 1 mg morfin subaraknoid mesafeye verilmigtir. Postoperatif 72 saat hastalar cerrahi bélgede duyulan ağrı (yok, hafif, orta giddetle, siddetli, cok siddetli), analjezik gereksinimi (analjeziğin verilme saati ve dozuî, ve yan etkiler (bulantı-kusma, hipotansiyon, solunum depresyonu, miyozis, somnolans, idrar retansiyonu, kaşıntı) bakımından dikkatli bir şekilde gözlem altında tutulmuştur. Elde edilen verilen istatistiksel olarak da değerlendirilmiştir. Sonuçlar intratekal yolla uygulanan morfinin postoperatif ağrıyı gidermede etkin olduğunu, hastaların bu evredeki analjezik gereksinimini azalttığını göstermektedir. Buna karşın bu uygulamaya bağlı
bazı yan etkiler de görülebilmektedir. Bunlar arasında en sık karşılaşılanı idrar retansiyonu ve bulantı kusmadır. Komplikasyonlar göz önüne alındığında, intratekal morfinin kullanılmasının ancak bu iş.igin özel ünitelerde yapılması gerekliliği kendiliğinden ortaya çıkmaktadır.

Keywords

hemoroidektomili , intratekal , morfinin

Ethical Statement

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Project Number

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Thanks

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