İntratekal Bupivakain İle Morfinin TUR-M Sonrası Postoperatif Analjeziye Etkisi

Yıl 2020, Cilt: 7 Sayı: 1, 65 - 69, 31.03.2020

Aylin İncesu Mustafa Nuri Deniz , Elvan Erhan , Güden Ugur

https://doi.org/10.34087/cbusbed.687605

Cited By: 1

Öz

Amaç: Bu randomize çalışmada transüretral mesane rezeksiyonu (TUR-M) sonrası analjezi için bupivakain ile iki farklı intratekal (IT) morfin dozu değerlendirildi.
Metodlar: Yetmiş beş hasta rastgele üç gruba ayrıldı. IT morfin (100 ug) ile 12,5 mg % 0,5 bupivakain (1. Grup), IT morfin (200 ug) ile 12,5 mg % 0.5 bupivakain (2. Grup) ve morfinsiz IT 12,5 mg % 0,5 bupivakain (3. Grup) alanlar olarak. Postoperatif ağrı 24 saat boyunca VAS ile değerlendirildi ve ağrı şiddeti orta derecede olan her hastaya intravenöz parasetamol ve Dexketoprophen trometamol verildi.
Bulgular: Grup I ve II'de VAS skorları 1 saat, 2 saat, 4 saat, 6 saat, 12 saatte Grup III'e göre anlamlı olarak düşüktü (p< 0.05). Analjezi talebi Grup III'te diğer iki gruba göre anlamlı derecede yüksekti (p< 0.05). Grup II'de postoperatif bulantı, diğer iki gruba göre daha fazla rapor edildi (p< 0.05).
Sonuç: IT % 12,5 mg % 0.5 bupivakain ile morfin (100 ug ve 200 ug), yanlız IT % 12,5 mg % 0,5 bupivakain’e kıyasla postoperatif ağrı skorlarında anlamlı bir azalma sağladı. TUR-M sonrasında postoperatif ağrı kontrolünde IT 100 ug morfin, IT 200 ug morfinden önemli ölçüde karşılaştırılabilir daha düşük yan etkiler sağladı.

Anahtar Kelimeler

Spinal anestezi, morfin, postoperative ağrı, transüretral mesane rezeksiyonu

Destekleyen Kurum

Yok

Proje Numarası

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The Efficacy of Intrathecal Morphine With Bupivacaine For Postoperative Analgesia After TUR-B

Öz

Objective,: In this randomized study, we evaluated two different doses of intrathecal (IT) morphine with bupivacaine for analgesia after transurethral resection of bladder (TUR-B).
Methods: Seventy-five patients were randomly divided into three groups. They were allocated to receive IT morphine (100 µg) with 12.5 mg 0.5% bupivacaine (Group 1), IT morphine (200 µg) with 12.5 mg 0.5% bupivacaine (Group 2), and IT 12.5 mg 0.5% bupivacaine without morphine (Group 3). Postoperative pain was evaluated by VAS during 24 h and each patient was given intravenous paracetamol and Dexketoprophen trometamol if pain severity was moderate.
Results: VAS scores were significantly lower in Groups I and II than Group III at 1h, 2h, 4h, 6h, 12h (p< 0.05) (Figure 1). The request for analgesia was significantly higher in Group III than the other two groups (p< 0.05). More patients reported postoperative nausea in Group II than the other two groups (p< 0.05) (Figure 2).
Conclusion: IT morphine (100 µg and 200 µg) with 12.5 mg 0.5% provided a significant reduction in postoperative pain scores compared to IT 12.5 mg 0.5% bupivacaine alone. IT morphine 100 µg provided comparable postoperative pain control with significantly lower side effects than IT morphine 200 µg after TUR-B.

Anahtar Kelimeler

Spinal anesthesia, morphine, postoperative analgesia, transurethral resection of bladder

Proje Numarası

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Kaynakça

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