Laparoskopik kolesistektomi sonrası postoperatif bulantı ve kusmanın önlenmesinde tropisetron ve palonosetron’un karşılaştırılması: Randomize, çift-kör çalışma

Year 2016, Volume: 43 Issue: 3, 406 - 412, 01.09.2016

Recep Aksu Cihangir Biçer

Abstract

Amaç: Postoperatif bulantı-kusma (POBK) anestezi sonrası
en sık ortaya çıkan yan etkilerden biridir. POBK hastanın
ameliyat sonrası derlenmesini ve hastanede kalış
süresini uzatır. Bu çalışmada, intraoperatif uygulanan
tropisetron ve palonosetronun, laparoskopik kolesistektomi
sonrası postoperatif bulantı kusma üzerine etkilerinin
karşılaştırılması amaçlandı.
Yöntemler: Laparoskopik kolesistektomi planlanan, ASA
I-II grubu, 18-65 yaş arası 142 hasta çalışmaya dahil
edildi. Endotrakeal entübasyon sonrası iv yoldan Palonosetron
Grubuna (Grup P) 0.075 mg palonosetron,
Tropisetron Grubuna (Grup T) iv 5 mg tropisetron verildi.
Hastaların postoperatif 0-72 saatlik zaman diliminde bulantı-kusma
skorları, antiemetik kullanımları ve VAS skorları
kaydedildi.
Bulgular: Vakaların postoperatif 0-24 ve 48-72 saatlik
dönemdeki bulantı-kusma skorları arasında gruplar arasında
istatistiksel fark bulunmazken (p > 0.05), 24-48 saatlik
dönemde ise Grup P’de, Grup T’ye göre bulantı-kusma
skorları daha düşük bulundu (p < 0.024) (Tablo 3).
Postoperatif antiemetik kullanımı açısından 72 saatteki
her bir dönemde gruplar arasında fark yoktu (p > 0.05).
72 saatlik toplam ek antiemetik tüketimi ise Grup T’de,
Grup P’ye göre istatistiksel olarak anlamlı yüksek bulundu
(p = 0.025) (Tablo 4).
Sonuç: POBK profilaksisinde antiemetik olarak kullanılan
palonosetron, postoperatif 24-48 saatler arasında POBK
şiddet skorunu ve toplam postoperatif 72 saatteki ek antiemetik
ihtiyacını tropisetrona göre daha fazla azaltmıştır.

Keywords

Postoperatif bulantı-kusma, laparoskopik cerrahi, palonosetron, tropisetron

Comparison of palonosetron and tropisetron used for postoperative nausea and vomiting prophylaxis after laparoscopic cholecystectomy: A Randomized, double blinded study

Abstract

Objective: Postoperative nausea-vomiting (PONV) is one of the most common side effects after anesthesia. PONV extends the duration of hospital stay and recov­ery time of the patient after the surgery. In this study, we compared the effects of tropisetron on palonosetron on postoperative nausea and vomiting after laparoscopic cholecystectomy. Methods: After endotracheal intubation, Palonosetron Group (Group P) received iv 0.075 mg of palonosetron and Tropisetron Group (Group T) received iv 5 mg of tro­pisetron. VAS scores, antiemetic use and nausea-vomit­ing scores were recorded in 0-72 hours interval. Results: In the 0-24 and 48-72 hour intervals, there were no statistical difference between the groups with respect to nausea-vomiting scores, but, in the 24-48 hour interval, nausea-vomiting score was lower in Group P than Group T (p < 0.024) (Table 3). There was no statistical difference in all 72 hour intervals with respect to antiemetic use (p > 0.05). 72 hours total antiemetic use was statisticaly higher in Group T than Group P (p = 0.025) (Tablo 4). Conclusion: For PONV prophylaxis, palonosetron de­creased the PONV score and antiemetic need more than tropisetron in the first 72 hours.

Keywords

postoperative nausea-vomiting, laparoscopic surgery, palonosetron, tropisetron

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