PERİOPERATİF DÜŞÜK-DOZ KETAMİN SPİNAL ANESTEZİ UYGULANAN GEBELERDE POSTOPERATİF SEZERYAN AĞRISINI, BULANTI VE KUSMA SIKLIĞINI AZALTIR MI?

Abstract

Amaç: Postoperatif ağrı sezaryen operasyonlarını takiben karşımıza çıkan en büyük sorunlardan birisi olmaya devam etmektedir. Akut ağrı tedavisindeki gelişmelere rağmen kişisel farklılıklar nedeniyle hastaları yeterince memnun etmek her zaman mümkün olamamaktadır. Ketamin 1960 yıllardan beri güçlü bir anestetik ve etkin bir analjezik olarak kullanılmaktadır. Bu çalışmada amacımız, sezaryen operasyonu için, spinal anestezi yapılmış gebelerde, uygulanan düşük doz ketaminin, postoperatif ağrı, bulantı ve kusma üzerine etkilerini incelemektir.

Gereç ve Yöntem: Çalışmaya, 120 hasta retrospektif olarak dahil edildi. Hastaların ağrı durumlarını değerlendirmek için Vizüel Analog Skala değerlerini 1., 2., 3., 4., 12., 24. ve 48. saatlerde inceledik. Bununla birlikte, postoperatif dönemdeki bulantı & kusma, ilk analjezik talep sürelerini ve ketamine bağlı oluşabilecek yan etkileri de kayıt altına aldık.

Bulgular: Vizüel Analog Skala değerlerinde 2., 4., ve 12. saatlerde ketamin grubunda anlamlı azalmalar olduğunu tespit ettik. Bu anlamlılığın 30. dakikada 1., 24. ve 48. saatlerde olmadığını gözlemledik. Hastaların postoperatif ilk analjezik talep sürelerinde ve bulantı & kusma oranlarında ketamin grubunda kontrol grubuna göre anlamlı azalma olduğunu saptadık. Psikodisleptik bulgularda ise ketamin grubunda anlamlı olmayan bir artış gördük.

Sonuç: Bu sonuçlar ışığında, düşük doz ketaminin, sezaryen operasyonlarında, spinal anestezi yapılan gebelerde, mevcut ağrı tedavilerini desteklemek için, etkin bir ilaç olduğunu düşünüyoruz. Aynı zamanda ketaminin postoperatif bulantı ve kusma oranlarında azalma sağlamasının da, önemli bir konu olduğu kanaatindeyiz.

Anahtar kelimeler: Ketamin; VAS; analjezi.

Keywords

• Ketamin,VAS,analjezi

PERIOPERATIVE LOW-DOSE KETAMINE DIMINISHES POST-OPERATIVE CAESAREAN PAIN, NAUSEA & VOMITING AFTER SPINAL ANAESTHESIA

Abstract

Objective: Despite various developments in the treatment of post-operative caesarean pain, there are still difficulties in satisfying patients due to individual differences. Ketamine is used as a potent anaesthetic and an effective analgesic since 1960’s. The purpose of our study is to observe the effects of low-dose ketamine applied following spinal anaesthesia for postoperative analgesia and  nausea & vomiting in pregnant patients.

Materıal and Method: We examined the Visual Analogue Scales values of 120 patients at the 1^st, 2^nd, 4^th, 12^th, 24^th, and 48^th hours and evaluated nausea & vomiting. We also recorded the first additional analgesic demands and ketamine associated adverse events.

Results: We detected significant differences between the visual analogue scale values of ketamine and control group in the 2^nd, 4^th and 12^th hours. Significant differences were also seen in the first analgesic demand periods. We found a significant decrease in nausea and vomiting and insignificant elevation of psychodysleptic findings in ketamine group.

Conclusion: We believe that low-dose ketamine can be effectively used to sustain analgesia in pregnant patients who received spinal anaesthesia. We further believe that the effect of ketamine in decreasing nausea and vomiting, in exchange of low levels of neuropsychiatric symptoms, is a remarkable subject.

Keywords: Ketamine; VAS; analgesia.

Keywords

• Ketamine,VAS,analgesia

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