Postoperatif Hasta Kontrollü Analjezi Uygulaması: Tek Merkez Deneyimi

Year 2019, Volume: 9 Issue: 2, 171 - 176, 30.06.2019

Yeşim Şenaylı , Alper Salman , Altan Şahin

https://doi.org/10.16899/jcm.566754

Abstract

Öz

Amaç: Bu retrospektif çalışmada postoperatif hasta kontrollü analjezi (HKA) uygulanan hastaların demografik özelliklerinin, ağrı durumlarının, kullanılan analjezik ajanların ve yan etkilerin incelenmesi amaçlanmıştır.

Gereç ve Yöntem: Hastanemizde yaklaşık 20 aylık periyotta HKA ile postoperatif analjezi tedavisi uygulanan hastalar retrospektif olarak değerlendirildi. Hastaların demografik bilgileri, klinik özellikleri, intravenöz veya epidural uygulama protokolleri kullanılarak servis şartlarında yaklaşık sekiz saat aralıklarla yapılan takip değerlendirme bulguları (ağrı, sedasyon, uykusuzluk, bulantı, kusma, kaşıntı) kaydedildi.

Bulgular: Çalışmaya alınan 810 hastanın %57,9’u kadın olup çoğu (%55,8) ortopedik cerrahi uygulanmış olan hastalardı. HKA, 730 (%90,4) hastada intravenöz, 80 (%9,6) hastada epidural yol ile uygulanmıştı. İntravenöz HKA kadınlarda, epidural HKA ise erkeklerde daha fazla tercih edilen bir uygulama idi. En sık tercih edilen analjezik ajan intravenöz uygulamada petidin iken, epidural uygulamada fentanil + bupivakain olarak saptandı. Hastalarda en sık görülen yan etkiler sedasyon/uyku hali, bulantı, kusma ve idrar retansiyonu idi.

Sonuç: Hastanemizde HKA uygulamasında intravenöz uygulamanın daha çok tercih edildiği, en sık tercih edilen analjezik ajanın intravenöz uygulamada petidin, epidural uygulamada fentanil + bupivakain olduğu görülmüştür. HKA ile ağrı tedavisi düşük yan etki düzeyleri ile iyi tolere edilmektedir.

Keywords

: Hasta kontrollü analjezi, postoperatif ağrı

Postoperative Patient-Controlled Analgesia: A Single Center Experience

Abstract

Abstract

Aim:The aim of this retrospective study was to investigate demographic characteristics, pain conditions, analgesic agents used, and side effects in patients who received postoperative patient-controlled analgesia (PCA).

Materials and Methods: Patients who received postoperative analgesia with PCA for approximately 20-month period in our hospital were retrospectively evaluated. Demographic information, clinical features and follow-up evaluation findings (pain, sedation, sleeplessness, nausea, vomiting, itching), which were obtained in approximately eight-hour intervals under service conditions using intravenous or epidural administration protocols, were recorded.

Results:Data of 810 patients were evaluated, of whom 57.9% were female and 55.8% underwent orthopedic surgery. PCA was administered by intravenous route in 730 patients (90.4%) and by epidural route in 80 patients (9.6%). Intravenous PCA was preferred more in females and epidural PCA was preferred more in males. While the most preferred analgesic agent was petidine in the intravenous PCA, it was fentanil + bupivacaine in the epidural PCA. The most common side effects were sedation/somnolence, nausea, vomiting, and urinary retention.

Conclusion:In our hospital, it was seen that intravenous PCA was more preferred and that the most frequently preferred analgesic agent was petidine in intravenous PCA and fentanyl + bupivacaine in epidural PCA. Pain treatment with PCA is well tolerated with low levels of side effect.

 

Keywords

Patient-controlled analgesia, postoperative pain

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