TY  - JOUR
T1  - Dexketoprofen Effectively Reduces Postoperative Pain and Meperidine Consumption After Lumbar Discectomy and Laminectomy
TT  - Lomber Diskektomi ve Laminektomi Operasyonlarında Preoperatif ve Postoperatif verilen Deksketoprofen Trometamolün Postoperatif Analjezi ve Meperidin Tüketimi Üzerine Etkisi
AU  - Yıldız, İsmail
AU  - Ceylan, İlkay
AU  - Karakoç, Ebru
AU  - Yelken, Birgül
PY  - 2018
DA  - September
DO  - 10.20515/otd.415188
JF  - Osmangazi Tıp Dergisi
PB  - Eskişehir Osmangazi Üniversitesi
WT  - DergiPark
SN  - 1305-4953
SP  - 79
EP  - 85
VL  - 40
IS  - 3
LA  - en
AB  - Postopeartive pain is a majorcontributor to increased morbidity. Analgesia is important in reducingpostoperative morbidity and hospital stay.We aimed to determine the efficacy and side effect profile of preemptiveand postoperative multimodal use of dexketoprofen added to meperidinepatient-controlled analgesia infusion inpatients undergoing lumbar discectomy and laminectomy. In this randomised, prospective,single-blind placebo-controlled trial, 60 patients undergoing laminectomy anddiscectomy were randomly (1:1) divided into two: Group I received placebowhereas Group II received 50 milligrammes dexketoprofen intravenously 30 minutesbefore surgery and 8 hours after the first dose. VAS scores, overall patientsatisfaction, analgesic related side effects (nausea, vomiting, dyspepsia,bleeding, headache, hypotension, bradycardia, respiratory distress, pruritus)at hours 1, 4, 8, 12 and 24 were collected after surgery. Bleeding was recorded as the total value ofaspirations during surgery, a number of sponges used during surgery andpostoperative bleeding from vacuum drainage tubes. Groups were distributedsimilarly regarding age, sex, weight, ASA, anaesthesia and surgery time.Intraoperative and postoperative bleeding was similar. First time for PCAanalgesic requirement was shorter in Group I.Group II had lower VAS scores on postoperative hours 1, 4, 8, 12 and 24.The total dosage of meperidine was lower in Group II at the 4th, 12th and 24thhours. Group II had lower rates ofgastrointestinal side effects and headache related with analgesic use and hadhigher rates of satisfaction in regards of postoperative analgesia. Currentstudy shows the multimodal use of dexketoprofen is a safe and effectiveanalgesia option in patients undergoing lumbar discectomy and laminectomy.Dexketoprofen is not associated with increased frequency side effects orbleeding.
KW  - postoperative pain
KW  - dexketoprofen
KW  - meperidine
KW  - laminectomy
N2  - Postoperatif ağrı morbiditeyi arttıranbaşlıca etkenlerdendir. Analjezi postopeatif morbiditenin azaltılmasında vehastanede kalışın kısaltılmasında etkilidir.Lomber diskektomi ve laminektomi uygulanacak hastalarda hasta kontrollüanaljezide kullanılan meperedin ile birlikte multimodal analjezi amacıylapreemptif ve postoperatif dönemde uygulanan deksketoprofenin etkinliğini ve yanetki profilini değerlendirmeyi amaçladık. Randomize, prospektif ve tek körplasebo kontrollü çalışmada lomberlaminektomi ve diskektomi uygulanacak hastalar randomize olarak iki grubaayrıldı. Grup I kontrol-plasebo grubu,Grup II’ye indüksiyondan 30 dakika önce intravenöz 50 miligram deksketoprofenve ikinci doz ilk dozdan 8 saat sonra 50mg deksketoprofen verildi. VAS skorları, hasta memnuniyeti, analjezik ilişkiliyan etkiler (bulantı, kusma, dispepsi, kanama, baş ağrısı, hipotansiyon,bradikardi, solunum sıkıntısı, kaşıntı) postoperatif dönemde 1,4,8,12 ve 24saatlarde kaydedildi. Kanama cerrahi sırasında aspiratörde biriken kan,kullanılan spançlar ve postoperatif dönemde vakum drenlerden gelen kan olaraktoplanarak kaydedildi. Gruplararasında yaş,cinsiyet, ağırlık, ASA skorları, anestezi ve cerrahi sürelerindefarklılık bulunmadı. İntaroperatif ve postoperatif kanama miktarları benzerdi.Grup 1’ de PCA’dan analjezik kullanımı ihtiyacı daha erken oldu.GrupII’de; postopeartif 1, 4, 8, 12 ve 24. saat VAS değerleri daha düşük bulundu.Grup 2’de kullnaılan meperidin dozları 4,12 ve 24. saatlerde daha düşüktü. Grup 2’ de analjezik kullanımına bağlı gastrointestinal yan etkiler ve baş ağrısıoranları düşüktü ve hasta tatmin oranları daha yüksek bulundu. Çalışmamızlomber laminektomi ve diskektomi olgularında multimodal analjezide deksketoprofen kullanımının kanamave diğer yan etki oranlarında artma olmadan güvenli ve etkili bir seçenekolduğunu göstermiştir.
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UR  - https://doi.org/10.20515/otd.415188
L1  - http://dergipark.org.tr/tr/download/article-file/487689
ER  -