Ratlarda Opioidlerin ve Non-Steroidal Anti-Enflamatuvar İlaçların Kırık İyileşmesi Üzerine Etkilerinin Karşılaştırılması

Yıl 2018, , 933 - 947, 15.08.2018

Muhammet Zeki Gültekin Serdar Yüksel Ender Alagöz Şule Özsoy Ali Avcı Mehmet Akif Güleç Oğuz Uğur

https://doi.org/10.30569/adiyamansaglik.444022

Öz

Amaç: Analjezik etkileri için kullanılan opioidlerin ve non-steroid
anti-enflamatuvar ilaçların kıkırdak harabiyetine yol açtığına ve kırık
iyileşmesini olumsuz etkilediği bilinmektedir. Bu çalışmada; ratlar üzerinde
deneysel modelde opioidler ve non-steroidal anti-enflamatuvar ilaçların kırık
iyileşmesine etkilerinin karşılaştırılması amaçlandı.

 

Yöntem: Çalışmamızda rastgele olarak 3 guruba ayrılan 60 adet Sprague
-Dawley cinsi rata femur kırığı oluşturulduktan sonra 2 hafta boyunca sırasıyla
serum fizyolojik, morfin ve karprofen verildi. Tüm gruplarda yarısını 4.
haftada diğer yarısını ise 8.haftada sarifiye ederek kırık kalluslarını akut ve
subakut dönemlerde biyomekanik, radyografik ve histopatolojik olarak
değerlendirildi.

 

Bulgular: Opioid kullanılan gruptaki
ratların 1.ay ve 2. aydaki kırık kalluslarının diğer iki gruptan histopatolojik
olarak olumsuz etkilendiğini fakat biyomekaniksel ve radyografik açıdan bir
fark olmadığı saptadı. Non-steroidal anti-enflamatuvar ilaç kullanılan grupta
ise kırık iyileşmesinin etkilenmediğini tespit edildi.

 

Sonuç: Gerek opioidler, gerekse non-steroidal anti-enflamatuvar
ilaçların kırık iyileşmesi sürecine etkileri ile ilgili yapılmış invitro ve
invivo çalışmalarda kırık iyileşmesini etkileri tartışmalıdır. Bizim çalışmamıza
göre kırık iyileşmesini olumsuz etkileyecek faktörleri (ileri yaş, açık kırık,
yumuşak doku hasarsı vs) olmayan hastalarda akut ağrı kontrolünde opioid ve
non-steroidal anti-enflamatuvar ilaçların rahatça kullanılabilir.

 

Anahtar Kelimeler

Opioid, Nonsteroid antienflamtuar ilaçlar, Kırık iyileşmesi, Rat, Fraktür

THE COMPARISON OF THE EFFECTS OF OPIOIDS AND ANTI-INFLAMMATORY DRUGS ON FRACTURE HEALING

Öz

Objective: Opioids and non-steroid anti-inlammatory drugs used
for analgesic effects are known to lead to cartilage destruction and to affect
cartilage healing negatively. In the present study, the effects of opioids and
non-steroid anti-inlammatory drugs on cartilage healing were aimed to be
compared on experimental model of rats.

Method: In our study, 60 Sprague –Dawley rats in which
femur fractures were intentionally formed were randomly divided into three groups
and then given physiological saline, morphine and carprofen for 2 weeks,
respectively. In all groups, half of the rats were sacrificed at week 4, and
the second half were sacrificed at week 8, and then fracture calluses were
assessed biomechanically, radiographically and histopathologically within the
acute and sub-acute periods.

Results: It was determined that the fracture calluses at 1st and 2nd
months of the rats given opioids were affected histopathologically negatively
from the other two groups, but there was no difference in
terms of biomechanical and radiographical effects. In the group treated with
non-steroidal anti-inflammatory drugs, however, no fracture healing was
detected to develop.

Conclusion: In in vitro and in vivo studies, the effects of both opioids and
non-steroid anti-inlammatory drugs on fracture healing period still remain
controversial. Based on our study findings, opioids and non-steroid
anti-inlammatory drugs can be conveniently used in pain control in the patients
not having factors (advanced age, open fracture, soft tissue injuries and so
on) to affect fracture healing.  

Anahtar Kelimeler

Fracture, opioids, non-steroid anti-inflammatory drugs, fracture healing, rat

Kaynakça

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