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POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI

Yıl 2009, Cilt: 18 Sayı: 1, 10 - 17, 01.03.2009

Öz

Özet : Çalışmamızda genel anestezi altında tiroidektomi
operasyonu geçirecek hastalarda (n=40) postoperatif
bulantı-kusma (POBK)’nın önlenmesinde tropisetronun
etkinliği metoklopramid ile karşılaştırıldı. Randomize
çift-kör çalışmamızda; American Society of
Anesthesiologists (ASA) I-II sınıflandırmasına göre 18-
70 yaş arası 40 hasta 20’şer kişilik iki gruba ayrıldı.
Metoklopramid grubu (Grup M)’na indüksiyondan önce
iv 10 mg metoklopramid ve tropisetron grubu (Grup
T)’na iv 2 mg tropisetron verildi. Bütün hastalara
standart genel anestezi uygulandı. İlaçların antiemetik
etkileri ve yan etkileri, her iki gruptaki antiemetik
gereksinimi 24 saat boyunca değerlendirildi. Grupların
bulantı-kusma skoru açısından karşılaştırılmasında
Grup T’de Grup M’ye göre bulantı-kusma skoru sıfır
olan hasta sayısı istatistiksel olarak anlamlı şekilde
yüksekti (p=0.027), diğer skorlar için gruplar arası
istatistiksel olarak anlamlı fark bulunmadı. Bulantıkusma görülme sıklığı her iki grupta benzerdi. Yan etkiler
açısından gruplar arası istatistiksel olarak anlamlı fark
belirlenemedi.
Tiroidektomi geçiren hastalarda POBK’yı önlemede
genel anestezi indüksiyonu öncesi 2 mg iv tropisetron
uygulandığında 24 saat boyunca POBK riskinin
metoklopramide göre daha az olduğu, dolayısıyla
tropisetronun uzun etkili bir antiemetik ajan olarak
POBK’nın önlenmesinde kullanılabileceği sonucuna
varıldı.

Kaynakça

  • 1. Stadler M, Bardiau F, Seidel L et al. Difference in risk factors for postoperative nausea and vomiting. Anesthesiology 2003;98:46-52.
  • 2. Koivuranta M, Laara E, Snare L, et al. A survey of postoperative nausea and vomiting. Anaesthesia 1997;52:443-449.
  • 3. Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg 2006;102:1884–1898.
  • 4. Watcha MF and White PF. Postoperative nausea and vomiting: its etiology, treatment and prevention. Anesthesiology 1992;77:162- 184.
  • 5. Ku CM, Ong BC. Postoperative nausea and vomiting: a review of current literature. Singapore Med J 2003;44:366-374.
  • 6. American Society of Health System Pharmacists. Prevention and treatment of postoperative nausea and vomiting. Am J Health-Syst Pharm 2005;62:1247-1260.
  • 7. Alon E, Buchser E, Herrera E, et al. Tropisetron for treating established postoperative nausea and vomiting: a randomized, doublelind, placebo-controlled study. Anesth Analg 1998;86:617-623.
  • 8. Zomers PJW, Langerberg CJM, de Brujin KM. Tropisetron for postoperative nausea and vomiting in patients after gynaecological surgery. Br J Anaesth 1993; 1: 677-80.
  • 9. Kranke P, Eberhart LH, Apfel CC, et al. Tropisetron for prevention of postoperative nausea and vomiting: a quantitative systematic review. Anaesthesist 2002;51:805 -814.
  • 10. de Bruijn KM. The development of tropisetron in its clinical perspective. Ann Oncol 1993;4 (Suppl 3):19-23.
  • 11. Kutz K. Pharmacology, toxicology and human pharmacokinetics of tropisetron. Ann Oncol 1993;4 (Suppl 3):15-18.
  • 12. Andrews PL. Physiology of nausea and vomiting. Br J Anaesth 1992;69 (Suppl 1):2- 19.
  • 13. Jokela R, Koivuranta M. Tropisetron or droperidol in the prevention of postoperative nausea and vomiting. A comparative, randomised, double-blind study in women undergoing laparoscopic cholecystectomy. Acta Anaesth Scand 1999;43:645-650.
  • 14. Kaufmann MA, Rosow C, Schnieper P, et al. Prophylactic antiemetic therapy with patientcontrolled analgesia: a double-blind, placebo -controlled comparison of droperidol, metoclopramide, and tropisetron. Anesth Analg 1994;78:988-994.
  • 15. Wang JJ, Ho ST, Uen YH, et al. Small-dose dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy: A comparison of tropisetron with saline. Anesth Analg 2002;95:229–232.
  • 16. Capouet V, De Pauw C, Vernet B, et al. Single dose i.v. tropisetron in the prevention of postoperative nausea and vomiting after gynaecological surgery. Br J Anaesth 1996;76:54-60.
  • 17. Alon E, Kocian R, Nett PC, et al. Tropisetron for the prevention of postoperative nausea and vomiting in women undergoing gynecologic surgery Anesth Analg 1996;82:338-341.
  • 18. Akın A, Esmaoglu A, Gunes I, et al. The effects of the prophylactic tropisetronpropofol combination on postoperative nausea and vomiting in patients undergoing thyroidectomy under desflurane anesthesia. Mt Sinai J Med 2006;73:560-563.
  • 19. Korttila K. The study of postoperative nausea and vomiting. Br J Anaesth 1992;69 (Suppl 1):20S-23S.
  • 20. Madenoglu H, Yıldız K, Doğru K, et al. Randomized, double-blinded comparison of tropisetron and placebo for prevention of postoperative nausea and vomiting after supratentorial craniotomy. J Neurosurg Anesthesiol 2003;15:82–86.

Comparison of the Effects of Tropisetron and Metoclopramid in Prevention of Postoperative Nausea and Vomiting

Yıl 2009, Cilt: 18 Sayı: 1, 10 - 17, 01.03.2009

Öz

Summary: This study compared the efficacy of
tropisetrone and metoclopramide in preventing
postoperative nausea-vomiting (PONV) of the patients
(n=40) who underwent thyroidectomy under general
anesthesia. In our randomized double-blind study, 40
patients (between the age 18-70 years) who were
classified in American Society of Anesthesiologists
(ASA) I and II groups were classified into two groups,
with 20 patients in each. Before induction, 10 mg
metoclopramide was administered to metoclopramide
group (Group M), while 2 mg tropisetrone was
administered to tropisetrone group (Group T)
intravenously. All patients had standard general
anesthesia. Antiemetic and side effects of the drugs,
and the antiemetic requirements of the patients in both
groups were followed up for 24 hours. When
postoperative nausea-vomiting scores of the groups
were compared, the number of the patients with a
score of 0 was statistically significantly higher in
Group M than in Group T (p=0.027), and no
differences were detected among the other scores. The
frequency of nausea-vomiting was almost the same in
both groups. There were no statistically significant
differences between the groups for side effects. The
results of this study indicated that 2 mg intravenous
tropisetron application before induction of general
anesthesia in thyroidectomy patients prevents
postoperative nausea-vomiting better than
metoclopramide in 24-hour period. In conclusion,
tropisetrone may be used as a long-lasting antiemetic
drug to prevent postoperative nausea-vomiting

Kaynakça

  • 1. Stadler M, Bardiau F, Seidel L et al. Difference in risk factors for postoperative nausea and vomiting. Anesthesiology 2003;98:46-52.
  • 2. Koivuranta M, Laara E, Snare L, et al. A survey of postoperative nausea and vomiting. Anaesthesia 1997;52:443-449.
  • 3. Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg 2006;102:1884–1898.
  • 4. Watcha MF and White PF. Postoperative nausea and vomiting: its etiology, treatment and prevention. Anesthesiology 1992;77:162- 184.
  • 5. Ku CM, Ong BC. Postoperative nausea and vomiting: a review of current literature. Singapore Med J 2003;44:366-374.
  • 6. American Society of Health System Pharmacists. Prevention and treatment of postoperative nausea and vomiting. Am J Health-Syst Pharm 2005;62:1247-1260.
  • 7. Alon E, Buchser E, Herrera E, et al. Tropisetron for treating established postoperative nausea and vomiting: a randomized, doublelind, placebo-controlled study. Anesth Analg 1998;86:617-623.
  • 8. Zomers PJW, Langerberg CJM, de Brujin KM. Tropisetron for postoperative nausea and vomiting in patients after gynaecological surgery. Br J Anaesth 1993; 1: 677-80.
  • 9. Kranke P, Eberhart LH, Apfel CC, et al. Tropisetron for prevention of postoperative nausea and vomiting: a quantitative systematic review. Anaesthesist 2002;51:805 -814.
  • 10. de Bruijn KM. The development of tropisetron in its clinical perspective. Ann Oncol 1993;4 (Suppl 3):19-23.
  • 11. Kutz K. Pharmacology, toxicology and human pharmacokinetics of tropisetron. Ann Oncol 1993;4 (Suppl 3):15-18.
  • 12. Andrews PL. Physiology of nausea and vomiting. Br J Anaesth 1992;69 (Suppl 1):2- 19.
  • 13. Jokela R, Koivuranta M. Tropisetron or droperidol in the prevention of postoperative nausea and vomiting. A comparative, randomised, double-blind study in women undergoing laparoscopic cholecystectomy. Acta Anaesth Scand 1999;43:645-650.
  • 14. Kaufmann MA, Rosow C, Schnieper P, et al. Prophylactic antiemetic therapy with patientcontrolled analgesia: a double-blind, placebo -controlled comparison of droperidol, metoclopramide, and tropisetron. Anesth Analg 1994;78:988-994.
  • 15. Wang JJ, Ho ST, Uen YH, et al. Small-dose dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy: A comparison of tropisetron with saline. Anesth Analg 2002;95:229–232.
  • 16. Capouet V, De Pauw C, Vernet B, et al. Single dose i.v. tropisetron in the prevention of postoperative nausea and vomiting after gynaecological surgery. Br J Anaesth 1996;76:54-60.
  • 17. Alon E, Kocian R, Nett PC, et al. Tropisetron for the prevention of postoperative nausea and vomiting in women undergoing gynecologic surgery Anesth Analg 1996;82:338-341.
  • 18. Akın A, Esmaoglu A, Gunes I, et al. The effects of the prophylactic tropisetronpropofol combination on postoperative nausea and vomiting in patients undergoing thyroidectomy under desflurane anesthesia. Mt Sinai J Med 2006;73:560-563.
  • 19. Korttila K. The study of postoperative nausea and vomiting. Br J Anaesth 1992;69 (Suppl 1):20S-23S.
  • 20. Madenoglu H, Yıldız K, Doğru K, et al. Randomized, double-blinded comparison of tropisetron and placebo for prevention of postoperative nausea and vomiting after supratentorial craniotomy. J Neurosurg Anesthesiol 2003;15:82–86.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA84AU94PP
Bölüm Araştırma Makalesi
Yazarlar

Nedim Çekmen Bu kişi benim

Mustafa Arslan Bu kişi benim

Mehmet Akçabay Bu kişi benim

Yayımlanma Tarihi 1 Mart 2009
Gönderilme Tarihi 1 Mart 2009
Yayımlandığı Sayı Yıl 2009 Cilt: 18 Sayı: 1

Kaynak Göster

APA Çekmen, N., Arslan, M., & Akçabay, M. (2009). POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI. Sağlık Bilimleri Dergisi, 18(1), 10-17.
AMA Çekmen N, Arslan M, Akçabay M. POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI. JHS. Mart 2009;18(1):10-17.
Chicago Çekmen, Nedim, Mustafa Arslan, ve Mehmet Akçabay. “POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI”. Sağlık Bilimleri Dergisi 18, sy. 1 (Mart 2009): 10-17.
EndNote Çekmen N, Arslan M, Akçabay M (01 Mart 2009) POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI. Sağlık Bilimleri Dergisi 18 1 10–17.
IEEE N. Çekmen, M. Arslan, ve M. Akçabay, “POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI”, JHS, c. 18, sy. 1, ss. 10–17, 2009.
ISNAD Çekmen, Nedim vd. “POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI”. Sağlık Bilimleri Dergisi 18/1 (Mart 2009), 10-17.
JAMA Çekmen N, Arslan M, Akçabay M. POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI. JHS. 2009;18:10–17.
MLA Çekmen, Nedim vd. “POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI”. Sağlık Bilimleri Dergisi, c. 18, sy. 1, 2009, ss. 10-17.
Vancouver Çekmen N, Arslan M, Akçabay M. POSTOPERATİF BULANTI-KUSMANIN ÖNLENMESİNDE TROPİSETRON VE METOKLOPRAMİDİN ETKİLERİNİN KARŞILAŞTIRILMASI. JHS. 2009;18(1):10-7.