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

Yıl 2017, Cilt: 80 Sayı: 1, 7 - 12, 31.03.2017

İpek Saadet Edipoğlu Fatma Sevinç Çelik Derya Özden Omaygenç

https://doi.org/10.18017/iuitfd.315513

Öz

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.

Anahtar Kelimeler

Ketamin, VAS, analjezi

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

Öz

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.

Anahtar Kelimeler

Ketamine, VAS, analgesia

Kaynakça

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