Comparison of efficiency of preemptive tramadol and paracetamol in postoperative pain therapy in pediatrics undergoing adenotonsillectomy and tonsillectomy

Year 2014, Volume: 21 Issue: 1, 11 - 15, 12.03.2014

Filiz Alkaya Solmaz , Ali Abbas Yılmaz Menekşe Hasdoğan Oya Özatamer Neslihan Alkış

Abstract

Comparison of efficiency of preemptive tramadol and paracetamol in postoperative pain therapy inpediatrics undergoing adenotonsillectomy and tonsillectomyObjective: Postoperative pain is the most important problem affecting the life quality of pediatric patientsundergoing adenotonsillectomy and tonsillectomy. In this study, we compared the effects of preemptivetramadol, and paracetamol usage on postoperative pain and also the side effects of these therapies in pediatricpatients undergoing adenotonsillectomy and tonsillectomy. Method: After the ethic committee approval,thirty patients aged between 3-12, undergoing adenotonsillectomy and tonsillectomy were included in thecurrent study. Oral 0.5 mg kg-1 midazolam were given to all patients one hour prior to the induction ofanesthesia. Patients were randomized into two groups. Group 1 (n=15) patients were administered 2 mg kg-1tramadol PO, and 20 mg kg-1 paracetamol suppository to Group 2 (n=15) as preemptive. After the standardmonitorization, 8% sevoflurane with 100% O2 were administered to the patients aged between 35 (n=10)and propofol 2.2 mg kg-1 iv and 0.6 mg kg-1 iv rocuronium were administered to the patients aged between6-12 (n=20). Anesthesia was maintained 34% sevoflurane with 50% N2O + 50% O2 after the endotracheal

Keywords

Tonsillectomy, Adenotonsillectomy, Analgesics, Tramadol, Paracetamol, Preemptive Analgesia, Postoperative Pain

ADENOTONSİLLEKTOMİ VE TONSİLLEKTOMİ GEÇİREN ÇOCUKLARDA POSTOPERATİF AĞRI TEDAVİSİNDE PREEMPTİF TRAMADOL VE PARASETAMOLÜN ETKİNLİKLERİNİN KARŞILAŞTIRILMASI

Abstract

Amaç: Adenotonsillektomi ve tonsillektomi geçiren çocuklarda postoperatif aðrý, yaþam kalitesini etkileyenen önemli problemdir. Bu çalýþmada preemptif tramadol veya parasetamol kullanýmýnýn, adenotonsillektomive tonsillektomi olan çocuklarda postoperatif analjezik etkinliklerini ve yan etkilerini karþýlaþtýrdýk. Metod:Etik kurul onayý alýnan, adenotonsillektomi ve tonsillektomi operasyonu planlanan 312 yaþ arasý 30 hastaçalýþmaya dahil edildi. Hastalara anesteziden bir saat önce oral 0,5 mg kg-1 midazolam verildi. Olgularrastgele iki gruba ayrýldý. Grup 1de (n=15); oral tramadol damla 2 mg kg-1, Grup 2de (n=15); supozituarparasetamol 20 mg kg-1 preemptif uygulandý. Standart monitörizasyonu takiben, 35 yaþ arasý çocuklarsevofluran indüksiyonu ile yeterli kas gevþemesi saðlandýktan sonra entübe edildi. 612 yaþýndaki çocuklariçin i.v. damar yolu saðlandýktan sonra propofol 2,2 mg kg-1 + rokuronyum 0,6 mg kg-1 dozlarýnda uygulandý,yeterli kas gevþemesi saðlandýktan sonra hastalar entübe edildi ve anestezi idamesi için %3-4 sevofluran,%50 N2O ve %50 O2 kullanýldý. Tüm hastalar ETCO2 3040 mm Hg olacak þekilde ventile edildi. Hemodinamikdeðiþkenler, anestezi ve cerrahi süreleri kaydedildi. Postoperatif 1., 2. ve 4. saatte derlenme ve aðrý skorlarýdeðerlendirildi. Gruplarda ek analjezik olarak supozituar parasetamol 22,5 mg kg-1 kullanýldý. Postoperatif24 saat içindeki analjezik gereksinimi, yan etkiler kaydedildi. Bulgular: Gruplar arasýnda demografik vehemodinamik veriler, derlenme ve aðrý skorlamalarý, postoperatif komplikasyonlar açýsýndan fark saptanmadý.Grup 1de postoperatif 1. saatte 4 hastada SpO2 96 ya düþtü. Postoperatif dönemde Grup 1de; 11 hastada,Grup 2de ise 9 hastada ek analjezik ihtiyacý oldu. Gruplar arasýnda ek analjezik ihtiyacý olan hasta sayýlarýve analjezik miktarý açýsýndan anlamlý fark saptanmadý (p >0,05). Sonuç: Çalýþmamýzda adenotonsillektomive tonsillektomi sonrasý aðrý kontrolünde preemptif uygulanan tramadol ve parasetamolün analjeziketkinliklerinin ve yan etkilerinin benzer olduðu kanýsýna varýldý

Keywords

Adenotonsillektomi, Tramadol, Parasetamol, Preemptif Analjezi, Postoperatif Aðrý

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