Yıl: 2009 Cilt: 21 Sayı: 2 Sayfa Aralığı: 54 - 61 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy

Öz:
Amaç: Parasetamol, primer olarak santral sinir sistemi üzerinde santral siklooksijenaz inhibisyonu yoluyla ve olasılıkla serotoninerjik sistemle indirekt etki ettiğine inanılan nonopioid bir ajandır. Bu çalışmada, laparatomi ile total abdominal histerektomi yapılan olgulara intravenöz (iv) 1 gr parasetamol, preoperatif veya intraoperatif verilerek ameliyat sonrası analjezik etkisinin saptanması amaçlandı. Gereç ve Yöntem: Elektif total abdominal histerektomi yapılacak 90 olgu randomize edilerek eşit üç gruba ayrıldı. Grup I’deki olgulara indüksiyondan 30 dakika önce 1 gr iv parasetamol, Grup II’deki olgulara cilt insizyonu kapatılmadan önce 1 gr iv parasetamol, Grup III’deki olgulara indüksiyondan 30 dakika önce ve cilt insizyonu kapatılmadan önce 100 ml iv serum fizyolojik verildi. Ameliyat sonrası tüm olgulara morfin ile iv hasta kontrollü analjezi uygulandı. Ameliyat sonrası dönemde olguların dinlenme ve hareket halindeki ağrı skorları, sedasyon skorları, hemodinamik parametreler, morfin tüketimi, yan etkiler, hasta ve hemşire tedavi memnuniyeti, hastanede kalış süreleri izlenerek kaydedildi. Bulgular: Kontrol grubunda hareket ve dinlenme halindeki ağrı skorları ve ameliyat sonrası tüm zaman dilimlerindeki morfin tüketimi ile kümülatif morfin tüketimi Grup I ve Grup II’den anlamlı olarak yüksek bulundu. Grup I ile Grup II karşılaştırıldığında Grup II’de toplam morfin tüketimi anlamlı olarak yüksek bulundu. Hiçbir olguda parasetamolün intraoperatif ve postoperatif hemodinami üzerine olumsuz etkileri saptanmadı. Sonuç: Total abdominal histerektomi operasyonu olan olgularda uygulanan preemptif 1 gr iv parasetamolün ameliyat sonrası dönemde etkin bir analjezi sağladığı, ameliyat sonrası morfin tüketimini ve yan etkileri azaltarak, hasta memnuniyetini arttırdığı saptandı.
Anahtar Kelime:

Konular: Cerrahi

Total abdominal histerektomide preemptif intravenöz parasetamolün analjezik etkisi

Öz:
Objectives: Paracetamol is primarily thought to be a cyclooxygenase inhibitor acting through the central nervous system. Indirect effects of paracetamol are through the serotoninergic system as a non-opioid analgesic. In this study, total abdominal hysterectomy patients were given intravenous (iv) paracetamol 1 g preoperatively or intraoperatively to assess its postoperative analgesic effects. Methods: 90 patients undergoing total abdominal hysterectomy were enrolled into the study. Patients were randomized into three groups: in Group I, iv paracetamol 1 g was given 30 minutes prior to induction. In Group II, iv paracetamol 1 g was given prior to skin closure. Group III served as the control group and received saline as placebo. Postoperatively, all patients received morphine via patient-controlled analgesia pump. Postoperatively, rest and activity pain scores, sedation scores, hemodynamic parameters, postoperative morphine consumption, side effects, patient satisfaction, and total hospital stay were recorded. Results: In the control group, at rest and movement pain scores and total morphine consumption via patient-controlled analgesia were higher than in Groups I and II. When Groups I and II were compared, total morphine consumption was much greater in Group II. Intravenous paracetamol intraoperatively and postoperatively did not result in any hemodynamic effects. Conclusion: In total abdominal hysterectomy, preemptive iv paracetamol 1 g provided good quality postoperative analgesia, with decreased consumption of morphine and minimal side effects.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA ARICI S, GURBET A, TÜRKER Y, Yavaşcaoğlu B, ŞAHİN Ş (2009). Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. , 54 - 61.
Chicago ARICI Semih,GURBET ALP,TÜRKER YUNUS GÜRKAN,Yavaşcaoğlu Belgin,ŞAHİN ŞÜKRAN Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. (2009): 54 - 61.
MLA ARICI Semih,GURBET ALP,TÜRKER YUNUS GÜRKAN,Yavaşcaoğlu Belgin,ŞAHİN ŞÜKRAN Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. , 2009, ss.54 - 61.
AMA ARICI S,GURBET A,TÜRKER Y,Yavaşcaoğlu B,ŞAHİN Ş Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. . 2009; 54 - 61.
Vancouver ARICI S,GURBET A,TÜRKER Y,Yavaşcaoğlu B,ŞAHİN Ş Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. . 2009; 54 - 61.
IEEE ARICI S,GURBET A,TÜRKER Y,Yavaşcaoğlu B,ŞAHİN Ş "Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy." , ss.54 - 61, 2009.
ISNAD ARICI, Semih vd. "Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy". (2009), 54-61.
APA ARICI S, GURBET A, TÜRKER Y, Yavaşcaoğlu B, ŞAHİN Ş (2009). Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. Ağrı, 21(2), 54 - 61.
Chicago ARICI Semih,GURBET ALP,TÜRKER YUNUS GÜRKAN,Yavaşcaoğlu Belgin,ŞAHİN ŞÜKRAN Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. Ağrı 21, no.2 (2009): 54 - 61.
MLA ARICI Semih,GURBET ALP,TÜRKER YUNUS GÜRKAN,Yavaşcaoğlu Belgin,ŞAHİN ŞÜKRAN Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. Ağrı, vol.21, no.2, 2009, ss.54 - 61.
AMA ARICI S,GURBET A,TÜRKER Y,Yavaşcaoğlu B,ŞAHİN Ş Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. Ağrı. 2009; 21(2): 54 - 61.
Vancouver ARICI S,GURBET A,TÜRKER Y,Yavaşcaoğlu B,ŞAHİN Ş Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. Ağrı. 2009; 21(2): 54 - 61.
IEEE ARICI S,GURBET A,TÜRKER Y,Yavaşcaoğlu B,ŞAHİN Ş "Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy." Ağrı, 21, ss.54 - 61, 2009.
ISNAD ARICI, Semih vd. "Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy". Ağrı 21/2 (2009), 54-61.