Lomber dar kanal ameliyatlarında preemptif analjezide pregabalin ve gabapentin kullanımının karşılaştırılması
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda Namık Kemal Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı'nda lomber spinal stenoz operasyonu geçirecek hastalarda; ameliyattan bir saat önce gabapentin veya pregabalin vererek, ameliyattan sonra ağrı skalası olan Vizuel Analog Skalası ve sedasyon skalası olan Ramsey Sedasyon Skalası sonuçlarını kullanarak, verilen analjezik dozlarını ve ilk analjezi ihtiyacının ortaya çıktığı süreyi belirlemeyi amaçladık. Çalışmamızda 18-65 yaş arası, lomber dar kanal operasyonu olması planlanan, Amerikan Anestezistler Derneği (ASA) I sınıflamasında bulunan, çalışmaya katılmayı kabul eden, iletişim sorunu olmayan, 50-80 kilo aralığında olan, ameliyat süresi 1-3 saat arasında süren 90 olgu çalışmamıza dahil edildi. Bu olgular ameliyattan 1 saat önce premedikasyon amacıyla; Gabapentin 800 mg tablet (Grup 1), Pregabalin 225 mg kapsül (Grup 2) ve plasebo (Grup 3) verilmesine göre 30'ar kişilik 3 gruba ayrıldı. Hastaların ameliyattan sonraki 1., 2., 4., 6., 8., 10., 12., 14., 16., 18., 20., 22., 24. saat Visual Analog Skala (VAS) puanı ve RAMSEY Sedasyon Skala puanı ve postoperatif dönemde ilk 24 saat içerisindeki analjezik ilaç kullanımı ile ilgili özellikleri kayıt edildi. Ameliyattan sonraki 1. saat, 2. saat, 4. saat VAS skoru puan ortalaması ile 1. grup, 2.grup ve 3. grup arasında istatistiksel açıdan anlamlı bir fark olduğu, ameliyat sonrası saatlik takipte RAMSEY Sedasyon Skalası puan değişimi ile ameliyat öncesi dönemde yapılan uygulamalar arasında istatistiksel açıdan anlamlı bir fark olmadığı, ameliyat öncesinde 1. grubun toplamda yapılan analjezik sayısı 3. gruptan anlamlı olarak daha düşük ve 2. grubun toplamda yapılan analjezik sayısı 3. gruptan anlamlı olarak daha düşük olduğu bulundu. Sonuçta yaptığımız literatür taramalarına paralel olarak lomber dar kanal operasyonu planlanan hastalara ameliyattan sonra olası ağrılarını en aza indirgeyebilmek için ameliyattan bir saat önce pregabalin veya gabapentin ile preemptif analjezi uygulamasının yeterli doz aralığında yapılabileceği kanısına varıldı. Anahtar Kelimeler: Lomber Spinal Stenoz, Ağrı Skalası, Sedasyon Skalası, Premedikasyon, Preemptif Analjezi.
In our study, in patients who will undergo lumbar spinal stenosis operation in Namık Kemal University Faculty of Medicine, Department of Anesthesiology and Reanimation; we aimed to determine the analgesic doses given and the time during which the first analgesia consumption arises by administering gabapentin and pregabalin one hour before the surgery and using the results of the Visual Analogue Scale (VAS), which is the pain scale, and the Ramsey Sedation Scale (RSS), which is the sedation scale, after the surgery. In our study, 90 patients aged 18-65 who planned to have a lumbar instrumentation operation, included in the American Society of Anesthesiologists (ASA) I classification, accepted to participate in the study, had no communication problems, weighed between 50-80 kilos, and the operation time lasted between 1-3 hours was included in our study. These cases were used for premedication 1 hour before the operation; Gabapentin 800 mg tablet (Group 1), Pregabalin 225 mg capsule (Group 2), and placebo (Group 3) were divided into three groups of 30 people each. Visual Analogue Scale (VAS) score of the patients at the 1st, 2nd, fourth, sixth, eighth, 10th, 12th, 14th, 16th, 18th, 20th, 22nd, 24th hours after surgery, and RAMSEY Sedation Scale score and characteristics of analgesic drug use in the first 24 hours postoperatively were recorded. There was a statistically significant difference between the 1st hour, 2nd hour, 4th-hour VAS score averages and the 1st group, 2nd group, and 3rd group after the surgery, with the RAMSEY Sedation Scale score change in the postoperative hour in the preoperative period. It was found that there was no statistically significant difference between the applications performed, the total number of analgesics performed in the 1st group before the operation was significantly lower than in the 3rd group, and the total number of analgesics in the 2nd group was significantly lower than the 3rd group. As a result, in parallel with the literature review we conducted, it was concluded that pregabalin or gabapentin and preemptive analgesia application one hour before the surgery could be applied at a sufficient dose range in order to minimize the possible pain after the operation in patients who were planned for lumbar stenosis operation. Keywords: Lumbar Spinal Stenosis, Pain Scale, Sedation Scale, Premedication, Preemptive Analgesia.
In our study, in patients who will undergo lumbar spinal stenosis operation in Namık Kemal University Faculty of Medicine, Department of Anesthesiology and Reanimation; we aimed to determine the analgesic doses given and the time during which the first analgesia consumption arises by administering gabapentin and pregabalin one hour before the surgery and using the results of the Visual Analogue Scale (VAS), which is the pain scale, and the Ramsey Sedation Scale (RSS), which is the sedation scale, after the surgery. In our study, 90 patients aged 18-65 who planned to have a lumbar instrumentation operation, included in the American Society of Anesthesiologists (ASA) I classification, accepted to participate in the study, had no communication problems, weighed between 50-80 kilos, and the operation time lasted between 1-3 hours was included in our study. These cases were used for premedication 1 hour before the operation; Gabapentin 800 mg tablet (Group 1), Pregabalin 225 mg capsule (Group 2), and placebo (Group 3) were divided into three groups of 30 people each. Visual Analogue Scale (VAS) score of the patients at the 1st, 2nd, fourth, sixth, eighth, 10th, 12th, 14th, 16th, 18th, 20th, 22nd, 24th hours after surgery, and RAMSEY Sedation Scale score and characteristics of analgesic drug use in the first 24 hours postoperatively were recorded. There was a statistically significant difference between the 1st hour, 2nd hour, 4th-hour VAS score averages and the 1st group, 2nd group, and 3rd group after the surgery, with the RAMSEY Sedation Scale score change in the postoperative hour in the preoperative period. It was found that there was no statistically significant difference between the applications performed, the total number of analgesics performed in the 1st group before the operation was significantly lower than in the 3rd group, and the total number of analgesics in the 2nd group was significantly lower than the 3rd group. As a result, in parallel with the literature review we conducted, it was concluded that pregabalin or gabapentin and preemptive analgesia application one hour before the surgery could be applied at a sufficient dose range in order to minimize the possible pain after the operation in patients who were planned for lumbar stenosis operation. Keywords: Lumbar Spinal Stenosis, Pain Scale, Sedation Scale, Premedication, Preemptive Analgesia.
Açıklama
Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
