A comparison of preemptive analgesia and postoperative analgesia in thoracotomies Torakotomi yapilan hastalarda preemptif analjezi i̇ie postoperatif analjezinin karşilaştirilmasi
Turk Anesteziyoloji ve Reanimasyon, cilt.29, sa.1, ss.18-22, 2001 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 29 Sayı: 1
- Basım Tarihi: 2001
- Dergi Adı: Turk Anesteziyoloji ve Reanimasyon
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.18-22
- Anahtar Kelimeler: Anaesthetic-opioid combination, Postoperative analgesia, Preemptive analgesia, Thoracotomy
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet
Özet
The analgesic effects of preoperative and postoperative initiation of bupivacaine (B) - morphine(M) combination via thoracic epidural route was compared in a prospective clinical study. Following approval of the Ethics Committee of the Department, 20 consenting patients submitted to thoracotomy were studied. Epidural catheter was inserted to all patients through T6.7 or T7-8 preoperatively. Then they were randomly allocated to one of the two groups: In G I a test dose of 2 mL lidocain 2 % was injected. After the test dosage, 10 mL bolus of a mixture containing 1mg/mL B + 0.1 mg/mL M in saline was injected preoperatively, followed by a 7 mL/hour infusion of the same mixture during operation. Postoperative analgesia was obtained with PCA technique with a concentration of 1 mg/mL B + 0.05 mg/mL M according to following program: no bolus dose, PCA set rate 5 mL/hour, delivery rate 3 mL with 30 minutes lock out time. In G II, patients have not received any medication through epidural catheter preoperatively and peroperatively. In G II anaesthesia was induced with thiopentone, fentanyl, vecuronium and was maintained with vecuronium, fentanyl, isoflurane. At the end of the operation the test dose of 2 mL lidocain 2 % was injected through epidural catheter. After the bolus dose of 10 mL, the same postoperative program was applied. VAS < 2 was achieved earlier in G I then in G II (during rest immediately in G I vs. 8 hour in G II, during coughing and movement 12 hour in G I vs. 24 hour in G II). In this study preemptive analgesia provided more effective postoperative analgesia. However studies using different concentrations and PCA programs seems to be necessary to find the ideal regimen.