Ekmekçi Perihan, Kazak Bengisun Züleyha, Kazbek Baturay Kansu, Öziş Salih Erpulat, Taştan Huri, Süer Arif Hikmet
Department of Anesthesiology and Reanimation, Ufuk University Faculty of Medicine, Dr. Ridvan Ege Hospital, Ankara, Turkey.
Agri. 2012;24(2):63-8. doi: 10.5505/agri.2012.71501.
Pain treatment in laparoscopic cholecystectomy, which is performed in increasing numbers as an ambulatory procedure, is an important issue.Although laparoscopic cholecystectomy is regarded as an ambulatory procedure, patients are often hospitalized due to pain and this increases opioid consumption and side effects caused by opioids. This study aims at evaluating the efficacy of adding dexketoprofen trometamol to tramadol with patient controlled analgesia (PCA) in postlaparoscopic cholecystectomy pain treatment.
40 patients in ASA I-II risk groups aged between 18-65 years were enrolled in the study and were randomized using closed envelope method. In Group TD 600 mg tramadol and 100 mg dexketoprofen trometamol, in Group T 600 mg tramadol was added to 100 ml 0.9% normal saline for PCA. 8 mg lornoxicam iv was given if VAS >40 in the postoperative period.
There was no statistically significant difference in terms of adverse effects (hypotension, bradycardia, sedation) but in Group T 4 patients complained of nausea and 3 complained of vomiting. Opioid consumption was lower and patient satisfaction was higher in group TD.
This study has shown that adding dexketoprofen trometamol to tramadol in patient controlled analgesia following laparoscopic cholecystectomy lowers VAS scores, increases patient satisfaction and decreases opioid consumption.
随着腹腔镜胆囊切除术作为一种门诊手术的开展数量不断增加,其疼痛治疗成为一个重要问题。尽管腹腔镜胆囊切除术被视为门诊手术,但患者常因疼痛而住院,这增加了阿片类药物的消耗量以及阿片类药物引起的副作用。本研究旨在评估在腹腔镜胆囊切除术后疼痛治疗中,将右酮洛芬氨丁三醇添加到曲马多患者自控镇痛(PCA)中的疗效。
40例年龄在18至65岁之间、ASA I-II风险组的患者纳入研究,并采用封闭信封法进行随机分组。在TD组中,将600mg曲马多和100mg右酮洛芬氨丁三醇用于PCA;在T组中,将600mg曲马多添加到100ml 0.9%生理盐水中用于PCA。术后若视觉模拟评分(VAS)>40,则静脉注射8mg氯诺昔康。
在不良反应(低血压、心动过缓、镇静)方面无统计学显著差异,但T组有4例患者主诉恶心,3例主诉呕吐。TD组的阿片类药物消耗量较低,患者满意度较高。
本研究表明,在腹腔镜胆囊切除术后患者自控镇痛中,将右酮洛芬氨丁三醇添加到曲马多中可降低VAS评分,提高患者满意度,并减少阿片类药物的消耗量。