Amaç: Multimodal analjezi postoperatif ağrının tedavisinde tercih edilen bir metodtur, analjezik ilaçların aditif etkisi yan etkilerden kaçınmaya olanak sağlar. Bu çalışmada postoperatif ağrıda deksketoprofen ve parasetamol kombinasyonunun etkilerinin karşılaştı-rılması amaçlandı.Yöntemler: Non-malin jinekolojik laparatomi geçirecek 96 hasta çalışmaya dahil edildi. Hastalar randomize 3 gruba ayrıldı. Grup D'ye operasyon bitiminden 15 dakika önce, postoperatif 8. ve 16. saatlerde 50 mg intravenöz deksktoprofen verildi. Grup P'ye 1 gr intravenöz parasetamol, Grup DP'ye 500 mgr parasetamol + 25 mgr deksketoprofen intravenöz olarak aynı zamanlarda verildi. Tüm hastalara postoperatif morfin infüzyonu uygulandı. Postoperatif 24. saatin sonunda total morfin tüketimi, visual analog skala, hasta memnuniyeti ve yan etkiler değerlendirildi. Bulgular:Grup DP'deki 24.saatteki vizüel analog skala diğer gruplara göre düşük bulundu, ve bu düşüklük Grup D ile karşı-laştırıldığında istatiksel yönden anlamlı idi. Her 3 grup arasında morfin tüketimi açısından fark bulunmadı. En az sayıda yan etki Grup DP idi.Sonuç: Jinekolojik abdominal cerrahide deksketoprofen ve parasetamol birlikteliğinin morfinle kullanımı iyi analjezi ve daha az yan etki sağlamaktadır.Anahtar Kelimeler: Postoperatif ağrı, deksketoprofen, parasetamol, multimodal analjezi Objective: Multimodal analgesic methods are preferred for the treatment of postoperative pain; as a result, the additive effects of analgesics are provided while probable side effects are avoided. The current study aimed to compare the effects of the combination of dexketoprofen and paracetamol with regard to postoperative pain therapy. Methods:Ninety-six patients who underwent non-malignant gynaecological laparotomy operations were included in this study. Patients were randomized into 3 groups. Group D received 50 mg intravenous dexketoprofen 15 minutes before the end of the operation and 8 and 16 hours after the operation. Group P received 1 g intravenous paracetamol and Group DP received the combination of 500 mg paracetamol and 25 mg dexketoprofen at the same time intervals. All patients received morphine infusion after operation. Total morphine consumption at 24 hours, visual analog scale, patient satisfaction and side effects were investigated. Results:Comparison of the visual analog scale scores revealed that the Group DP presented lower scores at 24th hours compared to the other groups; and the difference between Group DP and Group D was statistically significant. Total morphine consumption was not significantly different between the three groups. The minimum number of side effects was observed in the Group DP. Conclusion:Co-administration of paracetamol, dexketoprofen and morphine provided good analgesia and fewer side effects in gynaecological abdominal surgery.
All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments. Etik Kurul Onayı: Bu çalışma için onay Osmangazi Üniversitesi Etik Kurulu'ndan alınmıştır (no: 24; 10.10.2019). İnsan katılımcıların katıldığı çalışmalardaki tüm prosedürler, 1964 Helsinki Deklarasyonu ve daha sonra yapılan değişiklikler uyarınca gerçekleştirilmiştir.
Introduction: Postoperative cognitive dysfunction (POCD) has become a major concern for anesthesiologists and surgeons, particularly in elderly who already have limited cognitive status. General anesthesia is a well known risk factor for this entity. However, there is insufficient data regarding the association between regional anesthesia and POCD. This study aimed to investigate the impact of different regional anesthesia techniques on the development of POCD in elderly patients undergoing cataract surgery. Methods: The patients above 65 years who underwent cataract surgery were enrolled in this study. All patients were assigned to one of two anesthesia groups; topical anesthesia group (n=16) and retrobulbar blockade group (n=25). Cognitive status was assessed preoperatively and postoperatively (1st hour, 1st day, and 1st week), using Blessed Orientation-Memory-Concentration (BOMC) test. Results: The groups were similar in terms of age, gender, American Society of Anesthesiologist score, educational status, and baseline hemodynamic values (p>0.05). Postoperative lower BOMC scores were found in both groups at all 3 times when compared to preoperative scores however differences were not statistically significant. There were no differences in all BOMC scores between the groups (p>0.05). Conclusion: Both topical and retrobulbar blockade anesthesia had no significant effect on the development of POCD in geriatric patients undergoing cataract surgery.
Objectives: Hip surgeries performed in elderly patients are important in terms of both the physiological features of geriatric patients and the risks of surgery. The aim of this study was to evaluate the effects of age and the anesthesia method used on morbidity and mortality in geriatric patients who had hip surgery. Methods: Patients who were aged 65 and older who also had hip surgery and had American Society of Anesthesiologists (ASA) Physical Status Scale scores were included in the study. The patients were classified as aged (Group AG) for those ≥65 years of age, and very aged (Group VAG) for those ≥75 years of age. Details obtained from the hospital electronic records system of the patients' age, sex, ASA score, anesthesia method used, intraoperative and postoperative blood transfusion requirements, respiratory and cardiovascular complications, postoperative intensive care requirements, duration of hospital treatment, period of development of any postoperative complications, morbidity, and mortality were evaluated by age group. Results: A total of 258 patients between the ages of 65 and 95 who had hip surgery and available ASA scores were included in the study. In Group VAG, the rate of morbidity and mortality of ASA III and IV patients was high in the postoperative period. Regional anesthesia methods were used more often in Group VAG patients, and there were more cardiovascular complications developing in the intraoperative period in the general anesthesia patients, although there was no difference between anesthesia methods in terms of postoperative morbidity and mortality. Conclusion:In this study of elderly patients who had hip surgery, there was no correlation between the anesthesia method used and morbidity and mortality. Advanced age (≥75 years) and a high ASA score were the most important risk factors for mortality.
In our study, we aimed to evaluate the change in numerical rating scale (NRS) score and interventional procedures performed on patients with post-laminectomy syndrome whose NRS score 7 and above according to the NRS. Methods: This study was carried out by examining the files of 107 patients, including 69 women and 38 men, aged 18 years and over who had applied between February 1, 2010, and February 1, 2015. Pain localization, post-operative periods, interventional procedures, and post-procedural pain status were determined using pain monitoring forms and hospital automation system in our clinic. Statistical significance of the obtained data was evaluated by Pearson Chi-square test, Kruskal-Wallis H test, Friedman test, and Mann-Whitney U-test. p>0.05 was not statistically significant, p<0.05 was considered statistically significant. Results: With interventional procedures, 48.5% of patients had a reduction in pain of more than 50%. The success rate was 66.7% in patients with radicular pain. Pain palliation was achieved in 28.8% of patients who underwent transforaminal epidural steroid injection, whereas in patients undergoing dorsal root ganglion pulsed radiofrequency, this rate was 44.4%. When the pain scores of patients with permanent spinal cord stimulator (SCS) were compared with other patient groups, permanent SCS was found to be statistically and clinically significant (p<0.001). Conclusion:Post-laminectomy syndrome is not usually caused by a single pathology, and more than 1 intervention and recurrence are often needed. Post-laminectomy syndrome is a disease that requires a multidisciplinary approach and multiple treatment options must be decided according to the patient. More research is needed on treatment options.
Moderatörlüğü üstlenmiş olan ilk yazarın ardından yazar isimleri soyadına göre alfabetik olarak sıralanmıştır.
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