This study was aimed to compare the intraoperative sedative and perioperative analgesic drug requirements and the incidences of postoperative side effects on the patients who received preoperative gabapentin or placebo. Sixty patients undergoing nasal septal or nasal sinus surgery were included. The patients received either 600 mg gabapentin (Group G) or placebo (Group P) orally, 1 h before surgery. The scores for sedation and pain were recorded at 5, 15, 30, 45 and 60 min, intraoperatively and at 30 min, 1, 2, 4, 6, 9, 12, 16, 20, 24 h, postoperatively. Sedation was achieved with an IV bolus of propofol and continuous infusion of remifentanil. There were significant differences between gabapentin and placebo groups with regard to total consumptions of remifentanil (171.42 + or - 68 vs. 219.17 + or - 95 microg, respectively; P = 0.033) and propofol (59.45 + or - 36.08 vs. 104.14 + or - 54.98 mg, respectively; P = 0.001). Group G patients had significantly lower intraoperative VAS scores at all time points (P < 0.05). The anxiety score of Group G was better at all times (P < 0.05). All postoperative pain scores were lower in the Group G (P < 0.05). Time to first request for analgesic was 12.7 + or - 2.3 h in Group G, and 7.8 2.1 h in Group P (P < 0.0001). Total consumption of lornoxicam was lower in Group G (P < 0.004). We concluded that monitored anesthesia care combined with preoperative analgesia with a low dose of (600 mg) oral gabapentin is an efficient option with tolerable side effects for patients undergoing ear, nose and throat ambulatory surgery.
A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of the present study was to compare the reliability, suitability and the side effects of the spinal blocks produced by hyperbaric solutions of levobupivacaine, ropivacaine and bupivacaine in patients undergoing total hip or knee arthroplasty. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Ninety patients, aged 30-75 years with American Society of Anesthesiology (ASA) grade I-III, undergoing total hip and knee arthroplasty were included in the study and randomized into three groups. Spinal anesthesia was performed in all patients; among the study groups in Group HB 3 ml of 0.5% hyperbaric bupivacaine, in Group HR 3 ml of 0.5% hyperbaric ropivacaine and in Group HL 3 ml of 0.5% hyperbaric levobupivacaine were given intrathecally. The same surgeon performed all the operations. R Re es su ul lt ts s: : The mean duration of complete motor block was longest in Group HB(p=0.047). Onset of sensory block at dermatome level T10 was earliest in Group HL(p<0.002). Regression time of sensory block to dermatome level T10 and L1 was longest in group HB and shortest in group HR (p<0.05). First analgesic requirement was earliest in Group HR. More patients in Group HB required treatment for hypotension. Nausea/vomiting were significantly higher in Group HB (p<0.05). Incidence of hypotension was lowest in Group HR (p<0.001). C Co on nc cl lu us si io on n: : In 15 mg doses, hyperbaric levobupivacaine showed similar potency and block characteristics to hyperbaric bupivacaine, and the duration of motor and sensory block was the shortest with hyperbaric ropivacaine. Levobupivacaine and ropivacaine had fewer side effects. K Ke ey y W Wo or rd ds s: : Levobupivacaine; ropivacaine; orthopedics Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışma, total kalça ya da diz artroplastisi geçiren hastalarda hiperbarik ropivakain, levobupivakain veya bupivakain ile yapılan spinal anestezinin güvenilirliğini, uygunluğunu ve yan etkilerini karşılaştırmak amacıyla yapıldı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Yaşları 30-75 arasında değişen, Amerikan Anesteziyologlar Derneği (ASA) sınıflamasına göre sınıf I -III arasında olan ve total kalça ya da diz artroplastisi geçirecek 90 hasta çalışmaya alınarak randomize şekilde üç gruba ayrıldılar. Her üç gruba da spinal anestezi uygulandı; çalışmada yer alan gruplardan Grup HB'ye 3 ml %0.5 hiperbarik bupivakain, Grup HR'ye 3 ml %0.5 hiperbarik ropivakain ve Grup HL'ye 3 ml %0.5 hiperbarik levobupivakain intratekal olarak verildi. B Bu ul lg gu ul la ar r: : Motor blok süresi en uzun olan Grup HB idi (p = 0.047). Dermatom T10 düzeyinde en erken duyusal blok ortaya çıkışı Grup HL'de gözlendi (p < 0.002). Duyusal bloğun dermatom T10 ve L1 düzeyine gerileme süresinin grup HB'de en uzun, grup HR'de ise en kısa olduğu görüldü (p < 0.05). İlk olarak analjezik gereksinimi ortaya çıkan grup ise HR grubu oldu. Grup HB'de daha fazla sayıda hastanın hipotansiyon açısından tedavi edilmesi gerekti. Bulantı ve kusma da Grup HB'de diğer grup...
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