Abstract
Yirmi olguda abdominal cerrahi girişimlerden sonra oluşan ağrı,
visuel analog skalaya (VAS) göre saptandı, Birinci gruba in — 10)
epidural yoldan 0.1 mg fentanil sitrat, ikinci gruba ise yine epidural yoldan. 15 mg ketamin hidroklorid verildi. Her iki grupta fentanil
ve analjezi süreleri arasında anlamlı fark bulundu. (p, 0.05'den küçük).
Ağrılı dönemde fentanil ve ketamin verilmeden önce ortalama
sistolik kan basıncı, kalp hızı, AKŞ ve kortizol düzeylerinde yükselme
gözlendi. İlaçlar kullanıldıktan sonra epidural fentanil verilen grupta
daha fazla olmak üzere bütün bu parametrelerde belirgin bir düşme
gözlendi, (p, 0.05'den küçük).
Sonuç olarak kullandığımız ilaçların etkili bir analjezi sağlamalarına
karşılık, endokrin ve metabolik yanıtı kismen baskıladıkları, analjezi
süresince hastalara stressiz bir dönem geçirttikleri görülmektedir.
Ancak uyguladığımız kateter aracılığı ile bu sürenin, gerekli görülen
vakalarda uzatılması mümkündür.
Keywords
Ethical Statement
-
Supporting Institution
-
Project Number
-
Thanks
-
References
- 1-Arcario T Vaertikor J Johnson MD : Effect of diluent volume on analgesia produced by epidural fentanyl. Anesthesiology A 44 : 67, 1987.
- 2-Auwera DV Verborgh C Cawn F ; Analgesiç and cardiorespiratory effects of epidural sufentanil and morphine in humans, Anesth. Analg. 66 : 999-1003, 1987,
- 3-Bent JM Peterson JC Mashiter K : Effects of high dose fentanyl anesthesia on the established metabolic and endocrine response to surgery. Anaesthesia, 39 : 19-23, 1984.
- 4-Buckingham JC : Hypotalamo-pituitary responses to travma. Bri, Med. Bulletein, 11 : 203, 1985.
- 5-Clark NJ Meuleman T Liu WS: Comparison of sufentanyI-N,0 and fentanyI-N,0 in patients without cardiac disease undergoing general surgery. Anesthesiology. 66 ; 130-5, 1987,
- 6-Chrubasik J Wüst H Schulte-Mönting J : Analgesic potency of post-operative epidural fentanyl and alfentanyl. Anaesthesiology. 236 : 67, 1987.
- 7-Delitala Tomaesi Virdiş : Prolactin, growth hormone and thyrotropin, thyroid hormone secretion during stress states in mah. Balliere's Lli End and Met. 1: 391-414, 1987.
- 8-Downing R Davis 1 : Effect of intrathecal morphine on the adrenocortical and hypergiysemic responses to upper abdominal surgery. Br, J. Anaesth. 58 : 858 61, 1986.
- 9-Editoriyal : Fentanyl and the metabolic response to surgery. Br. J. Anaesth. 58 : 561-2, 1980,
- 10-Eugene PA Halter JB : Effect of spinal anaesthesia on adrenerjic tone neuroendocrine responses to surgical stress in humans. Anest, 55 : 120-6, 1981.
- 11-Gordon FH Scott DB Robb Rwt. : Modification of plasma corticosteroid concentrations during and after surgery by epidural blockade. Br. Med.J.i: 581-3, 1973,
- 12-George JM Reler EC : Morphine anaesthesia blocks cortisol and growth hormone response to surgical stress in humans, J, Clin End and Met. : 736-41, 1974.
- 13-Klinstedt C Giesceke E : High low dose fentanyl anesthesia. Circulatory and plazma catecholamine responses during cholecystectomy. Br. J. Anaesth. 59 : 184-8, 1987.
- 14-Konjiro M Koh S : Epidural ketamine does not produce analgesia. Anesthesiology. 68 : 120-6, 1988.
- 15-Moller IW Krantz T Wandall E : Effect of alfentanyl anaesthesia on the adrenocortical and hyperglisemic response to abdominal surgery. Br. J. Anaesth. 57: 591-4, 1985.
- 16-Malinow M Mokriski BL Wakefield ML: Anesthetic choice affects postcesaresan epidural fentanyl analgesia. Anesth, Analg. 67 : 51-5266, 1988.
- 17-Moh MS Chan CH Chung SK Lee Ty Lipmann M : Evaluation of the analgesic effect of epidural ketamine. Anest. Analg. 66 : 51-5191, 1987,
- 18-Naulty S Datta S Osthcimer G : Epidural fentanyl for postcesarean delivery pain management. Anesthesiology 63 : 694-698, 1985.
- 19-Normandak JP Sehmulian C Paterson JC : Epidural diamorphine and the metabolic response to upper abdominal surgery. Anaesthesia, 40 : 748-53, 1985.
- 20-Negre I Gueneron JP Ecoffey C ; Ventilatory response to canbondioxide after intramusculer and epidural fentanyl. Anest. Analg. 68 : 707-10, 1987.
- 21-Rutberg H Hakanson E : Effects of the extradural administrtion of morphine or bupivacaine on the endocrine response to upper abdominal surgery. Br. J. Anaesth. 58 : 233-7, 1984,
- 22-Rutter DV Skewes DG Morgan M : Extradural opioids for postoperative anal gesia. Br. J. Anaesth, 53 : 915-20, 1981.
- 23-Sebel PS Bovill JG : Opiold analgesics in cardisu aneslhesia, Kaplan J.A., ed. Cardiac Anaesthesia Orlando. Grue and Stratton Company. : PP ; 70-94, 1987,
- 24-Wasnich J Hurford W Gelb C : Epidural opioid analgesia does not alter the neuroendocrine response to thoracotomy. Anest. Analg. 70 : 51-5450, 1990
Abstract
Yirmi olguda abdominal cerrahi girişimlerden sonra oluşan ağrı,
visuel analog skalaya (VAS) göre saptandı, Birinci gruba in — 10)
epidural yoldan 0.1 mg fentanil sitrat, ikinci gruba ise yine epidural yoldan. 15 mg ketamin hidroklorid verildi. Her iki grupta fentanil
ve analjezi süreleri arasında anlamlı fark bulundu. (p, 0.05'den küçük).
Ağrılı dönemde fentanil ve ketamin verilmeden önce ortalama
sistolik kan basıncı, kalp hızı, AKŞ ve kortizol düzeylerinde yükselme
gözlendi. İlaçlar kullanıldıktan sonra epidural fentanil verilen grupta
daha fazla olmak üzere bütün bu parametrelerde belirgin bir düşme
gözlendi, (p, 0.05'den küçük).
Sonuç olarak kullandığımız ilaçların etkili bir analjezi sağlamalarına
karşılık, endokrin ve metabolik yanıtı kismen baskıladıkları, analjezi
süresince hastalara stressiz bir dönem geçirttikleri görülmektedir.
Ancak uyguladığımız kateter aracılığı ile bu sürenin, gerekli görülen
vakalarda uzatılması mümkündür.
Keywords
Ethical Statement
-
Supporting Institution
-
Project Number
-
Thanks
-
References
- 1-Arcario T Vaertikor J Johnson MD : Effect of diluent volume on analgesia produced by epidural fentanyl. Anesthesiology A 44 : 67, 1987.
- 2-Auwera DV Verborgh C Cawn F ; Analgesiç and cardiorespiratory effects of epidural sufentanil and morphine in humans, Anesth. Analg. 66 : 999-1003, 1987,
- 3-Bent JM Peterson JC Mashiter K : Effects of high dose fentanyl anesthesia on the established metabolic and endocrine response to surgery. Anaesthesia, 39 : 19-23, 1984.
- 4-Buckingham JC : Hypotalamo-pituitary responses to travma. Bri, Med. Bulletein, 11 : 203, 1985.
- 5-Clark NJ Meuleman T Liu WS: Comparison of sufentanyI-N,0 and fentanyI-N,0 in patients without cardiac disease undergoing general surgery. Anesthesiology. 66 ; 130-5, 1987,
- 6-Chrubasik J Wüst H Schulte-Mönting J : Analgesic potency of post-operative epidural fentanyl and alfentanyl. Anaesthesiology. 236 : 67, 1987.
- 7-Delitala Tomaesi Virdiş : Prolactin, growth hormone and thyrotropin, thyroid hormone secretion during stress states in mah. Balliere's Lli End and Met. 1: 391-414, 1987.
- 8-Downing R Davis 1 : Effect of intrathecal morphine on the adrenocortical and hypergiysemic responses to upper abdominal surgery. Br, J. Anaesth. 58 : 858 61, 1986.
- 9-Editoriyal : Fentanyl and the metabolic response to surgery. Br. J. Anaesth. 58 : 561-2, 1980,
- 10-Eugene PA Halter JB : Effect of spinal anaesthesia on adrenerjic tone neuroendocrine responses to surgical stress in humans. Anest, 55 : 120-6, 1981.
- 11-Gordon FH Scott DB Robb Rwt. : Modification of plasma corticosteroid concentrations during and after surgery by epidural blockade. Br. Med.J.i: 581-3, 1973,
- 12-George JM Reler EC : Morphine anaesthesia blocks cortisol and growth hormone response to surgical stress in humans, J, Clin End and Met. : 736-41, 1974.
- 13-Klinstedt C Giesceke E : High low dose fentanyl anesthesia. Circulatory and plazma catecholamine responses during cholecystectomy. Br. J. Anaesth. 59 : 184-8, 1987.
- 14-Konjiro M Koh S : Epidural ketamine does not produce analgesia. Anesthesiology. 68 : 120-6, 1988.
- 15-Moller IW Krantz T Wandall E : Effect of alfentanyl anaesthesia on the adrenocortical and hyperglisemic response to abdominal surgery. Br. J. Anaesth. 57: 591-4, 1985.
- 16-Malinow M Mokriski BL Wakefield ML: Anesthetic choice affects postcesaresan epidural fentanyl analgesia. Anesth, Analg. 67 : 51-5266, 1988.
- 17-Moh MS Chan CH Chung SK Lee Ty Lipmann M : Evaluation of the analgesic effect of epidural ketamine. Anest. Analg. 66 : 51-5191, 1987,
- 18-Naulty S Datta S Osthcimer G : Epidural fentanyl for postcesarean delivery pain management. Anesthesiology 63 : 694-698, 1985.
- 19-Normandak JP Sehmulian C Paterson JC : Epidural diamorphine and the metabolic response to upper abdominal surgery. Anaesthesia, 40 : 748-53, 1985.
- 20-Negre I Gueneron JP Ecoffey C ; Ventilatory response to canbondioxide after intramusculer and epidural fentanyl. Anest. Analg. 68 : 707-10, 1987.
- 21-Rutberg H Hakanson E : Effects of the extradural administrtion of morphine or bupivacaine on the endocrine response to upper abdominal surgery. Br. J. Anaesth. 58 : 233-7, 1984,
- 22-Rutter DV Skewes DG Morgan M : Extradural opioids for postoperative anal gesia. Br. J. Anaesth, 53 : 915-20, 1981.
- 23-Sebel PS Bovill JG : Opiold analgesics in cardisu aneslhesia, Kaplan J.A., ed. Cardiac Anaesthesia Orlando. Grue and Stratton Company. : PP ; 70-94, 1987,
- 24-Wasnich J Hurford W Gelb C : Epidural opioid analgesia does not alter the neuroendocrine response to thoracotomy. Anest. Analg. 70 : 51-5450, 1990
Details
| Primary Language | English |
|---|---|
| Subjects | Anaesthesiology |
| Journal Section | Articles |
| Authors | |
| Project Number | - |
| Publication Date | March 31, 1991 |
| Published in Issue | Year 1991 Volume: 44 Issue: 1 |
