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Öğe Postoperatif ağrı tedavisinde intravenöz hasta kontrollü analjezi yöntemi ile kullanılan tramadol, tramadol-metamizol ve tramadol lornoksikamın karşılaştırılması(2007) Kemal, Sibel Özçakır; Şahin, Şaziye; Apan, AlparslanBu çalışmada, alt abdominal cerrahide intravenöz HKA yöntemi ile kullanılan tramadol, tramadol-metamizol ve tramadol-lornoksikam kombinasyonlarının postoperatif analjezik etkilerinin karşılaştırılması amaçlandı. Alt abdominal cerrahi girişim uygulanacak 60 erişkin kadın hasta çalışmaya dahil edildi. Hastalar randomize olarak üç gruba ayrıldılar. Grup I (tramadol) için, 50 ml izotonik NaCl içinde 500 mg tramadol (10 mg/ml tramadol); Grup II (tramadol- metamizol) için, 50 ml izotonik NaCl içinde 250 mg tramadol 3000 mg metamizol (5 mg/ml tramadol 60 mg/ml metamizol) ve Grup III (tramadol- lornoksikam) için ise, 50 ml izotonik NaCl içinde 250 mg tramadol 20 mg lornoksikam (5 mg/ml tramadol 0,4 mg/ml lornoksikam ) içeren solüsyonlar hazırlandı. Her üç grupta da operasyon bitiminden 30-40 dakika önce başlanarak, 10 ml, 30 dakikada gidecek şekilde yükleme dozu uygulandı. Hasta ağrıdan ilk yakındığı zaman HKA uygulaması başlatıldı. Ağrı VAS ile ilk 1 saatte 15 dak. ara ile daha sonra ise 2., 4., 8., 12., 18. ve 24. saatlerde değerlendirildi. Eş zamanlı olarak vital parametreler, yan etkiler, sedasyon skorları ve total analjezik tüketimleri de değerlendirildi. Toplam tramadol ve antiemetik tüketimi ile postoperatif bulantı kusma insidansı, sadece tramadol kullanılan grup I’ de, diğer iki gruba göre belirgin derecede yüksek olarak tesbit edildi. Sonuç olarak; HKA yöntemi ile tramadol-metamizol ve tramadol-lornoksikam kombinasyonları uygulandığında, daha az yan etki ile etkin bir postoperatif analjezi sağlandı.Öğe The postoperative analgesic effects of magnesium infusion on brachial plexus block(2007) Anbarci, Özlem; Apan, Alaprslan; Şahin, ŞaziyeMagnesium sulphate infusion decreases analgesic requirements after general anesthesia. Aim of this study was to assess the effects of postoperative magnesium infusion for 24 hours on duration of the block, sedation and postoperative analgesic consumption after brachial plexus block. After obtaining approval from local ethic committee, 70 ASA class I and II patients were included to the randomised double blind study. Brachial plexus block was performed using axillary approach with lignocaine 1.25% adrenaline 1/200 000 40 ml. Groups received 5 mg/kg bolus and 500 mg/h magnesium sulphate infusion or saline controls at the same volume during 24 hour. Analgesia and sedation were assessed while determining time to first pain and rescue analgesic, time to regain motor capability, visual analogue scale and sedation scores for every 4 hour during postoperative 24 h. period. While time to first pain and rescue analgesic was increased, total analgesic consumption was reduced significantly on magnesium infusion group (Meperidine: C: 36.3 ± 42.6 mg, Mg: 11.7 ± 12.2 mg, p: 0.001). Visual analogue scales were also observed to be lower in all periods. Time to motor block resolution, and sedation scores were similar. Magnesium sulphate infusion is thought as a safe and suitable adjunct for reducing analgesic consumption and possible complications without interfering daily activity in patients undergoing brachial plexus block.Öğe The effects of lactated ringer and hes solutions in differing combinations to prevent hypotension due to spinal anesthesia(2006) Şahin, Şaziye; Sari, Filiz; Apan, Alpaslan; Başar, HülyaObjective: The aim of this study was to assess the effectiveness of preloading with crystalloid and colloid fluids on hypotension following spinal anaesthesia. Method: One hundred ASA Class I-II patients were randomly assigned to the study and divided into five groups. Group I: Lactated Ringer (LR) 1000 mL 30 minutes before spinal anaesthesia, Group II: HES %6 500 mL solution before the procedure, Group III: 500 mL RL before and HES %6 250 mL within 15 minutes after the procedure. Group IV and Group V received RL 500 mL + 500 RL mL, and HES %6 250 mL + HES %6 250 mL respectively, using the same timing protocol. Systolic, diastolic and mean arterial pressures and heart rates were measured at 1 minute intervals in the first 20 minutes and then every 5 minutes. Results: With the exception of the differences in diastolic blood pressures at the 2nd, 3rd, and 5th minutes, there was no difference in arterial blood pressures and heart rates between Group III and IV or Group IV and V. Conclusion: While significant correlation was found between spinal block level and the incidence of spinal hypotension, no difference was observed regarding the type, dosage, and timing of loading solutions before spinal anaesthesia.Öğe The postoperative analgesic effects of magnesium infusion on brachial plexus block(2007) Anbarci, Özlem; Apan, Alparslan; Şahin, ŞaziyeMagnesium sulphate infusion decreases analgesic requirements after general anesthesia. Aim of this study was to assess the effects of postoperative magnesium infusion for 24 hours on duration of the block, sedation and postoperative analgesic consumption after brachial plexus block. After obtaining approval from local ethic committee, 70 ASA class I and II patients were included to the randomised double blind study. Brachial plexus block was performed using axillary approach with lignocaine 1.25% adrenaline 1/200 000 40 ml. Groups received 5 mg/kg bolus and 500 mg/h magnesium sulphate infusion or saline controls at the same volume during 24 hour. Analgesia and sedation were assessed while determining time to first pain and rescue analgesic, time to regain motor capability, visual analogue scale and sedation scores for every 4 hour during postoperative 24 h. period. While time to first pain and rescue analgesic was increased, total analgesic consumption was reduced significantly on magnesium infusion group (Meperidine: C: 36.3 ± 42.6 mg, Mg: 11.7 ± 12.2 mg, p: 0.001). Visual analogue scales were also observed to be lower in all periods. Time to motor block resolution, and sedation scores were similar. Magnesium sulphate infusion is thought as a safe and suitable adjunct for reducing analgesic consumption and possible complications without interfering daily activity in patients undergoing brachial plexus block.
