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Öğe The comparison of the analgesic effect of dexketoprofen trometamol with lornoxicam and placebo on post-cesarean delivery pain(2012) Aykaç E.; Büyükkoçak Ü.; Köse E.A.; Sağsöz N.Objective: The aim was to compare the effect of dexketoprofen trometamol with lornoxicam and placebo on post-cesarean delivery pain. Method: Ninety patients scheduled for cesarean-section under spinal anesthesia were randomized equally into three groups. Before the surgical incision closure, 50 mg dexketoprofen trometamol (Group D), 8 mg lornoxicam (Group L) or 0.9% NaCl (Group P) was given intravenously. After the surgery all patients received intravenous tramadol via patient controlled analgesia device (bolus dose: 20 mg, lock out: 10 min.). Postoperative pain was assessed by visual analog scale (VAS). Additional analgesic doses of tramadol (20 mg, i.v) were given when the VAS value was ? 3. The time of the first analgesic requirement, VAS values at the 1, 3, 6, 12, 24 hours of the postoperative period, additional analgesic doses of tramadol, cumulative tramadol consumption, patient satisfaction, adverse effects of drugs were recorded. Results: The time of the first analgesic requirement was significantly longer and the VAS values at the postoperative first hour was significantly lower in the Group D than the Group L (p=0.01, p=0.007; respectively). The cumulative tramadol consumption and patient satisfaction was similar between the Group D and Group L. The additional analgesic consumption at postoperative first hour was significantly lower in the Group D when compared to Group L and Group P (p=0.01, p<0.001; respectively). The total additional analgesic consumption at the end of the postoperative 24 hours was lower in the Group D when compared to Group P and Group L (p=0.01, p<0.001; respectively). Conclusion: Dexketoprofen trometamol had more analgesic efficacy for postoperative pain at early postoperative period with prolonged first analgesic requirement time, decreased additional analgesic requirement, decreased VAS values in the first postoperative hour, when compared with lornoxicam.Öğe Effect of paracetamol pretreatment on rocuronium-induced injection pain: A randomized, double-blind, placebo-controlled comparison with lidocaine(Journal of Clinical and Analytical Medicine, 2014) Ateş G.; Köse E.A.; Öz G.; Apan A.Aim: To compare the effect of intravenous paracetamol on rocuronium-induced injection pain with that of lidocaine. Material and Method: One hundred and eighty patients scheduled for elective surgery under general anesthesia were recruited to this prospective, randomized, double-blinded, placebo-controlled study. A 20-gauge cannula was inserted into a vein on the dorsum of the patient's left hand and lactated Ringer's solution was infused at 100 ml/h. After 5 minutes, infusion was stopped and the left arm of the patient's was elevated for 15 seconds for gravity of venous blood. While venous occlusion was applied to the left upper arm using a pneumatic tourniquet, one of the pretreatment solutions (normal saline 5 mL, lidocaine 40 mg, paracetamol 50 mg) was injected over a period of 10 seconds. The intensity of the pain patients experienced was assessed using a 4-point verbal rating scale in Group C (normal saline 5 mL, n=60), Group L (lidocaine 40 mg, n=60) and Group P (paracetamol 50 mg, n=60). After 2 minutes, the venous occlusion was released and the patients received 0.06 mg/kg rocuronim bromide over 10 seconds and the rocuronim-induced pain was assessed. Results: The overall incidence of rocuronium-induced injection pain was significantly more in Group C than the other groups (p<0.001). The overall incidence of the rocuronium-induced injection pain was significantly less in Group L than in Group P and in Group C (p=0.009 and p<0.001, respectively). Additionally, the overall incidence of the rocuronium-induced injection was less in Group P than the Group C (p=0.002). Discussion: Intravenous pretreatment with paracetamol was effective in reducing the incidence and intensity of rocuronium-induced injection pain, but not as effective as intravenous lidocaine pretreatment.Öğe Efficacy of prophylactic ketamine in preventing postoperative shivering(Derman Medical Publishing, 2012) Köse E.A.; Honca M.; Akinci S.B.; Dal D.; Aypar U.Aim Treatment with ketamine and meperidine is effective in postoperative shivering. The aim of this study was to investigate the minimum effective dose of ketamine in the prevention of postanaesthetic shivering compared to placebo and meperidine. Material and Methods This prospective randomized double-blind study involved 150 ASA I and II patients undergoing general anesthesia. Patients were randomly allocated to receive normal saline (Group S, n=30), meperidine 20 mg (Group M, n=30), ketamine 0.1 mg/kg (Group K1, n=30), ketamine 0.25 mg/kg (Group K2, n=30) and ketamine 0.5 mg/kg (Group K5, n=30) intravenously 20 minutes before completion of surgery. The anesthesia was induced with propofol 2 mg/kg, fentanyl 1 ?g/kg and vecuronium 0.1 mg/kg. It was maintained with sevoflurane 2-3% and nitrous oxide 60% in oxygen. Tympanic temperature was measured immediately after induction of anesthesia, 30 minutes after induction and before administration of the study drug. Postoperative shivering was recorded using a four point scale and postoperative pain using a visual analogue scale (VAS) ranging between 0 and 10. Results The number of patients shivering on arrival the recovery room and at 10 minutes after operation were significantly less in Groups M and K5 than in Groups K1, K2 and Group S (p < 0.001 and p=0.001). The time to first analgesic requirement in Groups M and K5 was longer than in the Groups K1, K2 and Group S (P< 0.001). There was no difference between the five groups regarding VAS pain scores (p > 0.05). Conclusions Prophylactic usage of ketamine 0.5 mg/kg was effective to prevent postanaesthetic shivering, but ketamine 0.1 mg/kg and 0.25 mg/kg had no prophylactic effect.
