Çocuklarda Postoperatif Analjezide Kaudal Morfin Uygulaması -
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Dosyalar
Tarih
1998
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Yayıncı
Turgut Özal Tıp Merkezi Dergisi
Erişim Hakkı
Attribution 3.0 United States
Özet
Çalışmamızda, ürogenital bölgede cerrahi girişim geçirecek çocuklarda; kaudal bupivakain, morfin, epinefrin kombinasyonunun, postoperatif analjezik etkinliğini ve yan etkilerini değerlendirmeyi amaçladık. Yaşları 3-12 arasında değişen ve ürogenital bölgede operasyon geçirecek 27 erkek olgu ele alındı. Tiopental ( 4-6 mg/kg; iv ) veya halotan ile anestezi indüksiyonu gerçekleştirildikten sonra, vekronyum (1 mg/kg ) verilerek entübasyon yapıldı. İdamede, halotan ( % 0.5-1 ) ve N20-02 ( %50-50 ) kullanıldı. Operasyon bitip, anestezi sonlandırılmadan önce, lateral dekübitis pozisyonunda, 22 numara iğne ile kaudal mesafeye girilip, morfin (60 mgr/kg), bupivakain ( % 0.25'lik; 1 ml/kg ) ve epinefrin (1/ 200 000; 5 mgr/ml) karışımı verildi. Postoperatif 24 saatlik dönemde, analjezi süresi, kalitesi, ek analjezik ihtiyacı ve yan etkiler gözlendi. Olguların hiçbirinde ilk 15 saat analjezik gerekmedi, üç olguda analjezik ihtiyacı oldu. On iki olguda ( % 44.4) bulantı-kusma gözlemlendi. Bu dozda, uzun süreli ve etkin analjezi sağladık, ancak bulantı-kusma oranı yüksek olarak saptandı.
The aim of this study is to evaluate the postoperative analgesic effectiveness and side effects of caudal bupivacaine, morphine and epinephrine combination in children undergoing urogenital surgery. We studied, 27 male patients, aged 3-12, undergoing urogenital operations. Anaesthesia was induced with thiopental ( 4-6 mg/kg; iv ) or halothane. Tracheal entubation was performed with vecuronim bromide ( 1 mg/kg ). Maintanence of anaesthesia was performed with halothane ( 0.5-1 %) in N2O-O2 (50-50°%). At the end of operation, caudal morphi ne (60 mgr/kg), bupivacai ne ( 0.25 %; 1 ml/kg ) and epinephrine ( 1:200 000 ) were g iven via a 22 G needle, at the lateral decubitis position. The data of analgesia time, quality of the analgesia , additional analgesics and side effects during the postoperative 24 hour period were reported. None of the patients needed analgesics in the 15 hour period. After this period only 3 patients were given additional analgesics. Nausea and vomitting were observed in 12 patients ( 44.4 % ).In this study we provided, a long term and qualified analgesia in all patients, but nause and vomiting rate was high .
The aim of this study is to evaluate the postoperative analgesic effectiveness and side effects of caudal bupivacaine, morphine and epinephrine combination in children undergoing urogenital surgery. We studied, 27 male patients, aged 3-12, undergoing urogenital operations. Anaesthesia was induced with thiopental ( 4-6 mg/kg; iv ) or halothane. Tracheal entubation was performed with vecuronim bromide ( 1 mg/kg ). Maintanence of anaesthesia was performed with halothane ( 0.5-1 %) in N2O-O2 (50-50°%). At the end of operation, caudal morphi ne (60 mgr/kg), bupivacai ne ( 0.25 %; 1 ml/kg ) and epinephrine ( 1:200 000 ) were g iven via a 22 G needle, at the lateral decubitis position. The data of analgesia time, quality of the analgesia , additional analgesics and side effects during the postoperative 24 hour period were reported. None of the patients needed analgesics in the 15 hour period. After this period only 3 patients were given additional analgesics. Nausea and vomitting were observed in 12 patients ( 44.4 % ).In this study we provided, a long term and qualified analgesia in all patients, but nause and vomiting rate was high .
Açıklama
Turgut Özal Tıp Merkezi Dergisi.5 (2) :1998. İnönü Üniversitesi, Malatya.
Anahtar Kelimeler
Postoperatif analjezi, pediyatrik anestezi, kaudal blok, morfin, bupivakain, Postoperative analgesia, paediatric anaesthesia, caudal blocke, morphne, bupvacane
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Künye
Bakan, N.; Saydam, S.;Gürel, A.;Turgut Özal Tıp Merkezi Dergisi.5 (2) :1998. İnönü Üniversitesi, Malatya.
