İntratekal Hiperbarik Bupivakaine Eklenen Farklı Adjuvan Ajanların ve Total İntravenöz Anestezinin, Postoperatif Analjezik Özellikler Üzerine Etkileri

Authors : Abdulkadir Yektaş, Enver Belli

Pages : 113-120

View : 29 | Download : 14

Publication Date : 2014-06-01

Article Type : Research

Abstract :Aim: We planned the present study to reveal the effects of different adjuvant agents added to hyperbaric bupivacaine on post-operative analgesia and the post-operative analgesic differences between spinal anesthesia and total intravenous anesthesia TIVA . Materials and Methods: 100 cases were randomly divided into 5 groups of 20 cases. 15 mg 0.5%hyperbaric bupivacaine and 0.5 mL saline were used in Group SF; in other groups, Group HB, Group F and Group S, 2.5 mg hyperbaric bupivacaine, 25 μg fentanyl and 2.5 μg sufentanyl were added respectively to hyperbaric bupivacaine instead of saline. TIVA was administered in Group T, with propofol and remifentanyl. Total spinal drug volume was 3.5 mL. Post-operative analgesia duration, VRS scores at the end of post-operative analgesia duration, the amount of tramadol consumed in the 2nd hour after the post-operative analgesia and the amount of tramadol consumed at the 24th hour after the administration of analgesia were recorded. Results: The duration of post-operative analgesia in Group F and Group S was statistically significantly longer compared with other groups. The VRS scores at the end of post-operative analgesia duration in Group F and Group S was statistically significantly lower compared with other groups. The amount of tramadol consumed in the 2nd hour after post-operative analgesia and the amount of tramadol consumed at the 24th hour after the administration of anesthesia were statistically significantly lower in Group F and Group S. Conclusion: Fentanyl and sufentanyl prolong postoperative analgesia duration, lower the VRS scores at the end of post-operative analgesia duration and reduce the need of post-operative pain killers by creating intrathecal multimodal analgesia. Post-operative analgesia duration in spinal anesthesia is longer compared with TIVA and post-operative pain killer need is statistically significantly lower compared with TIVA
Keywords : spinal anesthesia, total intravenous anesthesia, intrathecal multimodal analgesia, fentanyl, sufentani