Sünnet sonrası analjezi amacı ile kaudal blok, dorsal penil bloğu, topikal analjezi ve sistemik analjezinin karşılaştırılması
Başlık çevirisi mevcut değil.
- Tez No: 354065
- Danışmanlar: PROF. DR. ZEYNEP ETİ
- Tez Türü: Tıpta Uzmanlık
- Konular: Anestezi ve Reanimasyon, Anesthesiology and Reanimation
- Anahtar Kelimeler: Analjezi, Hasta memnuniyeti, Komplikasyonlar, Postoperatif dönem, Sinir blokajı, Sünnet, Analgesia, Patient satisfaction, Complications, Postoperative period, Nerve block, Circumcision
- Yıl: 2011
- Dil: Türkçe
- Üniversite: Marmara Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: Belirtilmemiş.
Özet
The aim of our study was to compare the postoperative analgesic effect, side effects and parent satisfaction of caudal block, dorsal penile block, topical and systemic analgesia in children undergoing circumcision. After ethics committee approval and parental written concent, eighty children aged between 3-12 years, undergoing circumsicion were randomised into four groups (n=20). After induction, Group KA received caudal block with 0.25% bupivacain 1ml/kg; Group DP received dorsal penile block with 0.25% bupivacain 0.3ml/kg; Group TA received topical cream consisting of 3gr 2.5% lidocain and 2.5% prilocain 1 hour before operation and Group SA received 40mg/kg rectal/oral paracetamol, 3x1 mg/kg meperidine iv postoperatively. General anesthesia was induced with 8% sevoflourane and N2O inhalation in 30% O2 or thiopental 5-7 mg/kg iv and was maintained with 1 MAC sevoflourane and N2O in 30% O2. The severity of pain was measured with NRS and with CHEOPS in children who colud not express pain severity at postoperative 0, 2nd, 4th, 6th, 12th and 24th hours. When additional analgesia was required, meperidine 1mg/kg IV was administered. Patients' awakening time, first analgesic requirement time, first urination, mobilisation and discharge times, side effects and parental satisfaction according to a 4 point scale was measured. Data was statistically analysed with two-way ANOVA, Tukey-Kramer, Mann-Whitney U and chi-square tests. (p<0.05). The peroperative sevoflourane concentration was found to be lower in group KA at 15th minute (p<0,05). At postoperative first hour, the CHEOPS values were lower in Group KA and Group DP compared to other groups and in the first 2 hours the NRS values were lower in Group KA compared to Groups TA and SA (p<0,05). The need for additional analgesia was lower in Group KA and DP compared to other groups (p<0,05). No significant difference was found in awakening, first analgesic need, mobilisation and urination times (p>0,05). Parental satisfacsatisfaction was higher in Group KA compared to other groups and higher in Group DP compared to Groups TA and SA (p<0,05).
Özet (Çeviri)
The aim of our study was to compare the postoperative analgesic effect, side effects and parent satisfaction of caudal block, dorsal penile block, topical and systemic analgesia in children undergoing circumcision. After ethics committee approval and parental written concent, eighty children aged between 3-12 years, undergoing circumsicion were randomised into four groups (n=20). After induction, Group KA received caudal block with 0.25% bupivacain 1ml/kg; Group DP received dorsal penile block with 0.25% bupivacain 0.3ml/kg; Group TA received topical cream consisting of 3gr 2.5% lidocain and 2.5% prilocain 1 hour before operation and Group SA received 40mg/kg rectal/oral paracetamol, 3x1 mg/kg meperidine iv postoperatively. General anesthesia was induced with 8% sevoflourane and N2O inhalation in 30% O2 or thiopental 5-7 mg/kg iv and was maintained with 1 MAC sevoflourane and N2O in 30% O2. The severity of pain was measured with NRS and with CHEOPS in children who colud not express pain severity at postoperative 0, 2nd, 4th, 6th, 12th and 24th hours. When additional analgesia was required, meperidine 1mg/kg IV was administered. Patients' awakening time, first analgesic requirement time, first urination, mobilisation and discharge times, side effects and parental satisfaction according to a 4 point scale was measured. Data was statistically analysed with two-way ANOVA, Tukey-Kramer, Mann-Whitney U and chi-square tests. (p<0.05). The peroperative sevoflourane concentration was found to be lower in group KA at 15th minute (p<0,05). At postoperative first hour, the CHEOPS values were lower in Group KA and Group DP compared to other groups and in the first 2 hours the NRS values were lower in Group KA compared to Groups TA and SA (p<0,05). The need for additional analgesia was lower in Group KA and DP compared to other groups (p<0,05). No significant difference was found in awakening, first analgesic need, mobilisation and urination times (p>0,05). Parental satisfacsatisfaction was higher in Group KA compared to other groups and higher in Group DP compared to Groups TA and SA (p<0,05).
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