GKD Anest Yoð Bak Dern Derg. 2018; 24(1): 23-28 | DOI: 10.5222/GKDAD.2018.023

Administration of Paracetamol, Diclofenac Sodium, And Tramadol in Postoperative Analgesia After Coronary Artery Bypass Surgery

Yaþar Arslan¹, Türkan Kudsioðlu², Nihan Yapýcý², Zuhal Aykaç^3
1Afyon Kocatepe University, Department of Anesthesiology
²Siyami Ersek Thoracic and Cardiovasculary Center, Department of Anesthesiology
³Marmara University, Department of Anesthesiology

INTRODUCTION: The aim of this study was to compare the effects of paracetamol, diclofenac sodium, and tramadol administration in the postoperative period for the patients who underwent coronary artery bypass grafting (CABG) on postoperative pain.

METHODS: After the approval of ethics committee and informed consent 200 patients who undergoing CABG with normal renal and liver functions and an ejection fraction value of 40 % were included. The patients were randomly divided into four groups: group I (n=50) patients received paracetamol (IV), group II (n=50) patients received diclofenac sodium(IM), group III (n=50) patients received tramadol(IV), and group IV (n=50) patients received placebo. Group IV was given only 2 µg/kg/h of fentanyl for 2 hours. Hemodynamic values and biochemical parameters were recorded. Postoperative pain was assessed using visuel analog scale(VAS).
RESULTS: In the placebo group, PaCO2 levels were higher, mean arterial pressure was higher and extubation time was longer than the other groups. There was no statistically significant difference between the three analgesia groups.
DISCUSSION AND CONCLUSION: Based on our study results, analgesic effect of IV paracetamol appears to be similar to diclofenac and tramadol.

Keywords: paracetamol, diclofenac sodium, tramadol, coronary artery bypass grafting, postoperative analgesia.

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Koroner Arter Baypas Cerrahisinden Sonra Postoperatif Analjezide Parasetamol, Diklofenak sodyum ve Tramadol Verilmesi

Yaþar Arslan¹, Türkan Kudsioðlu², Nihan Yapýcý², Zuhal Aykaç^3
1Afyon Kocatepe Üniversitesi Týp Fakültesi, Anesteziyoloji Ana Bilim Dalý
²Dr.Siyami Ersek Göðüs Kalp ve Damar Cerrahisi Merkezi, EAH, Anesteziyoloji ve Reanimasyon Kliniði
³Marmara Üniversitesi Týp Fakültesi, Anesteziyoloji Ana Bilim Dalý

GÝRÝÞ ve AMAÇ: Bu çalýþmada koroner arter baypas (KABG) ameliyatý geçiren hastalara postoperatif süreçte parasetamol, diklofenak sodyum ve tramadol uygulamasýnýn postoperatif aðrý üzerine etkilerini karþýlaþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Etik komite ve bilgilendirilmiþ onamlarý alýnan KABG uygulanacak normal böbrek ve karaciðer fonksiyonlarýna sahip ve ejeksiyon fraksiyonu % 40 üzerinde olan 200 hasta çalýþmaya alýndý. Hastalar rastgele dört gruba ayrýldý; grup I (n=50) parasetamol IV, grup II (n=50) diklofenak sodyum IM, group III (n=50) IV tramadol alan hastalar, ve grup IV (n=50) plasebo. Grup IV de ki hastalar sadece 2 µg/kg/saat fentanil aldý. Hemodinamik ve biyokimyasal parametreler kaydedildi. Postoperatif aðrý vizüel analog skala (VAS) ile deðerlendirildi.
BULGULAR: Plesoba grubunda ekstübasyon zamaný daha uzun, PaCO2 seviyeleri ve ortalama kan basýncý diðer gruplara göre daha yüksekti. Diðer analjezi gruplarý arasýnda istatistiksel olarak anlamlý fark yoktu.
TARTIÞMA ve SONUÇ: Çalýþmamýzda IV parasetamol'ün analjezik etkisinin diklofenak ve tramadol'e benzer olduðu görüldü.

Anahtar Kelimeler: parasetamol, diklofenak sodyum, tramadol, koroner arter baypas greft, postoperatif analjezi

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