Akademik Veri Yönetim Sistemi
Anestezi Dergisi, cilt.12, sa.2, ss.129-134, 2004 (Scopus)
In the present study, we aimed to compare the analgesic efficacy and the side effects of epidural morphine and tramadol by using patient controlled epidural analgesia (PCEA) for postthoracotomy pain. After obtaining local ethic committee approval and informed consent, epidural catheters were inserted to 38 ASA I-II group adult patients undergoing thoracotomy through Th7-10 epidural space by using hanging drop technique at the end of the surgical procedure. Postoperatively patients were randomly allocated into two groups; Group I (n=19) received morphine (loading dose 2 mg, bolus dose 0.5 mg, lock out time 30 min, and 4 hour maximum dose 10 mg) and Group II (n=19) received tramadol (loading dose 50 mg, bolus dose 25 mg, lock out time 30 min, and 4 hour maximum dose 200 mg) by using PCEA for posthoracotomy pain. The quality of analgesia (with visual analogue scale-VAS), cumulative dosage of additional analgesic (Na diclofenac 75 mg) and vital signs (arterial blood pressure, heart rate, respiratory rate, SpO2, blood cortisol levels and side effects were recorded 48 hours postoperatively. Vital findings were similar in both groups. VAS levels were significantly higher in tramadol group at rest (6, 18, 30, 42 and 48 hours postoperatively, p<0.05) and during movement (4, 42 and 48 hours postoperatively, p<0.05). Additionally, the cumulative dosage of rescue analgesic medication was higher in tramadol group at the end of 48 hours postoperatively (p<0.05). Blood cortisol levels were also higher after 24 and 36 hours postoperatively (p<0.05). The side effects were similar between the groups. In conclusion, epidural administration of morphine by using PCEA method resulted in superior analgesia compared with epidural tramadol without increase in side effects.