Conference Paper
BibTex RIS Cite

Comparison of efficiency of preemptive tramadol and paracetamol in postoperative pain therapy in pediatrics undergoing adenotonsillectomy and tonsillectomy

Year 2014, Volume: 21 Issue: 1, 11 - 15, 12.03.2014

Abstract

Comparison of efficiency of preemptive tramadol and paracetamol in postoperative pain therapy inpediatrics undergoing adenotonsillectomy and tonsillectomyObjective: Postoperative pain is the most important problem affecting the life quality of pediatric patientsundergoing adenotonsillectomy and tonsillectomy. In this study, we compared the effects of preemptivetramadol, and paracetamol usage on postoperative pain and also the side effects of these therapies in pediatricpatients undergoing adenotonsillectomy and tonsillectomy. Method: After the ethic committee approval,thirty patients aged between 3-12, undergoing adenotonsillectomy and tonsillectomy were included in thecurrent study. Oral 0.5 mg kg-1 midazolam were given to all patients one hour prior to the induction ofanesthesia. Patients were randomized into two groups. Group 1 (n=15) patients were administered 2 mg kg-1tramadol PO, and 20 mg kg-1 paracetamol suppository to Group 2 (n=15) as preemptive. After the standardmonitorization, 8% sevoflurane with 100% O2 were administered to the patients aged between 35 (n=10)and propofol 2.2 mg kg-1 iv and 0.6 mg kg-1 iv rocuronium were administered to the patients aged between6-12 (n=20). Anesthesia was maintained 34% sevoflurane with 50% N2O + 50% O2 after the endotracheal

References

  • Myatt HM, Myatt RA. The development of a paediatric quality of life questionnaire to measure post-operative pain following tonsillectomy. Int J Pediatr Otorhinolaryngol 1998; 44: 115–23.
  • McQuay HJ. Pre-emptive analgesia. Br J Anaesth 1992; 69: 1-3.
  • Kissin I. Preemptive analgesia. Anesthesiology 2000; 93: 1138–43.
  • Staunstrup H, Ovesen J, Larsen UT, et al. Efficacy and tolerability of lornoxicam versus tramadol in postoperative pain. J Clin Pharmacol 1999; 39: 834–41.
  • Schmidt A, Björkman S, Akeson J. Preoperative rectal diclofenac versus paracetamol for tonsillectomy: effects on pain and blood loss. Acta Anaesthesiol Scand 2001; 45: 48–52.
  • Splinter WM, Rhine EJ, Roberts DW, , . Preoperative ketorolac increases bleeding after tonsillectomy in children. Can J Anesth 1996; 43: 560–3.
  • Rusy LM, Houck CS, Sullivan LJ, et al. A double- blind evaluation of ketorolac tromethamine versus acetaminophen in pediatric tonsillectomy: analgesia and bleeding. Anesth Analg 1995; 80: 226–9.
  • Remy C, Marret E, Bonnet F. State of the art of paracetamol in acute pain therapy Curr Opin in Anaesth, 2006: 19;562–565.
  • Juhl GI, Norholt SE, Tonnesen E, et al. Analgesic efficacy and safety of intravenous paracetamol administered as a 2 g starting dose fallowing third molar surgery. Eur J Pain 2006; 10: 371–77.
  • Romsing J, Moiniche S, Dahl JB. Rectal and parenteral paracetamol, and paracetamol combination with NSAIDs, for postoperative analgesia. British J Anaesth 2002; 88: 215–26
  • Katz J: Pre-emptive analgesia: Importance of timing. Can JAnaesth 2001; 48: 105-114.
  • Gunter JB, Varughese AM, Harrington JF, et al. Recovery and complications after tonsillectomy in children. a comparison of ketorolac and morphine. Anesth Analg 1995; 81: 1136–41.
  • Schäffer J, Piepenbrock S, Kretz FJ, Schönfeld C. Anaesthesist 1986; 35: 408-13.
  • Bösenberg AT, Ratcliffe S. The respiratory effects of tramadol in children under halothane anaesthesia. Anaesthesia 1998; 53: 960–964.
  • Karayazýlý R, Özkoçak I, Ayoðlu H, Yurtlu S, Okyay D, Hancý V. Çocuklarda peroral midazolam, ketamin ve tramadolün, sevoflurana baðlý postoperatif ajitasyon üzerine etkilerinin karþýlaþtýrýlmasý. Haseki Týp Bülteni 2010; 48: 146–52.
  • Hancý V, Erbay H, Tomatýr E, Atalay H, Tekelioðlu U. Çocuklarda preemptif farklý tramadol dozlarýnýn postoperatif aðrýya etkisi. Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesi Týp Dergisi 2007; 47: 249–61.
  • Özköse Z, Akçabay M, Kemaloðlu YK, Sezenler S. Relief of posttonsillectomy pain with low-dose tramadol given at induction of anesthesia in children. Int J Pediatric Otorhino 2000; 53: 207–14.
  • Schectar NL, The undertreatment of pain in children: An Overwiew. Pediatr Clin North Am. 1989; 36: 781- 94.
  • Hamid SK, Selby IR, Sikich N, Lerman J. Vomiting after adenotonsillectomy in children: a comparison of ondansetron, dimenhydrinate, and placebo. Anesth Analg 1998; 86: 496-500.
  • Aouad MT, Siddik SS, Rizk LB, Zaytoun GM, Baraka AS. The effect of dexamethasone on postoperative vomiting after tonsillectomy. Anesth Analg 2001; 92: 636-40.
  • Akkurt Ç, Ýnanoðlu K, Okuyucu Þ, Turhanoðlu S, Akoðlu E, Kireççi N. Çocuklarda tonsillektomi sonrasý kusma profilaksisinde metilprednizolon ve deksametazonun karþýlaþtýrýlmasý. Türk Anest Rean Derneði Dergisi 2008; 36: 317–23.
  • April MM, Callan ND, Nowak DM, Hausdorff MA. The effect of intravenous dexamethasone in pediatric adenotonsillectomy. Arch Otolaryngol Head Neck Surg 1996; 122: 117-20.
  • Rose JB, Watcha MF. Postoperative nausea and vomiting in paediatric patients. Br J Anaesth 1999; 83: 104-17.

ADENOTONSİLLEKTOMİ VE TONSİLLEKTOMİ GEÇİREN ÇOCUKLARDA POSTOPERATİF AĞRI TEDAVİSİNDE PREEMPTİF TRAMADOL VE PARASETAMOLÜN ETKİNLİKLERİNİN KARŞILAŞTIRILMASI

Year 2014, Volume: 21 Issue: 1, 11 - 15, 12.03.2014

Abstract

Amaç: Adenotonsillektomi ve tonsillektomi geçiren çocuklarda postoperatif aðrý, yaþam kalitesini etkileyenen önemli problemdir. Bu çalýþmada preemptif tramadol veya parasetamol kullanýmýnýn, adenotonsillektomive tonsillektomi olan çocuklarda postoperatif analjezik etkinliklerini ve yan etkilerini karþýlaþtýrdýk. Metod:Etik kurul onayý alýnan, adenotonsillektomi ve tonsillektomi operasyonu planlanan 312 yaþ arasý 30 hastaçalýþmaya dahil edildi. Hastalara anesteziden bir saat önce oral 0,5 mg kg-1 midazolam verildi. Olgularrastgele iki gruba ayrýldý. Grup 1de (n=15); oral tramadol damla 2 mg kg-1, Grup 2de (n=15); supozituarparasetamol 20 mg kg-1 preemptif uygulandý. Standart monitörizasyonu takiben, 35 yaþ arasý çocuklarsevofluran indüksiyonu ile yeterli kas gevþemesi saðlandýktan sonra entübe edildi. 612 yaþýndaki çocuklariçin i.v. damar yolu saðlandýktan sonra propofol 2,2 mg kg-1 + rokuronyum 0,6 mg kg-1 dozlarýnda uygulandý,yeterli kas gevþemesi saðlandýktan sonra hastalar entübe edildi ve anestezi idamesi için %3-4 sevofluran,%50 N2O ve %50 O2 kullanýldý. Tüm hastalar ETCO2 3040 mm Hg olacak þekilde ventile edildi. Hemodinamikdeðiþkenler, anestezi ve cerrahi süreleri kaydedildi. Postoperatif 1., 2. ve 4. saatte derlenme ve aðrý skorlarýdeðerlendirildi. Gruplarda ek analjezik olarak supozituar parasetamol 22,5 mg kg-1 kullanýldý. Postoperatif24 saat içindeki analjezik gereksinimi, yan etkiler kaydedildi. Bulgular: Gruplar arasýnda demografik vehemodinamik veriler, derlenme ve aðrý skorlamalarý, postoperatif komplikasyonlar açýsýndan fark saptanmadý.Grup 1de postoperatif 1. saatte 4 hastada SpO2 96 ya düþtü. Postoperatif dönemde Grup 1de; 11 hastada,Grup 2de ise 9 hastada ek analjezik ihtiyacý oldu. Gruplar arasýnda ek analjezik ihtiyacý olan hasta sayýlarýve analjezik miktarý açýsýndan anlamlý fark saptanmadý (p >0,05). Sonuç: Çalýþmamýzda adenotonsillektomive tonsillektomi sonrasý aðrý kontrolünde preemptif uygulanan tramadol ve parasetamolün analjeziketkinliklerinin ve yan etkilerinin benzer olduðu kanýsýna varýldý

References

  • Myatt HM, Myatt RA. The development of a paediatric quality of life questionnaire to measure post-operative pain following tonsillectomy. Int J Pediatr Otorhinolaryngol 1998; 44: 115–23.
  • McQuay HJ. Pre-emptive analgesia. Br J Anaesth 1992; 69: 1-3.
  • Kissin I. Preemptive analgesia. Anesthesiology 2000; 93: 1138–43.
  • Staunstrup H, Ovesen J, Larsen UT, et al. Efficacy and tolerability of lornoxicam versus tramadol in postoperative pain. J Clin Pharmacol 1999; 39: 834–41.
  • Schmidt A, Björkman S, Akeson J. Preoperative rectal diclofenac versus paracetamol for tonsillectomy: effects on pain and blood loss. Acta Anaesthesiol Scand 2001; 45: 48–52.
  • Splinter WM, Rhine EJ, Roberts DW, , . Preoperative ketorolac increases bleeding after tonsillectomy in children. Can J Anesth 1996; 43: 560–3.
  • Rusy LM, Houck CS, Sullivan LJ, et al. A double- blind evaluation of ketorolac tromethamine versus acetaminophen in pediatric tonsillectomy: analgesia and bleeding. Anesth Analg 1995; 80: 226–9.
  • Remy C, Marret E, Bonnet F. State of the art of paracetamol in acute pain therapy Curr Opin in Anaesth, 2006: 19;562–565.
  • Juhl GI, Norholt SE, Tonnesen E, et al. Analgesic efficacy and safety of intravenous paracetamol administered as a 2 g starting dose fallowing third molar surgery. Eur J Pain 2006; 10: 371–77.
  • Romsing J, Moiniche S, Dahl JB. Rectal and parenteral paracetamol, and paracetamol combination with NSAIDs, for postoperative analgesia. British J Anaesth 2002; 88: 215–26
  • Katz J: Pre-emptive analgesia: Importance of timing. Can JAnaesth 2001; 48: 105-114.
  • Gunter JB, Varughese AM, Harrington JF, et al. Recovery and complications after tonsillectomy in children. a comparison of ketorolac and morphine. Anesth Analg 1995; 81: 1136–41.
  • Schäffer J, Piepenbrock S, Kretz FJ, Schönfeld C. Anaesthesist 1986; 35: 408-13.
  • Bösenberg AT, Ratcliffe S. The respiratory effects of tramadol in children under halothane anaesthesia. Anaesthesia 1998; 53: 960–964.
  • Karayazýlý R, Özkoçak I, Ayoðlu H, Yurtlu S, Okyay D, Hancý V. Çocuklarda peroral midazolam, ketamin ve tramadolün, sevoflurana baðlý postoperatif ajitasyon üzerine etkilerinin karþýlaþtýrýlmasý. Haseki Týp Bülteni 2010; 48: 146–52.
  • Hancý V, Erbay H, Tomatýr E, Atalay H, Tekelioðlu U. Çocuklarda preemptif farklý tramadol dozlarýnýn postoperatif aðrýya etkisi. Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesi Týp Dergisi 2007; 47: 249–61.
  • Özköse Z, Akçabay M, Kemaloðlu YK, Sezenler S. Relief of posttonsillectomy pain with low-dose tramadol given at induction of anesthesia in children. Int J Pediatric Otorhino 2000; 53: 207–14.
  • Schectar NL, The undertreatment of pain in children: An Overwiew. Pediatr Clin North Am. 1989; 36: 781- 94.
  • Hamid SK, Selby IR, Sikich N, Lerman J. Vomiting after adenotonsillectomy in children: a comparison of ondansetron, dimenhydrinate, and placebo. Anesth Analg 1998; 86: 496-500.
  • Aouad MT, Siddik SS, Rizk LB, Zaytoun GM, Baraka AS. The effect of dexamethasone on postoperative vomiting after tonsillectomy. Anesth Analg 2001; 92: 636-40.
  • Akkurt Ç, Ýnanoðlu K, Okuyucu Þ, Turhanoðlu S, Akoðlu E, Kireççi N. Çocuklarda tonsillektomi sonrasý kusma profilaksisinde metilprednizolon ve deksametazonun karþýlaþtýrýlmasý. Türk Anest Rean Derneði Dergisi 2008; 36: 317–23.
  • April MM, Callan ND, Nowak DM, Hausdorff MA. The effect of intravenous dexamethasone in pediatric adenotonsillectomy. Arch Otolaryngol Head Neck Surg 1996; 122: 117-20.
  • Rose JB, Watcha MF. Postoperative nausea and vomiting in paediatric patients. Br J Anaesth 1999; 83: 104-17.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Dentistry
Journal Section Research Articles
Authors

Filiz Alkaya Solmaz

Ali Abbas Yılmaz This is me

Menekşe Hasdoğan This is me

Oya Özatamer This is me

Neslihan Alkış This is me

Publication Date March 12, 2014
Submission Date February 14, 2012
Published in Issue Year 2014 Volume: 21 Issue: 1

Cite

Vancouver Alkaya Solmaz F, Yılmaz AA, Hasdoğan M, Özatamer O, Alkış N. ADENOTONSİLLEKTOMİ VE TONSİLLEKTOMİ GEÇİREN ÇOCUKLARDA POSTOPERATİF AĞRI TEDAVİSİNDE PREEMPTİF TRAMADOL VE PARASETAMOLÜN ETKİNLİKLERİNİN KARŞILAŞTIRILMASI. Med J SDU. 2014;21(1):11-5.

                                                                                               14791 


Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.