24 research outputs found
Tramadol Iontophoresis Added to Treatment of Knee Osteoarthritis
No full textAmaç: Bu çalışmanın amacı diz OA hastalarında tedaviye eklenen tramadol iyontoforezinin tek başına uygulanan tedavi yöntemlerine (transkütanöz elektriksel sinir stimülasyonu, sıcak kompres, ultrason ve egzersiz tedavisi) üstün olup olmadığını incelemektir.Yöntem ve Gereçler: Çalışmaya Fizik Tedavi ve Rehabilitasyon polikliniğine başvuran 72 hasta dahil edildi. Hastaların tanısı, Amerikan Romatoloji Birliği (ACR) Diz OA kriterlerine göre konuldu. Hastalar rastgele iki gruba ayrıldı. İki haftalık süre boyunca Grup 1'deki hastalara fizik tedavi, Grup 2'deki hastalara ise tedaviye ek olarak tramadol iyontoforezi uygulandı. Hastalar tedaviden önce, 10. seansı takiben ve 1. ve 3. aylarda görsel ağrı skalası (GAS) ve Western Ontario ve McMaster Üniversiteleri Osteoartrit İndeksi (WOMAC) kullanılarak ağrı ve fonksiyonel kapasitelerine göre değerlendirildi.Bulgular: Yaş ortalaması ve ortalama ağrı süresi kontrol grubunda 58,53±8,38 ve 5,00±2,66 yıl, tramadol iyontoforez grubunda ise 58,15±7,70 ve 4,71±2,70 yıldı. Tedavi öncesinde gruplar arasında yaş ortalamaları, ortalama ağrı süresi, vücut kitle indeksi, VAS ve WOMAC skorları açısından anlamlı fark yoktu. 10. seansı takiben ve 1. ve 3. aydan sonra, başlangıç değerleriyle karşılaştırıldığında her iki grupta GAS ve WOMAC skorlarında anlamlı düşüş saptandı (p0.05).Sonuç: Fizik tedaviye eklenen tramadol iyontoforezin tedavi dönemi sırasında diz OA ağrısını rahatlatmada faydalı olabileceği sonucuna vardıkObjective: The objective of the present study was to investigate whether tramadol iontophoresis added to therapy is superior to the therapy methods alone (transcutaneous electrical nerve stimulation (TENS), hot pack, ultrasound, and exercise therapy) in patients with knee OA. Materials and Methods: A total of 72 patients who admitted to the outpatient clinic of Physical Medicine and Rehabilitation were included in this study. The diagnosis was based on the American College of Rheumatology (ACR) criteria for knee OA. The patients were randomly separated into two groups. Group 1 received physical therapy and Group 2 received tramadol iontophoresis in addition to the therapy for a period of two weeks. Patients were evaluated according to pain and functional capacity assessed using visual analogue scale (VAS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) before therapy and following the 10th session, and at 1 and 3 months.Results: The mean age and duration of the knee pain were 58.53±8.38, 5.00±2.66 years in the control group and 58.15±7.70, 4.71±2.70 years in the tramadol iontophoresis group. There were no significant differences between groups in the mean age and duration of the knee pain, body mass index (BMI), VAS and WOMAC scores before therapy. Following the 10th session, and after 1 and 3 months, VAS and WOMAC scores were significantly decreased in both groups when compared with the baseline values (p<0.001). VAS scores were significantly lower in the tramadol iontophoresis group compared to controls following the 10th session (p<0.001). However, no significant difference was found between WOMAC scores of the tramadol iontophoresis and control groups (p>0.05). Conclusion: We conclude that tramadol iontophoresis added to physical therapy may be useful for relieving pain of knee OA during the treatment perio
Epidural ropivacaine versus ropivacaine plus tramadol in postoperative analgesia in children undergoing major abdominal surgery: a comparison
No full textDiz protezi operasyonlarında anestezi yönteminin hemodinami üzerine etkileri
No full textAmaç: Diz protezi ameliyatlarında spinal ve genel anestezi yöntemlerinin metil metakrilat uygulaması, turnike şişirilmesi ve turnike indirilmesi sırasındaki hemodinamik değişiklikler üzerine olan etkilerini karşılaştırmayı amaçladık.Gereç ve Yöntemler: Total diz protezi cerrahisi yapılacak olan ASA I/II grubu 38 hasta randomize olarak sevofluran bazlı genel anestezi (n=20) ve 3 mL %0.5 levobupivakainin intratekal olarak uygulandığı spinal anestezi (n=18) grubu olmak üzere iki gruba ayrıldı. Tüm hastalara radial arter kateterizasyonu yapıldıktan sonra kardiyak output, arteriyel kan basınçları ve kalp atım hızı anestezi indüksiyonu veya spinal anestezi öncesi, entübasyon veya spinal anestezi sonrası 5, 10, 15. dakikalarda, turnike öncesi, turnike sonrası, kemik çimento öncesi ve sonrası 1, 3, 5, 10. dakikalarda ve turnike indirildikten 1 dakika sonra ölçülerek kaydedildi.Bulgular: Spinal anestezi ve genel anestezi grubunda turnike uygulaması kardiyak outputta ve kan basıncında anestezi öncesi değerlerine göre anlamlı olarak artışa sebep oldu. Kemik çimentosu uygulaması ve turnike çözülmesi her iki grupta kardiyak outputu ve kan basıncını düşürdü, ancak gruplar arası anlamlı bir farklılık bulunamadı.Sonuç: Turnike ve kemik çimentosu uygulanan diz protezi operasyonlarında uygulanan anestezi yöntemlerinin hemodinamik açıdan birbirinden farklı olmadığı sonucuna vardık.Objective: To compare the effects of spinal and general anaesthesia on hemodynamic variations during tourniquet application and cementation in patients undergoing total knee surgery.Materials and Methods: 38 ASA physical status I/II patients undergoing total knee surgery were randomized into two groups as spinal anesthesia group (n=18) where 3 mL of 0.5% levobupivacaine injected intrathecally and sevoflurane based general anesthesia group (n=20). Radial artery catheterization was performed in all of the patients and cardiac output, invasive arterial pressure and heart rate were measured and recorded before anesthesia indication or spinal blockade, at 5 th, 10 th, and 15 th min following endotracheal intubation or spinal blockade, just before and after tourniquet inflation, just before and at 1 st, 3 rd, 5 th, and 10 th min following bone cement placement, and at 1st min after tourniquet deflation.Results: Tourniquet application caused a significant increase in the blood pressure and cardiac output when compared to the values recorded before anesthesia in both groups. Sementation and deflation of the tourniquet caused decrease in blood pressure in both groups, but there was no significant difference between two groups.Conclusion: We concluded that total knee surgery with sementation and tourniquet application did not affect hemodynamic parameters in both spinal and general anesthesia groups
Negative pressure pulmonary edema (NPPE) after discectomy in general anesthesia with endotracheal intubation: Case report
No full textBackground: Negative-pressure pulmonary edema (NPPE) is a rare and serious complication after general anesthesia. Although it is generally seen after upper airway surgery, it can be seen in different types of surgery also. We report a young, healthy case that developed pulmonary hemorrhage and alveolar edema after extubation of the trachea. Case Report: A 27-year-old ASA II male with a history of smoking, underwent elective discectomy. Following uneventful surgery under general anesthesia, the patient was taken to supine position. He developed a marked inspiratory effort and he bit the endotracheal tube during position changing. Immediately after extubation, the patient developed respiratory distress. Due to desaturation the patient was reintubated An intense hemorrhagic fluid was suctioned in the endotracheal tube. The chest radiograph showed bilateral pulmonary infiltrates. After 24 hours of mechanical ventilation, the patient's symptoms improved and he was extubated. He was discharged from the hospital on the fourth postoperative day. Conclusions: Although it is rare, NPPE can be seen following operations other than upper airway surgery
Comparação de diferentes métodos de inserção de sonda nasogástrica em pacientes anestesiados e intubados
No full textSubakromiyal sıkışma sendromu olan hastalarda ketoprofen fonoforezi ile ketoprofen ve lidokain-prilokain fonoforez uygulamasının karşılaştırılması
No full textAmaç: Çalışmanın amacı, subakromiyal sıkışma sendromu olan hastalarda ketoprofen ve lidokain-prilokain fonoforez uygulamasının, tek başına ketoprofen fonoforezine bir üstünlüğü olup olmadığının değerlendirilmesi idi.Yöntem ve Gereçler: Çalışmaya subakromiyal sıkışma sendromu olan 70 (39 kadın, 31 erkek) hasta alındı. Hastalar iki gruba ayrıldı ve her iki grubada 15 seans fizik tedavi ve rehabilitasyon programı uygulandı. Birinci gruba ketoprofen ve lidokain- prilokain fonoforezi, ikinci gruba sadece ketoprofen fonoforezi uygulandı. Ayrıca tüm hastalara sıcak paket, TENS ve egzersiz uygulandı. Hastaların omuz ağrısı şiddeti vizüel analog skala (VAS) ile değerlendiridi. Eklem hareket açıklığı (EHA) gonyometre ile ölçüldü. Hastaların fonksiyonel durumu UCLA (The University of California-Los Angeles) skorlaması ile değerlendirildi. Tüm değerlendirmeler tedavi öncesinde, tedavi sonrası 1.ayda ve tedavi sonrası 3. ayda yapıldı.Bulgular: Tedavi öncesi iki grup arasında VAS, UCLA skorları açısından istatistiksel olarak fark yoktu (p>0.05). Tedavi sonrası 3.ay takiplerinde; grup 1'in VAS skorları grup 2'den daha düşük bulundu (p=0.020). Tedavi öncesi grup 2'nin EHA; fleksiyon, abduksiyon, iç rotasyon ölçümleri grup 1'den daha yüksekti (p=0.009, p=0.001, p=0.019). Tedavi sonrası 1. ay takiplerinde de grup 2'nin, abduksiyon ölçümleri grup 1'den daha yüksekti (p=0.024). Fakat tedavi sonrası 3.ay takiplerinde iki grup arasında UCLA ve EHA değerleri açısından istatistiksel olarak fark yoktu (p>0.05). Ayrıca, iki grup arasında tedavi öncesi ve sonrası dış rotasyon ölçümleri açısından fark yoktu (p>0.05).Sonuç: Çalışmamızda, subakromiyal sıkışma sendromu olan hastalarda, tedavi sonrası 3.ay değerlendirmede, ketoprofen ve lidokain- prilokain fonoforezi ağrı ve EHA üzerine daha etkili bulunmuştur.Objective: The aim of the present study was to compare ketoprofen phonophoresis with ketoprofen and lidocaineprilocaine phonophoresis in patients with subacromial impingement syndrome (SIS).Material and Methods: Seventy patients (39 female, 31 male) with SIS were included in this study. The patients were divided into two groups and a 15-session physical therapy and rehabilitation program was performed in each group. Ketoprofen and lidocaineprilocaine phonophoresis were performed in the first group and ketoprofen phonophoresis alone in the second group. Hot pack, transcutaneous electrical nerve stimulation (TENS) and exercises were applied in all patients. Severity of shoulder pain was determined by visual analogue scale (VAS). Range of motion (ROM) was measured by goniometer. Functional capacity of patients was evaluated by UCLA (The University of California-Los Angeles) score. All of the measurements were performed before treatment and in the 1st and 3rd months after treatment.Results: There was no significant difference between the two groups in VAS and UCLA scores before treatment initiation (p>0.05). VAS scores of Group 1 were lower than of Group 2 (p=0.020) in the 3rd month follow-up. ROMs and flexion, abduction and internal rotation were higher in Group 2 than Group 1 (p=0.009, p=0.001, p=0.019, respectively) before treatment. Abduction measurements in Group 2 were higher than in Group 1 in the 1st month after treatment (p=0.024). However, there was no significant difference between the two groups in UCLA and ROM values in the 3rd month (p>0.05). There was also no significant difference between the two groups in external rotation values before and after treatment (p>0.05).Conclusion: Our study showed that ketoprofen and lidocaineprilocaine phonophoresis were more effective on pain and ROM than ketoprofen phonophoresis alone in the 3rd month after treatment in patients with SIS
Periprostatic nerve blockage reduces postoperative analgesic consumption and pain scores of patients undergoing transurethral prostate resection
No full textIntroduction: To evaluate the effects of periprostatic bupivacaine administration on pain control and analgesic consumption after transurethral prostate resection (TURP). Materials and Methods: The study included 40 male patients with benign prostatic hyperplasia who underwent TURP, and they were divided randomly into two groups. All patients were operated under general anesthesia. The study group patients (n = 20) received periprostatic bupivacaine (0.5% 20 ml) injection (group I), and the control patients (n = 20) received only saline (NaCl 0.9% 20 ml) injection (group II). All injections were performed bilaterally into the periprostatic areas immediately after the TURP procedure via the transperineal route. In the postoperative period, all patients (groups I and II) received tramadol using a patient-controlled analgesia device. Postoperative pain was assessed and recorded using the visual analog scale (VAS) at postoperative hours 1, 2, 3, 4, 5, 6, 7, 8, 12, 16, 20, 24, and 48. Total tramadol consumptions and additional analgesic requirements were also recorded and compared between groups. Results: There was no difference in demographic data between the two groups (p > 0.05). VAS scores of the patients at hours 1, 3, 4, 5, 7, 8, and 12 were found to be significantly lower in group I than in group II (p < 0.05). Total tramadol consumption and patient-controlled analgesia demands of groups I and II were 153.5 ± 52.4 vs. 465.0 ± 55.1 mg and 17.1 ± 7.7 vs. 77.8 ± 7.5 mg, respectively (p < 0.001). No side effect was observed regarding bupivacaine injections. Conclusions: Periprostatic bupivacaine administration was a useful and safe method for postoperative pain control and reduced analgesic consumption in patients undergoing TURP. Copyright © 2007 S. Karger AG
The effect of anesthetic agents on perioperative bleeding during tonsillectomy: Propofol‐based versus desflurane‐based anesthesia
No full textThe analgesic efficacy of preoperative versus postoperative lornoxicam in varicocele repair
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