Fakülteler / Faculties
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Item The Impact of Multimodal Analgesia Timing on Postoperative Pain in Cesarean Delivery. A Prospective Randomized Study(2023) Ozmete, Ozlem; Sener, Mesut; Bali, Cagla; Caligan, Esla; Durdag, Gulsen Dorgan; Aribogan, Anis; 38131366AIM: The issue of preemptive or preventive use of paracetamol still raises questions in terms of multimodal analgesia in cesarean delivery. A combination of paracetamol and opioid is commonly used for pain management after cesarean delivery. This study aims to compare postoperative pain level and analgesic consumption when using paracetamol at two different perioperative times in cesarean section. MATERIAL AND METHODS: Sixty patients recruited for elective cesarean section under general anesthesia were included in this prospective study. Patients were randomly assigned to receive iv 1 g paracetamol 15 minutes before incision (Group PE) or after delivery of newborn (Group PV). Visual analog scale (VAS) values, 24-hour morphine consumption, additional analgesic requirement, side effects, and patient and surgeons' satisfaction were recorded. RESULTS: Demographic data and hemodynamic values of the patients were similar in both groups. There was no differences between groups in terms of VAS scores at rest and during movement, additional analgesic requirement during the postoperative 1st hour, and 24-hour total morphine consumption. There was no difference in side effects, and patient and surgeon satisfaction scores postoperatively. CONCLUSIONS: Preemptive and preventive use of paracetamol provides the same quality of analgesia and opioid sparing effect without increasing the frequency of adverse effects.Item Administration of paracetamol versus dipyrone by intravenous patient-controlled analgesia for postoperative pain relief in children after tonsillectomy(2015) Sener, Mesut; Kocum, Aysu; Caliskan, Ebru; Yilmaz, Ismail; Caylakli, Fatma; Aribogan, Anis; 25443442Background and objective: We compared the efficacy of intravenous (iv) paracetamol versus dipyrone via patient-controlled analgesia (PCA) for postoperative pain relief in children. Methods: The study was composed of 120 children who had undergone elective tonsillectomy after receiving general anesthesia. Patients were divided into 3 groups according to the dosage of postoperative intravenous-patient-controlled analgesia: paracetamol, dipyrone, or placebo. Pain was evaluated using a 0- to 100-mm visual analog scale and 1- to 4-pain relief score at 30 min, 1, 2, 4, 6, 12, and 24h postoperatively. Pethidine (0.25 mg kg 1) was administered intravenously to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24h postoperatively, and treatment related adverse effects were noted. Results: Postoperative visual analog scale scores were significantly lower with paracetamol group compared with placebo group at 6h (p < 0.05), dipyrone group compared with placebo group at 30 min and 6 h (p <0.05). No significant differences regarding visual analog scale values at 1, 2, 4, 12, and 24h were found. No significant differences were found between groups with respect to pain relief score (p >0.05). Postoperative pethidine requirements were significantly lower with paracetamol and dipyrone groups compared with placebo group (62.5%, 68.4% vs 90%, p < 0.05). No significant differences were found between groups with respect to nausea, vomiting and the any other adverse effects of the drugs (p >0.05). Conclusions: Paracetamol and dipyrone have well tolerability profile and effective analgesic properties when administered iv-PCA for postoperative analgesia in children after tonsillectomy. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.