Comparison of the effectiveness in Patient Control Analgesia with fentanyl or tramadol

Objective: In this study, our aim was to evaluate effectiveness and side effects of tramadol and fentanyl with patient control analgesia after lower abdominal surgery.
Study Design: Forty patient (ASA I-II) aged between 20-60 years who underwent elective lower abdominal surgery were enrolled. A standart general anesthesia was used. Fentanyl and tramadol were administered in group F ve T respectively with intravenous PCA (loading dose was 100p.gr and 100 mg, bolus dose was 5p.gr and 20 mg, lockout time was 10 and 15 minutes, respectively). Visuel analog score (VAS), sedation scores and siae effects were recorded at postoperative 6,12,24 hours. Total consumption of the both dmgs was also recorded.
Results: VAS Decreased continyously in 24 hours. VAS was significantly lower in the group T than group F at postoperative 6 th hour (p <0.05). Sedation scores were similar in both groups Urinary retention was obseived higher in group F (p<0.05). Total fentanyl and tramadol consumptions were 270.1 ±10.9 and 310.7 ± 18.9 respectively.
Conclusion: Fentanyl and tramadol are effective and safe analgesics for use in PCA. We concluded that the lower rate of respiratuar depression for tramadol makes it the ding of alternative to agonist opioids.

Hasta Kontrollü Aneljezide Tramadol ve Fentanil‘in Etkinliðinin Karþýlaþtýrýlmasý

Amaç: Bu çalýþmada, alt abdomiýýal cenalýi sonrasýpostoperatif aðrý saðaltýmýnda tramadol ile fentanil‘in intravenöz hasta kontrollü aneljezide (HKA) etkinliklerinin ve komplikasyonlarýnýn karþýlaþtýrýlmasý amaçlandý.
Materyal-metod: 20-60 yaþlarý arasýnda alt abdomiýýal elektif cerrahi geçirecek 40 hasta (ASA I-II) iki eþit gnýba ayrýlarak tek kör, prospektif olarak gerçekleþtirildi. Tüm hastalara standart genel anestezi uygulandý. HKA cihazý ile I. Gruba (Gnýp F) (ýý=20) IVfentanil (100pgr yükleme dozu, 5 pgr bolus ve 10 dk. kilitli kalýna süresi ), II. Gruba (Grup T), (ýý—20) IV tramadol (100 nýgyükleme dozu, 20 nýg bolus ve 15 dk kilitli kalma süresi) uygulandý. Aðrý þiddeti visuel aðn skalasý (VAS) (en iyi.O, en kötü: 10 olacak þekilde), sedasyon düzeyi ve komplikasyonlar postoperatif 6,12,24. saatlerde kaydedildi.
Bulgular: Her iki grupta VAS deðerleri baþlangýç deðerlerine göre anlamlý düþük idi (p<0.05). Postoperatif 6. saatte VAS deðeri tramadol gmbunda fentanil grubundan istatiksel olarak anlamlý düþük bulundu (p<0.05). Her iki grupta belirgin sedasyon gözlenmedi. Fentanil gmbunda idrar retansiyonýý tramadol grubuna göre daha fazla gözlendi (p<0.05). Toplam ilaç kullanýmý Grup Fde: 270.1 ± 10.9, Grup T de 310.7± 18.9 olarak belirlendi.
Sonuç: Postoperatif aðn tedavisi için ITKA‘da tramadol ve fentanil güvenli ve benzer etkinlikte olduðu, tramadolün opioidlere iyi bir alternatif olabileceði kanýsýna varýldý.