Author/Authors :
Bakı, Elif Doğan Afyon Kocatepe Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon AD, Turkey , Sıvacı, Remziye Gül Afyon Kocatepe Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon AD, Turkey , Kokulu, Serdar Afyon Kocatepe Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon AD, Turkey , Ela, Yüksel Afyon Kocatepe Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon AD, Turkey , Köken, Gülengül Afyon Kocatepe Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum AD, Turkey , Üstün, Kübra Demir Afyon Kocatepe Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon AD, Turkey , Ünlü, Bekir Serdar Afyon Kocatepe Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum AD, Turkey , Uzel, Hanife Afyon Kocatepe Üniversitesi - Tıp Fakültesi - Halk Sağlığı AD, Turkey
Abstract :
Purpose:The aim of this research was to test the hypothesis that intraoperative use of the mixture of 50% nitrous oxide/oxygen could reduce postoperative analgesic requirements and prevent acute pain from becoming chronic in patients who undergo hysterectomy. Materials and methods:Patients aged between 18-70 years, American Society of Anesthesiology (ASA) I-III to undergo hysterectomy were enrolled. After standart anesthesia induction, maintenance of anesthesia was provided in Group N (n=30) with 50% nitrous oxide/oxygen mixture in 1-2% sevoflurane and in Group H with 50% air/oxygen mixture in 1-2% sevoflurane. Patients’ demographic data, comorbidities and duration of the surgery were recorded. Tramadol infusion, administered with a patient controlled analgesia device was given to all the patients at the end of the surgery. Additional analgesic, diclofenac sodium implementation was planned in patients whose Visual Analogue Scale (VAS) scores were over 4. Heart rate, mean arterial pressure, peripheral oxygen saturation, and VAS scores were recorded at 0, 4, 12, and 24 hours postoperatively. Ramsey scores were recorded at 0 and 30th minute in the recovery room and at 4 and 12 hours postoperatively. Opioid consumption and whether the patients were given additional analgesics or not within 24 hours were recorded. 4 and 12 weeks after surgery, patients were called to find out if they had any pain that was limiting their daily activities (VAS 0-10) (if applicable: 1 or 0) which was also recorded. Results: Opioid consumption and additional analgesic given to patients were significantly lower in Group N. VAS values that were evaluated at all hours were significantly lower in Group N (p 0.001). The number of the patients with chronic pain was lower in Group N than Group H and it was significant at the 4th week postoperatively (p=0.038). Conclusion: The researchers believe that using nitrous oxide intraoperatively provides lower pain scores in the early postoperative period, less opioid consumption and much more effective analgesic effects at 4-12 weeks postoperatively.
