Ayvaz, Hakan Kastamonu Özel Anadolu Hastanesi - Anesteziyoloji Kliniği, Turkey , Düger, Cevdet Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Bulut, Filiz Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Gürsoy, Sinan Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Kaygusuz, Kenan Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , İsbir, Ahmet Cemil Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Kol, İclal Özdemir Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Gürelik, Bilge Sivas Numune Hastanesi - Anesteziyoloji Kliniği, Turkey , Mimaroğlu, Caner Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey

Effects of pre-emptive intravenous, spinal and epidural morphine on early postoperatıve analgesia and stress response

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In this study, it was aimed to determine the effects of preemptive intravenous, spinal and epidural morphine on analgesic consumption, and stress response in the early postoperative period. Sixty ASA I-II patients who were undergoing lower abdominal surgery were randomly divided into three groups. Group I patients were admisnistered 5 mg iv morphine 5 minutes before induction, Grup II patients were administered 0.5 mg of intrathecal morphine 5 minutes before induction, Group III patients were administered 5 mg epidural morphine 30 min before induction of anesthesia. Induction of anesthesia, was performed with 0.1 mg kg^-1 fentanyl and 4-7 mg kg^-1 thiopental sodium. For muscle relaxation 0.1 mg kg-1 vecuronium were given. Anaesthesia was maintained with 1-2% sevoflurane and 50% N2O. Pre and postoperative hemodynamic parameters, VAS (Visual Analog Pain Scale) scores, time to first analgesic requirement, total analgesic consumption were recorded. In addition, to evaluate the stress response blood samples were taken three times before the administration of preoperative medications, preoperative 30th minute, and postoperative and 2nd hour. In our study, postoperative VAS scores between groups was significantly different at all times for the iv group and the spinal group and iv group and epidural group (P 0.05). In terms of time to first analgesic requirement, total analgesic consumption of group iv and iv with a group of spinal epidural group and the difference between groups was significant (P 0.05). Operative in terms of prolactin and ACTH between groups was significantly different at all times for the iv group and the spinal group and iv group and epidural group (P 0.05). Cortisol, glucose, and insulin levels postoperatively for 2. hour intravenous group and the spinal epidural group and iv group and the difference between groups was significant (P 0.05). As a result of preemptive spinal and epidural morphine in relieving postoperative pain and suppress the stress response was found to be effective in group iv.

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Preemptive analgesia , morphine , spinal analgesia , epidural analgesia , intravenous analgesia , stress response

Cumhuriyet Medical Journal

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