EPIDURAL OPIATES USED IN TOTAL KNEE AND HIP ARTHROPLASTIES
Şerife Nursel UYSAL1, Hasan Hilmi MURATLI2, Deniz ERDEM1, Mehmet MUTLU1, Murat TEKİN3, Nermin GÖĞÜŞ4
1TC Sağlık Bakanlığı Ankara Numune Eğitim ve Araştırma Hastanesi 1. Anesteziyoloji ve Reanimasyon Kliniği
2TC Sağlık Bakanlığı Ankara Numune Eğitim ve Araştırma Hastanesi 3.Ortopedi ve Travmatoloji Kliniği
3TC Sağlık Bakanlığı Ereğli Devlet Hastanesi Anesteziyoloji ve Reanimasyon Kliniği
4TC Sağlık Bakanlığı Ankara Numune Eğitim ve Araştırma Hastanesi 1. Anesteziyoloji ve Reanimasyon Kliniği Şefi
Keywords: Epidural Anesthesia, Morphine, Tramadol Hydrocloride.
Abstract
Introduction: In this study we have compared the hemodynamic, respiratory and analgesic effects of epidural morphine and tramadol hydrocloride used for anesthesia and postoperative analgesia in total knee and hip arthroplasties.
Patients and methods: 30 patients in ASAI-II risk groups operated for total knee and hip arthroplasties included in this study. The patient group who had epidural morphine infusion formed the first (Group M) and the patients had epidural tramadol hydrocloride infusion formed the second (Group T) group. The patients in Group M had morphine infusion initiated with general anesthesia and continiued as long as 24 hours and patients in Group T had epidural hydrocloride infusion in same manner. Blood gas, mean arterial blood pressure and heart rate measurements done preoperatively and postoperatively for both groups. Pain while resting, sitting and couphing was evaluated using a scale equally divided to 10 sections from 0-10 (Visual Analog Scale: VAS).
Findings: pH, partial oxygen pressure (PaO2) and saturation (SAT) values were significantly lower in morphine group than the tramadol group. (p<0.05). Pain relieve of patients during while resting, sitting and couphing were significantly lower in Group M (p<0.05).
Discussion: According to our results we have found that postoperative analgesia in patients using morphine is more effective but epidural tramadol infusion is safer for hemodynamic and respiratory functions.