The efficacy of IV nimodipine and oral nifedipine on postoperative epidural morphine analgesis in patients undergoing spinal surgery

Omurga cerrahisinde IV nimodipin ve oral nifedipinin postoperatif epidural morfin analjezisi üzerine etkileri

Abstract

In 54 patients where PCA morphine was applied after spinal surgery, an assessment was made if calcium channel blockers; oral nifedipine and IV nimodipine minimized morphine consumption or not. Patients were allocated to one of three groups in a randomized-double-blinded manner and, in control group and IV nimodipine group, placebo was administered orally; in control group and oral nifedipine group, placebo was administered IV. Nimodipine was administered with a dose of 30 $mu$g/kg/h after induction of anaesthesia, and continued 20 for hours. Nifedipine was administered 2 hours before induction. In all three groups epidural analgesia protocol were similar. In addition to epidural analgesia, tenoxicam 20 mg IV was applied within the first 8 hours when pain scores were >4 and morphine requirements more than 10 mg. Postoperative pain scores were similar in three groups. Morphine consumption was lower in nimodipine group than control group in 24 hours (p

Özet

Omurga cerrahisi sonrası hasta kontrollü epidural analjezi (HKEA) yöntemi ile morfin uyguladığımız 54 olguda, kalsiyum kanal blokerle rinden oral nifedipin ve IV nimodipinin morfin tüketimini azaltıp azaltmadığı değerlendirildi. Olgular rasgele 3 gruba ayrılarak, çift kör yöntemle, kontrol grubu ve IV nimodipin grubuna oral plasebo; kontrol ve oral nifedipin grubuna IV plasebo uygulandı. Nimodipin, indüksiyondan sonra 30 $mu$g/kg/sa infüzyonla başlatılarak 20 saat süreyle uygulandı. Nifedipin, ameliyattan 2 saat önce verildi. Uç grupta da epidural analjezi protokolü aynı idi. Epidural analjeziye ek olarak, morfin tüketimi ilk 8 saatte 10 mg'ı geçen ve ağrı skorunu >4 olarak belirten olgulara tenoksikam 20 mg IV uygulandı. Postoperatif ağrı skorları gruplar arasında farklı bulunmadı. Nimodipin grubunda ilk 24 saatte (p