The effects of preemptive tramodol and lornoxicam on analgesia and stress in the early postoperative period [Preemptif uygulanan tramadol ve lornoksikamin erken postoperatif analjezi ve stres yanit üzerine etkileri]
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Aim: The aim of this study was to determine the effects of preemptive trampdol and lornoxicam on analgesia and stress response in the early postoperative period. Materials and Methods: Sixty ASA I-II patients, scheduled for open cholecystectomy were allocated randomly into three groups. Placebo in Control Group (Group K), 100 mg iv tramodol in Tramadol Group (Group T) and 8 mg iv lornoxicam in Lornoxicam Group (Group L) were administered 10 minutes before the anesthesia induction. The induction was performed with fentanyl 0.1 ?g kg-1 and thiopenthal 4-7 mg kg-1 sodium. Vecuronium 0.1 mg kg-1 was used for muscle relaxation, desflurane 4-6% and 50-50% N2O-O2 were used for maintenance. In preoperative and peroperative period, the patients' hemodynamic parameters were measured. In the postoperative period, the patients' hemodynamic parameters, Visual Analog Pain Scale (VAS) values, emergence score, first analgesic requirement time and total analgesic consumption were recorded. Three blood samplings were done at the preoperative period before the administration of the study drugs, at peroperative 30th minute and at postoperative 2nd hour to measure the levels of serum glucose, insulin, cortisol, prolactin, ACTH. Results: A significant difference was observed between control and tramodol groups in postoperative 15th and 30th minutes on visual analogue scale values. There was also significant difference among control, tramodol and lornoxicam groups in postoperative 2nd hour (p<0.05). Regarding the time for first analgesic requiremet, total analgesic consumption and patient's satisfaction; tramodol group was better than the control group and lornoxicam group, while lornoxicam group was better than the control group. On the postoperative 2nd hour, insulin levels in group K were lower than group T and group L (p<0.05). ACTH values of group L were also lower than group T (p<0.05). Conclusions: In conclusion, preemptive tramodol and lornoxicam are effective to eliminate postoperative pain and provide good postoperative analgesia. However, both drugs are insufficient to suppress the stress response.