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5 - Patient controlled analgesia with tramadol: comparison of bolus dose with combination of bolus dose and basal infusion
G. Ulufer Sivrikaya, Hale Dobrucali, Leyla T. Kılınç, Ayşe Hancı
Objective: In our study we aimed to investigate the effectiveness of basal infusion added to bolus dose for patient controlled analgesia (PCA) for postoperative pain management.
Study design: 36 patients undergoing abdominal hysterectomy under general anaesthesia were randomized to three groups after standart anaesthetic procedure. In Group I bolus dose regimen, in Group II bolus dose+low basal infusion rate, in Group III bolus dose+high basal infusion rate were used for PC A. Postoperative pain evaluation(with Verbal Rating Scale-VRS-), respiration rate, sedation score were recorded at I., 2., 4., 8., 12. and 24. hours postoperatively. Total analgesic consumption for 24 hours was calculated. Side effects were observed.
Results: VRS was higher in Group I than Group II and Group III and respiration rate was lower in Group II and Group III than Group I. But these differences were not statistically significant (p>0.05). Sedation score and total analgesic consumption were significantly higher in Group III than Group I (p<0.05). Gastrointestinal side effects were more frequent in Group II and Group III than Group I.
Conclusion: We concluded that basal infusion added to bolus dose has not provide a significant superiority to bolus dose alone when used with PCA for postoperative pain management. Also side effects, mainly respiratory depression, can be associated with the increased total analgesic consumption caused by basal infusion.
Keywords: Tramadol, patient controlled analgesia, bolus dose, basal infusion
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