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Volume: 32  Issue: 2  Year: 2020
  Comparison of epidural and intravenous route for acute and chronic postoperative pain control in patients with gynecological malignancy [Ağrı]
Ağrı. 2020; 32(2): 91-98 | DOI: 10.14744/agri.2019.26986  

Comparison of epidural and intravenous route for acute and chronic postoperative pain control in patients with gynecological malignancy

Bedih Balkan1, Gokhan Demirayak2, Halil Çetingök3, Cihan Comba2, Yusuf Ziya Yener1, Gülsüm Oya Hergünsel1, İsa Aykut Özdemir2
1Department of Anesthesiology and Reanimation, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
2Department of Gynecologic Oncology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
3Division of Algology, Department of Anesthesiology and Reanimation, İstanbul University Faculty of Medicine, İstanbul, Turkey

Objectives: This study compared the effects of patient-controlled epidural and intravenous analgesia on acute and chronic postoperative pain in patients who were operated on for gynecological malignancy.
Methods: Postoperatively, patient-controlled analgesia was administered via epidural route to Group 1 and the intravenous route to Group 2. Pain was evaluated using the Visual Analog Scale (VAS) in the acute phase at postoperative 24 hours and at 6 months in the chronic phase.
Results: The VAS scores at 24 hours were lower in Group 1 than in Group 2 (3.29 vs 3.93; p<0.05). The VAS scores at 6 months were 2.03 in Group 1 and 2.53 in Group 2, indicating no statistically significant difference (p>0.05). There was no significant difference in the Leeds Assessment of Neuropathic Symptoms and Signs pain scale scores at 6 months (p>0.05).
Conclusion: The results showed that epidural and intravenous analgesia had a similar effect regarding the chronicity of pain but better outcomes were achieved with epidural analgesia in the acute stage.

Keywords: Acute postoperative pain, chronic postoperative pain; epidural patient-controlled analgesia; gynecologic malignancy; intravenous patient-controlled analgesia.


Jinekolojik maligniteli hastalarda akut ve kronik postoperatif ağrı için epidural ve intravenöz yolun karşılaştırılması

Bedih Balkan1, Gokhan Demirayak2, Halil Çetingök3, Cihan Comba2, Yusuf Ziya Yener1, Gülsüm Oya Hergünsel1, İsa Aykut Özdemir2
1Bakırköy Dr Sadi Konuk Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye
2Bakırköy Dr Sadi Konuk Eğitim ve Araştırma Hastanesi, Jinekolojik Onkoloji Kliniği, İstanbul, Türkiye
3İstanbul Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı, Algoloji Bilim Dalı, İstanbul, Türkiye

Amaç: Jinekolojik malignite nedeniyle ameliyat edilen hastalarda epidural veya intravenöz hasta kontrollü analjezinin akut ve kronik postoperatif ağrı üzerine etkisini karşılaştırmak.
Gereç ve Yöntem: Postoperatif hasta kontrollü analjezi Grup 1 için epidural yol ve Grup 2 için intravenöz yoldan uygulandı. Ağrı, akut fazda postoperatif 24. saat ve kronik fazda 6. ayda Vizüel Analog Skoru (VAS) kullanılarak değerlendirildi.
Bulgular: 24. saatte VAS skoru Grup 1’de Grup 2’ye göre daha düşük bulundu (3.29 ve 3.93; p<0.05). Altıncı aydaki VAS skorları istatistiksel anlamlı farklılık göstermeyecek şekilde Grup 1’de 2.03 ve Grup 2’de 2.53 idi. Altıcı aydaki LANSS skorlarında da anlamlı farklılık yoktu (p>0.05).
Sonuç: Bizim sonuçlarımız, akut dönemde epidural analjezi ile daha iyi sonuçlar elde edilebilmesine rağmen epidural ve intravenöz analjezinin ağrının kronikliği için benzer etkilere sahip olduğunu gösterdi.

Anahtar Kelimeler: Akut postoperatif ağrı, kronik postoperatif ağrı; epidural hasta kontrollü analjezi; jinekolojik malignite; intravenöz hasta kontrollü analjezi.


Bedih Balkan, Gokhan Demirayak, Halil Çetingök, Cihan Comba, Yusuf Ziya Yener, Gülsüm Oya Hergünsel, İsa Aykut Özdemir. Comparison of epidural and intravenous route for acute and chronic postoperative pain control in patients with gynecological malignancy. Ağrı. 2020; 32(2): 91-98

Corresponding Author: Gokhan Demirayak, Türkiye


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