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Saracoglu K.T.,Marmara University | Saracoglu A.,Marmara University | Cakar K.,Maltepe University | Fidan V.,Central Education and Research Hospital | Ay B.,Acibadem University
Biomedical Papers | Year: 2012

Background. Intravenous patient-controlled analgesia (IV PCA) using opiods is an accepted method for delivering postoperative analgesia. The aim of this study was to compare fentanyl and tramadol with IV PCA after spinal anesthesia (SA) and general anesthesia (GA) following cesarean section (C/S). Methods. Ninety women were randomly assigned to three groups (n=30). Group 1 was treated with IV fentanyl PCA after SA. Groups 2 and 3 were treated with IV fentanyl PCA and IV tramadol PCA after GA. Outcome measures were recorded for the first 24 h post-anesthesia. Results. PCA use was significantly lower after SA (P<0.05). Eighteen patients in the SA Group and 27 patients and 24 patients from the GA groups required additional opioid. Opioid consumption and patient satisfaction were similar for groups after GA (P>0.05). 638.4 ± 179.1 μg fentanyl was consumed by patients of Group 2, 356.3 ± 87.0 μg fentanyl and 559.5 ± 207.0 mg tramadol was consumed by Group 1 and Group 3 respectively. There was no significant difference in the overall severity and incidence of nausea, drowsiness or pruritus. Conclusion. Our study shows that analgesic consumption and post-operative pain scores after SA in C/S decreased, without increase in adverse reactions.

Saracoglu A.,Central Education and Research Hospital | Saracoglu K.T.,Central Education and Research Hospital | Eti Z.,Marmara University
Archives of Medical Science | Year: 2011

Introduction: The aim of our study was to compare the effects of isobaric and hyperbaric bupivacaine combined with morphine or fentanyl in patients undergoing caesarean section. We assessed quality and spread of analgesia and anaesthesia, postoperative analgesic requirement and side effects. Material and methods: Hundred patients with American Society of Anesthesiologists physical status (ASA) I-II, age 18 to 40 years, were randomized to 4 groups. The intrathecal solutions were isobaric bupivacaine + morphine (group A), isobaric bupivacaine + fentanyl (group B), heavy bupivacaine + + morphine (group C) and heavy bupivacaine + fentanyl (group D). Mean arterial pressure, heart rate, oxygen saturation, ephedrine consumption, analgesic requirement time and additional analgesic needs were recorded. Results: The 1st min value of mean arterial pressure was the lowest one in all groups. Heart rate decreased significantly in group A at the 10th min but not in the other groups. The decrease of visual analogue scale (VAS) pain scores began in the groups after the 4th postoperative h (p < 0.05) and the VAS value of group B at the 8th h was significantly higher than the other groups. The first analgesic requirement time in the postoperative period was longer in patients who had intrathecal morphine than those who had fentanyl. The duration of analgesia with isobaric bupivacaine and morphine was the longest one. Conclusions: We concluded that intrathecal morphine provides a long duration of postoperative analgesia but the duration gets longer when it is combined with plain bupivacaine instead of heavy bupivacaine. Copyright © 2011 Termedia & Banach.

Saracoglu A.,Central Education and Research Hospital | Saracoglu K.T.,Central Education and Research Hospital | Umuroglu T.,Marmara University | But A.,Central Education and Research Hospital
Advances in Clinical and Experimental Medicine | Year: 2010

Background. Patient-controlled analgesia (PCA) is the most widely used treatment method for post-cesarean section pain. Objectives. To compare two different opioids with respect to analgesic quality and side effects. Material and Methods. Sixty patients undergoing elective cesarean surgery were enrolled into two groups. Group F (n = 30) had postoperative IV PCA with fentanyl and Group T (n = 30) had IV PCA with tramadol. Postoperative pain scores, opioid requirements, side effects and patient satisfaction were compared. Results. The patient demographics were similar in both groups. Group F patients consumed 638.4 ± 179 μg of fentanyl, and Group T patients consumed 559.5 ±207 mg of tramadol. The number of patients requiring additional opioid was similar in both groups. Patient satisfaction did not differ in the two groups. Conclusions. Both fentanyl and tramadol provide sufficient postoperative analgesia and patient satisfaction when used in PCA. © Copyright by Wroclaw Medical University.

Saracoglu K.T.,Central Education and Research Hospital | Saracoglu A.,Central Education and Research Hospital | Karacaa F.,Central Education and Research Hospital | Fidan V.,Central Education and Research Hospital
Journal of Research in Medical Sciences | Year: 2011

BACKGROUND: Accidental dural puncture during epidural blockade is a rare complication. Since postdural puncture headache (PDPH) is the most frequent complication, a wisely management method will also reduce the incidence of PDPH. METHODS: Five patients who had inadvertent dural puncture during the epidural procedure before hip or knee arthroplasty were included in this study. After dural puncture we drew back the epidural needle and placed an epidural catheter into the epidural space. RESULTS: Epidural anesthesia and postoperative epidural analgesia have been provided successfully in all cases. 20% showed PDPH. CONCLUSIONS: These results demonstrate the effectiveness of management skills after inadvertent dural punctures.

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