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Comparison of analgesic effects of tramadol, aldolan and morphine under thoracic surgery
Thoracotomy is one of the most painful surgical procedures known, and severe pain is encountered in 21-67% of patients after thoracotomy. The most important causes of this pain arise from the bone structures of the thoracic wall, damage to the costal joint junctions, stretching of the ligaments, rib fractures, and damage to the intercostal nerve and major muscles. Another factor that causes pain after thoracotomy is the chest tubes placed in the thorax to provide drainage (1).
As a result of this pain caused by loss of tissue and pulmonary reserve, effective coughing and decreased chest expansion can lead to serious complications such as atelectasis, ventilation/perfusion mismatch, hypoxemia, immobilization, thromboembolism and infection. These complications are associated with increased morbidity and mortality in thoracic surgery (2).
Ensuring pain management in patients undergoing thoracotomy is important in terms of reducing postoperative complications, ensuring early mobilization and increasing patient comfort. Since there is no single source that causes pain after thoracotomy, pain must be controlled at all levels. For this reason, a multimodal approach using pharmacological and non-pharmacological techniques is preferred in analgesia after thoracotomy. This approach reduces drug side effects along with the consumption of analgesics. Opioids and nonsteroidal anti-inflammatory drugs are used in pharmacological analgesia.
In our study, the investigators aim to compare the effects of tramadol, pethidine and morphine using intravenous patient-controlled analgesia in the treatment of postoperative pain in elective thoracic surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tramadol | Active Comparator | Tramadol receiving group |
|
| Aldolan | Active Comparator | Aldolan receiving group |
|
| Morphine | Active Comparator | Morphine receiving group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tramadol hydrochloride | Drug | Patients are receiving tramadol hydrochloride under thoracic surgery |
|
| Measure | Description | Time Frame |
|---|---|---|
| The rate of drugs's analgesic effects | To compare the analgesic effects of tramadol, pethidine and morphine in the treatment of postoperative pain in thoracic surgery, It will be assesed with numeric rating scale ( 0= no pain, 10= worst pain imaginable) | postoperative 24 hours |
| Comparing hemodynamic effects | To compare hemodynamic effects of tramadol, pethidine and morphine in the treatment of postoperative pain in thoracic surgery, It will be asssesed with measurements of intraoperative values of systolic, diastolic and mean arterial blood pressure | Intraoperatively, then postoperative 24 hours |
| Comparing respiratory effects | To compare respiratory effects of tramadol, pethidine and morphine in the treatment of postoperative pain in thoracic surgery. It will be asssesed with postoperative pulmonary complications such as failed extubation, bronchospasms or respiratory depressions. | postoperative 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse effects of analgesics | It was aimed to compare the effects of drugs in terms of side effects, early mobilization. | postoperative 24 hours |
| surgeon satisfaction | With a questionnaire, surgeon satisfaction will be assessed. (0 point= strongly disagree, 5 point= strongly agree) |
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Inclusion Criteria:
Exclusion Criteria:
. Have allergies to the drugs to be used
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Begum N Gokdemir, MD | Contact | 03122036868 | begokdemir@yahoo.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Baskent University Ankara Hospital | Ankara | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D013896 | Thoracic Diseases |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D012140 | Respiratory Tract Diseases |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
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| ID | Term |
|---|---|
| D014147 | Tramadol |
| ID | Term |
|---|---|
| D003511 | Cyclohexanols |
| D000441 | Hexanols |
| D005233 | Fatty Alcohols |
| D000438 | Alcohols |
| D009930 |
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3 groups of patients are received different type of analgesics
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Double blind
| Aldolan | Drug | Patients are receiving meperidine under thoracic surgery |
|
| Morphine hydrochloride | Drug | Patients are receiving Morphine hydrochloride under thoracic surgery |
|
| Immediately after the surgery |
| patient satisfaction | With a questionnaire, patient satisfaction will be assessed. (0 point= strongly disagree, 5 point= strongly agree) When Aldrete score> 8, patient will be questioned for satisfaction. | Postoperative 30th minute |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| Organic Chemicals |
| D004123 | Dimethylamines |
| D008744 | Methylamines |
| D000588 | Amines |
| D008055 | Lipids |