After laparotomy with transdermal fentanyl tramadol and tenoxicam combination comparison analgesic effect

It is quite well known that several drugs and methods are used for the severity of postoperative pain control. However, efficacy and complications of each drug and the method show differences; appropriate drug combination studies are ongoing in a controversial manner In this study, we aimed to compare the effects of drug treatment for postoperative pain control and to determine the protocol that minimises morfine consumption with transdermal fentanil (TDF) patch application accompanied tramadol and / or the use of tenoxicam. In this prospective randomized study, 80 patients were included after obtaining the approval of the Gaziantep Universitylocal ethics committee, who were ASA I-II-III, aged between 18-65 and underwent laparotomy. In all patients TDF patch (50μg / h) were applied 12 hours before the surgery and in PACU, patient controlled analjesia with morphine was installed. Patients were randomly divided into four groups.Postoperatively in Group 1 (n = 20) there wasn't any additional analgesia administered, in Group 2 (n = 20) 4x1 tramadol 100 mg, in Group 3 (n = 20) 1x1 tenoxicam 20 mg, in Group 4 (n = 20) 4x1 tramadol 100 mg and 1x1 tenoxicam 20 mg were administered.In 24 hours of follow-up demographic, hemodynamic data, RSS, in terms of mobilizing VAS, respiratory rates, values of saturation and side effects did not differ significantly among the four groups. The resting VAS values of the patients in Group 1; 2. and 4. hours were significantly lower than in Group 4 (p<0.05). Postoperative morphine consumption; for following every 6 hours both in Group 1 and 4 there was a significant difference from the other 3 groups (p<0.05). Morphine consumption; Group 1 was the higher, Group 4 was the lower. As a result; in all groups, effective analgesia was provided and complication ratio was not significant difference. KEY WORDS: Postoperative Pain Control, Tramadol, Tenoxicam, Transdermal Fentanyl Patch.