Comparison of epidural levobupivakaine added tramodol with morphine effects for postopertive analgesia on major abdominal surgery

Objective: In our study; we aimed to compare levobupivakain with morphine and tramadol added and levobupivakain?s effects of response to analgesy, hemodynamy and surgerical stress by using epidural way with patient control analgesy method for management postoperative analgesia in major abdominal surgery applied patentsMaterials and methods: With approval of Ethic Committee of Faculty of Cukurova University and written informed consent taken adult patients with ASA I-II group age between 18-65 were taken under study. To all patients epidural catheter (20 G) was inserted by using Tuohy needle (18 G) posoperativly in sitting position according to sterility conditions. Patient was grouped to 3 randomly, Levobupivakain (Group L), Levobupivakain+Morphine (group L+M) and Levobupivakain+Tramadol (group L+T). To general analgesia applied patients 30 min. before the finish of operation, 25 mg 0.5% Levobupivakain+15 mL 0.9% izotonic for Group L, 25 mg 0.5% Levobupivakain+14.5 mL 0.9% izotonic+100 microgram morphine for group LM and for Group LT 25 mg 0.5% Levobupivakain +13 mL 0.9% izotonic+ tramadol 100 mg was given as epidural catheter loading dose. Patients? hemodynamic parameters was recorded at intraoperative 5, 15, 30, 45 and 60 min. time intervals during operation period form preoperative term beginnig. To be able to apply patient control analgesy to patients at postoperative period equipment was connected to epidural catheter.Findings: Accordingly; Bolus doses are in patients in the Group L? Levobupivakain 12 mg bolus dose to patients in the Group of LM Levobupivakain 12 mg + morphine 1.2 mg bolus dose to patients in the group is LT. Levobupivakain 12 mg + 10 mg and tramadol all 3 Group will be created to lockout times 15 min. Postoperative Visual analogue scale patients in the period, given the requested bolus from an epidural patient control analgesy levobupivakain, morphine and tramadol dosage and side effects of the numbers, and in terms of post-operative 30. min, and at 1., 2., 3., 4., 24. Hours recorded by at times.Demoghraphic datas of groups are similar. Visual analogue scale scores are significantly higher in Group L than group LM and LT, less nausea and vomitting are seen in Group L not added opioid than group LM and LT. In our study no significant changes in hemodynamic datas, no need of eferdin in any patients was observed and no motor blockage occured.Result: Consequently; Implementation of a local analjesic agent combined with an opioid as continious epidurally application is an effective method in Postoperative Analgesia. In our search the most effective analgesia against side effect incidanse increase is obtained with Levobupivakain +Tramadol group.Key Words: Epidural patient controlled analgesia, levobupivakain, morfin, postoperative pain, tramadol