The comparison of the efficacy of preemptive oral gabapentin - tramadol combination and parasetamol - tramadol combination on the postoperatif tramadol consumption

APurpose: Application of intravenous patient controlled analgesia (PCA) with Tramadol is a routine method for controlling postoperative pain. In our study we aimed to compare the efficacy of preemptive oral gabapentin- tramadol combination, parasetamol- tramadol combination and tramadol only on the postoperatif tramadol consumption in patients undergoing breast reduction operation.Material and Methods: Our study was held on 51 patients (ASA I-III, aged between 18-60 yr) undergoing breast reduction operation after approval of Faculty Ethical Commitee and patient consent. Patients randomly divided into three groups. Group GT (gabapentin-tramadol) were received 600 mg tablet gabapentin and 35 mg drop tramadol one hour before the operation. Also 30 minutes before the end of operation, 1 mg/kg iv. tramadol and 10 mg metoklopramid HCL were administred. Grup PT (parasetamol-tramadol) were received 500 mg tablet parasetamol and 35 mg drop tramadol one hour before the operation. Also 30 minutes before the end of operation, 1mg/kg iv. tramadol and 10 mg metoklopramid HCL were administred. Grup T (tramadol) were received 35 mg drop tramadol one hour before the operation. Also 30 minutes before the end of operation, 1 mg/kg iv. tramadol and 10 mg metoklopramid HCL were administred. After the end of operation, Three groups were started to receive tramadol infusion and intravenous patient controlled analgesia (PCA) application (300 mg diluated with 0.09% 100 cc SF, 0.2 mg/kg PCA,15 min locked in time). Peroperative SpO2, KH, SKB, DKB, extubation, disillusion, response time to the verbal stimuli, postoperative pain scores (VRS, VAS), sedation level, total tramadol consumption, additional analgesic requirement and side effects (nausea and vomiting, diplopia, etc.) of groups were recorded and evaluated.Results: Peroperative SpO2, KH, SKB, DKB, extubation, disillusion, response time to the verbal stimuli, postoperative pain scores (VRS, VAS), total tramadol consumption, additional analgesic requirement and side effects of groups were similar to eachother. Peroperative second hour DKB values and postoperative twelfth hour additional analgesic requirement in Group PT was found higher than other two groups. There were no significantly differences in the groups except diplopia. It was found higher in favour in Group GT.Conclusion: Application of gabapentin- tramadol, parasetamol- tramadol and low dose tramadol (35 mg) given by preemptive oral in patients undergoing breast reduction operation did not affect intraoperative hemodynamic parameters. The tramadol combined with postoperatif PCA in all of three groups caused active analgesia and low pain scores. 24 hours total tramadol consumption and additional analgesia requirement except twelfth hour were similar in all groups. It was also concluded that diplopia incidence of incidents applied to gabapentin- tramadol in early postoperative term was higher than others.Anahtar Kelimeler: Gabapentin, patient controlled analgesia, preemptive analgesia, tramadol drop