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Çocuklarda Şaşılık Cerrahisi Öncesinde Profilaktik Olarak Uygulanan Tropisetron Postoperatif Kusmayı Önler mi?

Can Prophylactic Usage of Tropisetron Prevent Vomiting in Children after Straismus Surgery?

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Abstract (2. Language): 
Tropisetron is a new 5-HT3 receptor antagonist. The main objective of this study is to investigate efficiency of a single intravenous tropisetron administration for prevention of post operative vomiting in children after pediatric strabismus surgery. In a randomized, doubleblind and placebo-controlled trial, 40 children, aged 2-15 years, undergoing strabismus surgery were studied. Anesthesia induction was administrated by sevoflurane and nitrous oxide in oxygen or i.v.propofol. Patients intravenously received 0.1 mg/kg tropisetron or placebo after induction of anesthesia. The vomiting episodes were recorded during the first 24 hours after the surgery. Vomiting were seen in 25% of the cases (5 patients) in control group and in 15% of the cases (3 patients) in tropisetron group (p>0.05). Two or more vomiting episodes were recorded for three patients in the control group, but only two episodes were recorded for one patient in the tropisetron group during postoperative stage (p>0.05). Two patients in the control group needed metoclopramide while patients in the tropisetron group did not need it (p>0.05). It is suggested that tropisetron is more effective when compared to plasebo in controlling the incidence and frequency of emesis for children undergoing strabismus surgery.
Abstract (Original Language): 
Tropisetron, 5-HT3 reseptör antagonistleri grubundan yeni bir ajandır. Çalışmamızda pediyatrik şaşılık cerrahisini takiben oluşan kusmanın oluşumunu önleme amacı ile operasyon öncesi uygulanan tek doz tropisetronun etkinliğini araştırdık. Çalışmamız randomize, çift kör ve plasebo kontrollü olacak şekilde planlandı. Çalışmaya şaşılık cerrahisi uygulanacak olan yaşları 2-15 arası değişen 40 çocuk dahil edildi. Anestezi indüksiyonu için sevofluran, %60 N20/ %40 O2 veya intravenöz propofol kullanıldı. Hastalara indüksiyonu takiben, intravenöz olarak plasebo veya 0.1mg kg -1 tropisetron verildi. Operasyon bitimini takiben kusma atakları 24 saat boyunca kayıt edildi. Kontrol grubunda %25 olguda (5 hasta), tropisetron grubunda %15 olguda (3 hasta) kusma oldu (p>0.05). Postoperatif dönemde, kontrol grubunda 3 hastada 2 veya daha fazla kusma epizodu görülürken, tropisetron grubunda yalnızca tek bir hasta 2 kusma epizodu geçirdi (p>0.05). Kontrol grubunda 2 hastada metoklopiramid ihtiyacı olurken tropisetron grubunda hiçbir hastada olmadı (p>0.05). Tropisetron, pediyatrik yaş grubunda şaşılık cerrahisini takip eden postoperatif kusma insidansının ve frekansının azaltılmasında plaseboya göre daha etkili gibi görünmektedir.
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