Pediyatrik Üroloji Operasyonlarında Epidural Tramadol Ve Morfinin Analjezik Etkinliğinın Karşılaştırılması

In this study peroperative hemodynamic effects, postoperative analgesic effects and side effects of single dosage epidural application of tramadole and morphine were compared in children operated on for urological conditions. Fourty children aged between 3-14 operated on for urological conditions were included in the study. Following intubation, lateral decubitis position were instuted. In this position single dosages of 0.1 mg/kg morphine in 0.2 ml/kg isotonic saline solution to the Morphine group and 2 mg/kg tramadole in 0.2 ml/kg isotonic saline solution to Tramadole group was given to epidural space with an epidural syringe. During the post-operative 24 hours heart rate, systolic blood pressure, respiration rate, pain score and sedation level of the patients were followed up. Patients having 3 or less visual analogous score were accepted to have inadequate analgesia and treated with application of 20 mg/kg paracetamol supposituary. First analgesia requiring time was noted. Sedation level was evaluated by four-point sedation scorring between 0-3. In the post-operative period, pain scores, analgesic requirement rates were also similar in both groups. Nausia and vomitting, allergic rash, sedation score and respiratory depression were high in morphine group compared to tramadol group. Although general anesthesia is more oftenly applicated in pediatric interventions, regional anesthesia can also be applicated both intra and post-operatively offering adequate analgesia and early mobilization without causing respiratory depression in the post-operative period. We conclude that tramadole can safely be used epidurally as it has less side effects with the same efficacy as compared to the epidural usage of morphine. Key words: Epidural Anesthesia, Morphine , Tramadole