ﻣﻘﺎﯾﺴﮥ اﻟﻘﺎي ﺑﯿﻬﻮﺷﯽ ﺗﻮﺳﻂ ﺳﺪﯾﻢ ﺗﯿﻮﭘﻨﺘﺎل ﺑﺎ ﭘﺮوﭘﻮﻓﻮل در ﻣﯿﺰان ﻧﯿﺎز ﺑﻪ ﻣﺨﺪر ﭘﺲ از ﻋﻤﻞ ﺟﺮاﺣﯽ ﺷﮑﺴﺘﮕﯽ ﺗﯿﺒﯿﻮﻓﯿﺒﻮﻟﺎ

Comparison of anesthesia by sodium thiopental with propofol in reducing the need for opiate after tibiofibular fracture surgery

زﻣﯿﻨﻪ و ﻫﺪف ﺗﯿﻮﭘﻨــــﺘﺎل ﺳـــﺪﯾﻢ ﯾﮏ داروي ﻣﺘﺪاول در ﺑﯿﻬﻮﺷــﯽ اﺳﺖ وﻟﯽ اﯾﺪﺋﺎل ﻧﯿﺴﺖ؛ زﯾﺮا در ﭘﻮرﻓـﯿﺮي ﺣﺎد و ﻏﯿﺮه ﻣﻤــــﻨﻮع اﺳﺖ. در ﻣﻘﺎﺑﻞ، ﭘـﺮوﭘﻮﻓﻮل ﺟﺪﯾﺪﺗﺮﯾـﻦ دارو در ﺑﯿﻬﻮﺷﯽ اﺳﺖ ﮐﻪ ﺑﻪدﻟﯿﻞ ﺷـﺮوع اﺛـﺮ ﺳﺮﯾﻊ، ﻣﺪت اﺛﺮ ﮐﻮﺗﺎه و ﻏﯿﺮه، ﻣﺼﺮف آن رو ﺑﻪ اﻓﺰاﯾﺶ اﺳـﺖ. اﯾﻦ ﭘﮋوﻫﺶ ﺑﻪ ﻣﻘﺎﯾﺴﮥ اﻟﻘﺎي ﺑﯿﻬﻮﺷﯽ ﺗﻮﺳﻂ ﺳﺪﯾﻢ ﺗﯿﻮﭘﻨﺘﺎل ﺑﺎ ﭘﺮوﭘﻮﻓﻮل در ﻣﯿﺰان ﻧﯿﺎز ﺑﻪ ﻣﺨﺪر ﭘﺲ از ﻋﻤﻞ ﺟﺮاﺣﯽ ﺷﮑﺴﺘﮕﯽ ﺗﯿﺒﯿﻮﻓﯿﺒﻮﻟﺎر ﭘﺮداﺧﺘﻪ اﺳﺖ. ﻣﻮاد و روشﻫﺎ اﯾﻦ ﭘﮋوﻫﺶ ﯾﮏ ﮐﺎرآزﻣﺎﯾﯽ ﺑﺎﻟﯿﻨﯽ ﺗﺼﺎدﻓﯽ ﺑﻮد ﮐﻪ ﺑﺮ 173 ﺑﯿﻤﺎر در ﺑﯿﻤﺎرﺳﺘﺎن اﻣﺪاد ﺳﺒﺰوار اﻧﺠﺎم ﺷﺪ. ﺑﯿﻤﺎران ﺑﻪﻃﻮر ﺗﺼﺎدﻓﯽ ﺑﻪ 2 ﮔﺮوه ﻣﻄﺎﻟﻌﻪ و ﮐﻨﺘﺮل ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. اﻟﻘﺎي ﺑﯿﻬﻮﺷﯽ در ﮔﺮوه ﻣﻄﺎﻟﻌﻪ ﺑﺎ 2/2 kg/mgﭘﺮوﭘﻮﻓﻮل و ﮔﺮوه ﮐﻨﺘﺮل ﺑﺎ5 kg/mgﺗﯿﻮﭘﻨﺘﺎل ﺳﺪﯾﻢ اﻧﺠﺎم ﺷﺪ. در ﻫﺮ دو ﮔﺮوه ﻓﺸﺎر ﺧﻮن و ﺿﺮﺑﺎن ﻗﻠﺐ، ﭘﯿﺶ و ﭘﺲ از اﻟﻘﺎ و دﻗﺎﯾﻖ 1 ، 5 و 11 ﭘﺲ از اﻧﺘﻮﺑﺎﺳﯿﻮن ﺛﺒﺖ ﺷﺪ. در 4-3-2-1 ﺳﺎﻋﺖ ﭘﺲ از ﻋﻤﻞ ﺑﺎ ﭼﺎرت ﺑﺮرﺳﯽ ﺷﺪت درد و دادهﻫﺎ ﺛﺒﺖ ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ در ﮔﺮوه ﭘﺮوﭘﻮﻓﻮل در ﺳﺎﻋﺖ ﭼﻬﺎرم 44 ﻧﻔﺮ درد ﺧﻔﯿﻒ، 9 ﻧﻔﺮ درد ﻣﺘﻮﺳﻂ داﺷﺘﻨﺪ؛ وﻟﯽ درد ﺷﺪﯾﺪ ﮔﺰارش ﻧﺸﺪ)P= (. در ﮔﺮوه ﺗﯿﻮﭘﻨﺘﺎل در ﺳﺎﻋﺖ ﭼﻬﺎرم 53 ﻧﻔﺮ درد ﺧﻔﯿﻒ،11 ﻧﻔﺮ درد ﻣﺘﻮﺳﻂ و 5 ﻧﻔﺮ درد ﺷﺪﯾﺪ را داﺷﺘﻨﺪ)p=0/004. ﻧﺘﯿﺠﻪﮔﯿﺮي در اﯾﻦ ﭘﮋوﻫﺶ ﭘﺮوﭘﻮﻓﻮل آﺳﺘﺎﻧﮥ درد ﭘﺲ از ﺟﺮاﺣﯽ را اﻓﺰاﯾﺶ داد. ﺑﻪﻧﻈﺮ ﻣﯽرﺳﺪ ﻣﯽﺗﻮان آن را ﺟﺎﯾﮕﺰﯾﻦ ﻣﻨﺎﺳﺒﯽ ﺑﺮاي ﺗﯿﻮﭘﻨﺘﺎل ﻣﻌﺮﻓﯽ ﮐﺮد.

Introduction: Thiopental Sodium is a commonly used drug in anesthesia, but it is not ideal because barbiturate is prohibited in acute and allergic porphyria, and is not recommended in asthmatic and hypovolemic patients. Propofol is the newest drug in anesthesia due to its rapid onset, short duration of action, anti-nausea and a feeling comfort after use, its consumption is increasing. It is also safe in porphyry and asthma. This study compares the use of sodium antiproliferative drug propofol to reduce the need for opiate. Materials and Methods: This study was conducted on 173 patients admitted to Sabzevar Hospital. Patients were randomly divided into two study and control groups. Anesthesia induction was performed in the study group with propofol 2. 2 kg / mg and with thiopental sodium 5 kg / mg, in both groups, blood pressure and heart beats were measured before and after induction and minutes 1, 5 and 11 after intubation. Within 1-2-3-4 hours after operation with a pain control chart, the intensity of the pain was checked and the data were recorded. Results: In the propofol group at the 4th hour, 44 individuals feel mild pain, and 9 had moderate, but severe pain was not reported (P=0/44). In the thiopental group at the fourth hour, 53 patients feel mild pain, 11 had moderate and 5 had severe pain (P=0/44). Conclusion: Propofol increases the threshold of postoperative pain, so it can be a good alternative to thiopental.