Procjena analgezije opioidima i neopioidima intermitentnom primjenom i samostalna kontrola pumpom nakon lumbalne diskektomije

doctoral thesis

• Title (english): Opioid and nonopioid analgesia assessment through intermittent application and patient controlled analgesia pump after lumbar discectomy
• Author: Biljana Kurtović
• Mentor: Krešimir Rotim (mentor)
• Committee member: nije dostupno (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2018-04-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

Križobolja je jedno od najčešćih bolnih stanja odrasle, radno aktivne populacije te predstavlja ozbiljan socioekonomski problem. Diskektomija hernije lumbalnog međukralješničnog diska je zlatni standard u liječenju simptomatske hernije diska. Unatoč napretku razvoja medicine, farmakologije i tehnologije, učestalost postoperativne boli je i dalje visoka. U izradi doktorskog rada postavljena je hipoteza da se uporabom analgezije derivatima opioida putem samostalna kontrola pumpe učinkovitije smanjuje bol u usporedbi s uporabom intermitentne analgezije derivatima opioida i neopioidne analgezije nakon lumbalne diskektomije. Ciljevi rada bili su odrediti djelotvornost dvaju analgetika primijenjenih na različiti način te usporedbama doći do najdjelotvornijeg načina analgezije nakon lumbalne diskektomije. U istraživanju je sudjelovalo 200 bolesnika Klinike za neurokirurgiju Kliničkog bolničkog centra Sestre milosrdnice, u vremenskom periodu od svibnja 2016. do srpnja 2017. Znanstveni doprinos prospektivnog, randomiziranog kliničkog istraživanja je pronađena statistički značajna razlika u postizanju analgezije nakon lumbalne diskektomije primjenom samostalna kontrola pumpe u odnosu na intermitentnu primjenu nakon lumbalne diskektomije. Usporedbom vrste primijenjenih lijekova nisu nađene statistički značajne razlike. Na temelju dobivenih rezultata može se zaključiti da će primjena analgezije samostalna kontrola pumpom značajno pridonijeti ublažavanju postoperativne boli bolesnika, te se preporuča uvođenje samostalna kontrola pumpe kao standarda u cilju postizanja učinkovitije analgezije bez obzira na primjenjeni analgetik.

Abstract (english)

Low back pain is one of the leading cause of disabilty in an adult, working-active population representing a serious socioeconomic problem. Lumbar discectomy is the gold standard in symptomatic herniated disk treatment. Despite the advances in medicine, pharmacology and technology, postoperative pain frequency is still high. Hypothesis of this disertation is that opioid analgesia delivered by patient controlled pump is more effective in pain reduction compared to opioid intermittent analgesia and nonopioid analgesia after lumbar discectomy. The objectives were to determine the efficacy of two analgesics applied in different ways comparing the most effective method of analgesia. The study included 200 patients treated at the Department of Neurosurgery Sestre milosrdnice Clinical Hospital Center, during 14 months period. The scientific contribution of prospective, randomized clinical study is statistically significant difference of achieving analgesia after lumbar discectomy by patient controlled pump versus intermittent analgesia. No statistically significant differences were found by comparing types of used drugs. Based on the results obtained, it can be concluded that analgesia delivered by patient controlled pump will significantly contribute to postoperative pain reduction. Therefore it could be recommended introducing patient controlled pump as a standard in order to achieve more effective analgesia regardless of applied analgesic.

• Keywords: medicina
• Keywords (english): medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:269510
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
• Type of resource: Text
• Extent: 135 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-05 08:11:01