Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: ORIGINAL RESEARCH
Çocuklarda ABO Kan Grupları ile Adenotonsillektomi Operasyonları Sonrası Postoperatif Ağrı Arasındaki İlişki: Kohort Çalışma
Relationship Between ABO Blood Groups and Postoperative Pain After Adenotonsillectomy Operations in Children: A Cohort Study
Asutay GÖKTUĞa , Ceren KAÇANa , Hakan Volkan ACARa , Cumhur BAŞARANa , Gülbahar OKTANa , Türkay ÇAKANa , Hale YARKAN UYSALa , Sami Engin MUZb , Hatice KARADAŞb
aAnkara Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Ankara, Türkiye
bAnkara Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Hastalıkları Kliniği, Ankara, Türkiye
Turkiye Klinikleri J Anest Reanim. 2024;22(3):101-6
doi: 10.5336/anesthe.2024-107482
Article Language: TR
Full Text
ÖZET
 Amaç: ABO kan grubu tüm DNA varyantları arasında önemli genetik fenotiplerdendir. Kanser, kardiyovasküler hastalık ve diyabetle aralarında ilişki olduğu bilinmektedir. Kan grubunun ağrı üzerinde etkisi olabileceği öne sürülse de kanıtlanmış bir ilişki henüz yoktur. Bu çalışmada, adenotonsillektomi operasyonları geçiren çocuklarda ABO kan grupları ile postoperatif ağrı arasındaki ilişkinin araştırılması amaçlandı. Gereç ve Yöntemler: Bu prospektif ve gözlemsel çalışmaya etik kurul onayı alındıktan sonra kulak-burun-boğaz ameliyathanesinde adenotonsillektomi operasyonu geçiren 3-7 yaş aralığında Amerikan Anestezistler Derneği I-III grubunda 176 hasta dâhil edildi. Cerrahi tamamlandığında hastalar 15, 30 ve 45. dk'lar ile 1, 2, 6 ve 24. saatlerde postoperatif ağrı EVENDOL ölçeği ile değerlendirilerek 4 ve üzeri puana sahip hastalara tramadol 1 mg/kg intravenöz yolla uygulanarak total tramadol dozu not edildi. Veriler, Shapiro-Wilk testiyle analiz edildi, normal dağılıma uyan veriler ortalama±standart sapma, normal dağılıma uymayan veriler medyan ve minimum-maksimum olarak raporlandı. Gruplar arasındaki parametrelerin karşılaştırılmasında tek yönlü varyans analiziKruskal-Wallis testi kullanıldı. p<0,05 değerleri istatistiksel olarak anlamlı kabul edildi. Bulgular: Kan gruplarına göre 4 farklı grupta değerlendirilen hastaların yaş, vücut ağırlığı, ameliyat ve anestezi süreleri açısından gruplar arasında istatistiksel olarak anlamlı fark izlenmedi. Postoperatif analjezik uygulama sayısı ve toplam analjezik miktarları bakımından istatistiksel olarak anlamlı fark saptandı. Farkın hangi gruplar arasında olduğunu belirlemek için yapılan değerlendirmede, toplam analjezik miktarında B ve O grupları arasında, toplam analjezik uygulama sayısındaysa B ile O ve B ile AB grupları arasında anlamlı fark saptandı. Sonuç: Postoperatif B ve O kan gruplarında daha fazla analjezik kullanılmasına neyin katkıda bulunduğunu açıklayan net kanıt bulunmamakla birlikte opioid reseptörlerinin dağılımındaki farklılıktan kaynaklandığı düşünülmektedir. Bu varsayımları araştırmak için daha fazla çalışmaya ihtiyaç vardır ve bu çalışmaların postoperatif ağrı ile ABO kan grupları arasındaki ilişkiye ışık tutması beklenmektedir.

Anahtar Kelimeler: ABO kan grubu sistemi; ağrı; postoperatif; çocuk
ABSTRACT
 Objective: The ABO blood group is an important genetic phenotype among DNA variants, with known associations to cancer, cardiovascular disease, and diabetes. While blood group effects on pain have been suggested, no proven relationship exists. This study aimed to investigate the relationship between ABO blood groups and postoperative pain in children undergoing adenotonsillectomy. Material and Methods: This prospective, observational study included 176 children aged 3-7 years (American Society of Anesthesiologists I-III) undergoing adenotonsillectomy. Postoperative pain was assessed using the EVENDOL scale at 15, 30, and 45 minutes and 1, 2, 6, and 24 hours. Patients scoring ≥4 received intravenous tramadol (1 mg/kg), and total doses were recorded. Data were analyzed with the Shapiro-Wilk test; normally distributed data were reported as mean±standard deviation, and nonnormal data as median (min-max). One-way analysis of variance and KruskalWallis tests were used for group comparisons, with p<0.05 considered significant. Results: Patients were evaluated in 4 different groups according to their blood groups, and no statistically significant difference was observed between the groups in terms of age, body weight, surgery and anesthesia duration. A statistically significant difference was detected in terms of the number of postoperative analgesic applications and total analgesic amounts. In the evaluation made to determine which groups the difference was between, a significant difference was detected between groups B and O in terms of the total analgesic amount, and between groups B and O and B and AB in terms of the total analgesic application number. Conclusion: While no clear explanation exists for the increased analgesic use in B and O blood groups postoperatively, variations in opioid receptor distribution are suspected. Further research is required to explore these findings and clarify the relationship between ABO blood groups and postoperative pain.

Keywords: ABO blood-group system; pain; postoperative; child
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