{"id":2282,"date":"2025-12-26T16:19:33","date_gmt":"2025-12-26T13:19:33","guid":{"rendered":"https:\/\/demetdemircioglu.com\/?p=2282"},"modified":"2025-12-26T16:19:40","modified_gmt":"2025-12-26T13:19:40","slug":"kas-gevseticiler-ve-agri-kesiciler-bilim-ne-diyor-klinik-pratikte-nasil-kullanilmali","status":"publish","type":"post","link":"https:\/\/demetdemircioglu.com\/fr\/kas-gevseticiler-ve-agri-kesiciler-bilim-ne-diyor-klinik-pratikte-nasil-kullanilmali\/","title":{"rendered":"Kas Gev\u015feticiler ve A\u011fr\u0131 Kesiciler: Bilim Ne Diyor, Klinik Pratikte Nas\u0131l Kullan\u0131lmal\u0131?"},"content":{"rendered":"<p class=\"gtfy-1\">Kas-iskelet sistemi a\u011fr\u0131lar\u0131, fizik tedavi polikliniklerine ba\u015fvurunun en s\u0131k nedenleri aras\u0131ndad\u0131r. Bu a\u011fr\u0131larla birlikte kas gev\u015feticiler ve a\u011fr\u0131 kesiciler (analjezikler) yayg\u0131n olarak re\u00e7ete edilmekte ve hastalar taraf\u0131ndan s\u0131kl\u0131kla uzun s\u00fcreli kullan\u0131lmaktad\u0131r.<br>Peki bilimsel veriler bu ila\u00e7lar hakk\u0131nda ne s\u00f6yl\u00fcyor? Etkileri ne kadar g\u00fc\u00e7l\u00fc, hangi durumlarda faydal\u0131, hangi durumlarda s\u0131n\u0131rl\u0131d\u0131r?<\/p>\n\n\n\n<p class=\"gtfy-4\">Bu yaz\u0131da kas gev\u015feticiler ve a\u011fr\u0131 kesiciler,&nbsp;<strong>kan\u0131ta dayal\u0131 t\u0131p<\/strong>&nbsp;\u00e7er\u00e7evesinde ve&nbsp;<strong>fizik tedavi bak\u0131\u015f a\u00e7\u0131s\u0131yla<\/strong>&nbsp;ele al\u0131nacakt\u0131r.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity gtfy-7\"\/>\n\n\n\n<p class=\"gtfy-10\"><strong>Kas Gev\u015feticiler Nedir, Nas\u0131l Etki G\u00f6sterir?<\/strong><\/p>\n\n\n\n<p class=\"gtfy-13\">Skeletal muscle relaxant (SMR) olarak adland\u0131r\u0131lan kas gev\u015feticiler, kas dokusunu do\u011frudan \u201cgev\u015feten\u201d ila\u00e7lar de\u011fildir.<br>Bu ila\u00e7lar esas olarak&nbsp;<strong>merkezi sinir sistemi \u00fczerinden<\/strong>, sinir\u2013kas ileti\u015fimini bask\u0131layarak etki g\u00f6sterir.<\/p>\n\n\n\n<p class=\"gtfy-16\">En s\u0131k kullan\u0131lan kas gev\u015feticiler aras\u0131nda siklobenzaprin, tizanidin, baklofen ve metokarbamol yer al\u0131r. Bu ila\u00e7lar\u0131n temel hedefi, a\u011fr\u0131ya e\u015flik eden kas spazm\u0131n\u0131 azaltmak ve k\u0131sa s\u00fcreli rahatlama sa\u011flamakt\u0131r.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity gtfy-19\"\/>\n\n\n\n<p class=\"gtfy-22\"><strong>Akut Kas-\u0130skelet A\u011fr\u0131lar\u0131nda Etkinlik<\/strong><\/p>\n\n\n\n<p class=\"gtfy-25\">Bilimsel \u00e7al\u0131\u015fmalar, kas gev\u015feticilerin \u00f6zellikle&nbsp;<strong>akut bel ve boyun a\u011fr\u0131s\u0131nda<\/strong>&nbsp;plaseboya k\u0131yasla&nbsp;<strong>k\u00fc\u00e7\u00fck ve k\u0131sa s\u00fcreli bir a\u011fr\u0131 azalmas\u0131<\/strong>&nbsp;sa\u011flayabildi\u011fini g\u00f6stermektedir. Ancak bu etkinin:<\/p>\n\n\n\n<ul class=\"wp-block-list gtfy-31\">\n<li class=\"gtfy-28 gutenify-list-item\">genellikle birka\u00e7 g\u00fcn ile s\u0131n\u0131rl\u0131 oldu\u011fu,<\/li>\n\n\n\n<li class=\"gtfy-29 gutenify-list-item\">klinik olarak b\u00fcy\u00fck bir fark yaratmad\u0131\u011f\u0131,<\/li>\n\n\n\n<li class=\"gtfy-30 gutenify-list-item\">\u00e7o\u011fu \u00e7al\u0131\u015fmada NSA\u0130\u0130\u2019ler veya parasetamolden daha \u00fcst\u00fcn olmad\u0131\u011f\u0131<br>bildirilmi\u015ftir.<\/li>\n<\/ul>\n\n\n\n<p class=\"gtfy-34\">Meta-analizler, a\u011fr\u0131 skorlar\u0131nda ortalama 7\u20138\/100 puanl\u0131k bir azalma oldu\u011funu, buna kar\u015f\u0131n&nbsp;<strong>uyku hali, sersemlik ve a\u011f\u0131z kurulu\u011fu gibi yan etkilerin s\u0131k g\u00f6r\u00fcld\u00fc\u011f\u00fcn\u00fc<\/strong>&nbsp;ortaya koymaktad\u0131r.<\/p>\n\n\n\n<p class=\"gtfy-37\">Bu nedenle kas gev\u015feticiler, akut d\u00f6nemde&nbsp;<strong>k\u0131sa s\u00fcreli destek tedavisi<\/strong>&nbsp;olarak de\u011ferlendirilmeli, tek ba\u015f\u0131na kal\u0131c\u0131 \u00e7\u00f6z\u00fcm olarak g\u00f6r\u00fclmemelidir.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity gtfy-40\"\/>\n\n\n\n<p class=\"gtfy-43\"><strong>Kronik A\u011fr\u0131da ve Uzun S\u00fcreli Kullan\u0131mda Ne Oluyor?<\/strong><\/p>\n\n\n\n<p class=\"gtfy-46\">Kas gev\u015feticilerle ilgili en \u00f6nemli tart\u0131\u015fma alan\u0131,&nbsp;<strong>kronik kas-iskelet a\u011fr\u0131lar\u0131ndaki<\/strong>&nbsp;kullan\u0131md\u0131r.<\/p>\n\n\n\n<p class=\"gtfy-49\">2024 y\u0131l\u0131nda yay\u0131mlanan kapsaml\u0131 sistematik derlemeler, kas gev\u015feticilerin:<\/p>\n\n\n\n<ul class=\"wp-block-list gtfy-55\">\n<li class=\"gtfy-52 gutenify-list-item\"><strong>kronik bel a\u011fr\u0131s\u0131<\/strong>,<\/li>\n\n\n\n<li class=\"gtfy-53 gutenify-list-item\"><strong>fibromyalgie<\/strong>,<\/li>\n\n\n\n<li class=\"gtfy-54 gutenify-list-item\"><strong>kronik ba\u015f a\u011fr\u0131lar\u0131<\/strong><\/li>\n<\/ul>\n\n\n\n<p class=\"gtfy-58\">gibi durumlarda&nbsp;<strong>uzun vadeli anlaml\u0131 bir fayda sa\u011flamad\u0131\u011f\u0131n\u0131<\/strong>&nbsp;g\u00f6stermektedir.<\/p>\n\n\n\n<p class=\"gtfy-61\">Baz\u0131 \u00f6zel durumlarda (\u00f6rne\u011fin a\u011fr\u0131l\u0131 kas spazmlar\u0131 veya belirli n\u00f6rolojik tablolar) s\u0131n\u0131rl\u0131 fayda bildiriliyor olsa da, genel tablo \u015fudur:<br><strong>Uzun s\u00fcreli kas gev\u015fetici kullan\u0131m\u0131 i\u00e7in g\u00fc\u00e7l\u00fc bir kan\u0131t yoktur.<\/strong><\/p>\n\n\n\n<p class=\"gtfy-64\">Buna kar\u015f\u0131n uzun s\u00fcreli kullan\u0131mda:<\/p>\n\n\n\n<ul class=\"wp-block-list gtfy-70\">\n<li class=\"gtfy-67 gutenify-list-item\">sedasyon,<\/li>\n\n\n\n<li class=\"gtfy-68 gutenify-list-item\">d\u00fc\u015fme riski,<\/li>\n\n\n\n<li class=\"gtfy-69 gutenify-list-item\">g\u00fcnl\u00fck ya\u015fam fonksiyonlar\u0131nda bozulma<br>gibi g\u00fcvenlik sorunlar\u0131 \u00f6n plana \u00e7\u0131kmaktad\u0131r.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity gtfy-73\"\/>\n\n\n\n<p class=\"gtfy-76\"><strong>A\u011fr\u0131 Kesiciler (Analjezikler): A\u011fr\u0131y\u0131 Azalt\u0131r m\u0131, Sorunu \u00c7\u00f6zer mi?<\/strong><\/p>\n\n\n\n<p class=\"gtfy-79\">A\u011fr\u0131 kesiciler, \u00f6zellikle non-steroid antiinflamatuvar ila\u00e7lar (NSA\u0130\u0130\u2019ler), inflamasyonu bask\u0131layarak a\u011fr\u0131y\u0131 azalt\u0131r.<br>Ancak bu ila\u00e7lar da \u00e7o\u011fu zaman&nbsp;<strong>a\u011fr\u0131n\u0131n nedenini de\u011fil, a\u011fr\u0131 sinyalini bask\u0131lar<\/strong>.<\/p>\n\n\n\n<p class=\"gtfy-82\">Kronik kas-iskelet a\u011fr\u0131lar\u0131nda uzun s\u00fcreli a\u011fr\u0131 kesici kullan\u0131m\u0131:<\/p>\n\n\n\n<ul class=\"wp-block-list gtfy-88\">\n<li class=\"gtfy-85 gutenify-list-item\">fonksiyonel iyile\u015fme sa\u011flamaz,<\/li>\n\n\n\n<li class=\"gtfy-86 gutenify-list-item\">kas g\u00fcc\u00fc ve hareket kontrol\u00fcn\u00fc art\u0131rmaz,<\/li>\n\n\n\n<li class=\"gtfy-87 gutenify-list-item\">altta yatan post\u00fcral veya biyomekanik sorunlar\u0131 d\u00fczeltmez.<\/li>\n<\/ul>\n\n\n\n<p class=\"gtfy-91\">Bu nedenle a\u011fr\u0131 kesiciler, fizik tedavi ve rehabilitasyon programlar\u0131n\u0131n&nbsp;<strong>yerini tutmaz<\/strong>, yaln\u0131zca uygun hastada k\u0131sa s\u00fcreli destek sa\u011flar.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity gtfy-94\"\/>\n\n\n\n<p class=\"gtfy-97\"><strong>G\u00fcvenlik A\u00e7\u0131s\u0131ndan \u00d6nemli Bir Nokta: Kombinasyon Tedavileri<\/strong><\/p>\n\n\n\n<p class=\"gtfy-100\">Son y\u0131llardaki b\u00fcy\u00fck g\u00f6zlemsel \u00e7al\u0131\u015fmalar, kas gev\u015feticilerin \u00f6zellikle&nbsp;<strong>opioidlerle birlikte kullan\u0131ld\u0131\u011f\u0131nda<\/strong>&nbsp;ciddi riskler olu\u015fturabilece\u011fini g\u00f6stermi\u015ftir.<br>Bu kombinasyonlar:<\/p>\n\n\n\n<ul class=\"wp-block-list gtfy-106\">\n<li class=\"gtfy-103 gutenify-list-item\">a\u015f\u0131r\u0131 sedasyon,<\/li>\n\n\n\n<li class=\"gtfy-104 gutenify-list-item\">solunum depresyonu,<\/li>\n\n\n\n<li class=\"gtfy-105 gutenify-list-item\">d\u00fc\u015fme ve yaralanma riskinde art\u0131\u015f<br>ile ili\u015fkilendirilmi\u015ftir.<\/li>\n<\/ul>\n\n\n\n<p class=\"gtfy-109\">Bu nedenle kas gev\u015feticiler ve g\u00fc\u00e7l\u00fc a\u011fr\u0131 kesiciler birlikte kullan\u0131ld\u0131\u011f\u0131nda, mutlaka&nbsp;<strong>k\u0131sa s\u00fcreli, kontroll\u00fc ve hekim g\u00f6zetiminde<\/strong>&nbsp;olmal\u0131d\u0131r.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity gtfy-112\"\/>\n\n\n\n<p class=\"gtfy-115\"><strong>\u00c9valuation du point de vue de la physioth\u00e9rapie<\/strong><\/p>\n\n\n\n<p class=\"gtfy-118\">Fizik tedavide temel hedef yaln\u0131zca a\u011fr\u0131y\u0131 azaltmak de\u011fil,&nbsp;<strong>fonksiyonu geri kazand\u0131rmak ve tekrar eden a\u011fr\u0131lar\u0131 \u00f6nlemektir<\/strong>.<\/p>\n\n\n\n<p class=\"gtfy-121\">Bilimsel veriler net bir \u015fekilde \u015funu g\u00f6stermektedir:<\/p>\n\n\n\n<ul class=\"wp-block-list gtfy-127\">\n<li class=\"gtfy-124 gutenify-list-item\">\u0130la\u00e7lar semptomlar\u0131 ge\u00e7ici olarak azaltabilir<\/li>\n\n\n\n<li class=\"gtfy-125 gutenify-list-item\">Kal\u0131c\u0131 iyile\u015fme i\u00e7in\u00a0<strong>egzersiz, kas g\u00fc\u00e7lendirme, y\u00fck y\u00f6netimi ve post\u00fcr e\u011fitimi<\/strong>\u00a0\u015fartt\u0131r<\/li>\n\n\n\n<li class=\"gtfy-126 gutenify-list-item\">Fizik tedavi ile kombine edilmeyen ila\u00e7 tedavileri, a\u011fr\u0131n\u0131n tekrarlamas\u0131na zemin haz\u0131rlar<\/li>\n<\/ul>\n\n\n\n<p class=\"gtfy-130\">Bu nedenle kas gev\u015feticiler ve a\u011fr\u0131 kesiciler,&nbsp;<strong>do\u011fru hasta se\u00e7imiyle<\/strong>,&nbsp;<strong>do\u011fru s\u00fcrede<\/strong>&nbsp;et&nbsp;<strong>rehabilitasyon program\u0131n\u0131n bir par\u00e7as\u0131 olarak<\/strong>&nbsp;kullan\u0131lmal\u0131d\u0131r.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity gtfy-133\"\/>\n\n\n\n<p class=\"gtfy-136\"><strong>Conclusion<\/strong><\/p>\n\n\n\n<p class=\"gtfy-139\">Kas gev\u015feticiler ve a\u011fr\u0131 kesiciler, kas-iskelet sistemi a\u011fr\u0131lar\u0131nda k\u0131sa s\u00fcreli rahatlama sa\u011flayabilir. Ancak bilimsel kan\u0131tlar, bu ila\u00e7lar\u0131n&nbsp;<strong>uzun vadeli ve tek ba\u015f\u0131na bir \u00e7\u00f6z\u00fcm olmad\u0131\u011f\u0131n\u0131<\/strong>&nbsp;a\u00e7\u0131k\u00e7a ortaya koymaktad\u0131r.<\/p>\n\n\n\n<p class=\"gtfy-142\">Etkili ve kal\u0131c\u0131 bir tedavi i\u00e7in:<\/p>\n\n\n\n<ul class=\"wp-block-list gtfy-148\">\n<li class=\"gtfy-145 gutenify-list-item\">a\u011fr\u0131n\u0131n nedeninin belirlenmesi,<\/li>\n\n\n\n<li class=\"gtfy-146 gutenify-list-item\">ki\u015fiye \u00f6zel fizik tedavi program\u0131,<\/li>\n\n\n\n<li class=\"gtfy-147 gutenify-list-item\">egzersiz ve ya\u015fam tarz\u0131 d\u00fczenlemeleri<br>temel yakla\u015f\u0131m olmal\u0131d\u0131r.<\/li>\n<\/ul>\n\n\n\n<p class=\"gtfy-151\"><strong>A\u011fr\u0131y\u0131 susturmak de\u011fil, a\u011fr\u0131n\u0131n nedenini tedavi etmek esast\u0131r.<\/strong><\/p>\n\n\n\n<p class=\"gtfy-154\"><strong>Kaynaklar<\/strong><\/p>\n\n\n\n<p class=\"gtfy-157\">Oldfield, B. J., Rubin, R., &amp; Shmerling, R. H. (2024).&nbsp;<strong>Long-term use of skeletal muscle relaxant medications for chronic pain: A systematic review<\/strong>.&nbsp;<em>JAMA Network Open, 7<\/em>(2), e235781. https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.5781<\/p>\n\n\n\n<p class=\"gtfy-160\">Cashin, A. G., Folly, T., Bagg, M. K., et al. (2021).&nbsp;<strong>Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: A systematic review and meta-analysis<\/strong>.&nbsp;<em>BMJ, 374<\/em>, n1446. https:\/\/doi.org\/10.1136\/bmj.n1446<\/p>\n\n\n\n<p class=\"gtfy-163\">Shaheed, C. A., Maher, C. G., Williams, K. A., &amp; McLachlan, A. J. (2017).&nbsp;<strong>Efficacy and tolerability of muscle relaxants for low back pain<\/strong>.&nbsp;<em>European Journal of Pain, 21<\/em>(2), 228\u2013237.<\/p>\n\n\n\n<p class=\"gtfy-166\">Chung, H. S., &amp; Shmerling, R. H. (2024).&nbsp;<strong>Skeletal muscle relaxants for fibromyalgia: A systematic review and meta-analysis<\/strong>.&nbsp;<em>Regional Anesthesia and Pain Medicine, 49<\/em>(3), 185\u2013194.<\/p>\n\n\n\n<p class=\"gtfy-169\">Manca, A., da Silva, T., Hush, J., et al. (2025).&nbsp;<strong>Oral non-benzodiazepine muscle relaxants for people with acute and chronic primary low back pain<\/strong>.&nbsp;<em>European Spine Journal, 34<\/em>(1), 45\u201358.<\/p>\n\n\n\n<p class=\"gtfy-172\">Li, Y., Delcher, C., Wei, Y. J., et al. (2020).&nbsp;<strong>Risk of opioid overdose associated with concomitant use of opioids and skeletal muscle relaxants<\/strong>.&nbsp;<em>Clinical Pharmacology &amp; Therapeutics, 108<\/em>(1), 81\u201389.<\/p>\n\n\n\n<p class=\"gtfy-175\">Stefanus, S., Oldfield, B. J., &amp; Rubin, R. (2024).&nbsp;<strong>A comprehensive literature review of long-term use of muscle relaxant medications for chronic pain<\/strong>.&nbsp;<em>International Journal of Medical Sciences, 21<\/em>(4), 512\u2013523.<\/p>\n\n\n\n<p class=\"gtfy-178\">Witenko, C., Moorman-Li, R., Motycka, C. A., et al. (2014).&nbsp;<strong>Considerations for the appropriate use of skeletal muscle relaxants for acute low back pain<\/strong>.&nbsp;<em>P &amp; T, 39<\/em>(6), 427\u2013435.<\/p>","protected":false},"excerpt":{"rendered":"<p>Kas-iskelet sistemi a\u011fr\u0131lar\u0131, fizik tedavi polikliniklerine ba\u015fvurunun en s\u0131k nedenleri aras\u0131ndad\u0131r. Bu a\u011fr\u0131larla birlikte kas [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":2283,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_joinchat":[],"footnotes":""},"categories":[],"tags":[],"class_list":["post-2282","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/demetdemircioglu.com\/fr\/wp-json\/wp\/v2\/posts\/2282","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/demetdemircioglu.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/demetdemircioglu.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/demetdemircioglu.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/demetdemircioglu.com\/fr\/wp-json\/wp\/v2\/comments?post=2282"}],"version-history":[{"count":0,"href":"https:\/\/demetdemircioglu.com\/fr\/wp-json\/wp\/v2\/posts\/2282\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/demetdemircioglu.com\/fr\/wp-json\/wp\/v2\/media\/2283"}],"wp:attachment":[{"href":"https:\/\/demetdemircioglu.com\/fr\/wp-json\/wp\/v2\/media?parent=2282"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/demetdemircioglu.com\/fr\/wp-json\/wp\/v2\/categories?post=2282"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/demetdemircioglu.com\/fr\/wp-json\/wp\/v2\/tags?post=2282"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}