Effects of combined epidural analgesia with total intravenous anesthesia on risky patients underwent major abdomin

Amaç: Bu çalışmanın amacı, farklı klinik parametreler üzerinde sadece total intravenöz anestezi ve total intravenöz anestezi ile kombine epidural analjezinin etkilerini araştırmaktır. Gereç ve Yöntem: Bu prospektif, çift kör, randomize çalışmaya majör abdominal cerrahi geçirecek yüksek riskli 60 hasta dahil edildi. Anestezi indüksiyonu; IV remifentanil 0.5 mg/kg ve 40 ile 50 arasında bispektral indeks elde edilecek halde titre edilmiş propofol ile yapıldı. Entübasyon sonrası; Grup E için 0.1% bupivkain and 2 µg/ml fentanil infüzyon hızı 0. 15 ml/kg/h olacak şekilde epidural kataterden başlandı. Grup C ye ise aynı hızda serum salin infüzyonu başlandı. Bulgular: İntraoperatif ortalama arter basınçları Grup Ede Grup Cye oranla düşük bulundu (p

Majör abdominal cerrahi uygulanan yüksek riskli hastalarda total intravenöz anestezi ile kombine epidural analjezinin etkileri

Objectives: The aim of this study is to investigate the effects of combined epidural analgesia with total intravenous anaesthe- sia and only total intravenous anaesthesia on the different clinical parameters. Methods: Sixty high risk patients undergoing a major abdominal surgical procedure were included in this prospective, dou- ble blind, randomized study. Induction of anaesthesia was performed with IV remifentanil 0.5µg/kg and propofol titrated to achieve bispectral index score between 40 and 50. after intubation; in Group E, 0.1% bupivacaine and 2 µg/mL fentanyl were administered by an infusion rate at 0.15 ml/kg/h via the epidural catheter and Group C received epidural normal saline as same infusion rate. Results: In group E, intraoperative MAP values were significantly lower than those in group C (p<0.05). Time of extubation, time of eye opening with audible warning and time of verbal response was significantly lower in group E than those in group C. Total anaesthetic drug consumption was significantly higher in group C than those in group E (p<0.05). Conclusion: Based on lower requirements for propofol and remifentanil as well as the favourable effects on clinical param- eters; we conclude that bispectral index score guided combined epidural with total intravenous anaesthesia is superior to solely total intravenous anaesthesia in this type of surgery.

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Ağrı-Cover
  • ISSN: 1300-0012
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2018
  • Yayıncı: Ali Cangül