Süleyman GANİDAĞLI, Semra DEMİRBİLEK, Zeynep BAYSAL, İ. Halil KILIÇ, Cevdet BECERİK

Anestezi derinliği ve bispektral indeks monitorizasyonu

Bispektral indeksin (BİS), anestezik ilaçların sedatif ve hipnotik etkilerini ölçebildiği gösterilmiştir. Çalışmamızda BİS'in anestezi derinliği ve derlenme üzerine etkilerininin araştırılması amaçlandı. Anestezi indüksiyonu 2 µg.$kg^-1$ fentanil, 2 mg.$kg^-1$ propofol, 0.2 mg.$kg^-1$ mivakuryum ile sağlandı ve 2 L.$dk^-1$ $O_2$ + 3 L.$dk^-1$ N$O_2$ + sevofluran (% 0.5-2) ile sürdürüldü. Anestezi indüksiyonu sonrasında, elektif cerrahi geçiren 70 olgu 2 eşit gruba ayrıldı. Sevofluran Grup B'de BİS skoru 50-60 arasında olacak şekilde ayarlandı. Grup S'de ise sevofluran standart anestezi pratiğine göre verildi ve anestezist ölçülen BİS değerlerinden habersizdi. Kalp atım hızı (KAH), ortalama arter basıncı (OAB), bispektral indeks (BİS), end-tidal karbondioksit (ETCO2), end-tidal volatil ajan konsantrasyonu (ETVAK) değerleri kaydedildi. Bispektral indeks değerleri Grup S'de Grup B'ye göre daha düşüktü. Grup B'de ETVAK değerleri Grup S'den anlamlı olarak daha düşüktü. Benzer olarak derlenme süreleri Grup B de daha kısaydı. Sonuç olarak, BİS monitörizasyonu ile yeterli anestezi derinliği ile birlikte derlenme sürelerinde kısalma sağlanabileceği kanısına varıldı.

Anahtar Kelimeler:

Anestezikler, Anesteziden uyanma dönemi, Araştırma teknikleri, Anestezi

Depth of anesthesia and bispectral index monitoring

The bispectral index (BIS) has previously been shown to be a quantifiable measure of the sedative and hypnotic effects of anesthetics drugs. This study was designed to asses the effects of BIS monitoring on the depth of anesthesia and recovery profiles after surgery. Induction of anesthesia were provided with propofol (2 mg.$kg^-1$), fentanil (2 µg.$kg^-1$) and mivacurium (0.2 mg.$kg^-1$). Anesthesia was maintained with O2 (2 L.$min^-1$) + N20 (3 L.$min^-1$) + sevofluran (0.5-2 %). After induction of anesthesia, seventy patients who underwent elective surgery were allocated to two equal groups (Group B and Group S). Sevofluran was titrated to maintain the BIS value 50-60 in the group B. In the group S sevofluran was administered according to standard clinical practice, and anesthesiologist was blinded to the BIS value. Heart rate (HR), mean arterial pressure (MAP), BIS, end-tidal CO2 (ETCO2), end-tidal volatil anesthetic concentration of sevofluran (ETVAC) were recorded. The bispectral index values were significantly lower in the Group S compared with the group B. The ETVAC of sevofluran in the Group B was lower than those of the group S. Similarly, the times to recovery parameters were shorter in the Group B compared with the group S. As conclusion, BIS monitoring provided an adequate anesthesia and contributed to a faster emergence from anesthesia.

Keywords:

Anesthetics, Anesthesia Recovery Period, Investigative Techniques, Anesthesia,

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