Serpil ŞAVLI, Burkay ADALIĞ, Gülçin ÖZALP, Gonca TUNCEL, Nihal KADIOĞULLARI

Bispektral indeks monitörizasyonunun sevofluran tüketimi ve derlenme üzerine etkisi

Bu çalışmada, sevofloran anestezisi ile modifiye radikal mastektomi uygulanan hastalarda, Bispektral indeks (BIS) monitörizasyonunun anestezik tüketimi ve erken derlenme parametreleri üzerine etkileri değerlendirildi. ASA I-II grubu,18-50 yaş arası 40 kadın hasta çalışma kapsamına alındı. %8 sevofluran %70 N2O-%30 O2 ve 6 L dt' taze gaz akımı ile tidal volüm tekniği kullanılarak yapılan anestezi indüksiyonu takiben hastalar rastgele iki gruba ayrıldı. Anestezi derinliği, Kontrol grubunda (ri=20) pupil büyüklüğü, hemodinamik yanıtlar, gözyaşı varlığı gibi yöntemlerle, BIS grubunda (n=20) ise, BIS değeri 50-60 arasında tutularak izlendi. Ekstübasyon, göz açma, oryantasyon süreleri ve Aldrete skorunun 9 olduğu zaman kaydedildi. Operasyon süresince tüketilen sevofluran miktarları enjektöre çekmek yoluyla ölçüldü. BIS grubunda ortalama sevofluran tüketimi 100.6 ± 27.5 mL, Kontrol grubunda 128 ± 33.6 mL olarak hesaplandı (p

Anahtar Kelimeler:

Anesteziden uyanma dönemi, Kadın, Mastektomi, modifiye radikal, Anestezi ve analjezi

Effects of bispectral index (BIS) monitorisation on sevoflurane consumption and recovery

In this study, we evaluated the effects of Bispectral Index (BIS) monitorisation on anesthetic consumption and early recovery parameters of patients undergoing modifled radical mastectomy with sevoflurane anesthesia. ASA I-II, 40 female patients aged 18-50 were included in the study. After the induction of anesthesia using the tidal volume technique with 8% sevoflurane, N2O 70%, O2 30% and 6 L min fresh gas, the patients were randomly divided into two groups. The depth of anesthesia was maintained by Standard parameters such as pupil diameter, hemodynamic responses, the presence of tears in the Control group (n=20) and by keeping the BIS value between 50-60 in the BIS group (n=20). Time lapse before extubation, ey e opening, orientation and the Aldrete score to be 9 were recorded. The total dose of sevoflurane consumed during the operation was measured by using ah injector. The mean sevoflurane consumption was 100.6 ± 27.5 mL in the BIS Group and 128 ± 33.6 mL in the Control Group (p< 0.05). Recovery was found to be more rapid in the BIS Group (p< 0.05). We conculuded that BIS monitorisation during anesthesia provides optimum hypnosis and recovery while resulting in a reduction in anesthesia costs.

Keywords:

Anesthesia Recovery Period, Female, Mastectomy, Modified Radical, Anesthesia and Analgesia,

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1. Heier T, Steen PA: Assessment of anaesthesia depth. Acta Anaesthesiol Scand 1996; 40(9): 1087-100.
2. Kearse LA Jr, Manberg P, Chamoun N, deBros F, et al: Bispectral analysis of the encephalogram correlates with patient movementto skin incision during propofol/nitrous oxide anesthesia. Anesthesiology 1994; 81: 1365-70.
3. Song D, Grish PJ, White PF: Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia. Anesthesiology 1997; 87:842-8.
4. Burrow B, McKenzie B, Case C: Do anaesthetised patients recover better after bispectral index monitoring? Anaesth Intensive Care 2001; 29:239-45.
5. Wong J, Song D, Blanshard H, Grady D, et al: Titration of is of urane using BIS index improves early recovery of elderly patients undergoing orthopedic surgeries. Can J Anesth 2002; 49:13-8.
6. Guignard B, Coste C, Menigaux C, Chauvin M: Reduced isoflurane consumption with bispectral index monitoring. Acta Anaesthesiol Scand 2001; 45:308-14. 7. Yli-Hankala A, Vakkuri A, Annila P, Korttila K: EEG bispectral index monitoring in sevoflurane or propofol anaesthesia: analysis of direct costs and immediate recovery. Acta Anaesthesiol Scand 1999; 43:545-9.
8. Gan TJ, Glass PS, Windsor A, Payne F, et al: Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. Anesthesiology 1997; 87:808-15.
9. Stevens WC, Dolan WM, Gibbons RT: Minimum alveolar concentrations (MAC) of is of urine with and without nitrous oxide in patients of various ages. Anesthesiology 1975; 42:197-200
10. Wang J, Liu J, White PF, Klein KW, et al: Effects of end-tidal gas monitoring and flow rates on hemodynamic stability and recovery profiles. Anesth Analg 1994; 79:538-44.
11. Roizen MF, Toledano A: Technology assessment and the "learning contamination" bias. Anesth Analg 1994; 79:410-2.
12. Cooper HS, Epstein RH: Clinical utility of the bispectral index (BIS): Shortening the interval from end of surgery to extubation. Anesthesiology 1997; 87(3A):A437.