İ. Şener DEMİROLUK, ZİYA SALİHOĞLU, Saffet KARACA, Yıldız KÖSE

Bolus dozda ve bölünmüş dozlarda verilen mivakuryumun etkilerinin karşılaştırılması

Bu çalışmada; bölünmüş ve bolus dozlarda verilen mivakuryumun, entübasyon zamanı ve kalitesi ile nöromüsküler ve hemodinamik etkileri karşılaştırıldı. ASA I-II gruplarına dahil, elektif cerrahi uygulanacak 40 olgu rastlantısal olarak 20'şerli iki gruba ayrıldı. Grup I'de 0.25 mg $kg^{-1}$) mivakuryum 60 saniyede, Grup II'de mivakuryum bölünmüş dozda, 0.15 mg $kg^{-1}$,30 sn sonra 0.1 mg $kg^{-1}$) verildi. İndüksiyon 5 mg $kg^{-1}$) tiyopental, 2$mu$ $kg^{-1}$ fentanille sağlandı. İdamede % 0.5 -1.5 izofluran, O2/N20: (3/3 L $dk^{-1}$) karışımı kullanıldı. Tekli uyan kullanılarak % 95 blok olduğu zaman endotrakeal entübasyon uygulandı. Nöromüsküler bloğun (NMB) % 25 ve % 75 geri dönüş süreleri, %25-% 75 arası süreler kaydedildi. İndüksiyon öncesi, entübasyon öncesi, entübasyondan sonra 2,5,10 ve 15 dakikalarda hemodinamik değerler ortalama arter basıncı (OAB), kalp atım hızı (KAH) kaydedildi. Entübasyon kalitesi toplam puan olarak değerlendirildiğinde, Grup II'de Grup I'e oranla anlamlı olarak iyi olduğu gözlendi (p0.05). Her iki grupta da OAB entübasyon öncesi dönemde, İndüksiyon öncesi döneme göre düştü (p

Anahtar Kelimeler:

Entübasyon, intratrakeal, Anestezi, Doz-yanıt ilişkisi, ilaç, Nöromüsküler blokaj

Comparison of bolus or intermittent administration of mivacurium

We have compared the intubation conditions, durations of action cardiovascular effects, side effects of bolus or intermittent administration of mivacurium. Forty ASA physical status I-II patients, undergoing elective surgery, were randomly allocated into two groups. Patients in (Group I); received a single dose of mivacurium (0.25 mg $kg^{-1}$) in 60 sec and patients in Group II; received divided doses of mivacurium (0.15 mg $kg^{-1} $followed 30 seconds later by 0.1 mg$kg^{-1}$). Induction was achieved with 5 mg$kg^{-1}$ thiopentane and 2 $mu$g $kg^{-1}$ fentanyl. Anesthesia was maintained with 0.5-1.5 % vol. of isoflurane and $O_2$ / N2O: (3/3 L $min^{-1}$ . Single twitch stimulation was used. Endotracheal intubation was performed when a twitch of 95% was blocked. Average on set times of the NMB, the duration of NMB (Tl 25 %, Tl 75 % recovery times, recovery of 25%-75% were similar in both groups. There was no significant difference between the two groups. Total intubation conditions were good in Group II patients than Group I (p<0.05). We observed significant decreases in MAP before intubation in both mivacurium groups (p<0.05). HR values were increased at the 2nd minute and decreased at the 15th minute in both groups (p<0.05). We observed increased airway pressure in two patients and ventricular arrhythmia in a patient in Group I. incre-ased airway pressure was determined by manometer. in conclusion; administration of divided dose of mivacurium may provide some advantage.

Keywords:

Intubation, Intratracheal, Anesthesia, Dose-Response Relationship, Drug, Neuromuscular Blockade,

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