Osman Nuri AYDIN, Bakiye UĞUR, Feray GÜRSOY, Ayşe GÜREL

Çocuklarda rektal premedikasyon sevofluran anestezisinden uyanmayı etkiler mi?

Çalışmamızda; rektal premedikasyonda kullanılan diazepam, ketamin ve midazolamın, anestezi idamesi sevofloran ile sağlanmış olgularda anesteziden uyanma parametreleri üzerine olan etkilerinin ve komplikasyonlarının araştırılması amaçlandı. Çalışma, elektif cerrahi geçirecek, 3-8 yaşları arasında, 62 çocuk üzerinde prospektif, randomize, çift kör olarak gerçekleştirildi. Grup D'ye (n=15) 0.5 mg.kg-1 diazepam, Grup K'ye (n=15) 3 mg.kg-1 ketamin, Grup M'ye (n=16) 0.3 mg.kg-1 midazolam serum fizyolojik ile 5 mL'ye tamamlanarak 12 G kalınlıkta nelaton sonda yardımıyla rektal yoldan 5-7 cm içeriye uygulandı. Kontrol grubuna (Grup P, n=16) ise 5 mL serum fizyolojik uygulandı. Anestezi ve operasyon süreleri, anestezinin sonlandırılması-ekstübasyon, ekstübasyon-uyanma odasına alma ve uyanma odasından servise gönderme süreleri ve komplikasyonlar kaydedildi. Gruplar arasında operasyon ve anestezi süresi, anestezinin sonlandırılması-ekstübasyon süresi, ekstübasyon-uyanma odasına alma süresi, uyanma odasından servislerine gönderilme süresi ile gruplarda gelişen komplikasyonlar bakımından gruplar arasında fark belirlenmedi. Premedikasyon amacı ile rektal yolla diazepam, ketamin ve midazolam uygulanmasında, sevofluran anestezisinden uyanma parametreleri üzerine olan etkiler ve gelişen komplikasyonlar açısından gruplar arasında fark olmadığı saptandı. Bu ilaçların sevofluran anestezisinde premedikasyon amacıyla rektal yolla güvenli olarak kullanılabilecekleri sonucuna varıldı.

Anahtar Kelimeler:

Ketamin, Diazepam, Midazolam, Premedikasyon, İlaç uygulama, rektal, Anesteziden uyanma dönemi, Çocuk, Çift kör metot, İleriye dönük çalışma

Does rectal premedication delay recovery after sevoflurane anesthesia in children

We studied the effects of rectal premedication with diazepam, ketamine and midazolam on the recovery characteristics and complications of sevoflurane anesthesia in children. We studied 62 children, aged 3-8 yr, undergoing elective surgery. Patients were randomly assigned to four groups in this double-blind, prospective study. The groups were administered rectally diazepam 0.5 mg.kg-1 (Group D, n=15), ketamine 3 mg.kg-1 (Group K, n=15) and midazolam 0.3 mg.kg-1 (Group M, n=16) in 5 mL of %0.9 NaCl. All drugs were administered rectally through a 12 G suction catheter with its tip 5-7 cm proximal to the anal sphincter. The control group (Group P, n=16) received only 5 mL rectal SF. The duration of operation and anesthesia, end of anesthesia-extubation time, duration between extubation and admission to the post anesthesia care unit (PACU), discharge time PACU and complications were recorded. The duration of operation and anesthesia, end of anesthesia-extubation time, duration between extubation and admission to the post anesthesia care unit (PACU), discharge time PACU and complications were similar among the groups. There were no differences in parameters of recovery from sevoflurane anesthesia and complications between the groups. We concluded that these drugs could be safely used for rectal premedication in sevoflurane anesthesia.

Keywords:

Ketamine, Diazepam, Midazolam, Premedication, Administration, Rectal, Anesthesia Recovery Period, Child, Double-Blind Method, Prospective Studies,

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