Tülin TEKELİ, Gönül ÖLMEZ, Mehmet Ali ÖZYILMAZ

Epidural anestezi uygulamasında ropivakainin doz ve volümünün etkileri

Lokal anestezik volüm ve konsantrasyonunun epidural anestezik özellikler üzerine etkileri açıklığa kavuşmamıştır. Bu çalışma, farklı volüm ve konsantrasyonlardaki ropivakainin epidural blok özelliklerini tanımlama amacıyla planlandı. Çalışmamız, alt ekstremite cerrahisi planlanan ASA I - III risk grubunda olan 60 yetişkin hastada prospektif, randomize ve çift kör yöntemle gerçekleştirildi. Grup I'de 100 mg 10 mL %1'lik ropivakain, Grup II'de 100 mg 20 mL %0.5'lik ropivakain, Grup IH'te 150 mg 20 mL %0.75'lik ropivakain epidural yoldan uygulandı. Her üç grubun lokal anestezik özellikleri, hemodinami üzerine etkileri ve yan etkileri karşılaştırıldı. Bütün hastalarda cerrahi işlem için yeterli duyusal blok seviyesine ulaşıldı. Grup 11-I'ün T10 dermatomuna ulaşma süresi Grup H'ye göre anlamlı derecede kısa idi (p

Anahtar Kelimeler:

İlaç değerlendirmesi, Anestezi, epidural, Sinir bloğu

Effects of concentration and volume of ropivacaine in epidural anesthesia

Effect of local anesthetic concentration and volume on the epidural anesthetic properties is unclear. This study was performed to determine effects of a therefold difference in concentration and volume ropivacaine on epidural anesthesia. Sixty adult patients, ASA I-II, scheduled for lower limb surgery were included in this prospective, double blind study. Patients were randomly divided into three group with 20 in each. Group I received 1% ropivacaine in 10 mL volume (100 mg), Group II 0.5% ropivacaine in 10 mL volume (100 mg); and Group III 0.75% ropivacaine in 20 mL volume (150 mg) via epidural route. The groups compared with local anaesthetic properties, hemodinamic effects and adverse effects. Sensory anesthesia was adequate for surgery in all of the patients. The onset of sensorial analgesia at the T10 dermatome in groups HI was faster than Group H (p<0.05). Times to regression of anesthesia to Tw and T12 dermatoma increased in Group III. These changes were not statistically significant. The degree of motor blockade at 20 min and 120 min by using the Bromage scale was higher than the other group (p<0.001). Cardiovascular changes were similar in all three groups. Finally; intensity of sensory and motor block from epidural anesthesia with ropivacaine appears to depend primarily on total milligram dose and ropivacaine 0.75% in a volume of 20 mL proved to be a very potent local anesthetic with moderate motor blockade.

Keywords:

Drug Evaluation, Anesthesia, Epidural, Nerve Block,

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