Epidural anestezide bupivakain ile levobupivakainin etkilerinin karşılaştırılması

Çalışmamızda tek taraflı inguinal herni operasyonu planlanan ASA I-II risk grubundaki 40 olguda bupivakain ve levobupivakainin epidural anestezi uygulanması sonrasında oluşacak duyu ve motor bloğunun başlama ve şartlanma, iki segment regresyon zamanı, postoperatif ilk analjezik gereksinimi ve yan etkileri karşılaştırıldı. Olgular epidural aralığa enjekte edilecek ilaçlara göre iki eşit gruba ayrıldı. Grup B'ye 17 mL % 0.5'lik bupivakain, Grup L'ye 17 mL % 0.5'lik levobupivakain ile epidural anestezi uygulandı. Hasta grupları arasında demografik özellikleri, ortalama arter basıncı (OAB), kalp atım hızı (KAH) ile ASA dağılımları açısından istatiksel anlamlı fark bulunmadı. Her iki grupta da cerrahi için gerekli yeterli duyu bloğunun ortalama başlama zamanının eşit olduğu gözlendi (Grup B 16.75 dk, Grup L 15.15 dk). Duyu bloğunun iki segment regresyonu ile iki grup arasında duyusal bloğun tamamen regresyonu için geçen zaman Grup B ve Grup L'de benzerdi. Grup L'de tam duyusal regresyonun oluşması Grup B'ye göre daha geç bulundu (Grup B'de 317.15 dk, Grup L de 393.75 dk) (p>0.05). Alt ekstremitelerde motor bloğun regresyonu ve motor blok tam regresyonu süreleri Grup B'de, Grup L'ye göre anlamlı olarak uzun bulundu (p

Anahtar Kelimeler:

Bupivakain, Anestezi, epidural, Sinir bloğu, Ağrı, ameliyat sonrası

Comparison of the efficacy of bupivacaine and levobupivacaine in epidural anesthesia

In the current study, in 40 patients with ASA I-II preoperative health status undergoing inguinal hernia repair; onset, length, duration of motor and sensory block, two segment regression time, postoperative first analgesic requirement and side effects of bupivacaine and levobupivacaine on epidural anesthesia have been compared. Patients were allocated into two equal groups randomly. Group B received 17 mL 0.5 % bupivacaine, Group L received 17 mL 0.5 % levobupivacaine for epidural anesthesia. The groups were similar with respect of demographic properties, mean arterial pressures (MAP), heart rate (HR) and AS A. In both groups, onset of sensory block sufficient enough for surgery was found to be similar (Group B 16.75 dk, Group L 15.15 dk). Time elapsed for two segment sensory regression and total sensory regression for both groups were also similar, but total sensory regression in Group L is found to be approximately 75 min later than in Group B, but this had no statistical significance Group B 317.15 dk, Group L 393.75 dk) (p>0.05). In lower extremities, motor block regression time was significantly longer in group B than in group L (P<0.05). We concluded that, levobupivacaine which have similar properties with rasemic bupivacaine had longer sensory block time and shorter motor block removal time which allowed enough motor and sensory block f or lower abdominal surgery with more safety and less side effect.

Keywords:

Bupivacaine, Anesthesia, Epidural, Nerve Block, Pain, Postoperative,

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