Ayça ÖZCAN DUMANLI, Seval İZDEŞ, Meryem DEMİRTOLA, Orhan KANBAK

Epidural levobupivakain ve bupivakainin anestezi öncesi bispektral indeks ve anestezi sırasında sevofluran gereksinimine etkileri

Amaç: Eş değer dozda epidural levobupivakain ve bupivakainin uyanık dönemde bispektral indeks (BİS) ile genel anestezi sırasında sevoşuran gereksinimine etkilerini karşılaştırmayı amaçladık. Yöntem: Etik kurul izninden sonra, ASA I-II grubundan, 18-65 yaşında 66 hasta çalışmaya alındı. Epidural kateter takıldıktan sonra, hastalar rastgele yöntemle 3 gruba ayrıldı. Epidural kateterden Grup Kya % 0.9 serum fizyolojik, Grup Lye % 0.25lik levobupivakain, Grup Bye % 0.25lik bupivakainden 5mL bolus enjeksiyonun ardından aynı solüsyon 10 mL sa-1 hızda verildi. BİS değerleri ve duyusal blok seviyeleri 30 dk boyunca 5 dkda bir kaydedildi. Sonrasında BİS değeri 40-50 olacak şekilde sevoşuran ile genel anestezi uygulandı ve ekspire edilen sevoşuran konsantrasyonu (EtSEVO) kaydedildi. Bulgular: Uyanık dönemde BİS değerleri, Grup Kda tüm ölçüm zamanlarında diğer iki gruba göre istatistiksel olarak anlamlı yüksekti (p

Effects of epidural levobupivacaine and bupivacaine on the bispectral index during the awake phase and on sevoflurane requirement during general anesthesia

Objective: The aim of the study was to compare the effects of equivalent doses of epidural levobupivacaine and bupivacaine on bispectral index (BS) during the awake period and on sevoflurane requirements during general anesthesia. Methods: Following Ethical Committee approval, 66 patients aged between 18-65 years from ASA I-II group were enrolled in the study. After epidural catheter was placed, patients were randomly divided into 3 groups to receive epidural 0.9% saline (Group K), 0.25% levobupivacaine (Group L) or 0.25% bupivacaine (Group B). They received a 5 ml bolus injection followed by the same solution at a rate of 10 ml h -1 through the epidural catheter. BIS values and sensory block levels were evaluated and recorded every 5 min for 30 min. Anesthesia was then induced and maintained with sevoflurane to achieve BIS 40-50. The end-tidal sevoflurane concentrations (EtSEVO) were recorded. Results: In Group C, BIS values were significantly higher compared to other groups (p<0.05-p<0.01) during the awake period. BIS in Group L was significantly lower than in Group B, 15min after the epidural injection (p<0.05). Maximal sensory block level wasnt different 30min after epidural anesthesia. The EtSEVO was lower for all measurement times 20 minutes after the operation in Group L compared to Group C and at 35, 45, 50th min in Group L compared to Group B (p<0.05-p<0.001). Conclusion: It was concluded that the same dosage and concentration of epidural levobupivacaine caused higher level of decrease in BIS value during awake phase and in sevoflurane requirement during general anesthesia compared to epidural bupivacaine.

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