Betül YİĞİTBAŞI, Ruhiye REİSLİ, Eyüp HORASANLI, Semra DEMİRBİLEK, Beyazıt DİKMEN, Orhan KANBAK, Nermin GÖĞÜŞ

Epidural midazolamın sedasyon, analjezi ve hemodinami üzerine etkisi

Çalışmamızda epidural midazolamın hemodinami ve solunum parametrelerine, anestezinin başlangıç süresi ve seviyesine, sedasyon kalitesine etkileri araştırılmıştır. Herniyoplasti yapılacak ASA I-II grubundan 30 olgu iki eşit gruba ayrıldı. İntravenöz 7ml.kg-1 ringer laktat infüzyonundan sonra Grup P'ye 20 ml'ye serum fizyolojik (SF) ile tamamlanmış 300 mg prilokain, Grup M'e 20 ml'ye SF ile tamamlanmış 300 mg prilokain ve 0.05 mg.kg-1 midazolam epidural kataterden verildi. Hastaların arteryel kan basıncı, kalp hızı, solunum sayısı, SpO2 değerleri, duyu ve motor blok başlama ve maksimuma ulaşma zamanı, duyu ve motor blok geri dönüş zamanı, duyu ve motor blok süresi, analjezi niteliği, sedasyon skoru epidural enjeksiyondan sonra 5 dakikada bir kaydedildi. Hemodinamik parametreler gruplar arasında anlamlı fark göstermedi. Grup M'de Grup P'ye göre solunum sayısı 30. ve 45. dakikalarda anlamlı olarak arttı (p

Anahtar Kelimeler:

Anestezi, epidural, Midazolam, Bilinçli sedasyon, Analjezi, Prilokain

Effects of epidural midazolam on sedation, analgesia and hemodynamics

This prospective randomised study was designed to investigate the effects of epidural midazolam on hemodynamic stability, the quality of anesthesia, sedation, recovery and complications. Thirty patients (ASA I-II), scheduled for elective herniorrhaphy surgery, were assigned into two groups. After administration of 7 m I. kg-' of lactated Ringer's solution (ML) intravenously, patients were given either 300 mg plain prilocaine or 300 mg priloacine plus 0.05 mg.kg-' midazolam in 20 ml normal saline via epidural catheter. Then, patients were situated in 30° Fowler position. Noninvasive arterial pressures, heart rates, le vels of analgesia and score of sedation were measured every 5 minutes after epidural injection. Hemodynamic parameters were not statistically significant between the two groups. Respiration rate increased between.?(/' and 45th minutes in group M (p<0.01), but there was no difference in Sp02 levels of the two groups. Score of sedation was significantly higher in group M than group P (p<0.0i). Onset of analgesia was shorter but the duration of analgelsa was longer in group M than group P (p<0MI). Motor block was similar in both groups. Five patients required additional dose of prilocaine after the first injection in group P, but not in group M. We concluded that administration of midazolam to prilocaine via epidural catheter produced satisfactory quality of anesthesia and sedation with hemodynamic and respiratory stability.

Keywords:

Anesthesia, Epidural, Midazolam, Conscious Sedation, Analgesia, Prilocaine,

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