Feray ERDİL, A. Kadir BUT, Hüseyin İlksen TOPRAK, Erdoğan ÖZTÜRK, M. Özcan ERSOY

Epinefrinin oluşturduğu hemodinamik yanıtadeksmedetomidin ve midazolam sedasyonunun etkisi

Amaç: Septoplastilerde midazolam ve deksmedetomidin sedasyonunun; epinefrin içeren lokal anestezik (LA) infiltrasyonunun oluşturduğu hemodinamik yanıt ve postoperatif analjezik gereksinimi üzerine etkilerini incelemektir. Yöntem: Çalışmamız lokal anestezi ile septoplasti yapılacak 45 olguda gerçekleştirildi. Olgulara Ramsay sedasyon skoru 3-4 olacak şekilde deksmedetomidin (Grup D, n= 25) ve midazolam (Grup M, n=20) verildi. Olguların ortalama arter basıncı (OAB), kalp atım hızı (KAH), ve verbal ağrı skoru (VRS) operasyon öncesi, sedasyon ajanlarının uygulanması, epinefrinli LA infiltrasyonunu takiben ve operasyon sırasında kaydedildi. Postoperatif 1, 2, 4, 6, 12, ve 24. saatlerde O AB, KAH ve olguların ağrıları visual analog skala (VAS) ile değerlendirildi. İlk analjezik gereksinim zamanı ve total diklofenak tüketimleri kaydedildi. Bulgular: Grup D'de, O AB intraoperatif 10. dk'dan itibaren, KAH ise deksmedetomidin yükleme sonrası, intraoperatif20 ve 30. dk ile postoperatif 1. saatte giriş değerine göre anlamlı olarak azaldı (p

Effectsof dexmedetomidine and midazolam sedation on the haemodynamic response to epinephrine

Objective: The aim of our study is to evaluate the haemodynamic response of midazolam and dexmedetomidine sedation to local anaesthetic (LA) infiltration containing epinephrine and the analgesic effects and sedation during septoplasty operations. Methods: Dexmedetomidine (Group D; n:25) and midazolam (Group M; n:20) were given to patients as their sedation levels reached 3-4. The mean blood pressure (MBP), heart rate (HR), and visual analog scale (VAS) values were recorded preoperatively, after induction doses of sedation agents, after the infiltration of local anesthesia containing epinephrine and perioperatively. Postoperatively MBP and HR were recorded at 1,2, 4, 6,12, and 24 hours and the pain score of the patients was evaluated by VAS. Results: In group D, MBP after 10. minutes perioperatively, and HR after the dexmedetomidine induction, perioperatively at 20 and 30 minutes and postoperatively in the first hour were significantly lower when compared with the initial values (p<0.05). In group M, MBP after the induction and postoperatively at the 2nd hour was significantly lower when compared with the initial values, but HR was significantly increased after the induction, until the perioperative 30th minute (p<0.05). As for the evaluation of the groups: in group D, MBP till the perioperative 30th minute and postoperatively at 1,4 and 24 hours, and HR between the end of induction and the perioperative 30th minute were significantly lower when compared with group M (p<0.05). Total diclophenac consumption was significantly lower and the time to the first analgesic requirement was also significantly longer in group D when compared with group M (p<0.05). Postoperative VAS values were significantly lower in group D when compared with group M. Conclusion: The results of our study showed that dexmedetomidine sedation could be preferred in septoplasty operations because of its beneficial effects on haemodynamic response after LA infiltration containing epinephrine and for its analgesic properties which is important in the postoperative period.

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