Tezcan Gönül KELEŞ, Verda TOPRAK, Zeynep EKİCİ, Demet TOK

Günübirlik anestezide sevofluran veya desfluran ile birlikte fentanil ve remifentanil kombinasyonunun farklı derlenme skorları ile karşılaştırılması

Günübirlik anestezide sevofluran veya desfluran ile birlikte fentanil ve remifentanil kombinasyonunun farklı derlenme skorları ile karşılaştırılması, operasyon odası (00, Faz-1) ve anestezi sonrası bakım ünitesinde (ASBÜ, Faz-2) Fast-Track Skorldma (FTS) ve Aldrete Skorlama (AS) sistemleri kullanılarak değerlendirildi. Fakülte Etik Kurul Onayı ile, ASA I-II grubu, 18-60 yaş arası 80 olgu randomize olarak dört gruba ayrıldı. Gruplara göre uygulanan standart bir anestezi indüksiyonu sonrası; Grup (S+F)'ye; 1-3 % sevofluran + 2p.g kg'sa1 fentanil, Grup (S+R)'ye: 1-3 % sevofluran + 0.25 fig kg sa remifentanil, Grup (D+F)'ye: 2-5 % desfluran + 2 fig kg sa fentanil, Grup (D+R)'ye : 2-5% desfluran + 0.25 jıg kg'sa remifentanil ve 60% N2O verilerek anestezi idameleri sağlandı. Operasyonunun bitiminden 15 dk önce tüm olgulara standart analjezik ve anti emetik ilaç uygulandı. Tüm olguların ekstübasyon zamanları kaydedildi. 00'da (Faz-1) ekstübasyon sonrası 5. ve 10. dakikalarda FTS ve AS değerleri ile ASBÜ'de (Faz-2) 5.-15. ve 25. dakikalardaki FTS ve AS değerleri kaydedildi. ASBÜ'de ağrı ve bulantı şikayetleri değerlendirildi. P< 0.05 değeri anlamlı kabul edildi. Faz-1'de, 10.dk'da Grup (D+R) AS'ye göre, Grup (S+F)'den daha yüksek skora sahipti (p

Anahtar Kelimeler:

Günübirlik cerrahi işlemler, Anesteziden uyanma dönemi

The effect of combination of sevoflurane and desflurane with fentanyl and remifentanil on different recovery scores in outpatient anesthesia

We aim to compare sevoflurane and desflurane with fentanil and remifentanil in the operating room (OR-Phase-1) and post-anaesthesia care unit (PACU-Phase-2) by using Fast-Tract-Criteria (FTC) and Aldrete Criteria (AC) for ambulatory anesthesia. After obtaining appröval from the Faculty Ethics Committee, 80 ASA I-II patients, aged 18-60 were randomly divided into four groups (n=20). Following Standard anaesthesia induction, Group (S+F) received 1-3 % sevoflurane + 2 fig kg'h' fentanyl, Group (S+R) received 1-3% sevoflurane + 0.25 fig kg'h' remifentanil, Group (D+F) received2-5 % desflurane + 2 fig kg'h' fentanyl and Group (D+R) received 2-5% desflurane + 0.25 fig kg'h' remifentanil in 60% N2O for anaesthesia management. Fifteen minutes before the end of the surgery, Standard analgesic and anti-emetic medications were applied to ali patients. Extubation times were recorded, FTC and AC were evaluated in the OR at the 5'h and 10 minutes following extubation and in PACU at the 5"', 15"1 and 25"" minutes. Pain and emesis were evaluated in the PACU. P<0.05 was considered significani. in phase 1 at the 10'h min; Group (D+R) had a higherAC score than group (S+F) (p<0.05), in phase 2 at the 5a min; Group (D+R) had higher FTC and AC scores than the other groups (p<0.01 and p<0.05). in phase 2 at the 15"1 minute, Group (S+F) had a lowerAC score than the other groups (p<0.05). in ali patients, targeted discharge points were achieved at the 25'h minute in PACU. in conclusion, bothFTC andAC were applied easily in Phase 1 and Phase 2 to the four groups. The desflurane and remifentanil combination seems to be the most suitable for outpatient anesthesia.

Keywords:

Ambulatory Surgical Procedures, Anesthesia Recovery Period,

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