ÖZLEM SAĞIR, Ayşe Neslihan BALKAYA, Sabri ÖZASLAN, İsmail ARSLAN, Yücel MERİÇ, Ahmet KÖROĞLU, Ümit İNCEBOZ

Günübirlik cerrahide propofol-ketamin ile propofol- fentanil'in proseal laringeal maske airway yerleştirilmesi ve derlenme üzerine etkilerinin karşılaştırılması

Amaç: Bu çalışmanın amacı; anestezi indüksiyonundan önce verilen ketamin ve fentanilin, proseal laringeal maske airway (PLMA) yerleştirme koşulları, hemodinamik parametreler ve derlenme süreleri üzerine etkilerinin karşılaştırılmasıdır. Yöntem: Günübirlik histeroskopi operasyonu planlanan, ASA I-II grubu, 70 kadın hasta randomize olarak 2 gruba ayrıldı. Grup KPye 0,5 mg kg-1 ketamin ve Grup FPye 1 μg kg -1 fentanil i.v. uygulandıktan sonra hastalara 2,5 mg kg-1 propofol ile anestezi indüksiyonu sağlandı. ndüksiyon sonrası bispektral indeks (BİS) 40-60 arası olan hastalara uygun boyutta PLMA yerleştirildi. Anestezi idamesi %50 O 2, %50 nitröz oksit ve %2 sevoşuran ile sağlandı. PLMA yerleştirme kolaylığı ve hemodinamik değişiklikler kaydedildi. Hastaların göz açması ile Modifiye Aldrete skoru ≥ 9 olması arasında geçen süre derlenme süresi olarak kaydedildi Bulgular: Gruplar arasında PLMA yerleştirme kolaylığı açısından anlamlı fark gözlenmedi. ndüksiyondan sonra 5., 10. ve 15. dklarda BS değeri Grup KPde FPye göre anlamlı yüksekti (p= 0.013, p= 0.02, p= 0.016). Sistolik arter basınç değerleri indüksiyon sonrası, PLMA yerleştirme sonrası 1., 3., 5. ve 10. dk. Grup KPde FPye göre anlamlı şekilde yüksekti (p

Comparison of the effects of fentanyl-propofol and ketamine-propofol on the insertion of proseal laryngeal mask airway and recovery time in ambulatory surgery

Objective: The aim of this study is to compare the effects of ketamine and fentanyl administered prior to induction of anesthesia with propofol, on the ProSeal laryngeal mask airway (PLMA) insertion conditions, hemodynamic changes and recovery times. Method: Seventy female patients in ASA physical status I-II, who are scheduled for outpatient hysteroscopy, were randomly allocated into two groups. Anesthesia induction was provided to the patients with 2.5 mg kg propofol after the application of 0.5 mg kg-1 ketamine on Group KP and 1 μg kg-1 fentanil on Group FP. After induction, PLMA which is appropriate size for patients with bispectral index between 40-60 was placed. Maintainance of anesthesia was provided with 50% oxygen, 50% nitrous oxide and 2% sevoflurane. PLMA insertion facility and hemodynamic changes were recorded. Time between patients eye opening and Modifiye Aldrete score ≥ 9 was recorded as recovery time. Results: There was no significant difference between the groups with respect to ease of PLMA placement. After the induction, the BIS values Group KP were significantly higher compared to the FP at 5th , 10th, and 15th minutes. Systolic arterial pressure values were significantly higher in the group KP then the group FP after induction and after PLMA insertion at 1st, 3rd, 5 th, and 10th minutes. The incidence of hypotension was found significantly higher in group FP. Recovery times were similar between the groups. Conclusion: In our study, the use of ketamine and fentanyl combined with propofol was found to be similar effect on recovery times and PLMA insertion conditions. Since ketamine provides better hemodynamic stability compared to fentanyl, the combination of ketamine-propofol can be effectively used as an alternative to the combination fentanyl-propofol during the placement of PLMA.

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