Özdemir İclal KOL, Berrin D. ASLAN, Sinan GÜRSOY, Kenan KAYGUSUZ, Mustafa GÖNÜLLÜ

Hasta kontrollü sedasyonda propofol ve propofol-alfentanil'in karşılaştırılması

Bu çalışmada, spinal anestezi altında ürolojik endoskopik girişim uygulanan hastalara intraoperatif Hasta Kontrollü Sedasyonda propofol ile propofol-alfentanil kombinasyonunun etkilerini karşılaştırmayı amaçladık. Bu çalışma, ASA I-Il grubuna giren yaşları 35-75 arasında değişen 50 erkek hastada gerçekleştirildi. Grup Ve (n=25); 0.3 mg kg propofol, grup II'ye (n=25) 0.2 mg kg propofol ve 2 ßg kg alfentanil hasta kontrollü sedasyon cihazı ile uygulandı. Sedasyon öncesi, sedasyon sırasında 15 ve 30. dakikalarda, sedasyon sonu ve postoperatif 30. dakikada kalp atım hızı, ortalama arter basınçları, SpO2, solunum sayısı, anksiyete değerleri ve sedasyon değerleri kaydedildi. Operasyon sonunda hasta memnuniyeti, derlenme süresi ve amnezi olup olmadığı belirlendi. Tüm hastalarda istenilen sedasyon skorlarına ulaşıldı. Ancak gruplar arasında sedasyon skorları açısından fark yoktu. Her iki grupta da preoperatif anksiyete skorları yüksek olmasına rağmen intraoperatif ve postoperatif anksiyete skorları anlamlı olarak düşük bulundu. Gruplar arası derlenme skorları ve hasta memnuniyeti açısından fark yoktu. Hiçbir hastada amnezi olmadı. Grup I'de %52, Grup II'de % 24 yan etki görüldü. Sonuç olarak, propofol ve propofol-alfentanil kombinasyonu arasında sedasyon, anksiyete ve derlenme skorları ile hemodinamik etkileri açısından fark olmadığı ancak yan etki insidansının daha düşük olması göz önüne alınarak propofol-alfentanil kombinasyonunun daha üstün olduğu kanaatindeyiz.

Anahtar Kelimeler:

Bilinçli sedasyon, Alfentanil, Karşılaştırmalı çalışma, Propofol

A comparison of propofol with propofol-alfentanil using patient controlled sedation

The aim of this study was to compare Patient Controlled Sedation with propofol or a propofol-alfentanil combination in patients undergoing urologic endoscopic procedures under spinal anesthesia. The study was carried out on 50 male ASA I or IIpatients aged 35-75. Group I (n=25) received 0.3 mg kg propofol, Group II (n=25) recevied 0.2 mg kg propofol and 2 jig kg' alfentanil using a patient controlled sedation device. Heart rate, mean arterial pressure, SpO2, respiratory rate, anxiety and sedation degrees were recorded before sedation, at the 15 and 30 minute of sedation and at the postoperative 30 minute. At the end of the operation, patient satisfaction, recovery time and presence of amnesia were assessed. Sedation scores were within desirable levels in both groups, but there was no difference in the sedation scores. While preoperative anxiety scores were high, peroperative and postoperative scores decreased significantly. There was no difference between the groups in recovery scores or patient satisfaction. None of the patients had amnesia during sedation. The adverse effects noted were 52% in group 1,24% in group II. It was concluded that there are no differences in sedation, anxiety, recovery scores and hemodynamic effects between the groups. We think that the propofol-alfentanil combination is superior since its adverse effects were fewer.

Keywords:

Conscious Sedation, Alfentanil, Comparative Study, Propofol,

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