Özbek Berna ÖZER, M. Murat SAYIN, Taylan AKKAYA, Sumru ŞEKERCİ, Alp ALPTEKİN, Haluk GÜMÜŞ

Hiperbarik ropivakain kısa süreli bekleme ile yeterli unilateral spinal anestezi sağlar mı?

Günübirlik cerrahi anestezide diğer lokal anesteziklere alternatif bulmak amacıyla hiperbarik ropivakaini tek taraflı spinal anestezi uygulamalarında hiperbarik bupivakain ile karşılaştırmayı amaçladık. Bu randomize çift kör çalışma, ASAI-II grubuna dahil tek taraflı atroskopik diz cerrahisi geçirecek 40 hasta üzerinde yapıldı. Hastalar rastgele iki gruba ayrılarak Grup R'ye 3 mL %0.5'lik ropivakain (15 mg ropivakain + 240 mg dekstroz), Grup B'ye 3 mL %0.5'lik bupivakain (15 mg bupivakain + 240 mg dekstroz) intratekal olarak verildi. Spinal anestezi lateral dekübit pozisyon ve¬rilerek L3-4 aralığından gerçekleştirildi. Lateral dekübit pozisyonu 5 dakika korunduktan sonra hastalar sırt üstü (supine) pozisyona çevrildiler. Duyu bloğu pinprick testi, motor blok Modifiye Bromage Skorlaması (MBS) kullanılarak değerlendirildi Her iki grupta da ipsilateral ve kontralateral duyu bloğu seviyesi T9'a ulaştı. Medyan MBS ipsilateral tarafta her iki grupta da 1 idi (p>0.05). Grup B'de kontralateral taraftaki medyan MBS= 1 iken, Grup R'de medyan MBS= 4 idi (p

Anahtar Kelimeler:

Çift kör metot, Anestezi, spinal, Anestezikler, lokal, Bupivakain

Does hyperbaric ropivacaine provide adequate unilateral spinal anaesthesia?

In order to find an alternative to other local anaesthetics, we used hyperbaric ropivacaine for unilateral spinal anaesthesia in outpatient surgery. This prospective randomized study was conducted on 40 ASA I-II patients that were assigned for arthroscopic knee surgery. Patients were separated randomly into two groups. Group R received 3 mL ropivacaine 0.5% (ropivacaine 15 mg + dextrose 240 mg) and group B received 3 mL bupivacaine 0.5% (bupivacaine 15mg + dextrose 240 mg) intrathecally through the L3-4 intervertebral space in the lateral position. After staying in a lateral position for 5 minutes, patients were placed supine. Sensory and motor block were controlled with a pinprick test and Modified Bromage Scale (MBS), respectively. in both study groups, ipsilateral and contralateral sensory block reached the T9 level. The ipsilateral median MBS was 1 in both groups (p>0.05). The contralateral median MBS was 1 in group B and was 4 in group R (p<0.05). The mean sensory block duration was 200±22 min in group B and 148±24 min in group R. The mean motor block duration was 16±48 min group B and 97±38 min in group R (p<0.05). Hyperbaric ropivacaine could be an alternative to hyperbaric bupivacaine due to the shorter duration of actionfor unilateral spinal anaesthesia in outpatient surgical operations of lower extremities. The lateral stay period can be decreased, which may lead to a shorter anesthesia time.

Keywords:

Double-Blind Method, Anesthesia, Spinal, Anesthetics, Local, Bupivacaine,

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