Rıza ANVAROĞLU, Ebru KELSAKA, Binnur SARIHASAN, Mustafa DEMİRKAYA, Emre ÜSTÜN, Fatma ÜLGER

İntravenöz deksmedetomidin premedikasyonunun endotrakeal entübasyon ve ekstübasyona hemodinamik yanıt ve postoperatif analjezik tüketimi üzerine etkisi

Amaç: İntravenöz (iv) deksmedetomidin premedikasyonunun endotrakeal entübasyon ve ekstübasyona hemodinamik yanıt ve postoperatif tüketilen analjezik miktarına etkisini araştırmaktır. Yöntem: Çalışmaya 20-60 yaş grubu ASA I-II genel anestezi altında abdominal cerrahi planlanan 50 kadın hasta dâhil edildi. Deksmedetomidin grubuna (Grup D) indüksiyondan önce yükleme dozu olarak 0,5 μg kg-1 deksmedetomidin iv 10 dakikada verildi ve 0,5 μg kg-1 sa-1 deksmedetomidin infüzyonuna cerrahi işlem bitimine kadar devam edildi. Kontrol grubuna (Grup P) deksmedetomidin’in yükleme ve infüzyon hacmiyle eş değer volümde % 0.9 NaCl eş zamanlı olarak verildi. Anestezi indüksiyonu her iki grupta kirpik refleksi kaybolana kadar tiyopental, fentanil uygulaması ve kas gevfletici olarak vekuronyum ile sağlandı. Endotrakeal entübasyondan sonra ve intraoperatif 5, 10, 20, 30, 40, 60, 90, 120. dakikalarda ve ekstübasyondan 10 dk önce, ekstübasyonda, ekstübasyondan 10 dk sonra kalp hızı (KAH), ortalama arter basıncı (OAB) kaydedildi. Toplam tüketilen analjezik miktarı, ilk analjezik istek zamanı, analjezik istek sayıları ve ek analjezik gereksinimi kaydedildi. Bulgular: Gruplar arasında demografik özellikler benzerdi (p>0.05). Kontrol grubunda intraoperatif ve postoperatif KAH yüksekti (p

Anahtar Kelimeler:

Deksmedetodimin

The effect of intravenous dexmedetomidine premedication on hemodynamic response during endotracheal intubation and extubation and postoperative analgesic consumption

Objective: The aim of this study was to investigate the hemodynamic response to intravenous (iv) dexmedetomidine premedication during endotracheal intubation and extubation and the effect on postoperative analgesic consumption. Method: Fifty female patients, ASA I-II, aged 20-60 years, undergoing general anesthesia for abdominal surgery were enrolled in this study. Prior to anesthesia induction; patients in dexmedetomidine group (Group D) received dexmedetomidine hydrochloride 0,5 µg kg-1 in 10 minutes time. Following induction, dexmedetomidine 0.5 µg kg-1 h-1 was administered until the end of surgery. Patients in the control group (Group P) received 0,9 % saline as the same volume of medication used for group D and for the same infusion duration as in Group D. Anesthesia was induced with fentanyl, thiopental until loss of eyelash reflex and vecuronium was used for muscle relaxation. Heart rate, mean arterial pressure were recorded after intubation, at the 5th , 10th , 20th , 30th , 40th , 60th , 90th , and 120th minutes during surgery and 10 minutes before, during and 10 minutes after extubation. Total analgesic consumption, the first analgesic requirement time and the number of resque analgesics were recorded. Results: There was no significant difference between the groups according to demographic data (p>0.05). Intraoperative and postoperative heart rates were higher in the control group (p<0.05). Consumption of pethidine during postoperative analgesia, thiopental dose during induction, and number of required resque analgesics were lower in the dexmedetomidine group (p<0.05). Conclusion: Administration of dexmedetomidine 0.5 µg kg-1 10 minutes before anesthesia induction and followed by 0.5 µg kg-1 h-1 infusion, supressed hemodynamic response to anesthesia and surgery, and decreased postoperative analgesic consumption. We concluded that dexmedetomidine may be used for premedication without any effect on extubation and awakening time in patients undergoing major surgical procedures and suffering from pain.

Keywords:

Dexmedetomidine,

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