Ebubekir SALDUŞ, Selmin ÖKESLİ, ALPER KILIÇASLAN, Barış ÇANKAYA, Yasin TİRE

İntravenöz rejyonal anestezide prilokaine magnezyum eklenmesinin etkileri

Amaç: Bu çalışmada rejyonal intavenöz anestezi (RVA) uygulanan olgularda prilokain ve prilokain-magnezyum kombinasyonunun duyusal ve motor blok başlama ve geri dönüş sürelerini, analjezi ve anestezi kalitesini, ağrı ve sedasyona etkilerini ve yan etkilerini karşılaştırmayı amaçladık. Yöntem: Çalışmaya dahil edilen hastalar rastgele 2 gruba ayrıldı; Grup I (n=23)e 3 mg kg-1 prilokain Grup II (n=23)ye 3 mg kg-1 prilokain + %15lik 10 ml magnezyum sülfat 0.9 NaCl ile 35-45 mlye tamamlanarak verildi. Çalışma boyunca VAS ve RSS değerlendirildi. İntraoperatif VAS≥4 olunca olgulara fentanil ilave edildi. Fentanil verilme zamanı ve verilen total fentanil dozu kaydedildi. VAS≥4 değerine ulaşınca 500 mg parasetamol verildi. Parasetamol verilme zamanı ve verilen total parasetamol dozu kaydedildi. Hastalar tüm operasyon süresince ve postoperatif 24 saat boyunca istenmeyen yan etkiler açısından izlendi. Bulgular: Duyusal ve motor blok başlama zamanı Grup IIde anlamlı derecede kısa iken, duyusal ve motor blok sonlanma zamanı Grup IIde anlamlı derecede uzun bulundu (p

Effects of combınatıon of prılocaıne and magnesıum ın ıntravenous regıonal anesthesıa

Objective: In this study we aimed to compare sensory and motor block onset and recovery times, anesthesia and analgesia quality, effects on pain and sedation and side effects of intravenous regional anesthesia (IVRA) with prilocaine and prilocaine + magnesium sulphate combination. Method: IVRA was achieved with 3 mg kg-1 prilocaine diluated with saline to a total of 35-45 ml in Group I (n=23) and 3 mg kg-1 prilocaine plus 10 ml of %15 magnesium sulphate diluated with saline to total of 35-45 ml in Group II (n=23). VAS, and RSS were recorded. Time to first intraoperative fentanyl request and total fentanyl dose were noted. When VAS≥4, paracetamol was administrated. Time to first postoperative paracetamol request and total paracetamol dose were noted. Patients were followed up during operation and postoperative 24 hours with respect to advers events. Results: Sensory and motor block onset times were significantly shorter and recovery times were significantly longer in Group II (p<0,05). Tourniquet pain began significantly later and administirated fentanyl amount was smaller in Group II than Group I (p<0,05). Time to first analgesic request was significantly longer and administrated paracetamol amount was smaller in Group II (p<0,05). In Group II, VAS values were significantly lower than Group I at intraoperative and postoperative period (p<0,05). When adverse events were evaluated, all patients experienced a mild and short-lived injection pain due to magnesium injection in Group II. In Group I, 3 patients (13,04%) experienced short-lived metalic taste and one patient (4,34%) experienced short-lived tinnitus owing to local anesthesic. Conclusion: We have concluded that magnesium sulphate as an adjuvant to prilocaine has decreased tourniquet pain, perioperative and postoperative analgesic requirement in IVRA; thus it provides beter anesthesia and analgesia quality in appropriate patients.

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