Varol ÇELİKER, Elif BAŞGÜL, Altan ŞAHİN, Şennur UZUN, Betül BAHADIR, Ülkü AYPAR

Katarakt cerrahisinde midazolam, propofol ve fentanil kombinasyonlarının sedasyon ve hemodinamiye etkilerinin karşılaştırılması

Çalışmamızda, katarakt cerrahisinde peribulbar blok öncesi uygulanan midazolam, propofol ve fentanil kombinasyonlarının sedasyona etkisi, hemodinamikparametreler, postoperatif memnuniyet ve yan etkiler yönünden karşılaştırılması amaçlandı. Hastalar rasgele yöntemle 25 kişilik dört gruba ayrıldı; Grup M'ye midazolam (0.02 mg $kg^{-1}$), grup MP'ye midazolam (0.02 mg $kg^{-1}$ 0)+propofol (0.2 mg $kg^{-1}$), grup MF'ye midazolam (0.02 mg $kg^{-1}$)+ fentanil (l $mu$g $kg^{-1}$) ve grup MPF'ye midazolam (0.02 mg $kg^{-1}$)+ propofol (0.2 mg $kg^{-1}$)+ fentanil (l $mu$g $kg^{-1}$) uygulandı. Sedasyon düzeyi "hekim sorgulama skalası" ile, postoperatif hasta memnuniyeti ise "hasta değerlendirme skalası" ile değerlendirildi. Hastalar, bulantı, kusma ve başağnsı yönünden sorgulandı. Fentanil verilen gruplarda peribulbar blok uygulamasına yanıt minimaldi (p

Anahtar Kelimeler:

Propofol, Katarakt çıkartılması, İlaç kombinasyonları, Midazolam, Fentanil

Comparison of midazolam, propofol and fentanyl combinations for sedation in cataract extraction

The effects of midazolam and combination of midazolam with fentanyl and/or propofol on sedation, hemodynamic parameters, postoperative satisfaction and side effects were investigated. Group M received only midazolam 0.02 mg $kg^{-1}$, group MP midazolam 0.02 mg $kg^{-1}$ + propofol 0.2 mg $kg^{-1}$, group MF midazolam 0.02 mg $kg^{-1}$ + fentanyl 1 $mu$g $kg^{-1}$, group MPF midazolam 0.02 mg $kg^{-1}$ + propofol 0.2 mg $kg^{-1}$ + fentanyl 1 $mu$g $kg^{-1}$. The sedation levels of patients were measured according to a physician questionnaire. Postoperative nausea/vomiting, headache and patient satisfaction were determined via a patient evaluation scale. In the groups receiving fentanyl, the hemodynamic response to peribulber block insertion (FBI) was minimal (p<0.05). The respiration rate and O2 saturation of patients receiving midazolam, propofol and fentanyl decreased after sedation (p<0.01). Patients in the midazolam group showed a prominent reaction to PBI and movement during the operation was significant in this group (p<0.05). The sedation level was the best in the groups receiving fentanyl (p<0.05). Postoperative satisfaction was high in patients receiving midazolam, propofol and fentanyl (p<0.01). As a conclusion, the combination of midazolam, propofol and fentanyl may be preferred to only midazolam or midazolam+propofol or midazolam+fentanyl combinations with paying attention to the risk of desaturation.

Keywords:

Propofol, Cataract Extraction, Drug Combinations, Midazolam, Fentanyl,

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