Leyla İYİLİKÇİ, Gönül TEZCAN, Can EYİGÖR, Ali GÜNERLİ

Laringeal maske uygulamasında propofol ve midazolamın göz içi basıncı ile hemodinami üzerine etkileri

Bu çalışmada;Laringeal Maske(LM) uygulamasında propofol ve midazolam olmak üzere iki ayrı ajanın intraoküler basınç (İOB) ve hemodinami üzerine etkilerinin incelenmesi amaçlandı. ASA 1 ve II grubunda 50 üroloji genel cerrahi olgusu çalışmaya alındı.I.Gruba; (n=25) 0.25-0.1 mg $kg^{-}1$ midazolam, 10 $mu$ $kg^{-}1$ alfentanil ile indüksiyonu sonrası LM yerleştirildi ve idame 0.05 mg kg $sa^{-}1$ midazolam infüzyonu ile sağlandı. II. Gruba ;(n=25) 2-3 mg $kg^{-}1$ propofol ve10 mg $kg^{-}1$ alfentanil indüksiyonu sonrası, LM yerleştirildi ve idame 2-3 mg $kg^{-}1$ $sa^{-}1$ propofol infüzyonu ile sağlandı.Tüm olguların İOB (mmHg), ortalama arter basıncı (OAB),kalp atım hızı (KAH) değerleri;indüksiyon öncesi ($Z_1$), LM yerleştirilmesinden hemen sonra ($Z_2$), indüksiyondan 5 dk sonra ($Z_3$), LM çıkarıldıktan hemen sonra ($Z_4$), kaydedildi.İOB ölçümü tüm hastalarda aynı göz (sağ), % 0.4' lük oksibuprokain uygulaması sonrası, Schiöetz tonometresi ile ölçüldü. Gruplar arası karşılaştırmada KAH ve OAB ölçümleri $Z_2$, $Z_3$ ve $Z_4$ dönemlerinde propofol grubunda belirgin düşük bulundu (p

Anahtar Kelimeler:

Anestezi, genel, Göz içi basınç, Propofol, Larinks maskeleri, Midazolam

The effects of using laryngeal mask airway with propofol and midazolam on the hemodynamics and intraocular pressure

In this study, our object was to observe the effects of using Laryngeal Mask Airway (LMA) with propofol and midazolam on the hemodynamics and intraocular pressure (IOP). Fifty patients in ASA risk groups I and II that would undergone urological or general surgical procedures.In group I (n=25) patients received midazolam 0.25-0.1 mg .$kg^{-}1$ i.v.and alfentanyl 10 mg $kg^{-}1$ i.v. for induction and them.LMA was placed.Maintenance was performed by an infusion of midazolam 0.05 mg $kg^{-}1$ $h^{-}1$.In group II (n=25) patients received propofol 2-3 mg $kg^{-}1$ i.v. and alfentanyl 10 mg $kg^{-}1$ i.v. for induction and LMA was placed. Maintenance was performed by infusion of propofol 2-3 mg $kg^{-}1$ $h^{-}1$ . IOP (mmHg), mean arterial pressure (MAP) and heart rate (HR) were recorded just before induction ($T_1$) after the placement of LMA ($T_2$), 5 minutes after the induction ($T_3$) and after the displacement of LMA ($T_4$).IOP was measured in the right eye with after the administration of local anesthetic oxybuprocain HCI 0.4 % Schiöetz tonometry. During the group comparisons, HR and MAP values were found to be significantly low at $T_2$, $T_3$ and $T_4$ in propofol group when compared with group I (p<0.05).IOP values were significantly decrease at $T_2$ and $T_4$ measurements (p<0.001) in propofol group.No complication developed during removel of LMA. In our study;propofol in LMA administiration decreases the IOP however midazolam increases it minimal but this increases is not in the pathological values.In LMA administiration midazolam stabilizes the cardiovascular system better than propofol.For this reason, in this cases undergoing to ophthalmic operations whom are not in haemodynamic stabilization and have to keep the IOP steady, midazolam can be a good alternative.

Keywords:

Anesthesia, General, Intraocular Pressure, Propofol, Laryngeal Masks, Midazolam,

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