Tuna ALBAYRAK, Elvin KESİMCİ, Orhan KANBAK

Levobupivakain ile kombine spinal epidural anestezide epidural volüm genişletmenin duyusal ve motor blok ile hemodinami üzerine etkilerinin değerlendirilmesi

Amaç: Bu çalışmada kombine spinal epidural anestezi (KSEA) uygulamasında intratekal levobupivakain enjeksiyonundan sonra epidural kateterden verilen 10 mL serum fizyolojik (SF) solüsyonunun hemodinamik parametreler, duyusal blok seviyesi, motor ve duyusal blok derlenme süreleri üzerine etkisini değerlendirmeyi amaçladık. Yöntem: Etik kurul izni ve hasta olurları alındıktan sonra, elektif alt ekstremite cerrahisi planlanan ASA I-II grubunda 40 hasta çalışmaya dahil edildi. KSEA altında 2 mL %0.5 levobupivakain ve 25 jıgfentanil ile spinal anestezi yapılan hastalar rastgele iki eşit gruba ayrıldı. Grup S'ye spinal anesteziden 5 dakika sonra epidural kateterden 10 mL SF solüsyonu uygulanırken, Grup K'ya epidural kateterden herhangi bir ilaç uygulaması yapılmadı. Duyusal blok seviyesi, motor ve duyusal blok derlenme zamanları, vital bulgular ve yan etkiler kaydedildi. Bulgular: Duyusal blok seviyesinin Grup S'de, anlamlı olarak yüksek olduğu saptandı (p

Evaluation of the effects of volume extension in combined spinal epidural anesthesia with levobupivacaine on sensory and motor block and hemodynamics

Objective: We aimed to evaluate the effects of 10 mL normal saline solution administered through the epidural catheter following spinal anesthesia with levobupivacaine during combined spinal-epidural anesthesia (CSEA) on hemodynamic parameters, sensory block level, and motor and sensory block recovery times. Method: After institutional approval and informed consent, spinal anesthesia with 2 mL of levobupivacaine 0.5% and 25 pig fentanyl under CSEA were performed in 40 ASA 1-11 patients undergoing lower extremity surgery and then the patients were randomly assigned into two groups. In Group S, 5 minutes following spinal anesthesia, 10 mL saline was administered through the epidural catheter. In Group K, no solution was administered through the catheter. The sensory block level, sensory and motor block recovery times, vital signs and side effects were recorded. Results: Sensory block level was significantly higher in Group S (p<0.05). No significant difference was recorded in sensory and motor block recovery times and side effects between the groups. Conclusion: The epidural volume extension with 10 mL saline under CSEA improves both patient's comfort and postoperative analgesia by increasing the level of sensory block without affecting motor block.

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