Major ortopedik cerrahi için spinal anestezide izobarik ve hiperbarik ropivakain ve bupivakainin karşılaştırılması

Amaç: Bu çalışma total diz ve kalça artroplastisi uygulanan hastalarda izobarik bupivakain ve ropivakain kullanımı ile hiperbarik bupivakain ve ropivakain kullanımının etkinlik ile güvenilirliğini karşılaştırmak amacıyla gerçekleştirilmiştir. Gereç ve yöntem: Spinal anestezi altında diz veya kalça artroplasti cerrahisi planlanan ASA I-III grubuna dahil 120 hasta 4 gruba randomize edildi. Grup HB için 3 mL %0.5 hiperbarik bupivakain (n-30), Grup HR için 2 mL %0.75 hiperbarik ropivakain (n=30), Grup B için 3 mL %0.5 izobarik bupivakain (n=30) ve Grup R için 3 mL %0.75 izobarik ropivakain (n=30) kullanıldı. T10 seviyesinde duyusal bloğun başlangıç süresi ve bu seviyede duyusal bloğa ulaşma süresi, duyusal bloğun maksimum üst ve alt yayılım seviyeleri, motor blok yoğunluğu ve süresi kaydedildi. Bulgular: En kısa sürede tam motor blok Grup HB'de gelişmiştir (p

Comparison of plain and hyperbaric solutions of ropivacaine and bupivacaine for spinal anesthesia for major orthopedic surgery

Objective: In this study aimed to compare efficacy and safety of plain and hyperbaric solution of ropivacaine and bupivacaine for spinal anesthesia in patients undergoing total hip and knee arthroplasty. Methods: One hundered twenty patients, in ASA grade I-II. group undergoing total hip and knee arthroplasty under spinal anesthesia were included. For patients in Group HB 3 mL 0.5% hyperbaric bupivacaine, in Group HR 2 mL 0.75% hyperbaric ropivacaine, in Group B 3. mL 0.5% plain bupivacaine and in Group R 3 mL 0.75% plain ropivacaine were used. The onset and duration of sensory block at dermatome level T10, maximum upper and lower spread of sensory block, the onset insensity and duration of motor block were recorded. Results: The mean duration of complete motor block was the least in Group HB (p<0.05). Onset of sensorial block at dermatome level T 10 was the earliest in Group HB (p<0.05). Onset of sensorial blockage at dermatome level T10 and L, was the highest in Group R and the lowest in Group B (p<0.05). Need for the first analgesia administration was the earliest in Group B and the latest in Group R (p<0.05). Hypotension after spinal block and intraoperative nausea and vomiting were significantly higher in Group HB (p<0.05). Intraoperative hypotension was the least in Group HR (p<0.05). General anesthesia administration due to inadequate intra-operative analgesia was more frequent in Group B (p<0.05). Conclusion: Glucose addition to ropivacaine during spinal anesthesia limits cephalic spread, increases reliability of anesthesia and also decreases sensorial and motor block duration.

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Anestezi Dergisi-Cover
  • ISSN: 1300-0578
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1993
  • Yayıncı: Betül Kartal
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