Zekiye BİGAT, Nurten KAYACAN, Bilge KARSLI, AYŞE GÜLBİN ARICI, Meliha ERMAN

"OOSİT pick up" işleminde intraoperatif hemodinami ve postoperatif derlenme yönünden ilaç kombinasyonlarında tercihimiz ne olmalıdır?

Çalışmamızda in vitro fertilizasyon amacıyla yumurta toplama "oosit pick up" (OPU) işlemi uygulanacak olgularda midazolam + fentanil, propofol + fentanil, propofol + remifentanil kombinasyonlarını kullanarak intraoperatif hemodinami ve postoperatif sedasyon ile derlenmeye etkilerinin karşılaştırılması amaçlandı. "Oosit pick up" işlemi uygulanacak 45 olgu rasgele üç gruba ayrıldı. 1.gruba (MF) 0,3mg $kg^-1$ Midazolam + 2$mu$g $kg^-1$ Fentanil, 2. Gruba (PF) 3mg $kg^-1$ Propofol + 2$mu$g $kg^-1$ Fentanil, 3. Gruba (PR) 3 mg $kg^-1$ Propofol + 0,5$mu$g $kg^-1$ Remifentanil uygulandı. Kan basıncı, kalp hızı, periferik oksijen satürasyonu değerleri preoperatif, indüksiyon sonrası, OPU başlangıcı ve girişim süresince her 5 dakikada bir, girişim sonrası da 5., 10., 15., ve 30. dk'da kaydedildi. Girişim sırasında ilave ilaç gereksinimleri kaydedildi. Olguların derlenme ve sedasyon durumları OPU sonrası 5., 10., 15., ve 30 dk'da Aldrete Derlenme skoru ve Ramsey Sedasyon Skoru ile değerlendirildi. Bulantı, kusma, allerji gibi yan etkiler gözlenen olgular kaydedildi. Demografik veriler, anestezi ve OPU süreleri, hemodinamik veriler, Sp02 değerleri, ilave ilaç gereksinimleri tüm gruplarda benzerdi. En hızlı derlenme PR grubunda sağlanmış olmakla birlikte PF grubu ile arasındaki fark anlamsız bulunmuştur. En geç derlenme ise MF grubunda sağlandı ve diğer iki grup ile anlamlı derecede farklı bulundu (p

Anahtar Kelimeler:

Propofol, Oosit, Midazolam, Fentanil, İlaç kombinasyonları

Which drug combination is better for OOCYTE pick up process according to intraoperative hemodynamics and postoperative recovery?

Our aim was to compare Midazolam-Fentanyl (MF), Propofol-Fentanyl (PF), and Propofol-Remifentanil (PR) combinations and their effects on intraoperative hemodynamic andpostoperative recovery during 'oocyte pick up'(OPU). 45 patients undergoing OPU process divided into 3 groups. 0.3 mg $kg^-1$ Midazolam + 2 gr $kg^-1$ Fentanyl combination was administered to MF group, 3mg $kg^-1$ Propofol + 2 $mu$gr $kg^-1$ Fentanyl to PF group, and 3 mg $kg^-1$ Propofol + O.5 $mu$gr $kg^-1$ Remifentanil to PR group. Blood pressure, heart rate, peripheral oxygen saturation values were recorded preoperative af ter induction, at the beginning of OPU, and in every 5 minutes during process and 5-10-15-30 minutes after process. During process, if reguired; additional IV 0.05 mg Fentanyl or 0.25ugr Remifentanil doses administered and recorded. The recovery and sedation positions of the patients assessed by Aldrete Recovery Score and Ramsey Sedation Score after OPU at 5-10-15 and 30 minutes. For statistical analyse Independent Sample T Test and Post Hoc Scheffe Test were used. p values less than 0.05 was considered as significant. The demographic data, anesthesia and OPU durations, blood pressure, Sp02 values during ali measurements and additional drug needs during the process were ali similar between the groups. There was no significant difference between PF and PR groups according to sedation and recovery scores. The latest recovery and longest sedation duration was in group MF and it was significantly different from the other 2 groups (p<0.05). Propofol + Remifentanil induction provides quick recovery. Midazolam + Fentanyl induction provides late recovery but a more stable hemodynamics. For this reason, we think thatfor short-time processes MF can be a good alternative.

Keywords:

Propofol, Oocytes, Midazolam, Fentanyl, Drug Combinations,

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