Yasemin GÜNEŞ, Hakkı ÜNLÜGENÇ, Nurcan DORUK, Selim DEMİR, ABDULKADİR GEYLAN IŞIK

Rokuronyum ile oluşturulan nöromusküler blokta efedrinin etkisi

Çalışmamız indüksiyonda uygulanan tek doz, efedrinin rokuronyumun etki başlama, klinik etki süresi ve entübasyon kalitesi üzerine etkisini değerlendirmek amacıyla gerçekleştirildi. Çalışmaya, yaşları 19 - 65 arasında (ASA I-II) değişen 40 olgu alındı .Nöromusküler hastalık, kas gev-şeticilerle etkileşime girecek ilaç kullanımı ve kalp hastalığı öyküsü olanlar çalışma kapsamı dışında bırakıldı. Rutin monitorizasvon uygulanan olgularda anestezi indüksiyonu 2 mg.kg'1 propofol, idame ise sevofluran "c 2, %50 N20 ve 0, ile sağlandı, indüksiyonu takiben Grup l'e (n=22) 70 fig.kg'1 efedrin, Grup ll'ye (n~JH) 5 ml serum fizyolojik uygulandı. Maksımal eşik düzeyini saptamak amacıyla yanıtların stahiHzasyo-nıı için yaklaşık 5 dakika beklendikten sonra, 0.6 mg.kg4 rokuronyum uygulandı. Rokuronyumun uygulanmasından kas yanıtında % 95 depresyon sağlanana dek geçen süre (etki başlama süresi- EBS) ve rokuronyum uygulanmasından kas Yanıtında % 25 derlenmenin sağlandığı ana kadar geçen süre (etki siiresi-ES) kaydedildi. Olgularda indüksiyon öncesi ve sonrası, entübasyon sonrası henıodinamik değişiklikler i KAH, SAH, DAB'larıj ve SpO, kaydedildi. Grupların demografik özellikleri arasında bir farklılık saptanmadı. Efedrin uygulanan Grup Ede EBS 54.6+14 sn, Grup IE de 71.2+76 sn olarak bulundu (p

Anahtar Kelimeler:

Entübasyon, Efedrin, Propofol, Depresyon, Nöromüsküler blokaj

The effect of ephedrine on neuromuscular blockade with rocuronium

This study was performed to evaluate the effects of a single dose of ephedrine administered during induction on the onset time, clinical duration time of action and the intubation quality of rocuronium. After obtaining approval from the ethics committee, 40 patients between 19 to 65 years in ASA I or II satatus included in the study. Patients with neurumuscular and cardiovascular diseases or received medication that can interact with neuromuscular blocking agents were excluded. After the routine monitorisa-tion, anesthesia was induced by 2 mg.kg'1 propofol and maintaned by 2 % sevoflurane in SO % N20 and 02. Following the induction, 70 Ug.kgephedrine was administered to the Group I (n= 22), and 5 ml. of physiologic saline was given to the Group II (n=18). Rocuronium 0.6 mg.kg~' was administered in order to determine the maximum thereshold level. The time from the administration of rocuronium to reach 95% depression (onset time of rocuronium-OT) and 25% cure in the neuromuscular responses (clinical duration time of action- DT) were recorded. Changes in the hemodynamic parameters (SAP, DAP and HR) and SpO, values of the patients were also recorded. No differences were found in the demographic characteristics between the groups. OT values of the groups I and II were 54.6±14 and 71.2+16 seconds, respectively (p<0.05). DT values were found to be 44.3+15 and 35.3±11 minutes in the first and second groups, respectively . No differences were found in SAP, DAP, HR and SpO, values between the groups. In conclusion, the onset time of rocuronium could be shortened when used together with ephedrine and it can be a good alternative in patients requiring rapid intubation.

Keywords:

Intubation, Ephedrine, Propofol, Depression, Neuromuscular Blockade,

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