Spinal Anestezi Uygulanan Hipertansiyon Tanısı Olan Hastalarda Kristaloid İnfüzyonuna Başlama Zamanının Kan Basıncı Üzerine Etkisi
Amaç: Çalışmamızda spinal anestezi uygulanan hipertansiyon tanısı olan hastalarda kristaloid infüzyonuna başlama zamanının kan basıncı üzerine etkilerini retrospektif olarak araştırdık. Yöntem: Spinal anestezi uygulanan, hipertansiyon tanısı olan toplam 54 hasta anestezi gözlem kayıtları incelenerek bolus kristaloid infüzyonunun spinal anestezi uygulanmasından önce ve sonra yapılmasına göre iki gruba ayrıldı. I. Gruba (n=27) spinal anestezi uygulanmasından önce ve II. Gruba (n=27) spinal anestezi uygulanmasından sonra 15 ml kg-1 intravenöz kristaloid infüzyonunun ortalama 20 dakikada verildiği görüldü. Hastaların demografik verileri, hemodinamik parametreleri, sensöriyel ve motor blok seviyeleri, uygulanan vazopressör tedavi ve yan etkiler kaydedildi. Sistolik kan basıncının bazal SKB değerine göre %20’den daha fazla düşmesi veya SKB’nin 90 mmHg’nin altına inmesi hipotansiyon olarak kabul edildi. Bulgular: Gruplar arasında demografik veriler ve ameliyat süreleri açısından fark saptanmadı. Hipotansiyon görülme oranı tüm hastalarda %77.9 (Grup I’de %88.9, Grup II’de %77.8) bulundu. Sonuç: Çalışmamızda spinal anestezi uygulanan ve hipertansiyon tanısı olan hastalarda, kristaloidlerin spinal anestezi uygulanmadan önce bolus olarak verilmesi ya da spinal anesteziden sonra verilmesi hipotansiyon oranları üzerinde benzer sonuçlar oluşturdu.
The Effect of Start Time of Crystaloid Infusion on Blood Pressure in Patients With Hypertension Who Underwent Spinal Anesthesia
Objective: In our study we retrospectively investigated the effect of starting time of crystaloid infusion on blood pressure in patients with the diagnosis of hypertension who underwent spinal anesthesia. Methods: A total of 54 patients with the diagnosis of hypertension who underwent spinal anesthesia were divided into two groups according to whether bolus crystaloid infusion was performed before or after spinal anesthesia by reviewing observation records of anesthesia. 15 ml kg-1 intravenous of crystaloid infusion was given within an average 20 minutes for Group I (n=27) before spinal anesthesia and for Group II (n=27) after spinal anesthesia. Demographic data, hemodynamic parameters, sensory and motor block levels, vasopressor drug administration and side effects of the patients were recorded. Decrease in systolic blood pressure (SBP) more than 20% compared to baseline SBP or SBP below 90 mmHg was considered hypotension. Results: No difference was detected between the groups in terms of demographic data and operation time. It was found that the incidence of hypotension was 77.9% in all patients (88.9% in Group I, 77.8% in Group II). Conclusion: In our study, in patients with diagnosis of hypertension who underwent spinal anesthesia administration of crystaloids as bolus prior to spinal anesthesia or after spinal anesthesia had similar results on rates of hypotension.
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