Spinal anestezide profilaktik prehidrasyon ve efedrin uygulamalarının hemodinamik parametreler ile QT intervali üzerine etkilerinin karşılaştırılması

Amaç: Spinal anesteziye bağlı hipotansiyonu önlemede intravenöz efedrin uygulaması ile kolloid prehidrasyonunun hemodinamik parametreler ve QTc intervaline etkilerini karşılaştırmayı amaçladık. Yöntem: Etik komite izni alınan, artroskopik diz cerrahisi uygulanacak ASA I-II, 60 olgu randomize olarak 2 gruba ayrıldı. Olguların anestezi öncesi ve sonrası kan basınçları, kalp atım hızı, EKG kaydı alınarak QTc intervalleri kaydedildi. Grup K'ya spinal anestezi öncesi 500 mL %6 HES ile prehidrasyon; Grup E'ye spinal anestezi sonrası 15 mg iv efedrin uygulandı. Hipotansiyon, 5 mg iv efedrin ile tedavi edildi. Bulgular: Spinal anestezi sonrası kan basıncı, kalp hızları ve hipotansiyon sıklığı gruplarda benzer seyretti (p>0.05). QTc intervali spinal anestezi sonrası her iki grupta da uzamakla beraber (p0.05). İntraoperatif ve postoperatif verilen sıvı miktarları her iki grupta da benzer (p>0.05) olmasına rağmen ilk miksiyon zamanı Grup K'da Grup E'den daha erken izlendi (p

Comparison of the effects of prophylactic prehydration or ephedrine administration for spinal anesthesia on hemodynamic parameters and QT interval

Objective: To prevent spinal anesthesia induced hypotension, the effects of intravenous ephedrine and colloid prehydration on the hemodynamic parameters and QTc interval were compared. Method: After ethic committee approval, ASA I-II, 60 patients scheduled for arthroscopic knee surgery were randomly allocated into two groups. Before and after the anesthesia, blood pressures and heart rates were recorded. ECG recordings were used to measure the QTc intervals. In Group K, prehydration was performed with 500 mL 6% HES before spinal anesthesia. In Group E, ephedrin 15 mg iv was administered after spinal anesthesia. Five mg bolus ephendine was applied in case of hypotension. Results: The blood pressures, heart rates and hypotension incidence were similar among the groups (p>0.05). QTc intervals of both groups were extended after the spinal anesthesia (p<0.001), but the differences were not significant among the groups (p>0.05). Although intraoperative and postoperative intravenous fluid was similar in both groups (p>0.05), the first voiding time was earlier in Group K than Group E (p<0.01). Conclusion: The effects of prehydration with colloid and intravenous ephedrine for spinal anesthesia-induced hypotension have similar effect on hemodynamic parameters and QTc interval. Both methods could be performed depending on the patient's clinic and preference of the anesthesiologist.

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