Alper KARARMAZ, Sedat KAYA, M. Ali ÖZYILMAZ, Selim TURHANOĞLU, Süleyman GANİDAĞLI, Nurettin BAYHAN

Tramadolün laringoskopi ve entübasyon sırasındaki hemodinamik yanıt üzerine etkisi

Yapılan çalışmalar tramadolün entübasyon sonrası oluşan hemodinamik yanıtı baskılamada yetersiz olduğu yönünde sonuç vermektedir. Tramadol'ün etki başlangıç süresini göz önüne alarak, çalışmamızda, indüksiyon öncesi farklı zamanlarda uygulandığında, laringoskopi ve entübasyonda hemodinamik yanıt etkinliğini araştırmayı planladık. Elektif cerrahi planlanan ASA I-II sınıfında 60 olgu çalışmaya alındı. Operasyon odasına alınan olguların kalp atım hızı (KAH), noninvazif sistolik ve diyastolik kan basınçları (SKB, DKB) monitörize edildi ve başlangıç değerleri ölçülerek kaydedildi. Grup I (n=20), Grup II (n=20) ve Grup II'e (n=20) sırasıyla anestezi indüksiyonundan 5, 10 ve 15 dakika önce tramadol 1.5 mg kg-1, serum fizyolojik ile 10 ml'ye tamamlanarak iv olarak 1 dakika içinde verildi. İndüksiyon öncesi ve sonrası ile entübasyondan sonra ilk on dakika, dakikada bir; KAH, SKB ve DKB değerleri ölçülerek kaydedildi. Entübasyondan sonra, Grup I'de KAH birinci dakikada, SKB ve DKB birinci ve ikinci dakikalarda başlangıç değerine göre anlamlı olarak yüksekti (P

Anahtar Kelimeler:

Laringoskopi, Tramadol, Anestezi, Entübasyon, intratrakeal

The effect of tramadol on the haemodynamic response to laryngoscopy and intubation

Previous studies have showed that tramadol is not sufficient on blunting the haemodynamic response to the intubation. By considering onset time of tramadol, this study was designed to examine efficacy of tramadol used with different timing on reducing the haemodynamic response to the laryngoscopy and intubation. Sixty ASA I-II class patients, scheduled for elective surgery enrolled for this study. Heart rate (HR), non-invasive systolic and diastolic blood pressures (SBP, DBF) were monitored in the operation room and the initial values were recorded. Tramadol 1.5 mg kg<sup>-1</sup> completed to 10 ml with saline was administered via iv route in one minute to Groups I (n=20), II (n=20) and III (n=20) respectively 5, 10 and 15 minutes before induction. The values of HR, SBP and DBF were recorded before and after induction and the intervals as one minute for up to 10 minutes following intubation. In the patients of Group I, HR at first minute and SBP and DBF at first and second minutes after intubation were found significantly higher according to initial values (p<0.05). In the patients of Groups II and III, there were no significant increases in the HR, SBP and DBF values after intubation (p>0.05). We concluded that tramadol 1.5 mg kg<sup>-1</sup> given at least 10 minutes before induction can be sufficient to reduce the haemodynamic response to laryngoscopy and intubation.

Keywords:

Laryngoscopy, Tramadol, Anesthesia, Intubation, Intratracheal,

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