Alaadtin ULUÇ, HATİCE AYSEL ALTAN, Emine ÖZYUVACI, Serpil ERTÜRK, Ayşen HELVACI

Transüretral rezeksiyon operasyonlarında farklı anestezi uygulamalarının miyokard iskemisine etkileri ve iskeminin tanınmasında troponin-T testinin rolü

Yaşlı erkek populasyonuna uygulanan transüretral rezeksiyon (TUR) operasyonlarından sonra kardiyak komplikasyonlarda artış olduğu bilinmektedir. Çalışmamızda; genel anestezi, spinal anestezi, epidural anestezi ile yapılan TUR operasyonlarında, oluşan ya da var olan miyokard hasarını erken dönemde belirlemeyi amaçladık. ASA I-II sınıfında, toplam 45 olgu rastgele üç gruba ayrılarak, genel anestezi, spinal anestezi ve epidural anestezi uygulandı. Olguların hepsine preoperatif dönemde EKG çekilip, miyokarda özgü kreatin kinaz (CK-MB), kreatinin fosfokinaz (CPK), Troponin-T (Tn-T) düzeylerine bakıldı. İntraoperatif hemodinamik parametreler, 5., 10., 15., 20., 30., 40., 60. dakikalarda kaydedildi. Postoperatif dönemde aynı testler tekrar edildi. Tüm olgularda postoperatif CK-MB, CPK değerleri preoperatif kontrol değerine göre anlamlı olarak yüksek bulundu (p

Anahtar Kelimeler:

Anestezi, spinal, Troponin T, Transüretral prostat rezeksiyonu, Anestezi, epidural

Troponin-T as a marker for myocardial ischemia in patients undergoing different anesthesia techniques for transurethral resection

it is well known that cardiac complications are more frequently encountered in elderly patient population after transurethral resection of prostate (TUR-P). The aim ofthe study was to assess the early recognition of myocardial injury in patients, scheduledfor TUR operations under general, spinal or epidural anesthesia. ASA I-II, 45 cases were randomly divided into 3 groups to receive either general anesthesia, spinal anesthesia or epidural anesthesia. Preoperative ECG, Creatinin kinaze muscle and brain (CK-MB), creatinin phosphokinaze(CPK) and Troponin-T (Tn-T) levels were evaluated in ali patients. Intraoperative hemodynamic parameters were recorded at the Sth, l0th, 15th, 20th, 30th, 40th, and 60th minutes. Same laboratory tests were repeated in the postoperative period. For all cases, there was a signiflcant increase in the postoperative CK-MB, CPK values when compared with the preoperative control values (p<0.05). Clinicalfindings ofischemia were detected only in two cases. Positive Tn-T test results were positive in 9 cases in the general anesthesia group, in 9 of spinal anesthesia and in only öne case in the epidural anesthesia group. We concluded that epidural anesthesia is superior than general or spinal anesthesia in TUR-P operations when myocardial protective effect is considered.

Keywords:

Anesthesia, Spinal, Troponin T, Transurethral Resection of Prostate, Anesthesia, Epidural,

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