Nurten ÜNAL, Türkay ÇAKAN, Meltem Bababalım BEKTAŞ, Bülent BALTACI, Alp ALPTEKİN

DOĞUMUN İKİNCİ EVRESİNDE EPİDURAL ANALJEZİDE BUPİVAKAİN İLE BUPİVAKAİN VE FENTANİL KOMBİNASYONUNUN KARŞILAŞTIRILMASI

AMAÇ: Doğumun 2. evresinde epidural yolla uygulanan düşükkonsantrasyondaki bupivakain ve fentanil kombinasyonu ile dahayüksek konsantrasyondaki bupivakaini, analjezi kalitesi, bu evreninsüresi ve seyri, çıkımda enstrümantasyon gereksinimi, hemodinamikparametreler ile maternal ve neonatal yan etkiler bakımındankarşılaştırmayı amaçladık.GEREÇ VE YÖNTEM: Doğum eylemi başlamış ve ağrı kontrolüplanlanan 40 gebe rastgele 2 gruba ayrıldı. Epidural kateterizasyonutakiben doğumun 1. evresinde her 2 gruba 3 ml % 0.5 bupivakain ve 1ml fentanil (50 mcg), 8 ml % 0.9’luk NaCl ile 12 ml’ye tamamlanarakverildi. Doğumun 2. evresinde ise 1.gruba (n=20) 4 ml % 0,5bupivakain ve 4 ml %0.9’luk NaCl (toplam 8 ml), 2.gruba (n=20) ise3 ml % 0.5 bupivakain, 1 ml fentanil (50 mcg), 8 ml % 0.9’luk NaClkombinasyonundan 8 ml verildi. Çalışma süresince maternal sistolikve diastolik kan basınçları, kalp atım hızı ve fötal kalp atım hızlarıizlendi. Ağrı ve analjezinin etkinliği VAS ve “pin-prick” yöntemleri iledeğerlendirildi, maternal ve neonatal yan etkiler kaydedildi.BULGULAR: Birinci grupta analjezi başlama süresi anlamlı olarakuzun (p

COMPARISON OF BUPIVACAINE AND BUPIVACAINE PLUS FENTANYL COMBINATION USED IN EPIDURAL ANALGESIA IN THE SECOND STAGE OF LABOUR

INTRODUCTION: We aimed to compare the analgesic quality, progress and duration of second stage of labor, need for instrumental delivery, hemodynamic parameters, maternal and fetal side effects of lower concentration of bupivacaine plus fentanyl combination with a higher concentration of bupivacaine used via epidural route in second stage of labor. MATERIAL AND METHOD: Fourty parturient, in whom labour analgesia was planned, were randomized into 2 groups. After placement of epidural catheter, 3 ml of 0.5% bupivacaine plus 1 ml fentanyl (50 mcg) with 8 ml of 0.9 % NaCl were given to all patients in both groups in the first stage of labor. In the second stage of labor, 4 ml 0.5% bupivacaine plus 4 ml 0.9 % NaCl were given to the patients in the first group (n=20), while 8 ml of combination of 3 ml of 0.5% bupivacaine plus 1 ml fentanyl (50 mcg) with 8 ml of 0.9 % NaCl were administered to the patients in the second group. During the study, maternal systolic and diastolic blood pressures, heart rates and fetal heart rates were monitored. Pain and effectiveness of analgesia were assessed by VAS and pin-prick test and maternal and neonatal side effects were recorded. Results: In the first group, the onset time of analgesia was significantly (p0.05). Rescue analgesic for episiotomy repair in the second stage of labour was significantly higher in the first group (p

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