Dilek UÇAK, Yasemin GÜNEŞ, Ebru BİRİCİK, Murat ILGINEL

Altmışbeş yaş üzeri hastalarda tek doz esmolol’ün desfluran ve sevofluran anestezisinde trakeal entübasyona yanıt ve bispektral indeks üzerine etkisi

Amaç: Bu prospektif ve randomize çalışma, elektif cerrahi geçirecek 65 yaş ve üzeri ASA II-III hastalarda, sevofluran ve desfluran anestezisinde tek doz uygulanacak esmololün hemodinamik değişiklikler, entübasyona bağlı Bispektral indeks (BIS) değişiklikleri ve derlenme üzerine etkilerini karşılaştırmayı amaçlamaktadır. Gereç ve Yöntem: 65 yaş üzeri ASA II-III elektif cerrahi geçirecek 80 hasta 4 gruba ayrıldı. Tüm hastalara standart monitörizasyon ve BIS monitörizasyonu uygulandıktan sonra Grup I deki hastalara sevofluran ve intravenöz(IV) salin, Grup II deki hastalara desfluran ve IV salin, Grup III deki hastalara sevofluran ve tek doz esmolol (1 mg kg-1), Grup IV deki hastalara desfluran ve tek doz esmolol (1 mg kg-1) uygulandı. Hastaların indüksiyon ajan uygulanması sonrası, esmolol uygulanması sonrası, kas gevşetici uygulanması sonrası, entübasyon esnasında, entübasyon sonrası oksijen saturasyonu, sistolik kan basıncı, diyastolik kan basıncı, kalp atım hızı ve bispektral indeks değerleri kaydedildi. Bulgular: Tek doz esmolol uygulamasının sevofluran ve desfluran anestezisinde endotrakeal entübasyona bağlı BIS değerlerindeki artışı engellediği görüldü. Gruplar karşılaştırıldığında esmolol uygulanan gruplarda ekstübasyon, göz açma ve derlenme süreleri daha kısa bulundu. Sonuç: İleri yaş grubu hastalarda desfluran ve sevofluran anestezisinde tek doz uygulanan esmolol trakeal entübasyona yanıt olarak gelişen sempatik deşarjı ve BİS değerlerindeki artışı baskılamaktadır.

Anahtar Kelimeler:

Esmolol, endotrakeal entübasyon, BIS

Effect of single dose of esmolol on response to endotracheal intubation and bispectral index during sevoflurane and desflurane anesthesia in patients over 65 years

Purpose: In this prospective, randomized study, we aimed to compare the effects of single dose of esmolol on haemodynamic, bispectral index (BIS) changes related to intubation and recovery at sevoflurane and desflurane anaesthesia in 65 years and older patients who scheduled for elective surgeryMaterial and Methods: Eighty ASA II-III patients who undergo elective surgery were divided 4 groups. After standart and Bispectral monitoring to all patients, the first group received sevoflurane and salin,e second group received desflurane and salin. The patients in Group III received sevoflurane and single dose of esmolol(1 mg kg-1) and group IV received desflurane and single dose of esmolol(1 mg kg-1). While given induction drugs, neuromuscular blockers, during intubation and at 30 second, first minute and 5. minutes of intubation, oxygen saturation, systolic and diastolic blood pressure, heart rate, BIS values were recorded. Results: Single dose of esmolol administration during sevoflurane and desflurane anaesthesia was found to inhibit the increase of BIS values due to endotracheal intubation. When the groups compared, extubation, eye-opening and recovery time were significantly shorter in the groups which applied esmolol. Conclusion: In elderly patients, single dose esmolol administration in desflurane and sevoflurane anesthesia significantly inhibits sympathetic decharge and BIS value increases due to tracheal intubation.

Keywords:

Esmolol, endotrakeal entübasyon, BIS,

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