Ahmet TOPAL, Mehmet SARGIN, Tayfun ET, Sema Tuncer UZUN

Diyabetik Vakalarda Roküronyumun Nöromusküler Blok Özellikleri

Amaç: Diyabetik hastalarda motor sinir liflerinde fonksiyonel kayıplar ortaya çıkmakta ve bu durum anestezi yönetimini birçok yönden etkileyebilmektedir. Bu çalışmada roküronyumun nöromusküler blok etkilerinin non-diyabetik hastalara göre tip II diyabetli hastalarda farklı olup olmadığını araştırmayı amaçladık. Materyal ve Metod: 18 diyabetik ve 21 non-diyabetik hastanın, 0,6 mg kg-1 roküronyum uygulanmasından sonra nöromüsküler transport monitörü kullanılarak nöromusküler fonksiyonları değerlendirildi.Etki başlama süresi, klinik etki süresi, derlenme süresi, toplam roküronyum dozu, supramaksimal uyarı şiddeti ve Goldberg entübasyon skoru karşılaştırıldı. Bulgular: Etki başlama (118,33±41,61 sn. & 142,00±28,68 sn.) ve derlenme (13,33±9,83 dak. & 22,38±11,64 dak.) süreleri diyabetik hastalarda daha uzundu (p0,05). Sonuç: Diyabetik hastalarda etki başlama ve derlenme sürelerinde görülen uzamanın, diyabete bağlı gelişen nöropatik bir komplikasyon olduğunu ve roküronyumun farmakodinamiğinde diyabetin etkili olduğunu düşünmekteyiz.

Anahtar Kelimeler:

Nöromusküler blok, roküronyum, diyabet, genel anestezi.

Neuromuscular Characteristics of Rocuronium in Diabetic Patients

Purpose: In diabetic patients, there may be obsserved functional loss of motor nerve fibers and this fact may affect the management of anesthesia in many ways.In our study we aimed to research if there is any differences between non-diabetic patients and the patients who have type 2 diabetes on the side of nueromuscular blockade characteristics of rocuronium. Materials and method: 18 diabetic and 21 non-diabetic patients included to study, each patient evaluated by the NMT device after administiration of 0,6 mg/kg rocuronium intravenously.The onset of action time, clinical acting time , recovery time , total rocuronium dosage for each patient, amplitude of supramaximal excitation and Goldberg score were compared in the two groups. Results: Time of action (118,33±41,61 sn. & 142,00±28,68 sn.) and recovery time (13,33±9,83 dak. & 22,38±11,64 dak.) were longer than in diabetic patients (p0,05). Conclusion: We consider that the prolongation of onset of action time and recovery time in diabetic patients, is a complicaiton of diabetic neuropathy and diabetes may effect the pharmacodynamics of rocuronium.

Keywords:

neuromuscular block, rocuronium, diabetes, general anesthesia,

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Yazışma Adresi / Address for Correspondence: Dr. Mehmet Sargın Konya Eğitim ve Araştırma Hastanesi Anesteziyoloji ve Reanimasyon Kliniği KONYA E-mail: mehmet21sargin@yahoo.com G eliş tarihi/Received on : 28.05.2014
Kabul tarihi/Accepted on: 01.07.2014