Reyhan POLAT, Gözde BUMİN AYDIN, Meltem AKTAY İNAL, Jülide Ergil, Çiğdem Topçu Gülöksüz, İlkay Baran

Düşük doz seyreltilmiş bupivakain ile fentanil yoğunluğunun transüretral prostatektomi için uygulanan spinal blok süresi ve kalitesi üzerine etkisi

Amaç: Bu prospektif randomize kontrollü çalışmada, yaşlı hastalarda düşük doz, dilue bupivakain ile fentanilin yoğunluğunun transüretral prostatektomi (TURP) için uygulanan spinal blok süresini ve kalitesini etkileyip etkilemediğini araştırdık.Gereç ve Yöntem: Transüretral prostat rezeksiyonunu planlanan 60 hasta randomize olarak iki gruba ayrıldı. Grup H (n=30): Fentanil 20 mcg + hiperbarik bupivakain % 0.5 (1.5 ml) + normal salin 1.1 ml . Group I (n=30): Fentanil 20 mcg + plain bupivacain % 0.5 (1.5 ml) + normal salin 1.1 ml. Toplam %0.25 bupivakain (3 ml) intratekal uygulandı. Duyusal bloğun başlama zamanı ve blok süresi, motor bloğun derecesi, perioperatif anestezi kalitesi, yan etkiler ve analjezik gerekmeyen süre değerlendirildi.Bulgular: Pik duyusal blok seviyesi Grup H' de, Grup I' ye göre anlamlı derecede yüksekti. İlk analjezik gerekme zamanı Grup H' de daha uzun idi. Motor blok derecesi, anestezi kalitesi veya yan etkiler açısından gruplar arasında fark yoktu.Sonuç: Düşük doz dilue hiperbarik bupivakain ve fentanil birlikteliği, yaşlı hastalarda TURP için hemodinamik instabiliteye sebep olmadan ve derlenme süresini uzatmadan yeterli anestezi ve postoperatif analjezi sağlar.

Anahtar Kelimeler:

bupivacaine

Effect of baricity of low dose diluted bupivacaine with fentanyl on the duration and quality of spinal block in transurethral prostatectomy

Purpose: In this prospective randomized controlled trial, we investigated whether density of low dose diluted bupivacaine with fentanyl effects the duration and quality of the spinal block for transurethral prostatectomy (TURP) in elderly patients.Materials and Methods: Sixty patients requiring elective TURP were randomly allocated into two groups. Group H (n=30) received fentanyl 20 mcg+hyperbaric bupivacaine 0.5% (1.5 ml)+ saline 1.1 ml. Group I (n=30) received fentanyl 20 mcg+plain bupivacaine 0.5% (1.5 ml)+ saline 1.1 ml in total, bupivacaine 0.25% (3 ml) intrathecally. Onset, duration of the sensory block, the degree of motor block, perioperative anesthesia quality, side-effects, analgesic-free period were assessed.Results: The median peak level of the sensory block was significantly higher in Group H than in Group I. The time to the first analgesic request was longer in Group H). There were no differences between the groups for degree of the motor block, quality of anaesthesia, or adverse effects.Conclusion: Low-dose diluted hyperbaric bupivacaine with fentanyl provides adequate anaesthesia, postoperative analgesia without haemodynamic instability or prolonging the recovery time for TURP in elderly patients.

Keywords:

anaesthetic solutions, density; anaesthetic technique, intrathecal; anaesthetic local bupivacaine,

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