Caner MİMAROĞLU, Cevdet DÜGER, Hasan ÖZAL, İclal KOL ÖZDEMİR, Sinan GÜRSOY, Kenan KAYGUSUZ, Hayati ÖZTÜRK

Alt ekstremite cerrahilerinde sürekli spinal ve kombine spinal-epidural anestezisinin karşılaştırılması

Amaç. Bu çalışmada alt ekstremite cerrahisi yapılacak olan hastalarda %0,5 bupivakain + morfinkombinasyonu kullanarak, sürekli spinal anestezi ve kombine spinal epidural anesteziyöntemlerinin peroperatif dönemde anestezi kalitesi, hemodinamik stabilite, blok seviyesi,komplikasyonlar ve postoperatif dönemde analjezi kalitesi üzerine olan etkilerinin karşılaştırılmasıamaçlandı. Yöntem. Çalışmaya ASA I-III grubu 54 hasta dahil edildi ve hastalar rastgele iki grubaayrıldı. I. Gruba; (n=27) spinal kateter intratekal aralıkta 2-3 cm sefale olacak şekilde yerleştirildive kateterden intratekal aralığa 10 mg (2 mL) %0,5lik bupivakain + 0,1 mg morfin / 2,5 mLvolümde uygulandı. II. Gruba; (n=27) kombine spinal-epidural anestezi için intratekal aralığa 5 mg%0,5 bupivakain + 0,05 mg morfin / 2,5 mL volümde uygulandı. Tüm hastaların sistolik vediastolik arter basınçları, kalp atım hızları, periferik oksijen saturasyon değerleri, bromage,duyusal blok seviyesi, vizüel analog skala, verbal point skala değerleri, memnuniyet, ek dozgereksinimi ve dozlar kaydedildi. Bulgular. Gruplar arasında demografik özellikler, yönteminuygulanma ve ameliyat süreleri yönünden fark saptanmadı. Hemodinamik parametreler, motor veduyusal blok seviyeleri ve hasta memnuniyeti yönünden fark görülmezken, total ilaç tüketimikombine spinal epidural anestezi grubunda daha yüksekti (P

Continuous spinal and combined spinal-epidural anesthesia in the lower extremity surgery

Aim. In this study, it was aimed to compare the effects of the continuous spinal anesthesia and thecombined spinal-epidural anesthesia by using 0.5 % bupivacaine + morphine on peroperativeanalgesia quality, hemodynamic stability, block level, complications and postoperative analgesiaquality in surgery of the lower extremity. Method. Fifty-four, ASA I-III patients included thestudy and divided into the two groups randomly. In the first group (n=27), a spinal catheter wasplaced into the intrathecal space and 10 mg 0.5 % bupivacaine + 0.1 mg morphine/2.5 mL wereadministered. In the second group (n=27), 5 mg 0.5% bupivacaine + 0.05 mg morphine/2.5 mLwere administered intrathecal space and 30 mg 0.5% bupivacaine + 2 mg morphine/10 mL wereadministered into the epidural space. The time of the both procedures, systolic blood pressure,diastolic blood pressure, heart rate, bromage, sensorial block level, visual analog scale, verbalpoint scale values, patient s satisfaction, additional dose necessity and overall doses were recordedfor all patients. Results. There was no significant difference between the groups in point ofapplication time of the method and operation time. While there was no difference between thegroups in point of hemodynamic parameters, level of motor block, level of the sensorial block andpatient s satisfaction, the drugs consumption was higher in the combined spinal epiduralanesthesia group (P

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