Onur AVCI, S YILDIRIM, F OZKAN, U ERKORKMAZ

The effects of sevoflurane and propofol on acoustic rhinometric measurements

Amaç: Bu çalışmanın amacı, akustik rinometri (AR) yardımıyla kontrollü hipotansiyon sağlamak için kullanılan iki anestezik ajanın nazal mukozal vazodilatasyon üzerine etkilerini karşılaştırmaktı. Yöntem: Bu bir prospektif randomize klinik çalışmadır. 50 hasta propofol (Grup P; n=25) ve sevofluran (Grup S; n=25) grupları olmak üzere iki gruba rastgele dağıtıldı. Anestezi indüksiyonu sırasında, Grup P propofol(2 mg kg-1 IV)veGrup S minimal alveolar konsantrasyonu %6-8 olarak sevofluran aldı. Anestezi idamesi GrupP'de propofol(4 mg kg h-1)ile ve GrupS'de %2 sevofluran ile sağlandı. Her iki gruba da 0.025 µg kg min-1dozunda remifentanil analjeziği verildi. Hastalara nazal akustik rinometri (AR) ölçümleri yapıldı. Anestezik dozları, ortalama kan basıncı baz değerlerinin %20-25'i olacak şekilde ayarlandı. Bulgular: Her iki grupta da hem preoperative süre boyunca hem de anestezi indüksiyonundan 30 dakika sonra, supin pozisyondaki hastalardan alınan AR ve nazal minimal çapraz kesit alanı (MCA) ölçümleri arasında anlamlı bir fark vardı. Ancak anestezi indüksiyonundan sonra MCA1 ve MCA2 de her iki grup için anlamlı bir azalma gözlendi. Ek olarak, anestezi indüksiyonundan önce ve sonra alınan ölçümler arasındaki fark, sevofluran grubunda propofol grubuna göre daha büyüktü. Sonuç: Sevofluran kullanarak indüklenen kontrollü hipotansiyon, propofol ile uygulanan anesteziye göre daha yüksek derecede vazodilatasyona sebep olabilir

Sevofluran ve propofolün akustik rinometrik ölçümler üzerine etkisi

Objective: The aim of the study was to compare nasal mucosal vasodilation induced by two different anesthetic used to provide controlled hypotension with the aid of acoustic rhinometry (AR). Method: This study is prospective randomized clinical study. Fifty patients were randomized into propofol (Group P; n=25) and sevoflurane (Group S; n=25) groups. During anesthesia induction, Group P received propofol (2 mg kg-1 IV) and Group S was administered sevoflurane at a minimal alveolar concentration of 6-8%. Anesthesia was maintained with propofol (4 mg kg h-1) in Group P and 2% sevoflurane in Group S. Both groups received the analgesic remifentanil at a dose of 0.025 µg kg min-1. Patients were performed nasal acoustic rhinometry (AR) measurements. Anesthetic doses were adjusted so as to ensure intraoperative hypotension by maintaining mean arterial pressure at 20-25% lower than the baseline value. Results: In both groups, a significant difference was detected between AR and nasal minimal cross-sectional areas (MCA) measurements taken from the patients in the supine position, both during the preoperative period and at 30 minutes after the induction of anesthesia, but a meaningful decrease in MCA1 and MCA2 values after the induction of anesthesia was observed for both groups. In addition, differences in measurements taken before and after the induction of anesthesia were greater in amplitude for the sevoflurane group versus the propofol group. Conclusions: Controlled hypotension induced using sevoflurane anesthesia might result in higher degrees of vasodilation relative to propofol anesthesia

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