Spinal anestezi öncesi uygulanan gelofusine infüzyonunun hipotansiyon ve koagülasyon üzerine etkileri

Spinal anesteziye bağlı en önemli komplikasyon olan hipotansiyon, hemodinamisi uygun olmayan ve/veya yaşlı hastalarda ciddi sorunlar oluşturmaktadır. Çalışmamızda spinal blok sonrasında gelişebilecek hipotansiyonu profilaktik olarak önlemek amacıyla farklı dozlarda Gelofusine infüzyonu uyguladık. Bu amaçla alt extremitede ortopedik girişim planlanan ASA 1 grubuna dahil 45 hasta randomize olarak 3 gruba ayrıldı. Grup-I’e 5ml/kg, grup-II’ye 10ml/kg grup-III’e ise 15ml/kg miktarlarında 15 dk içerisinde Gelofusine . infüzyonu uygulandı. Spinal Blok sonrası peroperatif olarak her gruptan sadece birer hastada efedrin ile müdahale gerektirecek hipotansiyon gelişti. Jelatin (Gelofusine .) infüzyonu, olguların hiçbirinde trombosit sayısında anlamlı düşme ve kanama bozukluğu oluşturmadı” Sonuç olarak spinal sonrası gelişebilecek hipotansiyonu önlemede 5 ml/kg Gelofusine . infüzyonunun yeterli olduğu ve 15ml/kg miktarına kadarının kanama bozukluğu yaratmadan hipotansiyon gelişimini başarı ile önlediği kanaatine vardık.

Anahtar Kelimeler:

Anestezi, spinal, Jelatin, Polijelin, Hipotansiyon

Effects of gelofusine infusion applied before spinal anaesthesia on hypotension and coagulation

Hypotension is one of the most important complications of spinal anaesthesia. Hypotension may cause catastrophic side effects in hemodynamically unstable and/or old patients. Gelofusine has been used widely for many years for volume replacement therapies. But, it has disadvantages such as coagulopathy or trombositopenia. The aim of this study was to compare three different doses of gelofusine applied prophylactically before spinal anaesthesia for prevention of hypotension induced by spinal anaesthesia. The study was implemented 45 American Society of Anaesthesiologist physical status I-II orthopaedic patients. Fourty-five patients were allocated randomly into three groups. Gelofusine 5,10,15 mg/kg were infused intravenously in15 minutes in Group I,II and III respectively. Hypotension was observed in one patient for each group, which were treated with efedrin. Gelofusine prevented hypotension successfully in all three doses. Moreover, even the dose of 15mg/kg cause neither coagulopathy nor trombositopenia. We concluded that 5 mg/kg gelofusine is enough to avoid hypotension. Infusion of gelofusine in up to15 mg/kg was found to be safe for spinal anaesthesia; it does not have such side effect as coagulopathy or trombositopenia this doses.

Keywords:

Anesthesia, Spinal, Gelatin, Polygeline, Hypotension,

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