Ambulatuar kısa süreli jinekolojik girişimlerde opioid ajan seçimi
Çalışmaya 18-65 yaş arası, maske anestezisi altında uterus küretajı uygulanacak, ASA l-ll, 105 hasta dahil edildi. Hastalar randomize 3 gruba ayrıldı. Grup R (n=35) remifentanil 1 ug/kg, Grup A (n=35) alfentanil 10 ug/kg ve Grup F (n=35) fentaniM 1ug/kg uygulanmasını takiben bolus 2 mg/kg propofol IV verildi.Hemodinamik parametreler, spontan solunumun başlaması, girişimin bitiminden sonra sözlü uyarıya verbal cevap zamanı, postoperatif üniteye çıkarılma zamanı, yan etkiler ve girişim sonunda kullanılan toplam propofol miktarı, postoperatif derlenme skoru (Aldrete) ve anestezi sonrası taburcu etme skorlama sistemi (PADSS) skorları üç grup arasında karşılaştırıldı. Hemodinamik veriler karşılaştırıldığında bazal değerler arasında fark yok iken indüksiyon sonrası 1, 3 ve 5.dk.'larda grup remifentanil'de sistolik ve diastolik arter basınçları (SAB, DAB), kalp atım hızı (KAH), SpO2 değerlerinde düşme saptandı ve fark istatistiksel plarak anlamlı bulundu (p
The selection of opioid agent in short duration ambulatory gynecologic operations
The study has been performed on 105 patients in ASA l-ll, 18-65 years old, who underwent curettage operation under face mask anesthesia. The patients wege randomized into three groups; group R (n=35) remifentanil 1 fig/kg, group A (n=35) alfentanil 10 jug/kg, group F (n=35) fentanyl 1 jug/kg followed by 2 mg/kg propofol IV bolus. Hemodynamic parameters, spontaneous recovery of respiration, verbai response time following the completion of the procedure, the duration from operation room to postoperative recovery room, side effects and total dose of propofol, postoperative recovery score (Aldrete), discard score following the anesthesia (PADSS) were compared between three groups.No difference was found between hemodynamic parameters at the beginning, however systolic and diastolic blood pressures, heart rate, SpO2 levels significantly dropped 1, 3, 5 minutes after induction in group R (p<0.05). Spontaneous recovery of respiration was significantly shorter at group R compared to group F (p<0.05). The time keeping Aldrete score >9 and total dose of propofol were the lowest at group R and this was significant compared to other groups (p<0.05). Side effects and PADSS scores did not show any difference between groups.
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