Şeref OTELCİOĞLU, Hale BORAZAN, Işıl DAVARCI, Ahmet KEÇECİOĞLU

The effects of low dose levobupivacaine with or without sufentanil intrathecally in transurethral resection of prostate

Amaç: Bu çalışmada TURP cerrahisi geçirecek yaşlı hastalarda levobupivakain ile levobupivakain ile sufentanil kombinasyonunun klinik etkinliğinin karşılaştırılmasını amaçladık. Metod: 90 hasta rastgele 2 gruba ayrılarak spinal anestezi için bir gruba 10 mg levobupivakain (Grup L), diğer gruba 7.5 mg levobupivakain ile 2.5 μg sufentanil (Grup LS) verildi. dermatom seviyesi, maksimum duyusal blok düzeyi, duyusal bloğun T10'a ulaşma zamanı, duyusal ve motor blok süresi, cerrahi sonunda Bromage skoru, 2 segment gerileme zamanı ve yan etkiler kaydedildi. Bulgular: Gruplar arasında demografik ve hemodinamik veriler ile duyusal bloğun T10'a ulaşma ve 2 segment gerileme zamanı açısından anlamlı fark bulunmadı. cerrahi sonunda Bromage skoru ve maksimum motor blok oluşan hasta sayısı Grup L'de yüksekti (p

Transütretral prostat rezeksiyon cerrahisinde sufentanil ile beraber veya tek olarak düşük doz levobupivakainin etkisi

Aim: We aimed to compare the clinical efficacy of levobupivacaine alone and levobupivacaine/sufentanil combination in spinal anesthesia for transurethral resection of the prostate (TURP) in elderly patients. Method: Ninety patients were randomly assigned into two groups to receive either levobupivacaine 10 mg (Group L) or levobupivacaine 7.5 mg combined with 2.5 μg sufentanil (Group LS) for spinal anesthesia. The dermatome level and upper level of sensory blockade, time to develop a sensory block to T10, duration of sensory and motor blockade, Bromage score at the end of surgery, two- segment sensory regression time, and side effects were recorded. The quality of anesthesia was evaluated and rated after the surgery. Result: There were no significant differences between groups in demographic data or hemodynamic variables in terms of sensory blockade, onset time of sensory blockade to T10 dermatome, and two-segment regression. Bromage score at the end of surgery was significantly higher in Group L (p

PDF

___

1. Critchley LAH. Hypotension, subarachnoid block and the elderly patient. Anesthesia 1996;51:1139-43.
2. Carpenter RL, Caplan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology 1992;76:906-16.
3. Glaser C, Marhofer P, Zimpfer G, et al. Levobupivacaine versus racemic bupivacaine for spinal anesthesia. Anesth Analg 2002;94:194-8.
4. Bardsley H, Gristwood R, Baker H, Watson N, Nimmo W. A comparison of the cardiovascular effects of levobupivacaine and rac-bupivacaine following intravenous administration to healthy volunteers. Br J Clin Pharmacol 1998;46:245-9.
5. Lee YY, Muchhal K, Chan CK, Cheung AS. Levobupivacaine and fentanyl for spinal anesthesia: a randomized trial. Eur J Anaesthesiol 2005;22:899-903.
6. Ben-David B, Solomon E, Levin H, Admoni H, Goldzik Z. Intrathecal fentanyl with small-dose dilute bupivacaine: better anesthesia without prolonging recovery. Anesth Analg 1997;85:560-5.
7. Marandola M, Antonucci A, Tellan G, et al. Subarachnoid sufentanil as sole agent vs standard spinal bupivacaine in transurethral resection of bladder. Minerva Anestesiol 2005;71:83-91.
8. Kuusniemi KS, Pihlajamaki KK, Pitkanen MT, Helenius HY, Kirvela OA. The use of bupivacaine and fentanyl for spinal anesthesia for urologic surgery. Anesth Analg 2000;91:1452-6.
9. Burke D, Kennedy S, Bannister J. Spinal anesthesia with 0.5% S(-)-bupivacaine for elective lower limb surgery. Reg Anesth Pain Med 1999;24:519-23.
10. Favarel-Garrigues JF, Sztark F, Petitjean ME, Thicoipe M, Lassie P, Dabadie P. Hemodynamic effects of spinal anesthesia in elderly: single dose versus titration through a catheter. Anesth Analg 1996;82:312-6.
11. Olofsson C, Nygárds EB, Bjersten AB, Hessling A. Low-dose bupivacaine with sufentanil prevents hypotension after spinal anesthesia for hip repair in elderly patients. Acta Anaesthesiol Scand 2004;48:1240-4.
12. Karaman S, Kocabas S, Uyar M, Hayzaran S, Firat V. The effects of sufentanil or morphine added to hyperbaric bupivacaine in spinal anesthesia for Caesarean section. Eur J Anaesth 2005;23:285-91.
13. Hansdottir V, Hedner T, Woestenborghs R, Nordberg G. The CSF and plasma pharmacokinetics of sufentanil after intrathecal administration. Anesthesiology 1991;74:264-9.
14. Gupta A, Axelsson K, Thörn SE, et al. Low dose bupivacaine plus fentanyl for spinal anesthesia during ambulatory inguinal herniorrhaphy: a comparison between 6 mg and 7.5 mg bupivacaine. Acta Anaesthesiol Scand 2003;47:13-9.
15. Braga AF, Braga FS, Poterio GM, Pereira RI, Reis E, Cremonesi E. Sufentanil added to hyperbaric bupivacaine for subarachnoid block in Caesarean section. Eur J Anaesth 2003;20:631-5.
16. Dahlgren G, Hultstrand C, Jakobsson J, Norman M, Eriksson EW, Martin H. Intrathecal sufentanil, fentanyl or placebo added to bupivacaine for cesarean section. Anesth Analg 1997;85:1288-93.
17. Ferouz F, Norris MC, Leighton BL. Risk of respiratory arrest after intrathecal sufentanil. Anesth Analg 1997;5:1088-90.
18. Katsiris S, Williams S, Leighton BL, Halpern S. Respiratory arrest following intrathecal injection of sufentanil and bupivacaine in a parturient. Can J Anaesth 1998;45:880-3.
19. Callicot R, Jones R, Herman N. Determination of a dose response curve for intrathecal sufentanil in labor. Anesthesiology 1994;81:A1148.