Aslı YILDIRIM, Hülya GÖKSU, Çağlar Gonca TOPRAK, Rıfat KILIÇ, Mehmet Akif YAŞAR

İzofluran, desfluran ve sevofluran ile uygulanan düşük akımlı anestezinin, anestezi kalitesi ve güvenilirliğinin karşılaştırılması

Amaç: Düşük akımlı anestezi ekspirasyon havasının yeniden kullanımını artırmayı amaçlayan bir yöntemdir. Bu çalışmada düşük akımlı anestezide, izofluran, sevofluran, desfluran güvenlik ve anestezi kalitesi açısından karşılaştırıldı. Gereç ve Yöntem: Etik kurul ve hasta onayıyla, 20-50 yaşlarında, ASA I-II, 60 hasta çalışmaya alındı. Hastalar randomize olarak 3 gruba (n=20) ayrıldılar. Anestezi idamesinde %50 O2, %50 hava içinde; izofluran grubuna (Grup İ) %1.5 izofluran, sevofluran grubuna (Grup S) %2 sevofluran, desfluran grubuna (Grup D) %5 desfluran, uygulandı. Anestezi süresince hemodinamik, solunumsal parametreler izlendi, kan gazı örnekleri alındı. Kanda üre, kreatinin, serum glutamik okzaloasetik transferaz, serum glutamik pürivik transferaz, laktat dehidrogenaz, gama glutamil transpeptitaz, kreatin kinaz myokard bandı, troponin, idrarda üre ve kreatinin ölçüldü. Uyanma, derlenme kalitesi değerlendirildi.Veriler, Kruskal- Wallis, chisquare ve ANOVA testleri ile değerlendirildi. p

Anahtar Kelimeler:

Anestezi, İzofluran

The safety and quality of low flow anaesthesia with isoflurane, sevoflurane and desflurane

Objectives:Low flow anaesthesia is a method for reusing the expiration air. In this study we compare the anaesthesia quality and security at isoflurane, sevoflurane, desflurane in low flow anaesthesia. Materials and Methods: Ethical commity approval, ASA I-II group, 20-50 years old, 60 patients included into the study. The patients were randommily divided into 3 groups. 50 % O2 in 50 % air used for maintainance of anaesthesia, patients received 1,5 % isoflurane , 2 % sevoflurane, 5 % desflurane. Urea, creatinin, SGOT, SGPT, GGT, CK-MB, troponin blood samples obtained also both urine urea, creatinin measured. We examine the quality of awakening, recovery.Kruskal-Wallis, chi-square, ANOVA tests are used for the stastistical analysis. Results:The inspired O2 values decreased statistically significant at 7th period. The expired O2 values at sevoflurane group were statistically significant lower than control group at 8th,9th period.The inspired CO2 values at all three groups decreased statistically significant compared to control group.The expired CO2 values decreased CO2 values decreased statistically meaning fally at 6,8 and 9th periods at isoflurane group, when compared with 1th period, at 7,8 and 9 th periods at sevoflurane group , desflurane group.PaCO2 values at 1 th period were increased statistically significant at 6,8 and 9th periods in isoflurane and at 7,8 and 9th periods in both sevoflurane, desflurane groups. Conclusion: The low flow anaesthesia by all agents were secure. Three were no differences between the groups at lowering flows, however patients at desflurane group awaked , recovery earlier than other groups.

Keywords:

Anesthesia, Isoflurane,

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