Ayşegül CEYHAN, Selen TÜRKYILMAZ, Özcan Ayşe ONGUN, Kader ARSLAN, Mehmet ÖZEN, Bülent BALTACI

Comparison of the hemodynamic effects of sevoflurane and desflurane using a thoracic electrical bioimpedance monitor

Amaç: Genel anestezi sırasında kardiovasküler stabilitenin devam ettirilmesi, kalp hızı, kan basıncı, kardiak ritm ve bölgesel kan akımı üzerindeki zararlı etkilerden kaçınılması oldukça önemlidir. Çalışmamızda sevofluran ile desfluranın hemodinamik etkilerini torasik elektriksel biyoempedans yöntemi ile karşılaştırmayı amaçladık. Metod: Çalışmada 20-60 yaşları arasında ASA I-Il 40 hasta rastgele olarak 20'şer kişilik 2 gruba ayrıldı. İndüksiyon 7 mg/kg sodyum tiyopental ve 0,1 mg/kg vekuronyum bromid ve 1 fig/kg fentanil ile sağlandı. İdamede % 50 02 ve % 50 N20 ile sevofluran %2 veya desfluran %6 konsantrasyonlarda ile uygulandı. Hastalara 8 TEB elektrodu ve 5 EKG elektrodu takıldı. Bunlar Bernstein-Sramek eşitliğine göre düzenlenmiş NCCOM-3R7 (BOMED CO, ABD) TEB monitörüne bağlandı. Hastaların kalp hızı (KH), ortalama arter basıncı (OAB), kardiyak indeks ve hacim indeksi değerleri, indüksiyon öncesi (tl), entübasyondan 5 dakika sonra (t2), cerrahi insizyondan 5 dakika sonra (t3), takip eden 10. dakika. (14) ve 20. dakikada (t5) son olarak da ekstübasyondan 5 dakika (t6) sonra kaydedildi. Sonuçlar Student's t testi, Ki-kare testi ve Tekrarlı Ölçümlerde İki Yönlü Varyans Analizi yöntemleri ile değerlendirildi. Bulgular: Hasta özellikleri ve hemodinamik parametrelerin başlangıç değerleri bakımından istatistiksel bir farka rastlanmamıştır. KH değerlerinde her iki grupta da t4 ve t5'de başlangıca göre düşüş olmuştur (p

Sevofluran ve desfluranın hemodinamik etkilerinin torasik elektriksel biyoempedans yöntemi ile karşılaştırılması

Purpose: It is important to maintain cardiovascular stability and to avoid dangerous effects on the cardiovascular system during general anesthesia. Our aim is to compare the hemodynamic effects of sevoflurane and desflurane using a thoracic electrical bioimpedance (TEB) monitor. Methods: We randomized 40 patients, aged 20-60, ASA I-II group, into two groups. Anesthesia was induced with 7 mg/kg sodium thiopenthal, 1 /itg/kg fentanyl and 0.1 mg/kg vecuronium bromide. After intubation, 2% sevoflurane and 6% desflurane were given with 50% N2O and 02 to Group I (n=20) and Group II (n=20), respectively. Before anesthesia 8 TEB and 5 ECG (DII and V5) electrodes were placed and the patients were monitored using a NCCOM3-R 7 (BOMED CO, USA) TEB monitor, which was adjusted according to the Berstein-Sramek equality. The heart rate (HR), mean arterial pressure (MAP), cardiac index (CI) and stroke index (SI) of the patients were measured before induction (tl), 5 min after intubation (t2), 5 min after surgical incision (t3), on the 10th min (t4), on the 20th min (tS) and 5 min after extubation (t6). The results were evaluated by Student's t-test, chi-sq'uare test and repeated measure ANOVA. Results: Patients in the two groups did not differ in physical characteristics or the basal values of hemodynamic parameters. HR values were decreased significantly at times t4 and t5 in the two groups (p

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