Çiğdem ÜNAL, Hülya BAŞAR, Çiğdem TOPKAYA, Türkay ÇAKAN, Yasemin FİDAN, Hatice YAĞMURDUR

Genel anestezi altında abdominal histerektomi yapılacak hastalarda fentanil ve sufentanilin hemodinamik ve endokrin yanıt üzerine etkileri

Amaç: Bu çalışmada, genel anestezi altında abdominal histerektomi yapılacak hastalarda fentanil ve sufentanilin hemodinamik ve endokrin yanıt üzerine etkilerinin araştırılması amaçlanmıştır. Yöntem: Çalışmaya ASA I-II grubundan toplam 40 hasta dahil edildi. Hastalar iki gruba ayrılarak indüksiyon için Fentanil Grubuna (n=20) 5 mg kg-1 tiyopental, 1.5 mg kg-1 fentanil ve 0.1 mg kg-1 veküronyum verilirken, Sufentanil Grubuna (n=20) fentanil yerine 0.3 mg kg-1 sufentanil uygulandı. Anestezi idamesi sevofluran ve %50 O2+N2O karışımı ile sağlandı. Hastalarda bispektral indeks (BİS) monitörizasyonu sağlanarak operasyon boyunca BİS değerlerini 50±5 düzeyinde tutacak şekilde 50 mg fentanil ya da 5 mg sufentanil ek dozları yapıldı. Kalp atım hızı (KAH) ve ortalama arter basıncı (OAB) takip edilen hastalardan üç kez kan örneği alınarak plazma glukoz, insülin, prolaktin ve kortizol seviyeleri tespit edildi. Bulgular: Her iki grupta da özellikle entübasyonun 10. dk.’sından itibaren OAB ve KAH değerleri kontrol ölçümlerine göre anlamlı olarak azaldı (p0.05). Her iki grupta da cerrahi insizyondan 30 dk. sonra alınan kanda glukoz ve prolaktin düzeyleri artarken, ekstübasyondan hemen sonra alınan kanda glukoz, prolaktin ve kortizol düzeylerindeki artma indüksiyon öncesine göre istatistiksel olarak anlamlı değerlendirildi (p

The effects of fentanyl and sufentanil on hemodynamic and endocrine responses to abdominal hysterectomy under general anesthesia

Objective: To investigate the effects of fentanyl and sufentanil on hemodynamic and endocrine responses in patients undergoing abdominal hysterectomy under general anesthesia. Method: Forty ASA I-II patients scheduled for abdominal hysterectomy were randomly allocated to receive either 5 mg kg-1 thiopental, 1.5 mg kg-1 fentanyl, and 0.1 mg kg-1 vecuronium or 0.3 mg kg-1 sufentanil and the same amounts of thiopental and vecuronium. The anesthesia was maintained with sevoflurane and a 50% O2+N2O mixture. The bispectral index (BIS) monitoring was performed and fentanyl (50 mg) or sufentanil (5 mg) supplements were added to keep BIS at the 50±5 level. Mean arterial pressure (MAP) and heart rate (HR) were recorded. Plasma concentrations of glucose, insulin, prolactin, and cortisol were measured three times in the blood. Results: MAP and HR were significantly decreased from the 10th min of intubation in both groups (p0.05). While plasma glucose and prolactin concentrations were increasing from baseline values 30 min after skin incision, plasma glucose, prolactin and cortisol levels were increased after extubation in both groups (p

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