Pakize KIRDEMİR, Sinem SARI, Sadık ÖZMEN, Dilek KARAASLAN, Özlem ÖZORAK, Tuncer Tülay PEKER

Comparing analgesic and hemodynamic effects of unilateral spinal levobupivacaine, levobupivacaine-fentanyl and levobupivacaine-morphine combinations for arthroscopic procedures

Amaç: Artroskopik diz cerrahisi uygulanacak hastalara ünilateral spinal anestezide levobupivakain, levobupivakain-fentanyl, levobupivakain-morfinin analjezik ve hemodinamik etkinliğinin karşılaştırılmasını amaçladık.Yöntem: ASA I-II 44 olgu çalışmaya dahil edildi. Tüm olgular prehidrasyon sonrası opere olacak taraf üstte kalacak şekilde lateral dekübit pozisyona getirildi. Spinal iğne ile L3-L4/L4-L5 spinal aralığından girildi. Tüm gruplarda %0.5 levobupivakain 1ml ilaveten Grup L 1 ml distile su, Grup LF 25 mcg fentanyl (0.5 ml)+0.5 ml distile su, Grup LM 0.01 mg morfin (0.5 ml)+0.5 ml distile su toplam 2 ml olacak şekilde verildi. Hastalar 15 dakika bu pozisyonda yatırıldı. Hastaların tansiyon, kalp atım hızı ve oksijen satürasyon değerleri blok öncesi, blok sonrası 1.,3.,5.,10.,15.,20.,30.dakikalarda ve operasyon boyunca 15 dakikada bir kayıt edildi. Motor blok ve duyu seviyesi, yan etkiler, motor blok gerileme zamanı (MBGZ), ilk idrar yapma zamanı ve ilk analjezik gereksinimi (İAG) kayıt edildi. Bulgular: MBGZ Grup LM de en uzun bulundu ancak anlamlı değildi (p>0.05). İAG Grup LM de daha geç bulundu ve aradaki fark Grup L’ye göre anlamlı idi (p0.05). Grup L de motor blok oluşumu daha azdı (p

Artroskopik girişimlerde ünilateral spinal levobupivakain, levobupivakain-fentanyl ve levobupivakain-morfin kombinasyonlarının analjezik ve hemodinamik etkilerinin karşılaştırılması

Objectives: Aim of the study was to compare the analgesic and hemodynamic effects of levobupivacaine, levobupivacaine-fentanyl, levobupivacaine-morphine for arthroscopic knee surgery under unilateral spinal anesthesia.Methods: A total of 44 ASA I/II patients scheduled for arthroscopy were included in the study. After prehydration patients kept in a lateral position on the nondependent side. Spinal puncture was performed at L3–4/L4–5 intervertebral space. Patients divided into three subgroups: Group L (n=14) received 0.5% levobupivacaine 1 ml+1 ml distilled water; Group LF (n=15), 25 mcg fentanyl (0.5 ml)+0.5 ml distilled water; and Group LM (n=15), 0.01 mg morphine (0.5 ml)+0.5 ml distilled water. Patients remained in that position for 15 minutes. Blood pressure and heart rate were recorded before and 1st, 3rd, 5th, 10th, 15th, 20th and 30th minutes after the block and every 15 minutes during the operation. Motor blockade and sensorial level, side effects, motor block regression time (MBRT), first urination time and first analgesic need (FAN) were recorded. Results: Group LM had the longest MBRT, but difference with other groups did not reach to a significant level (p>0.05). Group LM had significantly longer FAN time compare with other groups (p

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