Zeynep Nur AKÇABOY, Murat AKÇAY, Bilgehan SÖNMEZ, Nermin GÖĞÜŞ, Ahmet KÜÇÜK, Erkan yavuz AKÇABOY

Tek taraflı spinal anestezide düşük doz bupivakain ve bupivakain-fentanil kombinasyonunun derlenmeye etkisi

Amaç: Çalışmada, tek taraflı spinal anestezi altında, elektif artroskopik diz cerrahisi uygulanan hastalarda, 6 mg hiperbarik bupivakain (HB) ile 4 mg hiperbarik bupivakaine eklenen 10 µg fentanil (F) ‘in etkilerini karşılaştırmayı amaçladık.Gereç ve yöntem: Yaşları 18-60 yıl arası ASA 1-2, 42 hasta etik kurul onayı alındıktan sonra çalışmaya dahil edildi. Hastalar rastgele iki gruba ayrıldı. Grup I (n=22) 6 mg HB+10µg F (1.4 mL) ve Grup II (n=22) 4 mg HB+10µg F (1 mL) olarak belirlendi. Hastalara standart monitörizasyon uygulandı ve hemodinamik parametreler kaydedildi. Spinal anestezi, lateral dekübit pozisyonunda, 25 G Quincke spinal iğne ile L3-L4 aralıktan spinal mesafeye girilerek uygulandı. Bu çalışmada hemodinamik etkiler, blok seviyeleri, derlenme karakteristiklerini değerlendirdik. Her hasta için aşağıdaki parametreler kaydedildi: Her iki grubun hemodinamik değişiklikleri (HD), T12 dermatoma ulaşma zamanı (T12D), maksimum duyusal blok (MDB), motor blok seviyeleri (MBS) ve derlenme parametreleri.Bulgular: Demografik veriler, hemodinamik değişiklikler gruplar arasında farklı değildi (p>0.05). Duyusal blok seviyesi ve T12 dermatoma ulaşma seviyeleri her iki grupda farksız olmasına (p>0.05) karşın, motor blok seviyesi, ambulasyon zamanı ve taburculuk süresi Grup I’de Grup II’ye göre istatistiksel olarak anlamlı olarak uzun bulundu (p0.05). Sonuç: Günübirlik artroskopik diz cerrahisi anestezisinde 6 mg HB+10 µg F ile karşılaştırıldığında, 4 mg HB+10µg F’in sağladığı derlenme karakteristiklerinden dolayı üstün olabilir.

Effects of unilateral spinal anesthesia with low dose bupivacaine and bupivacaine-fentanyl combination on recovery

Objectives: Our aim was to compare unilateral spinal anesthesia produced by 6 mg hyperbaric bupivacaine or 4 mg hyperbaric bupivacaine plus 10 µg fentanyl for day-case arthroscopic knee surgery.Material and methods: In this study we evaluated hemodynamic effects, block levels, and recovery characteristics. After approval of Institutional Ethics Committee, ASA I-II, 42 patients were enrolled into the study. Patients were randomly allocated in two groups. Group I (n=22) 6 mg hyperbaric bupivacaine+10µg fentanyl, group II (n=22) 4 mg hyperbaric bupivacaine+10µg fentanyl. The patients were applied standard monitoring, and hemodynamic parameters were recorded. Then spinal anesthesia was performed with the patient lateral decubitis position, using a 25 G Quincke spinal needle at the L3-4 intervertebral space. Parameters below were recorded for each patient: hemodynamic, time to reach to level of T12 dermatome, maximum sensory level, motor block levels and recovery characteristics level of motor block, level of sensory block, time to reach T12 dermatome.Results: Demographic and hemodynamic variables were not different between groups (p>0.05). Although level of sensory block, and time to reach T12 dermatome were not different (p>0.05), level of motor block, ambulation time and time to discharge were significantly longer in Group I than Group II (p

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