Muhammed Kaan YÖNEZ, Cengiz CEYLAN, Hanifi EROL, Muharrem EROL, Gültekin ATALAN

Tavşanlarda Propofol-Sevofluran, Midazolam-Sevofluran ve Medetomidin-Ketamin-Sevofluran Anestezi Kombinasyonlarının Göz İçi Basıncına Etkileri

Göz içi basıncı (GİB), humor aközün dengeli bir şekilde üretimi ve drenajına bağlı olarak şekillenmektedir. GİB, oftalmik cerrahide önemli ve yararlı parametreler arasında yer almaktadır. Bu çalışmanın amacı tavşanlarda propofol + sevofluran, midazolam + sevofluran ve medetomidine + ketamin + sevofluran anestezi kombinasyonlarının GİB üzerine etkilerinin karşılaştırılması, oftalmik cerrahi için optimal anestezi protokolünün araştırılmasıdır. Çalışmada 40 adet 4 aylık sağlıklı dişi (ortalama ağırlık 2.34±0.67 kg) Yeni Zelanda tavşanı kullanıldı. Hayvanlar; propofol + sevofluran (PS), midazolam + sevofluran (MS), medetomidine + ketamin + sevofluran (MKS) ve kontrol (K) grubu şeklinde her bir grupta 10 adet tavşan olmak üzere toplam dört gruba ayrıldı. GİB ölçümleri çalışma gruplarında sağ gözden anestezi öncesi (0. dk), sevofluran anestezisi boyunca 5, 10, 15, 20, 25 ve 30. dakikalarda ve anestezi sonrası 10, 20, 30, 60, 120. dakikalarda ve 24 saat sonra yapıldı. PS grubunda anestezi süresi boyunca 5 ve 25. dk’lar arasında GİB değerlerinde azalma görüldü. Genel olarak MS grubunun ölçülen GİB değerlerinin 0. dk’dan yüksek seyrettiği ve anestezi sonrası 10. dk’ya kadar artışın devam ettiği görüldü. MKS grubunun anestezi sırasında ölçülen GİB değerinin anestezi öncesi ve sonrası değerlerden yüksek olduğu tespit edildi. Bu çalışma sonunda PS kombinasyonunun göz cerrahisi için daha uygun bir anestezi kombinasyonu olduğu görüldü. Oküler cerrahide GİB değerinin artışı operatif ve postoperatif olarak istenmeyen bir durumdur. Özellikle GİB üzerine anestezi kombinasyonlarının etkileri daha ayrıntılı ve türlere özel olarak araştırılması gerekmektedir.

The Effects of Propofol-Sevoflurane, Midazolam-Sevoflurane and Medetomidine-Ketamine-Sevoflurane Anesthetic Combinations on Intraocular Pressure in Rabbits

Intraocular pressure (IOP) is dependent on equilibrium between the rate of formation and outflow humor aqueous in the eye. Determination of IOP is one of the most important points and a very useful parameter in ophthalmic surgery. The aim of this study was to compare the effects of propofol + sevoflurane, midazolam + sevoflurane, medetomidine + ketamine + sevoflurane anesthetic combinations on IOP, and to find out suitable anesthesia protocol in rabbits for ophthalmic surgery. For this purpose, a total of 40 healthy four months old New Zealand female rabbits (Mean weight 2.34±0.67 kg) were used as subjects. The animals were divided into four groups; propofol + sevoflurane (PS), midazolam + sevoflurane (MS), medetomidine + ketamine + sevoflurane (MKS), and control (C), each having 10 rabbits. The IOP was measured from the right eyes before injection of anesthetics (0. min), during sevoflurane anesthesia at 5th, 10th, 15th, 20th, 25th and 30th min, and post anesthesia at 10th, 20th, 30th, 60th, 120th min and 24 h in the study groups. In PS group; IOP values decreased during anesthesia between 5th and 25th min. In general, the measured IOP values of MS group were higher than 0th min, and the increases continued at 10th min in post anesthesia. The measured IOP values of MKS group during anesthesia were higher than other time points. As a result of this study PS anesthetic combination is an ideal anesthesia for ocular surgery in rabbits. The increase in IOP is undesirable in ocular surgery due to operative and postoperative complications. It was also concluded that investigating the effects of anesthetic combination on IOP should continue in more detailed researches including in different species.

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