Açık Prostatektomi Ameliyatı Geçirecek Hastalarda Tek Doz Spinal Anestezi ve Sürekli Spinal Anestezi Tekniklerinin Karşılaştırılması

ÖzAmaç: Bu çalışmada açık prostatektomi ameliyatı geçirecek hastalarda, tek doz spinal anestezi (SSA) ve sürekli spinal anestezi (CSA) yöntemlerinin hemodinami, anestezi kalitesi ve komplikasyonlar yönünden karşılaştırılması amaçlandı. Gereç ve yöntem: 50 yaşın üzerinde, 42 hasta (ASA 1-3), randomize olarak iki gruba ayrıldı. SSA’e (n=21,) 3,5 ml %0,5 hiperbarik bupivakain verildi. CSA’e (n=21) 1,5ml %0,5 hiperbarik bupivakain intratekal verildi. Sensoriyal blok torakal-10’a ve Bromage Skalası’nda 3’e ulaşana kadar ilki 15 dakika ve sonrakiler takip eden 5 dakika araile 0,5 ml %0,5 hiperbarik bupivakain uygulandı. Ameliyat süresince hastaların non invaziv arter basınçları, kalp atım sayıları, kan basınçlarındaki %25 düşme, kan kaybı miktarları, ek sıvı ihtiyaçları, vazoaktif medikasyon gereksinimleri, atropin gereksinimleri, ek lokal anestezik ihtiyaçları kaydedildi. Blok uygulama süresi, tam motor blok ve sensoriyal bloğun torakal-10’a ulaşma zamanı, 2 segment regresyon süresi, motor blok ve duyusal bloğun bitiş zamanı kaydedildi. Bulgular: CSA grubunda anestezi tekniğini uygulama süresi, tam motor blok oluşma süresi ve sensoriyal bloğun torakal-10’a ulaşma süresi uzun; iki segment regresyonsüresi, motor blok ve duyusal blok süresi kısa bulundu. SSA grubunda hipotansiyon, eksıvı ihtiyacı, efedrin gereksinimi CSA grubundan daha fazla bulundu. Sonuç: CSA grubunda düşük doz lokal anestezikle, uygun anestezi düzeyi ve daha iyi hemodinamik stabilite sağlandı. CSA uygun hastaya, doğru bir şekilde uygulandığında güvenilir ve etkin bir yöntemdir.

Anahtar Kelimeler:

Bupivakain, Hemodinami, Spinal anestezi, CSA

Comparison Of Single-Shot Spinal Anaesthesia and Continuous Spinal Anaesthesia In Patients Undergoing Open Prostatectomy

AbstractAim:In this study, in patients undergoing open prostatectomy, comparison of sin-gle shot spinal anesthesia (SSA) and continuous spinal anesthesia (CSA) methods in termsof hemodynamics, quality of anesthesia, and complications was aimed.Material and Methods:42 patients (ASA I-III) over 50 years of age were randomly divided into two groups. Patients in group SSA (n=21) received 3.5 ml of hyperbaricbupivacaine 0.5%. Patients in group CSA (n=21) received1.5 ml hyperbaric bupivacaine 0.5% intrathecally. Sensorial blockade reached at thoracal 10 (T-10) and at Bromage Scale 3, the first with 15 minutes and the latter doses with 5 minutes intervals 0,5 mL, hyperbaric bupivacaine %0,5 was administered. Throughout the operation patient’s non-invasive arterial blood pressure, heart rate, decrease in blood pressure 25%, amount of blood loss, additional fluid needs, vasoactive medication needs, atropine needs, additional local anesthetics needs, were recorded. Blocade performing time, the time full motor blockade and sen-sorial blockade’s reached at T-10, two segments regression time, resolution of motor and sensorial blockade time wererecorded. Results:In CSA Group performing of anesthesia time,full motor blockade achievement time needed and the timeneeded for sensorial blockade to reach T-10 was long, twosegment regression time, motor sensorial blockade time were short. In SSA group hypotension, additional fluid need andephedrine need were higher than CSA group.Conclusion: In CSA Group by low dose local anaest-hetic, appropriate anesthesia level and better hemodynamicstability were achieved. When CSA performed properly tosuitable patients, it is a reliable and effective technique.

Keywords:

Bupivacaine, Hemodyna-mics, Spinal anesthesia, CSA,

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