Özlem Kocatürk, Meryem Nil KAAN, İbrahim KURT

Veküronyum Kullanımında Görülen Rezidüel Kürarizasyon İnsidansı ve Yaş Gruplarının Buna Etkisi

AMAÇ: Bu çalışmanın amacı sağlıklı, eriskin hastalarda vekuronyuma baglı erken ve geç derlenme dönemindeki postoperatif rezidüel kürarizasyon (RK) insidansını ve buna yaş gruplarının etkisini araştırmaktır.GEREÇ VE YÖNTEMLER: Çalısma prospektif, gözlemsel olarak, elektif cerrahilerde vekuronyum kullanılan ve ameliyat bittikten sonra derlenme odasına alınan hastalarda yapıldı. Derlenme odasında akselomiyograf ile nöromusküler ileti monitorize edildi ve dörtlü uyarıya yanıt (TOF) oranı ölçüldü; 0,9’un altındaki değerler “RK var” olarak kaydedildi. Hastalara kullanılan anestezikler ve kas gevseticisinin seçimi, antidot (neostigmin) kullanımı, ekstübasyon ve derlenme odasına alınma kararları hastayı takip eden anestezi doktoruna bırakıldı. Yaş RK için risk faktörü olarak alındı, binary lojistik regresyon analizi yapıldı.BULGULAR: Çalışmaya vekuronyum kullanılan 94 hasta alındı. Hastaların %52,1’ine neostigmin yapıldı. Ortalanma cerrahi süresi 96,5 dakikaydı. Derlenme odasında erken derlenme döneminde RK insidansı (TOF <0,90) %13,8 ve geç derlenme döneminde ise %5,3 olarak bulundu. Regresyon analizine göre yaş faktörünün, hem erken (OR: 0,714; %95 CI: 0,675-1,085) hem de geç (OR: 0,836; %95 CI: 0,226 - 3,185) derlenme döneminde, RK üzerine anlamlı etkisi saptanmadı. SONUÇ: Veküronyuma bağlı RK insidansı düşük oranda bulundu. Yaş faktörünün de sistemik sorunu olmayan hastalar için RK açısından risk faktörü olmadığı düşünüldü

Anahtar Kelimeler:

Rezidüel Kürarizasyon, nöromusküler monitörizasyon, vekuronyum, yaş, derlenme dönemi

The Incidence of Residual Curarization Associated with Vecuronium and the Effect of Age Groups

OBJECTIVE: The aim of this study is to investigate the incidence of postoperative residual curarization (RC) associated with vecuronium administered to adult patients during early and late postoperative period and the effect of age groups. MATERIALS AND METHODS: This prospective and observational study was conducted after obtaining the permission of the local ethics committee. Adult patients who received vecuronium during general anesthesia for elective surgical procedure were included in the study. The decisions about the anesthetics and muscle relaxants used on the patients, reversal with neostigmine, extubation and transfer to the recovery room were left to be made by the anesthesiologist following the patient. The patient who was taken into the recovery room had neuromuscular monitoring using accelomyography. Train-of-four (TOF) ratios under 0.9 were recorded as “RC present”. Age was considered risk factor for RK, binary logistic regression analysis was conducted. RESULTS: This study included 94 patients were given vecuronium. Reversal was performed with neostigmine in 52.1% of the patients at the end of the operation. The median length of surgery was 96.5 minutes. RK incidence (TOF<0.90) in the recovery room was determined to be 13.1% (early recovery period) and 5.3% (late recovery period). Based on the regression analysis, the age factor did not have any significant effect onRC in the early (OR: 0.714; 95% CI: 0.675-1.085) and late (OR: 0.836; 95% CI: 0.226 - 3.185) recovery period. CONCLUSION: The incidence of RC following vecuronium is less frequent. It was shown to the age factor is not effect RC of vecuronium in early and late recovery period.

Keywords:

Residual curarization, neuromuscular monitoring, vecuronium, age, recovery period,

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