Rejyonel İntravenöz Anestezide Lidokain ve Lidokain-Midazolamın Etkinliklerinin Karşılaştırılması
Rejyonel intravenöz anestezide (RİVA) kullanılacak ideal ajan ile ilgili net bir yaklaşım yoktur. Lokal anestezik ajanlara çeşitli adjuvanlar eklenerek RİVA kalitesi artırılmaya ve lokal anestezik yan etkilerinden kaçınılmaya çalışılmaktadır. Bu çalışmada RİVA sırasında lidokaine eklenen midazolamın blok kalitesi üzerine etkilerinin araştırılması amaçlanmıştır.Üst ekstremite cerrahisi geçirecek yaşları 18-60 yaş arasındaki hastalar rastgele 2 gruba ayrıldı. Opere olacak kol yukarıya kaldırılarak venöz boşalma yapıldıktan sonra çift kaflı turnike yerleştirildi, turnikenin şişirilmesini takiben el sırtındaki venöz kanülden kontrol grubuna (Grup K) 40 ml volümde 3 mg/kg %2’lik lidokain, midazolam grubuna (Grup M) ise toplamda 40 ml volümde 3 mg/kg %2’lik lidokain içinde 50 μg/kg midazolam enjekte edildi. Turnike süresi, oluşan duyusal ve motor blok, duysal ve motor blok dönme zamanı, intraoperatif ağrı seviyesi ve postoperatif ilk analjezik ihtiyaç zamanı kayıt edildi.Turnike süresi ve intraoperatif ağrı seviyeleri açısından gruplar arasında fark saptanmadı. Duysal ve motor blok başlama zamanı Grup M’de daha kısa bulundu (p:0.000). Motor blok dönme zamanı Grup M’de daha kısa idi (p:0.003). Postoperatif ilk analjezik ihtiyaç zamanının Grup K’da daha önce olduğu gözlendi (Grup K:74.678, Grup M: 86.123 dakika). Lidokaine midazolam eklenerek uygulanan RİVA da herhangi bir yan etki ile karşılaşılmadan daha hızlı başlangıçlı bir anestezi ve analjezi elde edilmiştir.
Anahtar Kelimeler:
rejyonel intravenöz anestezi, lidokain
Comparing Effects of Lidocaine and Lidocaine-Midazolam in Regional İntravenous Anesthesia
There is no clear approach to the ideal agent to be used in regional intravenous anesthesia (RIVA). Various adjuvants are added to local anesthetic agents to increase the quality of RIVA and to avoid local anesthetic side effects. The purpose of this study is to research the effect on block quality in RIVA by adding midazolam to lidocaine. Patients aged 18-60 years old who underwent upper extremity surgery were randomly assigned 2 groups. A double-headed tourniquet was placed after venous drainage by lifting the upper arm. Following inflating the tourniquet, the control group (Group K) received 3 mg/kg 2%lidocaine and the midazolam group (Group M) received 3mg/kg lidocaine and 50 µgr/kg midazolam in 40 cc volume on the arm that will be operated. Tourniquet time, onset and recovery times of sensory and motor block, intraoperative pain level, and first postoperative analgesic requirement time were recorded. There was no difference between the groups in terms of tourniquet time and intraoperative pain levels. Sensory and motor block onset times were significantly shorter in Group M (p:0.000). The first postoperative analgesic requirement time was observed earlier in Group K (Group K:74.678, Group M: 86.123 minute). A quicker onset anesthesia and analgesia were obtained without any side effects in the RIVA applied by adding midazolam to the lidocaine.
Keywords:
regional intravenous anesthesia, lidocaine,
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- ISSN: 1305-4953
- Yayın Aralığı: Yılda 6 Sayı
- Başlangıç: 2013
- Yayıncı: Eskişehir Osmangazi Üniversitesi Rektörlüğü