Majör alt ekstremite cerrahisinde epidural yolla uygulanan levobupivakain ile bupivakainin peroperatif ve postoperatif stres yanıt üzerine etkilerinin karşılaştırılması
Cerrahi travmanın tetiklediği stres yanıt, patolojik bir süreç olarak kabul edilmektedir. Olguların perioperatif devreyi daha güvenli geçirmesinde stres yanıtın baskılanması önem kazanmaktadır. Bu çalışmada epidural yoldan uygulanan levobupivakain ile bupivakainin peroperatif ve postoperatif stres yanıt üzerine etkisinin araştırılması planlandı. Çalışmamız Süleyman Demirel Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim dalında majör alt ekstremite operasyonu planlanan 43 ASA I-III olgu üzerinde yapıldı. Olgular randomize olarak iki ayrı gruba ayrılarak Grup L (n=22)'deki olgulara %0,5 levobupivakain 15 mL + 5 mL serum fizyolojik, Grup B (n=21)'deki olgulara %0,5 bupivakain 15 mL + 5 mL serum fizyolojik epidural aralıktan uygulandı. Cerrahi travmaya bağlı stres yanıtı değerlendirmek amacıyla ameliyat salonuna gelişte (preoperatif), cerrahi insizyondan yarım saat sonra (peroperatif) ve operasyon sonrası 24. saatte (postoperatif) plazmada GH, sT3, TSH, kortizol düzeyleri bakıldı, kontrol değerleriyle ölçüm yapılan değerler karşılaştırıldı. Grup L'deki olgularda GH değerinde postoperative 24. saatte kontrol değerlerine ve peroperatif değere göre anlamlı artış (p
Comparison of the effects of levobupivacaine and bupivacaine that administered through epidural route on peroperative and postoperative stressresponse in major lower limb surgery
Stress response that surgical trauma induced is accepted as a pathological process. By that mean, attenuating stress response for a safe perioperative period gains importance. In this study investigating the effects of levobupivacaine and bupivacaine via epidural on preoperative and postoperative stress response was planned. Our study was performed in Suleyman Demirel University School of Medicine Department of Anaesthesiology and Reanimation in 43 ASA I-III cases that lower limb surgery has been planned. Cases were divided randomly into two groups 0,5% 15 mL levobupivacaine + 5 mL saline was administered in Group L (n=22) cases and 0,5% 15 mL bupivacaine + 5 mL saline was administered through epidural space in Grup B cases. For evaluating stress response due to surgical trauma; plasma GH, sT3, TSH, cortizol levels were investigated at the arriving to the operation room (preoperative), 30 minutes after surgical incision (peroperative) and at 24thhour after the operation (postoperative) and compared with control values. In Group L; significant increase in GH in postoperative 24th hour according to control and peroperative values (p<0,001, p=0,007) was observed; significant decrease in St3 in postoperative 24thhour according to control and peroperative values ( p<0,001, p<0,001) was observed also. In Group B; significant increase in GH in postoperative 24thhour according to control and peroperative values (p=0,003, p=0,023) and significant decrease in St3 in postoperative 24thhour according to control and peroperative values (p<0,001, p=0,002) was observed. We concluded that levobupivacaine and bupivacaine, for minimizing the stress response due to surgical trauma have no difference between each other respect to attenuation of stress response
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- ISSN: 1300-7416
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 1994
- Yayıncı: SDÜ Basımevi / Isparta
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