Fatih ŞİMŞEK, Süleyman DENİZ, Tarık PURTULOĞLU, Ömer YANARATEŞ, Tuna ERTÜRK, Ercan KURT

Kombine spinal ve epidural anestezide idrar test stribinin kullanılması

Çalışmamızda kombine spinal epidural anestezi uygulaması esnasında serbest akışı gözlenen sıvının beyin omurilik sıvısı olduğunun belirlenmesine yönelik idrar stribi yöntemini kullanmayı ve bu yöntemi kullanırken glukoz ve pH parametrelerinin etkinliklerini karşılaştırmayı amaçladık. Yöntem: Çalışmaya kombine spinal epidural anestezi altında alt ekstremite cerrahisi planlanan 70 hasta dahil edildi. Hastalar, beyin omurilik sıvısının kontrolü idrar stribinin glukoz parametresi ile yapılanlar glukoz grubu, pH parametresi ile yapılanlar pH grubu olacak şekilde iki gruba randomize olarak ayrıldı. Tüm hastaların renk değişiklikleri ve blok seviyeleri her iki grupta da ayrı ayrı kaydedildi. Bulgular: Her iki grupta, idrar test şeridi renk değişimi 34 hastada pozitif ve 1 hastada negatif bulundu. Gruplar arasında istatistiksel olarak anlamlı bir fark tespit edilmedi. Blok seviyesi açısından glikoz grubunda 3 (%9) ve pH grubunda 1 (%3) hastada hiçbir blok seviyesi tespit edilemedi. Bu parametre açısından gruplar arasında istatistiksel olarak anlamlı fark tespit edildi. Sonuç: Kombine spinal epidural anestezi uygulamaları esnasında serbest akışı gözlenen sıvının beyin omurilik sıvısı olduğunun belirlenmesinde idrar stribinin güvenle kullanılabileceği bir kez daha teyit edilmiş oldu. Beyin omurilik sıvısı tespitinde, idrar stribinin pH parametresinin glikoz parametresine göre daha etkin bir yöntem olduğu kanaatine varıldı

Use of urine test strips in combined spinal and epidural anesthesia

In this study, we aimed to show which parameter can be used to get a realible result in differentiation of cerebro spinal fluid (CSF) and saline by using the urine test strips. We compared the effectiveness of glucose and pH parameters by dripping CSF samples obtained from spinal needle during combined spinal-epidural anesthesia (CSEA) by means of glucose and pH regions of the urine test strip. Methods: After obtaining written consent, 70 patients scheduled for lower extremity surgery under CSEA were included in this unicenter and randomized clinical study. During the intervention, block levels and color changes in urine test strips' glucose and pH parameters were all recorded. Results: In both groups, urine test strip color change were positive in 34 patients and negative in 1 patient. There was no statistically significant difference. In our study, even free CSF flow was detected after CSEA implementation, block levels were detected as "none" in 3 patients in "glucose" group (9%) and 1 patient in "pH" group (3%). There was a statistically significant difference in comparison of block levels. Conclusion: We found out that CSF samples dripped on urine test strips caused a color change in glucose and pH parameters, similar to previous results. However there was no block levels in 1 patient in "pH" and 3 patients in "glucose" groups. We concluded that pH parameters are more reliable than glucose parameters in detecting CSF

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