Fatih Uğur, Aliye Esmaoğlu, Tamer Güneş, Nebahat Gülcü, Adem Boyacı

Sezaryen Seksiyo Operasyonlarında İntratekal Bupivakaine Fentanil veya Morfin Eklenmesinin Etkileri

Amaç: Bu çalışma sezaryen seksiyo operasyonu için uygulanan spinal anestezide %0,5'lik 10 mg bupivakaine 20mg fentanil veya 0,1 mg morfin eklenmesinin etkinlik ve güvenilirliğinin karşılaştırılması amacıyla planlanmıştır. Hastalar ve Yöntem: Çalışmaya 40 olgu alındı. Olgular % 0,5 bupivakain ile 20mg fentanil (0,5cc) (Fentanil Grubu) veya %0,5 bupivakain ile 0,1 mg morfin (0,5cc) (Morfin Grubu) almak üzere rastgele iki gruba ayrıldı. Spinal anestezi 25 Gauge iğne ile L3-4 veya L4-5 aralığından uygulandı. Bulgular: İntratekal enjeksiyondan cerrahinin başlamasına kadar geçen süre, cerrahinin bitişi, iki segment gerileme,duyusal ve motor bloğun tamamen geri dönme zamanları gruplar arasında anlamlı fark göstermedi. Bulantı, kusma, hipotansiyon insidansı yönünden gruplar benzerdi. İntraoperatif analjezi yönünden gruplar benzer olup postoperatif bulantı morfin grubunda anlamlı olarak yüksek bulundu. Birinci ve 5. dakika Apgar skoru, umblikal venöz ve arteriyel kan gazı ile değerlendirilen yenidoğan durumu iki grupta da mükemmel bulundu. Sonuç: İntratekal bupivakaine eklenen fentanil, bupivakaine eklenen morfine benzer intraoperatif analjezi sağladı. Her iki ilaç da sezaryen operasyonlarında etkin şekilde ve güvenle kullanılabilir sonucuna varıldı. Anahtar kelimeler: Sezaryen seksiyo, İntratekal, Fentanil, Morfin

Anahtar Kelimeler:

Sezaryen seksiyo, İntratekal, Fentanil, Morfin

The Effects of Fentanyl or Morphine Added to Intrathecal Bupivacaine in Spinal Anesthesia for Cesarean Section

Background: The present study was undertaken to compare the efficacy and safety of hyperbaric bupivacaine with 20mg fentanyl or 0,1 mg morphine for spinal anesthesia in patients undergoing cesarean section. Material and Methods: Forty patients were included in the study. They were allocated to receive either 0,5% 10 mg bupivacaine with 20mg (0,5cc) fentanyl (Fentanyl Group) or 0,5% bupivacaine with 0,1 mg (0,5cc) morphine (Morphine Group). Spinal anesthesia was performed using 25 G needle at the L3-4 or L4-5 interspace. Results: The times from intrathecal injection to the start of surgery, end of surgery, two segment regression, and complete recovery of sensation and motor power were not different among the groups. The incidences of nausea, vomiting and hypotension were similar in groups. In respect of intraoperative analgesia the groups were similar but postoperative vomiting was significantly higher in Morphine Group. Neonatal condition, as evaluated by the Apgar's scores at 1 and 5 min, and umbilical venous and arterial blood gases were excellent in the two groups. Conclusion: The intraoperative analgesia achived with intrathecal bupivacaine plus fentanyl was similar to that in the case of bupivacaine plus morphine. Both drugs can be used effectively and safely in the cesarean operations. Key Word: Cesarean section, Intrathecal, Fentanyl, Morphine

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