Hüseyin İ. TOPRAK, Özlem SAĞIR, Semra DEMİRBİLEK, Ahmet KÖROĞLU, Kadir DEMİR, M.özcan ERSOY

Yaşlı Olgularda Spinal Hiperbarik Ropivakainin İki Farklı Dozunun Etkisi

Amaç: Son yıllarda yapılan çalışmalarda spinal anestezide ropivakain kullanımının yararları gösterilmiştir. Bu çalışmada, spinal anestezi altında ürolojik cerrahi girişim geçirecek yaşlı olgularda iki farklı dozda intratekal hiperbarik ropivakainin etkinlik ve güvenilirliğini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya, ürolojik cerrahi geçirecek, ASA I-III grubu, 65 yaş üstü 50 erkek olgu dahil edildi. Olgular, iki farklı intratekal hiperbarik ropivakain dozundan (Grup I, 15 veya Grup II, 18 mg) birini alacak şekilde rasgele iki gruba ayrıldı. Duyu bloğu pinprik testi, motor blok ise modifiye Bromage skoru ile değerlendirildi. Hemodinamik veriler ve yan etkiler kaydedildi. Bulgular: Duyu bloğu süresi grup II'de (223.7 ± 88.1 dk) grup I'e (192.6 ± 61.2 dk) göre daha uzundu, ancak istatistiksel olarak anlamlı değildi. Motor blok süresi grup II'de grup I'e göre anlamlı olarak daha uzundu (141.7 ± 43.3 ve 114.5 ± 25.9 dk) (p<0.05). Duyu bloğunun 2 dermatom gerileme zamanı gruplar arasında anlamlı olarak farklı değildi (67.8 ± 22.4 ve 79.2 ± 32.2 dk). Gelişen yan etkiler açısından gruplar birbirine benzerdi. Sonuç: Yaşlı olgularda spinal anestezi amacıyla hiperbarik ropivakainin 15 ve 18 mg'lık dozları kullanılabilir. Fakat 15 mg'lık hiperbarik ropivakainin daha kısa süreli duyusal ve motor blok oluşturması önemli bir avantajdır. Anahtar kelimeler: Spinal anestezi, Hiperbarik ropivakain, İleri yaş

Anahtar Kelimeler:

Spinal anestezi, Hiperbarik ropivakain, İleri yaş

The Effects of Two Different Doses of Spinal Hyperbaric Solution of Ropivacaine in Elderly Patients

Aim: Ropivacaine has been recently demonstrated useful for spinal anaesthesia in several studies. In this study, we were aimed to investigate the safety and efficacy of two different doses of intrathecal hyperbaric ropivacaine in elderly patients undergoing urological surgery. Materials and Methods: Fifty male patients (ASA I-III, aged ≥ 65 yr) scheduled for urological surgery were studied. Patients were randomly allocated to one of the two doses of spinal ropivacaine: 15 or 18 mg. Sensory changes were assessed by pinprick test and motor blockage was assessed by modified Bromage score. The haemodynamic variables and adverse events were recorded. Results: Although the duration of sensory block in group II was longer than group I (223.7 ± 88.1 min and 192.6 ± 61.2 min), the difference between the groups was not significant. Motor block was significantly longer in the group II than in the group I (141.7 ± 43.3 min vs 114.5 ± 25.9 min) (P<0.05). The time to regression of two dermatomes of the sensory block in the group I (67.8 ± 22.4 min) was shorter than in group II (79.2 ± 32.2 min), but the difference was not significant. The incidence of side effects was similar between groups. Conclusion: We thought that hyperbaric ropivacaine 15 or 18 mg for spinal anaesthesia may be more suitable in elderly patients, but a shorter sensory and motor blockade time of hyperbaric ropivacaine 15 mg was a major advantage. Key words: Spinal anaesthesia, Hyperbaric ropivacaine, Elderly patients

Keywords:

Spinal anaesthesia, Hyperbaric ropivacaine, Elderly patients,

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