Berk ÖZKAYNAK, Adil POLAT, Kerem ERKALP, Sıtkı Nadir ŞİNİKOĞLU, Funda GÜMÜŞ, Nalan ŞANLI, Ayşin ALAGÖL

The analgesic and hemodynamic effects of dexmedetomidine and remifentanil during chest tube removal

Amaç: Bu çalışmada remifentanil ve deksmedetomidinin göğüstüpü çekilmesi sırasında ağrı giderici etkileri incelendi ve bu etkiler sedasyon seviyeleri ile pulmoner ve hemodinamik yanıtlar açısından karşılaştırıldı. Çalışma planı: Çalışma prospektif, randomize ve çift kör olarak tasarlandı. Çalışmaya Şubat 2011 - Temmuz 2011tarihleri arasında koroner arter baypas greft (KABG) cerrahisiyapılan ardışık 41 hasta (31 erkek, 10 kadın; ort. yaş 55.7±10.3 yıl; dağılım 27-77 yıl) dahil edildi. Tüm göğüs tüpleri ameliyat sonrası 48. saatte çekildi. Hastalar deksmedetomidin(0.5 mg/kg) (grup D) ve remifentanil (0.5 mg/kg) (grup R) olmak üzere rastgele iki gruba ayrıldı. Ağrı ve sedasyon seviyeleri numerik dereceleme skalası (NRS) ve Ramsay skorlarıile değerlendirildi. Kan basınçları [sistolik (SAB), diyastolik (DAB) ve ortalama (OAB)], periferik oksijen satürasyonları(SpO2), solunum hızları (SH) ve kalp hızları (KH) ilaç perfüzyonu öncesinde, sonrasında ve tüp çekildikten sonra ikişerdakika ara ile kaydedildi. Bulgular: İki gruptaki hastaların demografik özellikleri benzerdi. Grup D’de ağrı skorları tüp çekildikten sonra altı ve 10. dakikalarda kaydedilen ölçümlerinde daha düşüktü. Başlangıç ölçümleri ile karşılaştırıldığında, Ramsayskorları perfüzyon sonrası tüm ölçümlerde anlamlı olarakfarklı bulundu (p

Göğüs tüpü çekilmesi sırasında deksmedetomidin ve remifentanilin analjezik ve hemodinamik etkileri

Background: This study aims to investigate the effects ofremifentanil and dexmedetomidine in alleviating pain duringchest tube removal and these effects were compared in terms ofsedation levels, pulmonary and hemodynamic responses.Methods: The study was designed as a prospective, randomized,double-blinded study. Between February 2011 and July 2011, 41consecutive patients (31 males, 10 females; mean age 55.7±10.3years; range 27 to 77 years) who underwent coronary arterybypass graft (CABG) surgery were enrolled. All chest tubeswere removed in postoperative 48th hour. The patients wererandomized into two groups as dexmedetomidine (0.5 mg/kg)group (group D) and remifentanil (0.5 mg/kg) group (group R).The pain and sedation levels were assessed by numerical ratingscale (NRS) and Ramsay scores. Blood pressures [systolic (SAP),diastolic (DAP) and mean (MAP) pressures], peripheral oxygensaturation (SpO2), respiratory rate (RR) and heart rate (HR) wererecorded before and after the agent perfusion and every twominutes after the tube was removed.Results: The demographic characteristics of the patients in bothgroups were similar. The pain scores were lower during themeasurements which were recorded at six and 10 minutes afterchest tube removal in group D. The Ramsay scores were found tobe statistically different at all measurements following perfusion,compared to the baseline measurements (p

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