Tamer BALCIOĞLU, Atilla ÇEVİK, Seden KOCABAŞ

Çocuklarda rokuronyum ile sağlanan nöromüsküler blok üzerine inhalasyon anestezisi ve intravenöz anestezinin etkilerinin karşılaştırılması

Çocuklarda halotan ile inhalasyon anestezisi ve propofol-alfentanil ile İntravenöz anestezi sırasında rokuronyum ile sağlanan nöromusküler bloğun ve entübasyon koşullarının karşılaşlırılınası amaçlandı. Yaşları 3-12 yıl arasında olan 40 olgu rasgele ikiye ayrıldı. Anestezi indüksiyonu ve idamesinde olgulara 2 $mu$g/kg fentanil, 5 mg/kg tiyopenton, 0.6 mg/kg rokuronyum ve % 33 oksijen % 67 azotprotoksid içerisinde % 1.01.5 halotan (inhalasyon grubu, n=20) veya 2 $mu$g/kg fentanil, 2 mg/kg propofol, 0.6 mg/kg rokuronyum ve % 33 oksijen % 67 azotprotoksid yanısıra, ilk. 10 dk.'da 12 mg/kg/sa, ikinci 10 dk.'da 8 mg/kg/sa ve ameliyat sonlanana dek 6 mg/kg/sa dozunda propofol infüzyonu, ilk 10 dk.'da 90 $mu$glkg/sa ve ameliyat sonlanana dek 60 $mu$g/kg/sa dozunda alfentanil infüzyonu (İntravenöz anestezi (İVA) grubu) uygulandı. Her iki grupla anestezi indüksiyonu ile eş zamanlı olarak nöromüsküler ileti TOF-Guard ile monitörize edildi ve maksimum nöromüsküler blok oluştuğunda entübasyon gerçekleştirildi. Her 15 sn.'de bir 2 Hz frekansta, 60 mA güçte TOF madunda uyarı uygulandı ve nöronrüsküler etki süreleri ölçüldü. İlk etki ve etki başlama sürelerinde ve entübasyon skorunda gruplar arasında fark saptanmadı (p>0.05). Klinik etki ve total etki süreleri ve derlenme indeksi açısından inhalasyon grubunda İVA grubuna oranla anlamlı uzama saptandı (p

The comparison of the effects of inhalational and intravenous anaesthesia on the neuromuscular block of rocuronium in children

The aim of this study was to compare the neuromuscular block and intubation conditions when rocuronium is administered during either inhalation anaesthesia with halothane or intravenous anaesthesia with profol-alfentanil. Forty patients aged between 2-12 years were randomized into two groups. Anaesthesia was induced and maintained with 2 $mu$g/kg fentanyl, 5 mg/kg thiopentone, 0.6 mg/kg rocuronium, 67 % nitrous oxide in 33 % oxygen and 1-1.5 % halothane (inhalation group, n=20) or 2 $mu$g/kg fentanyl, 2 mg/kg propofol, 67 % nitrous oxide in 33 % oxygen, 12 mg/kg/h propofol for 10 min. after induction, followed by 8 mg/kg/h for the next 10 min. and 6 mg/kg/h until the end of operation, 90 $mu$g/kg/h alfentanil for 10 min. after induction and 60 $mu$g/kg/h until the end of operation (intravenous anaesthesia (IVA) group). Following induction of anaesthesia, ulnar nerve was stimulated at the wrist using TOF nerve stimulation. Intubation was performed at the onset of maximal neuromuscular block. TOF stimuli of 2 Hz frequency and 60 mA were applied to the ulnar nerve every 15 sec. Lag-time and onset time values and intubation scores did not differ significantly between groups (p>0.05). The clinical duration, total duration and recovery index values were significantly longer in the inhaled anaesthetic group (p

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