Aynur ATAY, Noyan KOROĞLU, Erol GÖKEL, Bahar KUVAKİ

Sevofluran ve intravenöz anestezi sırasında rokuronyumun oluşturduğu nöromüsküler bloğun değerlendirilmesi

Bu çalışmada, elektif cerrahi girişim için sevofluran (n=21) veya TIVA (n=23) uygulanan ASA I-II grubu olgularda, rokuronyumun oluşturduğu nöromüsküler blok (NMB) etkisi ve entübasyon koşulları değerlendirildi. Propofol-Rokuronyum (P-R) grubuna (n=23) 2 $mu$g/kg fentanil ve 2 mg/kg propofol ile indüksiyondan sonra 5-10 mg/kg/st propofol ve 4-10 $mu$g/kg/st fentanil infüzyonu uygulandı. Sevofluran-Rokuronyum (S-R) grubuna (n=21) 2 $mu$g/kg fentanil ve 2 mg/kg propofol ile indüksiyondan sonra sevofluran uygulandı. Tüm olgular anestezi indüksiyonundan 10 dk sonra 0.6 mg/kg rokuronyum uygulanarak entübe edildi. Periferik sinir stimülatörü ile nöromüsküler ileti monitörizasyonu yapıldı ve ameliyat süresince NMB ile ilgili şu değerler kaydedildi: etki başlama süresi, klinik etki süresi (T25), derlenme indeksi (T25-75)' spontan derlenme süresi (T4/T1, TOF 70), T1-T2-T3-T4 (1. 2. 3. 4.) yanıtlarının geri gelme süreleri. Klinik etki süresi (T25) P-R grubunda 43.53+8.61, S-R grubunda 59.79+16.26 dk bulundu. Derlenme indeksi (T25-75) P-R grubunda 14.40+4.80, S-R grubunda 26.52+8.10 dk bulundu. Spontan derlenme süresi (T4/T1) karşılaştırıldığında P-R grubunda 61.48+14.72, S-R grubunda 101.99±15.17 dk bulundu. P-R grubunda T1,T2,T3,T4 süreleri sırasıyla 33.38+6.85, 39.41±7.49, 42.72+8.55, 44.00±8.42 dk saptanırken bu süreler S-R grubunda 41.54±11.43, 50.33±13.49, 57.00±14.07, 60.23+15,11 dk olarak saptandı. Gruplar arasındaki farklılıklar anlamlıydı (p

Neuromuscular blocking effects of rocuronium during sevoflurane or intravenous anaesthesia

In this study intubating conditions and neuromuscular blocking effects of rocuronium in patients scheduled for elective surgery and anaesthetized either with sevoflurane (n=21) or with TIVA (n=23) were studied. In Propofol-Rocuronium (P-R) group patients received 2 $mu$g/kg fentanyl, 2 mg/kg propofol for induction and 5-10 mg/kg/h propofol, 4-10 $mu$g/kg/h fentanyl infusion for maintenance. In Sevoflurane-Rocuronium (S-R) group patients received 2 $mu$g/kg fentanyl, 2 mg/kg propofol for induction and sevoflurane for maintenance. 60 % N2O and 40 % O2 was used in all patients during maintenance of anaesthesia. Ten min after induction 0.6 mg/kg rocuronium was administered and patients were intubated. Neuromuscular block was monitored using train of four stimulation. Onset time, clinical duration (T25), recovery index (T25-T75) spontaneous recovery time (T4/T1), and time to return of T1-T2-T3-T4 were recorded. T25 was 43.53+8.61 min in P-R group and 59.79+16.26 min in S-R group. T25-75 was 14.40±4.80 min in P-R group and 26.52±8.10 min in S-R group. T4/T1 was 61.48+14.72 min in P-R group and 101.99+15.17 min in S-R group. Time to return of T1 was 33.38±6.85 min in P-R group and 41.54±11.43 min in S-R group; T2 was 39.41+7.49 min in P-R group and 50.33+13.49 min in S-R group; T3 was 42.72+8.55 min in P-R group and 57.00+14.07 min in S-R group and T4 was 44.00±8.42 min in P-R group and 60.23+15.11 min in S-R group. The differences between the groups were statistically significant (p

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