Hakan CANATAY, Nur BAYKARA, Levent KILIÇKAN, Kamil TOKER, Tülay ŞAHİN

Sevofluran'ın neden olduğu postoperatif titremeye klonidinin etkisi

Genel anesteziden derlenme sırasında titreme oldukça yaygındır. Titreme, hastaya rahatsızlık vermesi yanında, ameliyat sonrası ağrıyı artırabilir ve koroner arter hastalığı veya kalp yetersizliği olan hastalarda oksijen tüketiminde artış ile ortaya çıkabilen komplikasyonlara neden olabilir. Alfa.2 adrenerjik reseptör agonisti olan klonidin, anestezi sonrası titremeyi azaltır. Bu çalışmada sevofluran anestezisi altındaki hastalarda ameliyat sonrası gözlenebilen titremeye klonidin'in etkisini araştırdık. Elektif kulak veya burun cerrahisi geçirecek 30 hasta çalışmaya alındı. Genel anestezi indüksiyonu tüm hastalarda 2.0 mg/kg propofol ve 1.5 $mu$g/kg fenlanil İV ile sağlandı. Genel anesteziye sevofluran (end-tidal konsantrasyon % 1.5% 2.0) ve % 70 N2O+% 30 oksijen ile devam edildi. Ekstübasyondan 5 dk önce rasgele seçilmiş olan hastalara toplam 10 mL içerisinde 2 $mu$g/kg klonidin (Grup l: n=15) veya 10 mL serum fizyolojik (Grup ll: n=15) İV verildi. Ameliyat sonrası titreme "3-point" skala, ağrı 100 mm vizüel analog skala, sedasyon ise Ramsey Sedasyon Skalası ile değerlendirildi. Her iki grupta da derin sedasyon ve ağrı VAS değerleri arasında anlamlı bir farka raslanmadı. Sevofluran anestezisi altında klonidin verilmeyen grupta % 86.6 oranında titreme gözlenirken, klonidin alan hastalarda bu oran % 13.3 olarak tespit edildi (p

The effect of clonidine on postoperative shivering in sevoflurane anaesthetized patients

Shivering is common during recovery from general anaesthesia. Besides the discomfort for the patient, shivering can exacerbate postoperative pain and induce complications in patients with coronary artery disease or heart failure by increasing oxygen consumption. Clonidine, an alpha2- adrenergic receptor agonist reduces postanaesthetic shivering. We evaluated the effect of clonidine on postoperative shivering in sevoflurane anaesthetized patients. We studied 30 patients undergoing elective ear or nose surgery. General anaesthesia was induced with an IV bolus of 2.0 mg/kg propofol and 1.5 $mu$g/kg fentanyl. General anaesthesia was maintained with sevoflurane (1.5 %2.0 % end-tidal concentration) and 70 % nitrous oxide in oxygen. Five minutes before tracheal extubation, patients were randomly assigned to receive saline or 2 $mu$g/kg clonidine intravenously. Postoperative shivering was assessed by using 3-point scale. Postoperative pain was assessed by using a 100 mm visual analog scale. There was no difference between two groups with respect to degree of sedation and severity of pain. Postoperative shivering was observed in 86.6 % of the patients given sevoflurane without clonidine and in 13.3 % of the patients with clonidine (p

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