Noyan KOROĞLU, Aynur ATAY, Erol GÖKEL, Van Lale KOROĞLU, Leyla İYİLİKÇİ

Sezaryen olgularında hızlı endotrokeal entübasyonda rokuronyum ve süksinilkolinin karşılaştırılması

Sezaryen olgularında hızlı endotrakeal entübasyonda rokuronyum ve süksinilkolinin entübasyon kalitesi, annede, hemodinamik, yenidoğanda nörolojik ve fizyolojik etkilerinin karşılaştırılması amaçlandı. Sezaryen yapılacak, 80 gebe rasgele 20'şer kişilik, 4 gruba ayrıldı. Anestezi indüksiyonunda; rokuronyum-propofol (R-P) grubunda 2 mg/kg propofol, 0.6 mg/kg rokuronyum; rokuronyum-tiyopenton (R-T) grubunda 5 mg/kg tiyopenton, 0.6 mg/kg rokuronyum; süksinilkolin-propofol (S-P) grubunda 2 mg/kg propofol, 1.5 ıng/kg süksinilkolin; süksinilkolin-tiyopenton (S-T) grubunda 5 mg/kg tiyopenton, 1.5 mg/kg süksinilkolin uygulandı. Kas gevşetici enjeksiyonundan yirmi saniye sonra larengoskopi hazırlığına başlandı ve klinik bulgulara göre entübasyon gerçekleştirildi. "TOF-GUARD" sinir stirnülatörü ile TOF formunda uyarılar verildi ve addüktör pollisis kasının yanıtı izlendi. Kas gevşetici etki başlama zamanı, entübasyon kalitesi değerlendirildi. Fetus umblikal arter/ven kanında pH, PaO2, PaCO2, HCO3, O2 satürasyonu ölçüldü. Birinci ve 5. dk APGAR skorları kaydedildi. Gruplara göre kabul edilebilir koşullarda, entübasyon zamanları ortalama 38-42 saniye arasında oldu, entübasyon kalitesinde gruplar arasında fark bulunmadı. Etki başlama zamanları; süksinilkolin gruplarında (S-P: 48.42±18.64, S-T: 57.50±16.53 sn), rokuronyum gruplarından (R-P: 90.00±23.30, R-T: 107.33±40.08 sn) anlamlı kısa bulundu (p

Comparison of rocuronium and succinylcholine for rapid sequence intubation cesarean section

We aimed to study the effects of rocuronium and succinylcholine on the quality of rapid sequence intubation, hemodynamic effects on the mother and neurologic and physiologic effects on the fetus. Eighty term pregnant patients were randomly divided into 4 groups each containing 20. For the induction of anesthesia, patients received 0.6 mg/kg rocuronium following 2 mg/kg propofol in rocuronium-propofol (R-P) group, 0.6 mg/kg rocuronium following 5 mg/kg thiopentone in rocuronium-thiopentone (R-T) group, 1.5 mg/kg succinylcholine fallowing 2 mg/kg propfol in succinylcholine-propofol (S-P) group and 1.5 mg/kg succinylcholine following 5 mg/kg thiopentone in succinylcholine-thiopentone (S-T) group. Twenty seconds after injection of neuromuscular blocking agent preparation for laryngoscopy was started and patients were intubated according to clinical conditions. Neuromuscular conduction was evaluated with the motor response in musculus adductor pollicis by using stimulations in the form of TOF with TOF-Guard nerve stimulator. After the delivery of the fetus umbilical arterial/venous pH, PaO2, PaCO2, HCO3, SaO2 values were measured, 1. and 5. min APGAR scores were recorded. Mean time to intubation was between 38-42 seconds when appropriate clinical conditions were reached and there was no difference in quality of intubation between groups. When the mean onset of action for each group were compared, there was a significant difference between the group R-P (90.00±23.30 sec) and groups S-P (48.42±18.64 sec) and S-T (57.50±16.53 sec) (p

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