Mehmet GAMLI, Eyüp HORASANLI, Bayazıt DİKMEN, Dilşen ÖRNEK, Aydın SELÇUK, Melekşah PEKEL

The effects of adding tramadol to ropivacaine on axillary brachial plexus blockade in uremic patients

Amaç: Bu çalışma; üremik hastalarda aksiler brakial pleksus bloğunda ropivakaine tramadol eklenmesinin anestezi kalitesi, duyusal ve motor blok süresi ve ilk analjezik gereksinim üzerine etkisini değerlendirmek için tasarlanmıştır. Yöntem ve gereçler: Etik kurul onayı ve bilgilendirimiş hasta oluru alındıktan sonra arteriovenöz fistül operasyonu düşünülen kırkbeş ASA III üremik hasta (30-80 yaş arası) rastgele iki gruba ayrıldı. Aksiller blok sinir stimülatörü kullanılarak multiple enjeksiyon tekniği ile yapıldı. Grup R’deki hastalara (n = 23) 38 mL ropivakain (3,75 mg/mL) ve 2 mL serum fizyolojik ve Grup RT’deki hastalara (n = 23) 38 mL ropivakain (3,75 mg/mL) ve 2 mL tramadol (50 mg/mL) uygulandı. Radial, median ve ulnar sinirlere ait duyusal ve motor blok başlama zamanı ve süreleri, analjezi süresi, ilk analjezik gereksinim zamanı, hemodinami ve yan etkiler kaydedildi.Bulgular:Demografik data, duyusal ve motor blok başlama zamanı ve duyusal ve motor blok başlama süreleri, analjezi süresi, anestezi kalitesi ve ilk analjezik gereksinim zamanı açısından her iki grup arasında benzerdi. Bununla birlikte, hemodinamik parametreler ve yan etkiler açısından da fark yoktu. Sonuç:Üremik hastalarda, arteriovenöz fistül operasyonu için aksiler brakiyal pleksus anestezisinde 3,75 mg/mL ropivakaine 100 mg tramadol eklenmesi, sinir blok karakteristikleri üzerine yararlı etki göstermemiştir.

Üremik hastalarda aksiller brakial pleksus bloğunda ropikaine eklenen tramadolün etkisi

Abstract: Aim: To evaluate the effect of tramadol added to ropivacaine on quality of anesthesia, onset of sensory and motor blockade, duration of sensory and motor blockade, and first analgesic request time for axillary brachial plexus block in uremic patients. Materials and methods: After institutional approval and informed consent had been obtained, 45 ASA III uremic patients (age range 30-80) scheduled for arteriovenous fistula surgery were included in the study. Patients were randomly allocated into 2 groups. Axillary block was performed with a peripheral nerve stimulator by multiple injection technique. Patients in Group R (n = 23) received 38 mL of ropivacaine (3.75 mg/mL) and 2 mL of normal saline, and patients in group RT (n = 22) received 38 mL of ropivacaine (3.75 mg/mL) and 2 mL of tramadol (50 mg/mL). The onset and duration of sensory and motor block in the distribution of the radial, median, and ulnar nerves; the duration of analgesia; the time to first requirement of analgesic; hemodynamics; and side effects were recorded. Results: Demographic data, onset of sensory and motor block, duration of sensory and motor block, quality of anesthesia, and first analgesic requirement times were similar between the groups. In addition, hemodynamic parameters and side effects did not differ between the groups. Conclusion: The addition of 100 mg of tramadol to 3.75 mg/mL of ropivacaine does not have any beneficial effect on the nerve block characteristics of axillary brachial plexus anesthesia for arteriovenous fistula surgery in uremic patients.

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