Gülten KORKMAZ, Aynur ÖZENSOY, Tülin Akarsu AYAZOĞLU, F. Doğu GEYİK, M. Akif CANDAN

Günübirlik Artroskopik Diz Cerrahisinde Hiperbarik Levobupivakain ile Yapılan Bilateral ve Unilateral Spinal Bloğun Karşılaştırılması

Amaç: Artroskopik diz cerrahisi geçirecek hastalarda intratekal hiperbarik levobupivakainin bilateral ve unilateral pozisyonda kullanımlarının, sensoryal blok düzeyleri, motor blok derecesi ve motor bloğun geri dönüş süresi, anestezi kalitesi ve komplikasyonları, hemodinamik stabilite açısından karşılaştırılması amaçlanmıştır. Materyal ve Metot: ASA (American Society of Anesthesiologists) I-II grubunda toplam 60 hasta iki gruba ayrıldı. A grubu hastalara 2 ml % 0,75 levobupivakain + 1 ml %20 dekstroz içeren bir karışım oturur pozisyonda 10 saniyede enjekte edildi. Grup Bdeki hastalara lateral dekübitis (yan yatar) pozisyon verildikten sonra intratekal ilaç eşit doz ve sürede yapıldı. Hastaların sensoryal blok seviyeleri, sensoryal bloğun T10 düzeyine ulaşma zamanı, maksimal üst dermatom seviyesi, maksimal üst dermatom seviyesine ulaşma zamanı ve bloğun sonlanma zamanı, motor bloğun başlama zamanı, maksimal motor bloğa ulaşma zamanı ve L1 düzeyine ulaşma ve sonlanma süreleri kaydedildi. Karşılaştırmalarda Students t, Paired t test, Fisher exact test ve ki-kare testleri kullanıldı. Analiz sonrası ortaya çıkan p

(Comparison of bilateral and unilateral spinal block with hyperbaric levobupivacaine for outpatient arthroscopic knee surgery)

Background: We aimed to compare intrathecal hyperbaric levobupivacaine at bilateral and unilateral position in terms of level of sensory block, degree of motor block, turnaround time of motor block, quality and complications of anaesthesia and hemodynamic stability in arthroscopic knee surgery. Material and Methods: Sixty patients with ASA (American Society of Anesthe-siologists) physical status I-II group were divided into two groups. In group A, a mixture of 2 ml %0,75 levobupivacaine +1 ml 20% dextrose was injected intrathecally in ten seconds at sitting position. In group B, after giving the lateral position, unilateral spinal anesthesia was applied in equal dose and duration. Sensory block levels of the patients, time to reach T10 level of sensory block, maximum upper dermatomal level, time to reach the maximum level of the upper dermatome and time to termination of the block, onset time of motor block, time to reach maximal motor block and time to attain the level of L1 and termination time was recorded. Student's t, paired t-test, Fisher's exact test and chi-square tests were used for comparisons. After the analysis of the results p value of <0.05 was considered significant. Results: In group A, onset time of sensory block, time to rise of sensory block to L1 dermatome and ending time of sensory block was longer than those of group B and it was statistically significant (p<0.001). Conclusions: We concluded that unilateral hyperbaric levobupivacaine forms more quick and more effective sensory and motor block than bilateral hyperbaric levobupivacaine and provide a significant advantage in ambulatory arthroscopic surgery.

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