Bünyamin MUSLU, Selda MUSLU, R.Dilek ZENGİN, Ayşegül ÖZKÖK, Özcan ERDEMLİ

Remifentanil nörolept anestezide fentanile alternatif olabilir mi ?

Çalışmamızda remifentanil ile uyguladığımız nörolept anestezi (NA) tekniğini fentanil ile uygulanan NA tekniği ile karşılaştırıp hemodinami, derlenme, kan glukoz değerleri ve gelişebilecek komplikasyonlar üzerine etkisini araştırdık. Laparoskopik kolesistektomi uygulanan 30 hasta rastgele iki eşit gruba ayrıldı. İndüksiyon, droperidol (0.15 mg kg-1), maskeyle %50 O2-%50 N2O, remifentanil grubunda 0.5 μg kg-1 remifentanil, fentanil grubunda 2 μg kg-1 fentanil ile uygulandı. Bütün hastalara roküronyum bromür (0.6 mg kg-1) uygulamasını takiben idamede sırasıyla remifentanil infüzyonu (0.25 μg kg-1dk-1) ve 20 dk aralıklarla fentanil (50 μg) kullanıldı. Hemodinamik veriler, kan glukoz değerleri, derlenme süreleri ve gelişen komplikasyonlar kaydedildi. Remifentanil grubunda hemodinaminin daha stabil ve kan glukoz değerlerinin daha düşük olduğu görüldü (p

Anahtar Kelimeler:

Nörolept analjezi, Anesteziden uyanma dönemi, Anestezi, Fentanil, Glukoz, Hemodinamikler

Remifentanil can be an alternative to fentanyl in neurolept anesthesia ?

In this study, we compared remifentanil neuroleptanesthesia (NA) with fentanyl NA and investigated the effects on hemodynamic parameters, recovery characteristics, blood glucose levels and possible complications. Thirty patients who undervent laparoscopic cholecystectomy were randomly divided into two groups. Anaesthesia was induced by droperidol (0.15 mg kg-1), 50% O2-5%0 N2O inhalation and remifentanil 0.5 μg kg-1 in remifentanil group, fentanyl 2 μg kg-1 in fentanyl group. After neuromuscular blockade with rocuronium bromide (0.6 mg kg-1), maintenance was done with remifentanil infusion (0.25 μg kg-1min-1) and fentanyl (50 μg) for every 20 minutes. Hemodynamic datas, blood glucose levels, recovery characteristics and complications were recorded. In remifentanil group we observed that; hemodynamic parameters were more stable and blood glucose levels were lower (p<0.05). Also in remifentanil group, time to discharge from the operating room and recovery ward were shorter than fentanyl group (respectively, p<0.05, p<0.01). Complications such as intraoperative awareness and postoperative hypotension were lower in remifentanil group (p<0.05). Although the differences were not statistically significant postoperative pain and total analgesic utilization were higher in remifentanil group. Stability of hemodynamics, shorter recovery time and less postoperative complications were observed in neuroleptanesthesia with remifentanil. We concluded that, NA with remifentanil can be alternative to NA with fentanyl and can be used widely in clinical practice.

Keywords:

Neuroleptanalgesia, Anesthesia Recovery Period, Anesthesia, Fentanyl, Glucose, Hemodynamics,

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