Epidural anestezide %0.5 bupivakain ve % 0.5 levobupivakain kullanımının QT dispersiyonu ve hemodinamik etkilerinin karşılaştırılması
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Tarih
2010
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info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı, epidural yolla uygulanan %0.5 bupivakain ile %0.5 levobupivakainin; hemodinamik ve QT dispersiyonu etkilerinin değerlendirilmesidir. Yöntem: Epidural anestezi ile operasyon planlanan 60 hasta çalışmaya dahil edildi. Randomize olarak 2 gruba ayrıldı; Grup B'de (n30) 15 mL %0.5'lik bupivakain, Grup L'de (n30) 15 mL %0.5'lik levobupivakain epidural yoldan uygulandı. Peroperatif dönemde sistolik kan basıncı (SKB), diyastolik kan basıncı (DKB), ortalama kan basıncı (OKB), kalp atım hızı (KAH), periferik oksijen satürasyonu (Sp02), solunum sayısı ve yan etkiler kaydedildi. Postoperatif dönemde motor blok geri dönüş süreleri 30 dk.'lık periyotlarla değerlendirildi ve total blok süreleri kaydedildi. Preoperatif, ilk epidural anestezi uygulamasından 30 dk. sonra ve postoperatif 24. saatte EKG çekildi ve bir kardiyolog tarafından değerlendirildi. Bulgular: Motor blok gelişimi ve total blok süreleri Grup B'de yüksekti (p0.05) ve 180. dk. OKB Grup B'de azalmıştı (p0.05). En uzun düzeltilmiş QT zamanı ve en kısa düzeltilmiş QT zamanı Grup B'de uzamıştı (p0.05). Hipotansiyon görülme sıklığında ise Grup B'de artış saptandı (p0.05). Sonuç: Kardiyak problemleri olan, daha az motor blokaj istenen hastalarda levobupivakainin bupivakaine iyi bir alternatif olabileceğini düşünmekteyiz.
Objective: The aim of this study was to compare the hemodynamic variables and QT dispersion effects of 0.5% bupivacaine and 0.5% levobupivacaine using epidural via. Methods: Sixty patients scheduled for operation under epidural anesthesia were included to this study. The patients were randomized into two groups; 15 mL of 0.5% bupivacaine was given to Group B patients (n30) and 15 mL of 0.5% levobupivacaine was given to Group L patients (n-30). Systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, saturation of peripheral oxygen, respiratory rate and side-effects were recorded during perioperative period. Postoperatively, motor blockade recovery time was assessed at 30-minute intervals and total motor blockade time was recorded. ECG was recorded at preoperatively, at 30 minutes after first epidural anesthetic and postoperatively 24-hour and was assessed by a cardiologist. Results: Motor blockade and total blockage time were found to be longer in Group B (p<0.05). Mean blood pressure at the 180th minute was found to be decreased in Group B (p<0.05). The longest corrected QT interval and the shortest corrected QT interval were increased in Group B (p<0.05). Incidence of hypotension was higher in Group B (p<0.05). Conclusion: Levobupivacaine can be preferred to bupivacaine in patients having cardiac problem and when less motor blockade is desired.
Objective: The aim of this study was to compare the hemodynamic variables and QT dispersion effects of 0.5% bupivacaine and 0.5% levobupivacaine using epidural via. Methods: Sixty patients scheduled for operation under epidural anesthesia were included to this study. The patients were randomized into two groups; 15 mL of 0.5% bupivacaine was given to Group B patients (n30) and 15 mL of 0.5% levobupivacaine was given to Group L patients (n-30). Systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, saturation of peripheral oxygen, respiratory rate and side-effects were recorded during perioperative period. Postoperatively, motor blockade recovery time was assessed at 30-minute intervals and total motor blockade time was recorded. ECG was recorded at preoperatively, at 30 minutes after first epidural anesthetic and postoperatively 24-hour and was assessed by a cardiologist. Results: Motor blockade and total blockage time were found to be longer in Group B (p<0.05). Mean blood pressure at the 180th minute was found to be decreased in Group B (p<0.05). The longest corrected QT interval and the shortest corrected QT interval were increased in Group B (p<0.05). Incidence of hypotension was higher in Group B (p<0.05). Conclusion: Levobupivacaine can be preferred to bupivacaine in patients having cardiac problem and when less motor blockade is desired.
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Cerrahi
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Anestezi Dergisi
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Cilt
18
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3
