Sezaryenlerde Bupivakaine Eklenen Sufentanil ve Fentanilin Maternal ve Neonatal Etkileri
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Dosyalar
Tarih
2003
Dergi Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada sezeryanlarda intratekal bupivakaine eklenen sufentanil, fentanil ve plasebonun maternal ve neonatal etkilerinin araştırılmasını amaçlandık. Etik komite onayı alındıktan sonra, 45 miyadında gebe randomize olarak üç gruba ayrıldı. Grup K'ya (Kontrol grubu) 10 mg bupivakain heavy ve 2 mL izotonik mayi, Grup F'ye 10 mg bupivakain heavy ve 25 µg fentanil, Grup S'e ise 10 mg bupivakain heavy ve 10 µg sufentanil, tüm gruplarda verilecek mayi toplam 4 mL olacak şekilde intratekal olarak uygulandı. Olguların hemodinamik parametreleri, motor ve duyusal blokajları, ameliyat sonrası ilk analjezik ihtiyaç zamanları ve perpost operatif yan etkiler takip edildi. Göbek kordonundan arteryal kan gazı örnekleri, 1.-5. dk Apgar skorları ve yenidoğan bebeklerin 2. saat Nörolojik ve Adatif Kapasite Skorları (NAKS) değerlendirildi. Hasta özellikleri, L1-2, T10 ve maksimal dermatomlara ulaşım zamanları, motor blok derecesi ve motor bloğun ortadan kalkış zamanları, kan gaz analizleri, Apgar ve NAKS skorları açısından gruplar arasında fark yoktu. Bulantı, grup K da grup S ve F'e göre daha fazla gözlendi (p0.05). Kaşıntı Grup S ve F de Grup K'ya göre daha fazla gözlendi (p0.05). Bu yan etki Grup S'de daha belirgindi (p0.05). İlk analjezik ihtiyacı süresi grup K'ya göre grup S ve F de daha uzunken (p0.05), grup S ile grup F karşılaştırıldığında grup S de daha uzun bulundu (p0.05). Spinal anestezi için bupivakaine eklenen 25 µg fentanil veya 10 µg sufentanilin intraroperatif bulantıyı azaltmaları ve postoperatif ilk analjezik ihtiyacı süresini uzatmaları yanında neonatal yan etkilerinin olmaması nedeni ile sezaryenlerde güvenle kullanılabileceği kanısındayız.
We aimed to evaluate the maternal and neonatal effects of intrathecal sufentanil, fentanyl and plasebo added to hyperbaric bupivacaine for cesarean section. After etthical comittee approval, 45 healty, full-term parturients allocated into three groups. Group K (control group) received 10 mg bupivacaine heavy and 2 cc % 0.9 NaCl, Group F received 10 mg bupivacaine heavy and 25 µg fentanyl and Group S received 10 mg bupivacaine heavy and 10 µg sufentanil intrathecally. Total volume of 4 mL was used in both groups. Haemodynamic values, sensory and motor blocs, the first requirement time for analgesia and Intra/post-operative side effects were recorded. Blood samples were collected from the umblical artery for blood gas analyses. Apgar score at 1 and 5 min. and Neurologic and Adaptive Capacity Score (NACS) of newborns at 2 hr was evaluated. There were no significant differences in patients characteristics, time to reach L1-2, T10 and maximal sensory level, degree and resolution of motor block, blood gas analyses, Apgar and NACS scores. Nausea was more in group K than in group S and F (p<0.05). Pruritus was a frequent side effect both in group S and F (p<0.05), but it was more remarkable in group S (p<0.05). Complete analgesia was prolong in group F and S than in group K. The first requirement time for analgesia was longer in group S compared to group F (p<0.05). In summary, intrathecal fentanyl 25 µg or sufentanil 10 µg added to hyperbaric bupivacaine for cesarean section reduced nausea and increased the duration of analgesia in the early postoperative period. Because this combinations had no adverse effects on neonatals we concluded that they can be used safely in cesarean sections.
We aimed to evaluate the maternal and neonatal effects of intrathecal sufentanil, fentanyl and plasebo added to hyperbaric bupivacaine for cesarean section. After etthical comittee approval, 45 healty, full-term parturients allocated into three groups. Group K (control group) received 10 mg bupivacaine heavy and 2 cc % 0.9 NaCl, Group F received 10 mg bupivacaine heavy and 25 µg fentanyl and Group S received 10 mg bupivacaine heavy and 10 µg sufentanil intrathecally. Total volume of 4 mL was used in both groups. Haemodynamic values, sensory and motor blocs, the first requirement time for analgesia and Intra/post-operative side effects were recorded. Blood samples were collected from the umblical artery for blood gas analyses. Apgar score at 1 and 5 min. and Neurologic and Adaptive Capacity Score (NACS) of newborns at 2 hr was evaluated. There were no significant differences in patients characteristics, time to reach L1-2, T10 and maximal sensory level, degree and resolution of motor block, blood gas analyses, Apgar and NACS scores. Nausea was more in group K than in group S and F (p<0.05). Pruritus was a frequent side effect both in group S and F (p<0.05), but it was more remarkable in group S (p<0.05). Complete analgesia was prolong in group F and S than in group K. The first requirement time for analgesia was longer in group S compared to group F (p<0.05). In summary, intrathecal fentanyl 25 µg or sufentanil 10 µg added to hyperbaric bupivacaine for cesarean section reduced nausea and increased the duration of analgesia in the early postoperative period. Because this combinations had no adverse effects on neonatals we concluded that they can be used safely in cesarean sections.
Açıklama
Anahtar Kelimeler
Çift arkus aorta
, Trakeobronşiyal obstrüksiyon, Double aortic arch, Tracheobronchial obstruction
Kaynak
Türk Anestezi ve Reanimasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
31
Sayı
10
Künye
Reisli, R., Tuncer, S., Çelik, J., Yosunkaya, A., Uzun, S., Sarkılar, G., Ökeşli, S., (2003). Sezaryenlerde Bupivakaine Eklenen Sufentanil ve Fentanilin Maternal ve Neonatal Etkileri. Türk Anestezi ve Reanimasyon Dergisi, 31(10), 522-528.
