İntrakraniyal kitle cerrahisinde propofol-remifentanil ile desfluran-remifentanil anestezisinin karşılaştırılması
Küçük Resim Yok
Tarih
2006
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Dergi ISSN
Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Elektif intrakraniyal kitle cerrahisinde propofol-remifentanil ve desfluran-remifentanil ile gerçekleştirilen anestezi uygulamalarının hemodinami ve derlenme üzerine olan etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntem: ASA I-III grubu, 18-65 yaşları arasında 40 olgu rasgele iki gruba (Grup I Propofol, Grup II Desfluran) ayrıldı. Tüm olgulara premedikasyonda 0,03 mg kg-1 midazolam, anestezi indüksiyonunda 1 mg kg-1 lidokain, 1 µg kg-1 remifentanil (60 saniyede) intravenöz uygulandı. Eş zamanlı remifentanilin 0,5 µg kg-1 dak-1 infüzyonuna başlandı. Remifentanil uygulamasını takiben 2 mg kg-1 intravenöz propofol verildi. Dura açılmasından sonra remifentanil infüzyonu % 50 azaltıldı. Anestezinin idamesinde birinci grupta 6 mg kg-1st-1 propofol infüzyonu, ikinci grupta % 3 konsantrasyonda desfluran ortalama arter basıncı 60-100 mmHg olacak şekilde kullanıldı. Olgular kalp atım hızı (KAH), ortalama arter basıncı (OAB), derlenme kriterleri, peroperatif komplikasyonlar açısından değerlendirildi. Bulgular: Grup I'de entübasyondan 2 dakika sonra (t3), 10 dakika sonra (t4) ve çivili başlık takılınca (t5) başlangıca göre OAB artış oranı Grup II'ye göre fazlaydı (sırasıyla; p0.008, p0.008, p0.013). Çivili başlık takıldıktan 10 dakika sonra (t7) ve dura insizyonunda (t8) ise, başlangıca göre OAB artış oranı Grup II'de yüksekti (p0.030, p0.037). Gruplar KAH yönünden karşılaştırıldığında entübasyondan 2 dakika sonra (t3) ve 10 dakika sonra (t4) başlangıca göre Grup II'deki azalma daha fazlaydı (sırasıyla; p0.001, p0.001). Çivili başlık takılınca (t5), çivili başlık takıldıktan 10 dakika sonra (t7) ve dura insizyonunda (t8) ise, Grup I'deki azalma oranı Grup II'ye göre fazlaydı (sırasıyla; p0.002, p0.010, p0.007). Grup II'de göz açma ve ekstübasyon zamanları daha kısaydı (sırasıyla; p0.005, p0.001). Sonuç: İntrakraniyal kitle cerrahisinde, remifentanil ile kombine edilen desfluran ve propofol anestezisinin intraoperatif hemodinamik yanıtı etkin olarak baskıladığı, fakat desfluran ile kombinasyonun daha kısa sürede derlenme sağladığı kanısına varıldı.
Aim: In this study, we aimed to evaluate the effects of propofol-remifentanil and desflurane-remifentanil anaesthesia on haemodynamics and recovery in elective intracranial mass surgery. Materials and Methods: Forty cases, ASA I-III, between 18-65 years age were randomly assigned into two groups (Group I: Propofol, Group II: Desflurane). All of the cases were premedicated with 0.03 mg kg-1 midazolam, anaesthesia induced with 1 mg kg-1 lidocaine and 1 µg kg-1 remifentanil intravenous (iv) bolus in 60 seconds. At the same time remifentanil infusion 0,5 µg kg-1 min-1 was started. After remifentanil administration, 2 mg kg-1 propofol applied to the patient. After dural opening, remifentanil infusion decreased 50 % of the beginning rate. Anaesthesia maintained in the first group with 6 mg kg-1 h-1 propofol infusion and in the second group with 3 % desflurane concentration to mean arterial pressure between 60-100 mmHg. Heart rate (HR), mean arterial pressure (MAP), recovery criteria, perioperative complications were evaluated. Results: In Group I, MAP was higher at 2 minutes (t3) and 10 minutes (t4) after intubation; during head holder application (t5) (respectively; p0.008, p0.008, p0.013). Ten minutes after head holder application (t7) and at dural incision (t8) MAP was higher in Group II (p0.030, p0.037). When groups were compared according to heart rates, at 2 minutes (t3) and 10 minutes (t4) after intubation decrement in Group II was higher (respectively; p0.001, p0.001). However, during head holder application (t5), ten minutes after head holder application (t7) and at dural incision (t8) decrement in Group I was higher than Group II (respectively; p0.002, p0.010, p0.007). In Group II eye opening, and extubation times were shorter (respectively; p0.005, p0.001). Conclusion: In conclusion, we decided that remifentanil combined desflurane and propofol anesthesia suppressed the intraoperative hemodynamic responses efficiently but desflurane remifentanil combination had a shorter recovery time in intracranial mass surgery.
Aim: In this study, we aimed to evaluate the effects of propofol-remifentanil and desflurane-remifentanil anaesthesia on haemodynamics and recovery in elective intracranial mass surgery. Materials and Methods: Forty cases, ASA I-III, between 18-65 years age were randomly assigned into two groups (Group I: Propofol, Group II: Desflurane). All of the cases were premedicated with 0.03 mg kg-1 midazolam, anaesthesia induced with 1 mg kg-1 lidocaine and 1 µg kg-1 remifentanil intravenous (iv) bolus in 60 seconds. At the same time remifentanil infusion 0,5 µg kg-1 min-1 was started. After remifentanil administration, 2 mg kg-1 propofol applied to the patient. After dural opening, remifentanil infusion decreased 50 % of the beginning rate. Anaesthesia maintained in the first group with 6 mg kg-1 h-1 propofol infusion and in the second group with 3 % desflurane concentration to mean arterial pressure between 60-100 mmHg. Heart rate (HR), mean arterial pressure (MAP), recovery criteria, perioperative complications were evaluated. Results: In Group I, MAP was higher at 2 minutes (t3) and 10 minutes (t4) after intubation; during head holder application (t5) (respectively; p0.008, p0.008, p0.013). Ten minutes after head holder application (t7) and at dural incision (t8) MAP was higher in Group II (p0.030, p0.037). When groups were compared according to heart rates, at 2 minutes (t3) and 10 minutes (t4) after intubation decrement in Group II was higher (respectively; p0.001, p0.001). However, during head holder application (t5), ten minutes after head holder application (t7) and at dural incision (t8) decrement in Group I was higher than Group II (respectively; p0.002, p0.010, p0.007). In Group II eye opening, and extubation times were shorter (respectively; p0.005, p0.001). Conclusion: In conclusion, we decided that remifentanil combined desflurane and propofol anesthesia suppressed the intraoperative hemodynamic responses efficiently but desflurane remifentanil combination had a shorter recovery time in intracranial mass surgery.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Türk Anestezi ve Reanimasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
34
Sayı
5
