A comparison of general anesthesia with general anesthesia plus epidural levobupivacaine or bupivacaine [Genel anestezi ve genel anestezi ile birlikte uygulanan epidural levobupivakain veya bupivakain anestezisinin karşilaştirilmasi]
Küçük Resim Yok
Tarih
2008
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Aim: In this study, we aimed to compare the effects of general anesthesia and general anesthesia combined with epidural anesthesia, using two different local anesthesics levobupivacane or bupivakaine on the response to surgical stress, intraoperative hemodynamics, recovery, advers effects and postoperative analgesia. Materials and Methods: Fiftyfour patients scheduled for TAH-BSO were randomly divided into three groups,. General anesthesia+epidural bupivacaine group (Group I), general anesthesia+epidural levobupivacaine group (Group II) and general anesthesia group (Group III) were assigned. Lomber epidural catheter was placed in Group I and Group II. Anesthesia was induced in Group I and Group II, after T6 sensorial block were achieved. Anaesthesia induction was performed with propofol 2 mg kg-1, remifentanil 1 ? kg-1 min-1 and rocuronium 0.6 mg kg-1, in all groups. Anaesthesia maintanence was provided with in 50 % O2-air, 1 % sevoflurane and 0.1 ?g kg-1 min-1 remifentanil infusion. Blood glucose, Cortisol, insulin and CRP were measured. Preoperatively and postoperative 1st and 24th hours. All patients assessed in terms of hemodynamic values, the levels of sensorial and motor block, total dose of sevoflurane and remifentanil used intraoperatively, recovery, VAS and side effects. Epidural bupivacaine+morphine patient controlled analgesia (PCA) was used in Group I, epidural levobupivacaine +morphine PCA was used in Group II and iv morphine PCA was used in Group III, for postoperative pain management. Results: There were no significant diffirences between Group I and Group II in terms of time to reach to T6 dermatome, maximum sensorial block level, and motor block (p>0.05). Total remifentanil, sevoflurane and neuromusculer blocker requirements were greater in Group III compared to other two groups (p<0.05). Spontane respiration time, extubation time, eye opening time, ?9 Aldrete Recovery Score time to were statistically longer in Group III than Group I and Group II (p<0.05). Glucose, insulin and CRP values were similar at all times, among the groups (p>0.05). Cortisol values increased at 1st hour postoperatively in Group III than Group I and Group II (p<0.05). VAS values were greatest at the 0. minutes in Group III, but there were no diffirence at other times. In terms of postoperative side effects, nause-vomiting and pruritis were more frequent in Group III, but these were not statistically significant (p>0.05). Conclusion: According to these results, we concluded that epidural bupivacaine's and levobupivacaine's effects were similar in our study and we also concluded that epidural anaesthesia combined with general anaesthesia; provide better hemodynamic stability and analgesia postoperatively, suppressed stres response compared to general anaesthesia. Keywords: Bupivacaine, epidural anaesthesia, general anaesthesia, levobupivacaine, stress respons.
Açıklama
Anahtar Kelimeler
Kaynak
Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
36
Sayı
2
