Trakeal Entübasyonda Oluşan Hemodinamik Yanıtın Kontrolünde Sufentanilin Farklı Dozlarının Karşılaştırılması
Küçük Resim Yok
Tarih
2003
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Çalışmamızda laringoskopi ve entübasyona hemodinamik yanıtta sufentanilin en uygun, yeterli ve güvenilir dozunu belirlemeyi amaçladık. Çalışma elektif cerrahi planlanan ASA I-II sınıfı, kardiyovasküler hastalığı olmayan, normotansif 45 olguda gerçekleştirildi. Olgular rasgele olarak 3 eşit gruba ayrıldı. Bütün olgulara intravenöz 0.03 mg kg-1 midazolam premedikasyonundan 10 dk sonra, Grup I'e (GI) 0.1 µg kg-1, Grup II'ye (GII) 0.15 µg kg-1, Grup III'e (GIII) 0.2 µg kg-1 sufentanil intravenöz uygulandı. Yaklaşık 2 dk sonra 2 mg kg-1 propofol ve 1.5 mg kg-1 süksinil kolin verildi. Olgular direk laringoskopi ile entübe edildiler. Sistolik arter basıncı (SAB), diyastolik arter basıncı (DAB), ortalama arter basıncı (OAB) ve kalp atım hızı (KAH), başlangıçta (midazolam uygulamasından 10 dk sonra) (t0), propofol uygulamasından önce (t1), laringoskopi öncesi (t2), trakeal entübasyondan sonra 1. ve 3 dk (t3, t4) ölçüldü. Grup içi parametre değerleri karşılaştırıldığında G I'de entübasyon sonrası (t3, t4) KAH'da artış gözlendi (p0.05). G II'de indüksiyon sonrası (t2) SAB değeri başlangıç değeri ile karşılaştırıldığında anlamlı olarak düşük bulundu (p0.05). G III'de tüm hemodinamik parametre değerleri (SAB, DAB, OAB; KAH) t2, t3 ve t4' de anlamlı düşük bulundu (p0.05). Gruplar karşılaştırıldığında ise G I ve G II arasında hemodinamik parametre değerleri açısından tüm ölçüm zamanlarında farklılık gözlenmezken,G III'de G I'e göre t3'de SAB, OAB ve KAH; t4'de SAB, DAB, OAB ve KAH'da, G II'ye göre, t3 ve t4'de KAH değerleri anlamlı olarak düşük bulundu (p0.05). GIII'de 7 olguda bradikardi gözlendi. Sonuç olarak, kardiovasküler hastalığı olmayan, normotansif olgularda laringoskopi ve entübasyon sonrası cevabın önlenmesinde 0.15 µg kg-1 sufentanilin yeterli ve güvenilir olduğu kanısındayız.
In our study, we aimed to determine the most appropriate, sufficient, and safe dose of sufentanil in the hemodynamic response to laringoscopy and intubation. This study was performed on 45 ASA I-II physical status, without cardiovascular illness, normotansive patients planned for elective surgery. Patients were randomized into three equal groups. All patients received an intravenous midazolam premedication (0.03 mg kg-1). Ten minutes after, 0,1 µg kg-1 sufentanil in Group I (GI), 0.15 µg kg-1 sufentanil in Group II (GII) and 0.2 µg kg-1 sufentanil in Group III (GIII) were administrated intravenously. About two minutes after, all patients received 2 mg kg-1 propofol and 1.5 mg kg-1 succinylcholine. The patients were intubated under direct laringoscopy. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and heat rate (HR) were measured: at the beginning (10 min. after midazolam application) (t0), before propofol (t1), before laryngoscopy (t2), 1 and 3 minutes after the tracheal intubation (t3,t4). When the group parameter values were evaluated, it was observed that there was an significant increase in HR after the intubation (t3,t4) in G I (p>0.05). In G II SAP was significantly decrease after induction (t2) when compared with t0 (p<0.05). All hemodynamic parameter values (SAP, DAP, MAP, HR) were found significantly decrease at t2, t3, t4 in G III (p<0.05). When the groups were compared, there were no differences in all measurement times in the aspect of hemodynamic parameter values between G 1 and G II (p>0.05). SAP, MAP, HR values at t3 and SAP, DAP, MAP, HR at t4 were found significantly lower in G III than in G I (p<0.05) and HR values at t3, t4 were found significantly lower in G III than G II (p<0.05). Bradycardia occurred in seven patients in G III. As a result; We think that 0.15 µg kg-1 sufentanil was safe and satisfactory to suppress the response after laryngoscopy and tracheal intubation in healthy normotensive patients without cardiovascular disease.
In our study, we aimed to determine the most appropriate, sufficient, and safe dose of sufentanil in the hemodynamic response to laringoscopy and intubation. This study was performed on 45 ASA I-II physical status, without cardiovascular illness, normotansive patients planned for elective surgery. Patients were randomized into three equal groups. All patients received an intravenous midazolam premedication (0.03 mg kg-1). Ten minutes after, 0,1 µg kg-1 sufentanil in Group I (GI), 0.15 µg kg-1 sufentanil in Group II (GII) and 0.2 µg kg-1 sufentanil in Group III (GIII) were administrated intravenously. About two minutes after, all patients received 2 mg kg-1 propofol and 1.5 mg kg-1 succinylcholine. The patients were intubated under direct laringoscopy. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and heat rate (HR) were measured: at the beginning (10 min. after midazolam application) (t0), before propofol (t1), before laryngoscopy (t2), 1 and 3 minutes after the tracheal intubation (t3,t4). When the group parameter values were evaluated, it was observed that there was an significant increase in HR after the intubation (t3,t4) in G I (p>0.05). In G II SAP was significantly decrease after induction (t2) when compared with t0 (p<0.05). All hemodynamic parameter values (SAP, DAP, MAP, HR) were found significantly decrease at t2, t3, t4 in G III (p<0.05). When the groups were compared, there were no differences in all measurement times in the aspect of hemodynamic parameter values between G 1 and G II (p>0.05). SAP, MAP, HR values at t3 and SAP, DAP, MAP, HR at t4 were found significantly lower in G III than in G I (p<0.05) and HR values at t3, t4 were found significantly lower in G III than G II (p<0.05). Bradycardia occurred in seven patients in G III. As a result; We think that 0.15 µg kg-1 sufentanil was safe and satisfactory to suppress the response after laryngoscopy and tracheal intubation in healthy normotensive patients without cardiovascular disease.
Açıklama
Anahtar Kelimeler
Acil Tıp, Anestezi
Kaynak
Türk Pediatri Arşivi
WoS Q Değeri
Scopus Q Değeri
Cilt
31
Sayı
3
Künye
Tuncer, S., Reisli, R., Yosunkaya, A., Tavlan, A., Uzun, S., Ökeşli, S., (2003). Trakeal Entübasyonda Oluşan Hemodinamik Yanıtın Kontrolünde Sufentanilin Farklı Dozlarının Karşılaştırılması. Türk Pediatri Arşivi, 31(3), 116-120.
