Çocukların premedikasyonunda intranazal midazolam ve midazolam-sufentanilin karşılaştırılması
Küçük Resim Yok
Tarih
2008
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çocuklarda premedikasyonda intranazal uygulanan midazolam ve düşük doz midazolam-sufentanil kombinasyonunun sedasyon, hemodinami ve derlenme üzerine olan etkilerinin karşılaştırılması amaçlandı. Gereç ve Yöntem: Elektif tonsillektomi ve/veya adenoidektomi operasyonu planlanan 50 çocuk randomize olarak iki gruba ayrıldı. Olgulara Grup M (n25): 0,2 mg kg-1 midazolam, Grup M/S (n25): 0,1 mg kg-1 midazolam 0.75 µg kg-1 sufentanil premedikasyon amacıyla anestezi indüksiyonundan 20 dk. önce intranazal olarak uygulandı. Premedikasyon uygulanmadan önce ve sonra ortalama kan basıncı (OKB), kalp hızı (KH), periferik oksijen satürasyonu (SpO2) ve Ramsey sedasyon skorları değerlendirildi. Olguların ailelerinden ayrılmaları ve operasyon masasında venöz kanülasyona yanıtları değerlendirildi. Anestezi indüksiyonu % 50 O2 - % 50 N2O içinde % 8 sevofluran, 10 µg kg-1 alfentanil ile sağlandı. Yüz maskesine yanıt (kabul/ret) şeklinde değerlendirildi. Anestezi uygulaması % 50 O2 - % 50 N2O karışımı içinde % 2-3 sevofluran ile sürdürüldü. Operasyon sonrası görülen ajitasyon Davis skorlaması, ağrı seviyeleri “postoperative pain score” (POPS) skorlaması ile değerlendirildi. Bulgular: Gruplar arasında hemodinamik ölçümlerde anlamlı farklılık gözlenmedi (p0.05). Aileden ayrılma, yüz maskesine yanıt, postoperatif 30. dk.’daki POPS ve Davis skoru Grup M’de, venöz kanülasyona yanıt, Grup M/S’de daha iyi saptandı (p0.05). Postoperatif 10. dk.’daki Davis ve POPS skorları benzerdi (p0.05). Sonuç: Midazolam-sufentanil kombinasyonunun, tek başına midazolam kullanılmasına iyi bir alternatif oluşturamadığı kanısına varıldı.
Aim: We aimed to compare the effect of midazolam and the combination of low dose of midazolam and sufentanil applied intranasal on sedation, hemodynamic parameters and recovery in children for premedication. Materials and Methods: 50 children scheduled for elective tonsillectomy and/or adenoidectomy were randomized into two groups: Group M (n25): received midazolam 0.2 mg kg-1, Group M/S (n25): received 0.1 mg kg-1 midazolam plus 0.75 µg kg-1 sufentanil intranasal 20 minutes before anesthesia induction. Mean arterial pressure, heart rate, pulse oximetry and Ramsey sedation scores were recorded before and after premedication. The moods of children at the time of separation from parents are recorded as silence or not. The response to venous canulation was assessed operation desk. Anesthesia induction was provided with % 8 sevoflurane in 50 % O2-50 % N2O and 10 µg kg-1 alfentanil. The response to face mask was evaluated as accept/deny. Anesthesia was maintained with % 2-3 sevoflurane in 50 % O2-50 % N2O mixture. Postoperative agitation and pain level were determined with Davis Score and POPS respectively. Results: There were no difference in hemodynamic parameters between the groups (p>0.05). Children&#8217;s mood at the time of seperating from parents, response to face mask, POPS and Davis scores at postoperative 30th minute in Group M, response to venous canulation in Group M/S were significally better (p<0.05). There were no significant difference with respect to Davis and POPS scores measured at postoperative 10th minutes (p>0.05). Conclusions: Midazolam-sufentanil combination used in this study was not found to be a good alternative to midazolam only.
Aim: We aimed to compare the effect of midazolam and the combination of low dose of midazolam and sufentanil applied intranasal on sedation, hemodynamic parameters and recovery in children for premedication. Materials and Methods: 50 children scheduled for elective tonsillectomy and/or adenoidectomy were randomized into two groups: Group M (n25): received midazolam 0.2 mg kg-1, Group M/S (n25): received 0.1 mg kg-1 midazolam plus 0.75 µg kg-1 sufentanil intranasal 20 minutes before anesthesia induction. Mean arterial pressure, heart rate, pulse oximetry and Ramsey sedation scores were recorded before and after premedication. The moods of children at the time of separation from parents are recorded as silence or not. The response to venous canulation was assessed operation desk. Anesthesia induction was provided with % 8 sevoflurane in 50 % O2-50 % N2O and 10 µg kg-1 alfentanil. The response to face mask was evaluated as accept/deny. Anesthesia was maintained with % 2-3 sevoflurane in 50 % O2-50 % N2O mixture. Postoperative agitation and pain level were determined with Davis Score and POPS respectively. Results: There were no difference in hemodynamic parameters between the groups (p>0.05). Children&#8217;s mood at the time of seperating from parents, response to face mask, POPS and Davis scores at postoperative 30th minute in Group M, response to venous canulation in Group M/S were significally better (p<0.05). There were no significant difference with respect to Davis and POPS scores measured at postoperative 10th minutes (p>0.05). Conclusions: Midazolam-sufentanil combination used in this study was not found to be a good alternative to midazolam only.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Türk Anestezi ve Reanimasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
36
Sayı
5
