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Timpanoplasti Cerrahisinde Desfluran ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması

Year 2013, Volume: 13 Issue: 1, 4 - 10, 01.01.2013

Abstract

Amaç:

İnhalasyon anesteziklerinin ve intravenöz anestezik ilaçların kan glukoz seviyelerine etkileri uzun zamandır araştırılan konular arasındadır. Ancak nispeten yeni ajanlar olan sevofluran ve desfluran ile bu etkileri karşılaştıran yeterli çalışma yoktur. Bu çalışmada; timpanoplasti ameliyatlarında sevofluran ve desfluran anestezisinin kan glukoz (GLC) düzeylerine etkileri araştırılmıştır.

Gereç ve yöntem:

Çalışmamızda 18-65 yaş arası ASA I-IIrisk grubundaki 60 hasta iki gruba ayrıldı. I. gruba sevofluran-remifentanil (grup S), II. gruba desfluran-remifentanil(grup D) uygulandı. Ameliyat öncesi 8 saat açlıktan sonra, intraoperatif 5., 10., 30., 60., 90., 120., dakikalarda ve ekstübasyondan sonra 30 dk’da kan GLC değeri ölçüldü. İntraoperatif 5. ve 120. dk’da kan laktat seviyesi ölçüldü.  

Bulgular:

GLC ortalamaları açısından gruplar arasında istatistiksel olarak anlamlı farklılık saptanmadı (p>0,05). Desfluran grubundaki olguların GLC ortalamaları değişimi incelendiğinde; tüm ölçüm zamanlarındaki GLC ortalaması başlangıç GLC ortalamasından istatistiksel olarak anlamlı derecede daha yüksek izlendi. Sevofluran grubundaki olguların zaman içindeki GLC ortalamaları değişimi incelendiğinde; 3. Ölçüm GLC ortalaması hariç, diğer ölçüm zamanlarındaki GLC ortalaması başlangıç ölçüm zamanlarındaki GLC ölçüm ortalamasından istatistiksel olarak anlamlı derecede daha yüksek saptandı.

Sonuç:

Sevofluran ve desfluran anestezisi uygulanan gruplar arasında, cerrahi esnasında ve postoperatif dönemdekan GLC düzeylerine etkileri açısından farklılık bulunamamıştır. 

References

  • Schricker T, Lattermann R, Schreiber M, Geisser W, Georgieff M, Radermacher P. The hyperglycaemic response to surgery: pathophysiology, clinical implications and modification by the anaesthetic technique. Clinica Intensive Care. 1998;9 (3):118-28.
  • Warner DS, Gionet TX, Todd MM, McAllister AM. Insulininduced normoglycemia improves ischemic outcome in hyperglycemic rats. Stroke. 1992;23 (12):1775-81.
  • Schricker T, Lattermann R, Fiset P, Wykes L, Carli F. Integrated analysis of protein and glucose metabolism during surgery: effects of anesthesia. J Appl Physiol. 2001;91 (6):252330.
  • Solca M, Salvo I, Russo R, Fiori R, Veschi G. Anaesthesia with desflurane-nitrous oxide in elderly patients. Comparison with isoflurane-nitrous oxide. Minerva Anestesiol. 2000;66 (9):621-6.
  • Oyama T, Murakawa T, Matsuki A. Endocrine evaluation of sevoflurane, a new inhalation anesthetic agent. Acta Anaesthesiol Belg. 1989;40 (4):269-74.
  • Oyama T, Takazawa T. Effects of halothane anaesthesia and surgery on human growth hormone and insulin level in plasma. Br J Anaesth 1971;43:573–80.
  • Diltoer M, Camu F. Glucose homeostasis and insulin secretion during isoflurane anesthesia in humans. Anesthesiology 1988; 68:880–6.
  • Ittichaikulthol W, Lekprasert V, Pausawasdi S, Suchartwatnachai P. Effect of intraoperative fluid on blood glucose level in neurosurgery. J Med Assoc Thai. 1997;80 (7):461-5.
  • Suchartwatnachai P, Kaewsing P. Effect of sevoflurane and isoflurane on blood glucose level in neurosurgery. Thai J Anesthesiol. 2003;29 (4):198-203.
  • Saho S, Kadota Y, Sameshima T, Miyao J, Tsurumaru T, Yoshimura N. The effects of sevoflurane anesthesia in insulin secretion and glucose metabolism in pigs. Anesth Analg 1997;84:1359–65.
  • Tanaka T, Nabatame H, Tanifuji Y. Insulin secretion and glucose utilization are impaired under general anesthesia with sevoflurane as well as isoflurane in a concentrationindependent manner. J Anesth 2005;19:277–81.
  • Baldini G, Bagry H, Carlı F. Depth of anesthesia with desflurane does not influence the endocrine-metabolic response to pelvic surgery. Acta Anaesthesiol Scand 2008; 52: 99–105.
  • Giesecke K, Hamberger B, Ja¨rnberg PO et al. High- and lowdose fentanyl anaesthesia: hormonal and metabolic responses during cholecystectomy. Br J Anaesth 1988; 61: 575–82.
  • Moller IW, Krantz T,Wandall E, Kehlet H. Effect of alfentanil anaesthesia on the adrenocortical and hyperglycaemic response to abdominal surgery. Br J Anaesth 1985; 57: 591–
  • Bovill JG, Sebel P, Fiolet JWTet al. The influence of sufentanil on endocrine and metabolic responses to cardiac surgery. Anesth Analg 1983; 62: 391-7.
  • Schrıcker T, Galeone M, Wykes L, Carli F. Effect of desflurane/remifentanil anaesthesia on glucose metabolism during surgery: a comparison with desflurane/ epidural anaesthesia. Acta Anaesthesiol Scand 2004; 48: 169-1
  • Yazışma Adresi / Correspondence: Dr Levent ÖZTÜRK e-posta: dr_levent@yahoo.com Tel: 03122912525/2706 10

Comparisons Of Desflurane And Sevoflurane Anesthesia In Their Effects On Blood Glucose Levels During Tympanoplasty Operations

Year 2013, Volume: 13 Issue: 1, 4 - 10, 01.01.2013

Abstract

Introduction: The effects of intravenous anesthetic drugs and inhaled anesthetics to the blood glucose (GLC) levels were investigated. Unfortunately, there is no adequate studies comparing these effects with new agents such as sevoflurane and desflurane drugs. In this study, blood GLC level changes among the the patients undergoing general anesthesia with sevoflurane and desflurane during the tympanoplasty surgery, were investigated. Material and methods: 60 patients,ages ranging between 18-65 in the ASA I-II risk group were randomly allocated to one of the two groups; The sevoflurane-remifentanyl drugs combination was applied to the group S and the desfluran-remifentanyl drugs combination was used for the group D. After fasting for 8 hours at the preoperative period, the blood GLC levels were measured before induction, at the 5 th , 10 th , 30 th , 60 th , 90 th , 120 th minutes, during the intraoperative period and 30 minutes after the extubation. Blood lactate levels were measured intraoperatively at 5th and 120th minutes.Results: There was no statistically significant difference between groups in terms of mean glucose levels (p>0,05). A statistically significant difference was observed between the T1-T6 and T0 values obtained in the desflurane groups according to the mean GLC level. In the sevoflurane group; there was no statistically significant difference at the third measurement time (p=0,223). In all other measurement times, the mean GLC levels were statistically significantly higher than the first measurement time.Conclusion: There was no difference between the two groups, in terms of blood GLC levels, representing patients who underwent anesthesia with sevoflurane and desflurane during tympanoplasty surgery.

References

  • Schricker T, Lattermann R, Schreiber M, Geisser W, Georgieff M, Radermacher P. The hyperglycaemic response to surgery: pathophysiology, clinical implications and modification by the anaesthetic technique. Clinica Intensive Care. 1998;9 (3):118-28.
  • Warner DS, Gionet TX, Todd MM, McAllister AM. Insulininduced normoglycemia improves ischemic outcome in hyperglycemic rats. Stroke. 1992;23 (12):1775-81.
  • Schricker T, Lattermann R, Fiset P, Wykes L, Carli F. Integrated analysis of protein and glucose metabolism during surgery: effects of anesthesia. J Appl Physiol. 2001;91 (6):252330.
  • Solca M, Salvo I, Russo R, Fiori R, Veschi G. Anaesthesia with desflurane-nitrous oxide in elderly patients. Comparison with isoflurane-nitrous oxide. Minerva Anestesiol. 2000;66 (9):621-6.
  • Oyama T, Murakawa T, Matsuki A. Endocrine evaluation of sevoflurane, a new inhalation anesthetic agent. Acta Anaesthesiol Belg. 1989;40 (4):269-74.
  • Oyama T, Takazawa T. Effects of halothane anaesthesia and surgery on human growth hormone and insulin level in plasma. Br J Anaesth 1971;43:573–80.
  • Diltoer M, Camu F. Glucose homeostasis and insulin secretion during isoflurane anesthesia in humans. Anesthesiology 1988; 68:880–6.
  • Ittichaikulthol W, Lekprasert V, Pausawasdi S, Suchartwatnachai P. Effect of intraoperative fluid on blood glucose level in neurosurgery. J Med Assoc Thai. 1997;80 (7):461-5.
  • Suchartwatnachai P, Kaewsing P. Effect of sevoflurane and isoflurane on blood glucose level in neurosurgery. Thai J Anesthesiol. 2003;29 (4):198-203.
  • Saho S, Kadota Y, Sameshima T, Miyao J, Tsurumaru T, Yoshimura N. The effects of sevoflurane anesthesia in insulin secretion and glucose metabolism in pigs. Anesth Analg 1997;84:1359–65.
  • Tanaka T, Nabatame H, Tanifuji Y. Insulin secretion and glucose utilization are impaired under general anesthesia with sevoflurane as well as isoflurane in a concentrationindependent manner. J Anesth 2005;19:277–81.
  • Baldini G, Bagry H, Carlı F. Depth of anesthesia with desflurane does not influence the endocrine-metabolic response to pelvic surgery. Acta Anaesthesiol Scand 2008; 52: 99–105.
  • Giesecke K, Hamberger B, Ja¨rnberg PO et al. High- and lowdose fentanyl anaesthesia: hormonal and metabolic responses during cholecystectomy. Br J Anaesth 1988; 61: 575–82.
  • Moller IW, Krantz T,Wandall E, Kehlet H. Effect of alfentanil anaesthesia on the adrenocortical and hyperglycaemic response to abdominal surgery. Br J Anaesth 1985; 57: 591–
  • Bovill JG, Sebel P, Fiolet JWTet al. The influence of sufentanil on endocrine and metabolic responses to cardiac surgery. Anesth Analg 1983; 62: 391-7.
  • Schrıcker T, Galeone M, Wykes L, Carli F. Effect of desflurane/remifentanil anaesthesia on glucose metabolism during surgery: a comparison with desflurane/ epidural anaesthesia. Acta Anaesthesiol Scand 2004; 48: 169-1
  • Yazışma Adresi / Correspondence: Dr Levent ÖZTÜRK e-posta: dr_levent@yahoo.com Tel: 03122912525/2706 10
There are 17 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Selim Çolak This is me

Levent Öztürk This is me

Bekir Kürkçüoğlu This is me

Gökçer Uğur This is me

Abdülkadir But This is me

Publication Date January 1, 2013
Published in Issue Year 2013 Volume: 13 Issue: 1

Cite

APA Çolak, S., Öztürk, L., Kürkçüoğlu, B., Uğur, G., et al. (2013). Timpanoplasti Cerrahisinde Desfluran ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması. Ankara Medical Journal, 13(1), 4-10.
AMA Çolak S, Öztürk L, Kürkçüoğlu B, Uğur G, But A. Timpanoplasti Cerrahisinde Desfluran ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması. Ankara Med J. January 2013;13(1):4-10.
Chicago Çolak, Selim, Levent Öztürk, Bekir Kürkçüoğlu, Gökçer Uğur, and Abdülkadir But. “Timpanoplasti Cerrahisinde Desfluran Ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması”. Ankara Medical Journal 13, no. 1 (January 2013): 4-10.
EndNote Çolak S, Öztürk L, Kürkçüoğlu B, Uğur G, But A (January 1, 2013) Timpanoplasti Cerrahisinde Desfluran ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması. Ankara Medical Journal 13 1 4–10.
IEEE S. Çolak, L. Öztürk, B. Kürkçüoğlu, G. Uğur, and A. But, “Timpanoplasti Cerrahisinde Desfluran ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması”, Ankara Med J, vol. 13, no. 1, pp. 4–10, 2013.
ISNAD Çolak, Selim et al. “Timpanoplasti Cerrahisinde Desfluran Ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması”. Ankara Medical Journal 13/1 (January 2013), 4-10.
JAMA Çolak S, Öztürk L, Kürkçüoğlu B, Uğur G, But A. Timpanoplasti Cerrahisinde Desfluran ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması. Ankara Med J. 2013;13:4–10.
MLA Çolak, Selim et al. “Timpanoplasti Cerrahisinde Desfluran Ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması”. Ankara Medical Journal, vol. 13, no. 1, 2013, pp. 4-10.
Vancouver Çolak S, Öztürk L, Kürkçüoğlu B, Uğur G, But A. Timpanoplasti Cerrahisinde Desfluran ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması. Ankara Med J. 2013;13(1):4-10.