Epidural Anestezide Alkalinize Lidokain Kullanımı

Abstract

Bu calisma epidural anestezide, alkalinize lidokainin etkisini incelemek amaciyla planland.. Hastalar iki gruba ayrilarak birinci gruptaki hastalara pH’s1 6.890 olan piyasadaki normal lidokainden uygulanirken ikinci gruptaki hastalara 20 ml lidokain icine 2.2 ml NaHCO; eklenerek hazirlanan ve pH s1 7.50 olan soltisyon uygulandi. Iki grupta da lokal anestezik icine 12/00,000 lik epinefrin ilave ediidi. Buti hastalarda ilk 30 dakika icinde analjezinin baslamasi, cerrahi anestezi olusma suresi, analjezi devam suresi, motor blok, ayrica kan basinci ve nabiz deferleri saptandi. Birinci grupta cerrahi analjezi olusma stiresi 13.77dk bulunurken, ikinci grupta 7.60 dakika idi. Aym sekilde total analjezi stresinin birinci grupta 140 dakika iken ikinci grupta 187 dakika oldugu gézlenmistir. iki grup karsilastirildiginda bu degerler hem klinik hem de istatistiksel olarak 6nemli bulunmustur.

Keywords

• Alkalinize lidokain
• Epidural anestezi
• anestezi

Use of Alkalinized Lidocaine in Epidural Anesthesia

Abstract

The study was designed to evaluate the effects of alkalinized lidocaine in epidural anesthesia. The patients were divided into two groups : The first group received commercial lidocaine with pH 6.80 while the second group received solution with pH 7.50, which was prepared by addition of 2.2 ml of NaHCo:; to 20 ml commercial lidocaine epinephrine in 1/200,000 concentration was added to local anesthetic solution in both groups. In all patients, the onset of analgesia, the time when surgical analgesia occured, the duration of analgesia, motor blockade, and also pulse rate and blood pressure were determined within 30 minutes. The time of surgical analgesia in the first group was 13.77 minutes, while it was 7.60 minutes in the second group. Meanwhile, it was observed that the duration of analgesia was 140 minutes in the first group, while it was 187 minutes in the second group. When the two groups were compared, the results were found significant both from the statistical and clinical point of view.

Keywords

• Alkalinised lidocaine
• epidural anesthesia.
• ANESTHESİA

References

1. 1. Bedder MD Kozody R Craig DB : Comparison Bupivacaine and Alkalinized Bupivacaine in Brachial Plexus Anesthesia, Anesth. Analg. 67 : 48-52 1988,
2. 2. Bourke DL: Carbonated Lidocane, Anest. Analg. 67 : 482-490 1988.
3. 3. Bromage PR Burfoot MT Crowel DE Truent AP: Quality of Epidural Blockage III : Corbonaetd Local Anesthetic Solutions, Br. J. Anesth. 39 . 197, 1967.
4. 4, Churchill Davidson and Wylie WD (Ceviren Akyén G) . Anestezi Uygulamasi, 2; 1446-1458, 1984.
5. §. Difazio CA Carron H Grasslight KR Mascicki JC Bolding WR Johns RA : Comparison of pH-adjusted lidocaine solutions for Epidural Anesthesia, Anesth. Analg. 65 : 760-764, 1986.
6. 6. Hilgier M: Alkalinisation of Bupivacaine for Brachial Plexus Block, Reg. Anesth. 10 : 59-61, 1985.
7. 7,Mc Morland GH Douglas MJ Jeffery WK Ross PLE Axelson JE Kim JHK Gambling DR Robertson K - Effect of pH-adjustment of Bupivacaine on Onset and Duration of Epidural Analgesia in Parturients, Can. Anesth. Soc. J. 33 : 537-541, 1986.
8. 8. Okten F Saygin B Sekerci S ; Epidural Anestezide Alkalinize Bupivacaine Kullaninu, A.U, Tip Fak. Mec. 43 : 879-888, 1990,

9. 9. Parnass SM Currand MJA Becker GL : Incidence of Hypotension Associated with Epidural Anesthesia Using Alkalinised Lidocaine for Cesarian Section, Anesth. Analg. 66 : 1148-1150, 1987.
10. 10. Racle JP Jourdren L Benkhadra A Pog JY Fockenier F : Effect of Adding Sodium Bicarbonate to Bupivacaine for Spinal Anesthesia in Elderly Patients, Anesth. Analg. 67: 570-573, 1988.
11. 11. Ritchie JM Greengoard P , On the Active Structure of Local Anesthetics, J. Pharmacol, 183: 241, 1961.
12. 12. Ritchie JM Ritchie B Greengoard P : The Effect of the Nerve Sheath on the Action of Local Anesthetics, J. Pharmacol. 150: 160, 1965.
13. 13. Strobel GE Bianchi CP : The effect of pl] Gradients on the Action of Procaine and Lidocaine in Intact and Desheathed Sciatic Nerves, J. Pharmacol. 172: 1, 1979
14. 14. Sukhani R Winnie AP : Clinical Pharmacokinetics of Carbonated Local Anesthetics Il: Interscalene Brachial Block Model, Anesh. Analg, 66 , 1245-1250, 1987.