Research Article
BibTex RIS Cite

Epidural Anestezide Kullanılan Levobupivakain veya Bupivakain Hemoreoloji ve Koagülasyon Faktörlerini Etkiler Mi?

Year 2018, Volume: 45 Issue: 4, 4 - 9, 13.12.2018

Abdulmenap Güzel

https://doi.org/10.5798/dicletip.468043

Abstract



Amaç: Lokal anestezik ajan olan levobupivakain ve
bupivakainin hemoreoloji ve koagülasyon faktörleri üzerindeki etkilerini
araştırmayı amaçladık.

Yöntemler: Epidural anestezi planlanan ASA I-II grubu, yaşları
18–64 arasında değişen 40 hasta çalışmaya alındı. Hastalar rastgele 2 gruba
ayrılarak epidural anestezi için levobupivakain (Grup1) ve bupivakain (Grup2)
uygulandı. Kan basıncı, periferik oksijen satürasyonu ve vücut ısısı sürekli
monitörize edildi. Motor blok ve duyu seviyelerine bakıldı. Hemoreoloji ve
koagülasyon parametreleri için alınan kan örnekleri çalışıldı.

Bulgular: Gruplar arasında hemodinamik, kan ve plazma
viskozitesi, onkotik basınç ve osmolalite değerleri bakımından istatistiksel
olarak anlamlı bir fark saptanmadı. Fibrinojen değerleri Grup 1’de Grup 2’ye
göre daha fazla azalma saptandı (p=0.015). aPTT değeri Grup 1’de Grup 2’ye göre
anlamlı bir artış görüldü (p=0.017). FVIII açısından gruplar arasında fark
bulunmamasına rağmen Grup 2’de daha fazla artış saptandı. Total protein, Hb, Hct,
PT ve INR parametreleri açısından gruplar arasında anlamlı bir fark saptanmadı.

Sonuç: Levobupivakain ve bupivakain ile yapılan epidural
anestezide; hemoreolojik açıdan gruplar arasında anlamlı bir fark saptanmadı.
Koagülasyon parametreleri normal sınırlar içerisinde olmasına rağmen, grup 1
ile kıyaslandığında grup 2 de aPTT değerleri düşük, fibrinojen ve FVIII
düzeyleri ise daha yüksek saptandı. Sonuç olarak epidural anestezi için
kullanılan levovupivakain ve bupivakainin hemoreoloji ve koagülasyon faktörleri
üzerine benzer etkiler gösterdiğini ve anestezik ajan seçiminde her ikisinin de
tercih edilebileceği kanaatindeyiz.

Keywords

Hemoreoloji viskozite

References

  • 1. Rawal SN. Postoperatif Ağrı Tedavisi. Ağrı. İstanbul, Nobel Tıp Kitapevleri 2000; 124–41.
  • 2. Gordon RJ, Ravin MB. Rheology and anesthesiology. Anesth Analg 1978; 57: 252–61.
  • 3. Kim, S. A Study of Non-Newtonian Viscosity and Yield Stress of Blood in a Scanning Capillary-Tube Rheometer. A Doctor of Philosophy Thesis Submitted to the Faculty of Drexel University, 2002; 1–49.
  • 4. Baskurt OK, Meiselman HJ. Blood rheology and hemodynamics. Seminars in Thrombosis and Hemostasis. 2003; 29: 435–50.
  • 5. Bediz Cem Ş, Topçu A. Arlab IV. Hücresel, Moleküler ve Analitik Teknikler Kursu. Eritrosit Deformabilitesi ve Agregasyonunun Ölçülmesi. 2007; 15–6.
  • 6. Mokken FC, Henny CP, Gelb AW, et al. The effects of propofol compared to high-dose fentanyl anesthesia on rheologic parameters in coronary artery surgery. J Cardiothorac Vasc Anesth. 1993; 7: 10-6.
  • 7. Reinhart WH. Hemorheology: Blood flow hematology. Schweiz Med Wochenschr. 1995;125: 387–95.
  • 8. Beilin B, Mayburd E, Yardeni IZ, Hendel D, Robinson D, Bessler H. Blood Rheology in PCA and PCEA After Total Knee Arthroplasty. J Arthroplasty. 2006; 21: 179–84.
  • 9. Késmárky G, Kenyeres P, Rábai M, Tóth K. Plasma viscosity: a forgotten variable Clin Hemorheol Microcirc. 2008; 39: 243–6
  • 10. Khodabandehlou T, Boisseau MR, Le Devehat C. Blood rheology as a marker of venous hypertension in patients with venous disease. Clin Hemorheol Microcirc. 2004; 30: 307–12.
  • 11. Beridze M, Momtselidze N, Shakarishvili R, McHedlishvili G. Effect of nitric oxide initial blood levels on erythrocyte aggregability during 12 hours from ischemic stroke onset. Clin Hemorheol Microcirc. 2004; 30: 403–6.
  • 12. Von Tempelhoff GF, Heilmann L, Pollow K, Hommel G. Monitoring of rheologic variables during postoperative high-dose brachytherapy for uterine cancer. Clin Appl Thromb Hemost. 2004; 10: 239–48.
  • 13. Pargalava N, Mantskava M, McHedlishvili G. Regional and systemic hemorheological disorders during feet diabetic gangrene. Clin Hemorheol Microcirc. 2004; 30: 457–9.
  • 14. Liou JT, Mao CC, Liu FC, et al. Levobupivacaine differentially suppresses platelet aggregation by modulating calcium release in a dose-dependent manner. Acta Anaesthesiol Taiwan. 2012; 50: 112-21.
  • 15. Binici O, Kati I, Goktas U, Soyaral L, Aytekin OC. Comparing effects of low and high-flow anesthesia on hemorheology and coagulation factors. Pak J Med Sci. 2015; 31: 683-7.
  • 16. Koch T, Fichtner A, Schwemmer U, Standl T. Levobupivacaine for epidural anaesthesia and postoperative analgesia in hip surgery. Anaesthesist 2008; 57: 475–82.
  • 17. Herrera R, De Andrés J, Estañ L, et al. Hemodynamic impact of isobaric levobupivacaine versus hyperbaric bupivacaine for subarachnoid anesthesia in patients aged 65 and older undergoing hip surgery. BMC Anesthesiol. 2014; 14: 97.
  • 18. Morgan GE, Jr Maged SM: Clinical Anestesiology, 2nd Ed. Appleton Lange, USA. 1996; 200–11.
  • 19. Odoom JA, Bovill JG, Hardeman MR, Oosting J, Zuurmond WA: Effects of epidural and spinal anesthesia on blood rheology. Anest Analg 1992; 74: 835–40.
  • 20. David M. Eckmann, Shelly Bowers. Hematocrit, Volume Expander, Temperature, and Shear Rate Effects on Blood Viscosity. J Trauma. 1991; 31: 8–14.
  • 21. Wysocki M, Persson B. Haemodynamic and haemorheological effects of hypervolaemic haemodilution in men with primary hypertension. J Hypertens. 1987; 5: 185–9.
  • 22. Koenig W. Sund M. Association between plasma viscosity and blood pressure. Results from the Monica-project Augsburg. Am J Hypertens. 1991; 4: 529–36.
  • 23. Bowdler AJ, Foster AM. The effect of donor age on the flow properties of blood. Part I: Plasma and whole blood viscosity in adult males. Exp Gerontol. 1987; 22: 155–64
  • 24. Jung F, Roggenkamp HG. Effect of sex, age, body weight, and smoking on plasma viscosity. Klin Wochenschr. 1986; 64: 1076–81.
  • 25. McGinley E, Lowe GD. Blood viscosity and haemostasis in the nephrotic syndrome. Thromb Haemost. 1983; 49: 155–7.
  • 26. Richard LC, Büller HR, Bovill J, Ten Cate JW. Influence of anaesthesia on coagulation and fibrinolytic proteins. Br J Anaesth 1983; 55: 869–72.
  • 27. Rosenfeld BA, Beattie C, Christopherson R, Norris EJ, Frank SM. The effects of different anestehetic regimens on fibrinolysis and the development of postoperative arterial thrombosis. Anesthesiology 1993; 79: 435–43.
  • 28. Sharma SK, Philip J. The effect of anesthetic techniques on blood coagulability in parturients as measured by thromboelastography. Anesth Analg. 1997; 85: 82–6.
  • 29. Kohrs R, Hoenemann CW. Bupivacaine inhibits whole blood coagulation in vitro. Reg Anesth Pain Med. 1999; 24: 326–30.
  • 30. Leonard SA, Walsh M. Evaluation of the effects of levobupivacaine on clotting and fibrinolysis using thromboelastography. Eur J Anaesthesiol. 2000; 17: 373–8.
  • 31. Kohrs R, Hoenemann CW, Feirer N, et al. Bupivacaine inhibits whole bloods coagulation in vitro. Reg Anesth. 1996; 21: 13–7.
  • 32. Donadoni R, Baele G. Coagulation and fibrinolytic parameters in patients undergoing total hip replacement: influence of the anaesthesia technique. Acta Anaesthesiol Scand. 1989; 33: 588–92.
  • 33. Bredbacka S, Blombäck M. Per- and postoperative changes in coagulation and fibrinolytic variables during abdominal hysterectomy under epidural or general anaesthesia. Acta Anaesthesiol Scand. 1986; 30: 204–10.

Year 2018, Volume: 45 Issue: 4, 4 - 9, 13.12.2018

Abdulmenap Güzel

https://doi.org/10.5798/dicletip.468043

Abstract

References

  • 1. Rawal SN. Postoperatif Ağrı Tedavisi. Ağrı. İstanbul, Nobel Tıp Kitapevleri 2000; 124–41.
  • 2. Gordon RJ, Ravin MB. Rheology and anesthesiology. Anesth Analg 1978; 57: 252–61.
  • 3. Kim, S. A Study of Non-Newtonian Viscosity and Yield Stress of Blood in a Scanning Capillary-Tube Rheometer. A Doctor of Philosophy Thesis Submitted to the Faculty of Drexel University, 2002; 1–49.
  • 4. Baskurt OK, Meiselman HJ. Blood rheology and hemodynamics. Seminars in Thrombosis and Hemostasis. 2003; 29: 435–50.
  • 5. Bediz Cem Ş, Topçu A. Arlab IV. Hücresel, Moleküler ve Analitik Teknikler Kursu. Eritrosit Deformabilitesi ve Agregasyonunun Ölçülmesi. 2007; 15–6.
  • 6. Mokken FC, Henny CP, Gelb AW, et al. The effects of propofol compared to high-dose fentanyl anesthesia on rheologic parameters in coronary artery surgery. J Cardiothorac Vasc Anesth. 1993; 7: 10-6.
  • 7. Reinhart WH. Hemorheology: Blood flow hematology. Schweiz Med Wochenschr. 1995;125: 387–95.
  • 8. Beilin B, Mayburd E, Yardeni IZ, Hendel D, Robinson D, Bessler H. Blood Rheology in PCA and PCEA After Total Knee Arthroplasty. J Arthroplasty. 2006; 21: 179–84.
  • 9. Késmárky G, Kenyeres P, Rábai M, Tóth K. Plasma viscosity: a forgotten variable Clin Hemorheol Microcirc. 2008; 39: 243–6
  • 10. Khodabandehlou T, Boisseau MR, Le Devehat C. Blood rheology as a marker of venous hypertension in patients with venous disease. Clin Hemorheol Microcirc. 2004; 30: 307–12.
  • 11. Beridze M, Momtselidze N, Shakarishvili R, McHedlishvili G. Effect of nitric oxide initial blood levels on erythrocyte aggregability during 12 hours from ischemic stroke onset. Clin Hemorheol Microcirc. 2004; 30: 403–6.
  • 12. Von Tempelhoff GF, Heilmann L, Pollow K, Hommel G. Monitoring of rheologic variables during postoperative high-dose brachytherapy for uterine cancer. Clin Appl Thromb Hemost. 2004; 10: 239–48.
  • 13. Pargalava N, Mantskava M, McHedlishvili G. Regional and systemic hemorheological disorders during feet diabetic gangrene. Clin Hemorheol Microcirc. 2004; 30: 457–9.
  • 14. Liou JT, Mao CC, Liu FC, et al. Levobupivacaine differentially suppresses platelet aggregation by modulating calcium release in a dose-dependent manner. Acta Anaesthesiol Taiwan. 2012; 50: 112-21.
  • 15. Binici O, Kati I, Goktas U, Soyaral L, Aytekin OC. Comparing effects of low and high-flow anesthesia on hemorheology and coagulation factors. Pak J Med Sci. 2015; 31: 683-7.
  • 16. Koch T, Fichtner A, Schwemmer U, Standl T. Levobupivacaine for epidural anaesthesia and postoperative analgesia in hip surgery. Anaesthesist 2008; 57: 475–82.
  • 17. Herrera R, De Andrés J, Estañ L, et al. Hemodynamic impact of isobaric levobupivacaine versus hyperbaric bupivacaine for subarachnoid anesthesia in patients aged 65 and older undergoing hip surgery. BMC Anesthesiol. 2014; 14: 97.
  • 18. Morgan GE, Jr Maged SM: Clinical Anestesiology, 2nd Ed. Appleton Lange, USA. 1996; 200–11.
  • 19. Odoom JA, Bovill JG, Hardeman MR, Oosting J, Zuurmond WA: Effects of epidural and spinal anesthesia on blood rheology. Anest Analg 1992; 74: 835–40.
  • 20. David M. Eckmann, Shelly Bowers. Hematocrit, Volume Expander, Temperature, and Shear Rate Effects on Blood Viscosity. J Trauma. 1991; 31: 8–14.
  • 21. Wysocki M, Persson B. Haemodynamic and haemorheological effects of hypervolaemic haemodilution in men with primary hypertension. J Hypertens. 1987; 5: 185–9.
  • 22. Koenig W. Sund M. Association between plasma viscosity and blood pressure. Results from the Monica-project Augsburg. Am J Hypertens. 1991; 4: 529–36.
  • 23. Bowdler AJ, Foster AM. The effect of donor age on the flow properties of blood. Part I: Plasma and whole blood viscosity in adult males. Exp Gerontol. 1987; 22: 155–64
  • 24. Jung F, Roggenkamp HG. Effect of sex, age, body weight, and smoking on plasma viscosity. Klin Wochenschr. 1986; 64: 1076–81.
  • 25. McGinley E, Lowe GD. Blood viscosity and haemostasis in the nephrotic syndrome. Thromb Haemost. 1983; 49: 155–7.
  • 26. Richard LC, Büller HR, Bovill J, Ten Cate JW. Influence of anaesthesia on coagulation and fibrinolytic proteins. Br J Anaesth 1983; 55: 869–72.
  • 27. Rosenfeld BA, Beattie C, Christopherson R, Norris EJ, Frank SM. The effects of different anestehetic regimens on fibrinolysis and the development of postoperative arterial thrombosis. Anesthesiology 1993; 79: 435–43.
  • 28. Sharma SK, Philip J. The effect of anesthetic techniques on blood coagulability in parturients as measured by thromboelastography. Anesth Analg. 1997; 85: 82–6.
  • 29. Kohrs R, Hoenemann CW. Bupivacaine inhibits whole blood coagulation in vitro. Reg Anesth Pain Med. 1999; 24: 326–30.
  • 30. Leonard SA, Walsh M. Evaluation of the effects of levobupivacaine on clotting and fibrinolysis using thromboelastography. Eur J Anaesthesiol. 2000; 17: 373–8.
  • 31. Kohrs R, Hoenemann CW, Feirer N, et al. Bupivacaine inhibits whole bloods coagulation in vitro. Reg Anesth. 1996; 21: 13–7.
  • 32. Donadoni R, Baele G. Coagulation and fibrinolytic parameters in patients undergoing total hip replacement: influence of the anaesthesia technique. Acta Anaesthesiol Scand. 1989; 33: 588–92.
  • 33. Bredbacka S, Blombäck M. Per- and postoperative changes in coagulation and fibrinolytic variables during abdominal hysterectomy under epidural or general anaesthesia. Acta Anaesthesiol Scand. 1986; 30: 204–10.
There are 33 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Articles
Authors

Abdulmenap Güzel 0000-0003-2261-0072

Publication Date December 13, 2018
Submission Date October 7, 2018
Published in Issue Year 2018 Volume: 45 Issue: 4

Cite

APA Güzel, A. (2018). Epidural Anestezide Kullanılan Levobupivakain veya Bupivakain Hemoreoloji ve Koagülasyon Faktörlerini Etkiler Mi?. Dicle Medical Journal, 45(4), 4-9. https://doi.org/10.5798/dicletip.468043
AMA Güzel A. Epidural Anestezide Kullanılan Levobupivakain veya Bupivakain Hemoreoloji ve Koagülasyon Faktörlerini Etkiler Mi?. diclemedj. December 2018;45(4):4-9. doi:10.5798/dicletip.468043
Chicago Güzel, Abdulmenap. “Epidural Anestezide Kullanılan Levobupivakain Veya Bupivakain Hemoreoloji Ve Koagülasyon Faktörlerini Etkiler Mi?”. Dicle Medical Journal 45, no. 4 (December 2018): 4-9. https://doi.org/10.5798/dicletip.468043.
EndNote Güzel A (December 1, 2018) Epidural Anestezide Kullanılan Levobupivakain veya Bupivakain Hemoreoloji ve Koagülasyon Faktörlerini Etkiler Mi?. Dicle Medical Journal 45 4 4–9.
IEEE A. Güzel, “Epidural Anestezide Kullanılan Levobupivakain veya Bupivakain Hemoreoloji ve Koagülasyon Faktörlerini Etkiler Mi?”, diclemedj, vol. 45, no. 4, pp. 4–9, 2018, doi: 10.5798/dicletip.468043.
ISNAD Güzel, Abdulmenap. “Epidural Anestezide Kullanılan Levobupivakain Veya Bupivakain Hemoreoloji Ve Koagülasyon Faktörlerini Etkiler Mi?”. Dicle Medical Journal 45/4 (December 2018), 4-9. https://doi.org/10.5798/dicletip.468043.
JAMA Güzel A. Epidural Anestezide Kullanılan Levobupivakain veya Bupivakain Hemoreoloji ve Koagülasyon Faktörlerini Etkiler Mi?. diclemedj. 2018;45:4–9.
MLA Güzel, Abdulmenap. “Epidural Anestezide Kullanılan Levobupivakain Veya Bupivakain Hemoreoloji Ve Koagülasyon Faktörlerini Etkiler Mi?”. Dicle Medical Journal, vol. 45, no. 4, 2018, pp. 4-9, doi:10.5798/dicletip.468043.
Vancouver Güzel A. Epidural Anestezide Kullanılan Levobupivakain veya Bupivakain Hemoreoloji ve Koagülasyon Faktörlerini Etkiler Mi?. diclemedj. 2018;45(4):4-9.