Vücut Yuvarlaklık İndeksinin Spinal Anestezi Blok Karakteristik Özellikleri Üzerine Etkileri

Year 2022, Volume: 5 Issue: 2, 67 - 75, 29.12.2022

Nuran Akıncı Ekinci Mahmut Sami Tutar Betül Kozanhan

https://doi.org/10.56728/dustad.1173736

Abstract

Vücut yuvarlaklık indeksi (BRI), insan vücut şeklinin boy ve bel çevresini birleştiren bir elips olduğu varsayımına dayanır. Bu çalışmada, elektif cerrahi geçiren hastalarda BRI'nın spinal anestezi [SA] duyu seviyeleri ve hipotansiyon üzerine etkisini araştırmayı amaçladık. Bu gözlemsel çalışmada, transüretral ve alt ekstremite cerrahisi için L3-L4 intervertebral boşluktan, 15 mg %0.5 hiperbarik bupivakain kullanılarak, tek seferde spinal anestezi uygulanan, ASA fiziksel durumu I-III olan 18-80 yaşındaki hastalar prospektif olarak kaydedildi. On beş ve 30. dakikalarda maksimum duyusal blokaj seviyesi, bloğun L2 seviyesine gerileme süresi, hipotansiyon, bradikardi oluşumu kaydedildi. BRI, bel ve kalça çevresi parametreleri 15. dakikada maksimum duyusal blokaj düzeyi için bağımsız predikte edici faktörler olarak bulundu [OR=65.7 %95 GA: 1.304-3310, p=0.036; OR=0.733 %95 CI: 0.558-0.963, p=0.026; OR=1.065 %95 CI: 1.001-1.133, p=0.047; sırasıyla]. SA sonrası hipotansiyon gelişmesi ile antropometrik değişkenlerle ilişkili bulunmadı. BRI, SA uygulanan hastalarda lokal anesteziklerin artan sefalik yayılımını öngörmek için yeni bir pratik araç olarak kullanılabilir.

Keywords

Spinal anestezi, vücut yuvarlaklık indeksi, hipotansiyon, obezite, sefalik yayılım

Effects of Body Roundness Index on Spinal Anesthesia Block Characteristics

Abstract

Body roundness index (BRI) is based on the assumption that the human body's shape is an ellipse, which combines height and waist circumference. We aimed to investigate the effect of BRI on spinal anesthesia [SA] sensory levels and hypotension in patients undergoing elective surgery. In this observational study, we prospectively enrolled 18-80 years old patients with ASA physical status I-III who underwent single-shot spinal anesthesia using 15 mg 0.5% hyperbaric bupivacaine at L3–L4 intervertebral space for transurethral and lower limb surgery. Maximum sensory blockade level at 15th and 30th min, block regression time to L2 level, hypotension, bradycardia occurrence were recorded. BRI, waist, and hip circumference were found as independent predictive factors in a maximum sensory blockade level at 15th min [OR=65.7 95% CI: 1.304-3310, p=0.036; OR=0.733 95% CI: 0.558-0.963, p=0.026; OR=1.065 95% CI: 1.001-1.133, p=0.047; respectively]. Hypotension after SA was not associated with anthropometric variables. BRI can be used as a new practical tool to predict the increased cephalic spread of local anesthetic in patients undergoing SA.

Keywords

Spinal anesthesia, body roundness index, hypotension, obesity, cephalic spread.

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