SPİNAL ANESTEZİDE SEDASYON AMAÇLI UYGULANAN DEKSMEDETOMİDİNİN YÜKLEMELİ VE YÜKLEMESİZ İNFÜZYONUNUN HEMODİNAMİ VE SEDASYON ÜZERİNE ETKİLERİNİN RETROSPEKTİF İNCELENMESİ

Year 2018, Volume: 19 Issue: 1, 11 - 16, 15.01.2018

Mustafa Kemal Yıldırım Berit Gökçe Ceylan Haci Ömer Osmanlıoğlu Naciye Er Füsun Eroğlu

https://doi.org/10.18229/kocatepetip.411174

Abstract

AMAÇ: Bu çalışmanın amacı rejyonel anestezide sedasyon amaçlı uygulanan deksmedetomidinin spinal anestezide yüklemeli ve yüklemesiz infüzyonunun hemodinami ve sedasyon üzerine etkilerinin retrospektif olarak karşılaştırılmasıdır.

GEREÇ VE YÖNTEM: Kasım 2003 - Şubat 2015 tarihleri arasında spinal anestezi ile alt abdominal ve alt ekstremite cerrahisi uygulanmış ve sedasyon amaçlı intravenöz deksmedetomidin infüzyonu yapılmış toplam 60 hastanın medikal ve anestezi kayıtları retrospektif olarak değerlendirildi. Hastalar deksmedetomidinin yüklemeli, grup A (n=40) ve deksmedetomidinin yüklemesiz idame, grup B (n=20) uygulananlar olarak iki gruba ayrıldı. Taranan olgularda hemodinamik veriler Kalp Atım Hızı (KAH), Ortalama Arter Basıncı (OAB) ve Ramsey Sedasyon Skoru (RSS) retrospektif olarak değerlendirildi.

BULGULAR: KAH; grup A’ da, spinal anestezinin 10. dk’sından operasyonun 50. dk’ya kadar, Grup B’ de ise spinal anestezinin 20. dk’sından operasyonun 50. dk’ sına kadar kontrol değerine oranla, istatistiksel olarak anlamlı oranda azaldı. OAB; grup A’ da, spinal anestezinin 15. dk’sından operasyonun 50. dk kadar grup B’ de ise spinal anestezinin 10.dk’sından operasyonun 50. dk kadar kadar tüm zaman aralıklarında kontrol değerine oranla istatistiksel olarak anlamlı oranda azaldı. RSS değerleri her iki grup arasında kontrol, 5. dk, 25. dk, 30. dk’daki kayıt aralıklarında istatiksel olarak anlamlı fark bulundu.

SONUÇ: Spinal anestezili olgularda; deksmedetomidin yükleme dozu yapmadan idame deksmedetomidin infüzyonuyla hemodinamik dengesizliği daha aza indirerek RSS’da uygun sedasyon düzeyine ulaşılabilineceği retrospektif olarak gözlemlendi.

Keywords

Spinal anestezi, Sedasyon, Deksmedetomidin

EVALUATION OF THE EFFECTS OF DEXMEDETOMIDINE INFUSION WITH OR WITHOUT PRELOADING THAT IS APPLIED BY THE AIM OF SEDATION ON SPINAL ANAESTHESIA ON HEMODINAMI AND SEDATION RETROSPECTIVELY

Abstract

OBJECTIVE: The aim of this study is to compare the effects of infusion of dexmedetomidine in spinal anaesthesia with or without preloading that is applied by the aim of sedation on regional anaesthesia on sedation and hemodinamia retrospectively.

MATERIAL AND METHODS: The medical and anaesthesia records of total 60 patients were evaluated retrospectively that lower abdominal and extremity surgery was applied with spinal anaesthesia and that dexmedetomidine infusion was applied for the aim of sedation between November 2003 - January 2015. The patients were divided into two groups as dexmedetomidine infusion with preloading; Group A (n=40) and dexmedetomidine infusion without preloading; Group B (n=20).The hemodynamic values Heart Rate (HR), Mean Arterial Pressure (MAP) and Ramsey Sedation Score (RSS) were evaluated on examined cases.

RESULTS: The HR was decreased statistically significantly in Group A from the 10th minutes of the spinal anaesthesia to the 50th minutes of operation; and decreased statistically significantly from 20th minutes of the spinal anaesthesia to 50th minutes of operation. MAP was decreased statistically significantly according to control values in all time intervals from 15th minutes of spinal anaesthesia to 50th minutes of operation in Group A and from 10th minutes of spinalanaesthesia to 50th minutes of operation in Group B.The RSS values were found statistically significantly different between two groups on 5th, 25th, and 30th minutes.

CONCLUSIONS: It is observed retrospectively that the proper sedation level can be reached without dexmedetomidine preloading on spinal anaesthesia applied cases by minimising hemodynamic instability.

Keywords

Spinal anaesthesia, Sedation, Dexmedeto-midine.

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