Comparing Effects of Lidocaine and Lidocaine-Midazolam in Regional İntravenous Anesthesia

Year 2018, Volume: 40 Issue: 3, 19 - 24, 01.09.2018

Nurbanu Yaşar Ayten Bilir , Dilek Ceyhan Cemil Sabuncu

https://doi.org/10.20515/otd.395166

Abstract

There is no clear
approach to the ideal agent to be used in regional intravenous anesthesia
(RIVA). Various adjuvants are added to local anesthetic agents to increase the
quality of RIVA and to avoid local anesthetic side effects. The purpose of this
study is to research the effect on block quality in RIVA by adding midazolam to
lidocaine. Patients aged 18-60 years old who underwent upper extremity surgery
were randomly assigned 2 groups. A double-headed tourniquet was placed after
venous drainage by lifting the upper arm. Following inflating the tourniquet,
the control group (Group K) received 3 mg/kg 2%lidocaine and the midazolam
group (Group M) received 3mg/kg lidocaine and 50 µgr/kg midazolam in 40 cc
volume on the arm that will be operated. Tourniquet time, onset and recovery
times of sensory and motor block, intraoperative pain level, and first
postoperative analgesic requirement time were recorded. There was no difference
between the groups in terms of tourniquet time and intraoperative pain levels.
Sensory and motor block onset times were significantly shorter in Group M
(p:0.000). The first postoperative analgesic requirement time was observed
earlier in Group K (Group K:74.678, Group M: 86.123 minute). A quicker onset
anesthesia and analgesia were obtained without any side effects in the RIVA applied
by adding midazolam to the lidocaine.

Keywords

regional intravenous anesthesia, lidocaine

Rejyonel İntravenöz Anestezide Lidokain ve Lidokain-Midazolamın Etkinliklerinin Karşılaştırılması

Abstract

Rejyonel intravenöz
anestezide (RİVA) kullanılacak ideal ajan ile ilgili net bir yaklaşım yoktur.
Lokal anestezik ajanlara çeşitli adjuvanlar eklenerek RİVA kalitesi artırılmaya
ve lokal anestezik yan etkilerinden kaçınılmaya çalışılmaktadır. Bu çalışmada
RİVA sırasında lidokaine eklenen midazolamın blok kalitesi üzerine etkilerinin
araştırılması amaçlanmıştır.Üst ekstremite cerrahisi geçirecek yaşları 18-60
yaş arasındaki hastalar rastgele 2 gruba ayrıldı. Opere olacak kol yukarıya
kaldırılarak venöz boşalma yapıldıktan sonra çift kaflı turnike yerleştirildi,
turnikenin şişirilmesini takiben el sırtındaki venöz kanülden kontrol grubuna
(Grup K) 40 ml volümde 3 mg/kg %2’lik lidokain, midazolam grubuna (Grup M) ise
toplamda 40 ml volümde 3 mg/kg %2’lik lidokain içinde 50 μg/kg midazolam
enjekte edildi. Turnike süresi, oluşan duyusal ve motor blok, duysal ve motor
blok dönme zamanı, intraoperatif ağrı seviyesi ve postoperatif ilk analjezik
ihtiyaç zamanı kayıt edildi.Turnike süresi ve intraoperatif ağrı seviyeleri açısından
gruplar arasında fark saptanmadı. Duysal ve motor blok başlama zamanı Grup M’de
daha kısa bulundu (p:0.000).  Motor blok
dönme zamanı Grup M’de daha kısa idi (p:0.003). Postoperatif ilk analjezik
ihtiyaç zamanının Grup K’da daha önce olduğu gözlendi (Grup K:74.678, Grup M:
86.123 dakika). Lidokaine midazolam eklenerek uygulanan RİVA da herhangi bir
yan etki ile karşılaşılmadan daha hızlı başlangıçlı bir anestezi ve analjezi
elde edilmiştir.

Keywords

rejyonel intravenöz anestezi, lidokain

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