Timpanoplasti Cerrahisinde Desfluran ve Sevofluran Anestezisinin Kan Glukoz Düzeyleri Üzerine Etkilerinin Karşılaştırılması

Öz

Amaç:

İnhalasyon anesteziklerinin ve intravenöz anestezik ilaçların kan glukoz seviyelerine etkileri uzun zamandır araştırılan konular arasındadır. Ancak nispeten yeni ajanlar olan sevofluran ve desfluran ile bu etkileri karşılaştıran yeterli çalışma yoktur. Bu çalışmada; timpanoplasti ameliyatlarında sevofluran ve desfluran anestezisinin kan glukoz (GLC) düzeylerine etkileri araştırılmıştır.

Gereç ve yöntem:

Çalışmamızda 18-65 yaş arası ASA I-IIrisk grubundaki 60 hasta iki gruba ayrıldı. I. gruba sevofluran-remifentanil (grup S), II. gruba desfluran-remifentanil(grup D) uygulandı. Ameliyat öncesi 8 saat açlıktan sonra, intraoperatif 5., 10., 30., 60., 90., 120., dakikalarda ve ekstübasyondan sonra 30 dk’da kan GLC değeri ölçüldü. İntraoperatif 5. ve 120. dk’da kan laktat seviyesi ölçüldü.  

Bulgular:

GLC ortalamaları açısından gruplar arasında istatistiksel olarak anlamlı farklılık saptanmadı (p>0,05). Desfluran grubundaki olguların GLC ortalamaları değişimi incelendiğinde; tüm ölçüm zamanlarındaki GLC ortalaması başlangıç GLC ortalamasından istatistiksel olarak anlamlı derecede daha yüksek izlendi. Sevofluran grubundaki olguların zaman içindeki GLC ortalamaları değişimi incelendiğinde; 3. Ölçüm GLC ortalaması hariç, diğer ölçüm zamanlarındaki GLC ortalaması başlangıç ölçüm zamanlarındaki GLC ölçüm ortalamasından istatistiksel olarak anlamlı derecede daha yüksek saptandı.

Sonuç:

Sevofluran ve desfluran anestezisi uygulanan gruplar arasında, cerrahi esnasında ve postoperatif dönemdekan GLC düzeylerine etkileri açısından farklılık bulunamamıştır. 

Anahtar Kelimeler

• Anestezi
• kan glukoz düzeyi
• sevofluran
• desfluran

Comparisons Of Desflurane And Sevoflurane Anesthesia In Their Effects On Blood Glucose Levels During Tympanoplasty Operations

Abstract

Introduction: The effects of intravenous anesthetic drugs and inhaled anesthetics to the blood glucose (GLC) levels were investigated. Unfortunately, there is no adequate studies comparing these effects with new agents such as sevoflurane and desflurane drugs. In this study, blood GLC level changes among the the patients undergoing general anesthesia with sevoflurane and desflurane during the tympanoplasty surgery, were investigated. Material and methods: 60 patients,ages ranging between 18-65 in the ASA I-II risk group were randomly allocated to one of the two groups; The sevoflurane-remifentanyl drugs combination was applied to the group S and the desfluran-remifentanyl drugs combination was used for the group D. After fasting for 8 hours at the preoperative period, the blood GLC levels were measured before induction, at the 5 th , 10 th , 30 th , 60 th , 90 th , 120 th minutes, during the intraoperative period and 30 minutes after the extubation. Blood lactate levels were measured intraoperatively at 5th and 120th minutes.Results: There was no statistically significant difference between groups in terms of mean glucose levels (p>0,05). A statistically significant difference was observed between the T1-T6 and T0 values obtained in the desflurane groups according to the mean GLC level. In the sevoflurane group; there was no statistically significant difference at the third measurement time (p=0,223). In all other measurement times, the mean GLC levels were statistically significantly higher than the first measurement time.Conclusion: There was no difference between the two groups, in terms of blood GLC levels, representing patients who underwent anesthesia with sevoflurane and desflurane during tympanoplasty surgery.

Keywords

• Anesthesia
• Blood glucose level
• Sevoflurane
• Desflurane.

Kaynakça

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17. Yazışma Adresi / Correspondence: Dr Levent ÖZTÜRK e-posta: [e-mail] Tel: [phone] 10