BibTex RIS Kaynak Göster

-

Yıl 2015, Cilt: 78 Sayı: 1, 6 - 12, 26.02.2015

Gülin Haroğlu Orçan Mehmet Büget S. İpek Edipoğlu Halil Balcı Kamil Pembeci Lütfi Telci Süleyman Küçükay

https://doi.org/10.18017/iuitfd.m.13056441.2015.78/1.6-12

Öz

Objectives: RIVA (Regional Intravenous Anesthesia) is frequently preferred during distal upper extremity operations (hand, wrist and forearm) compared to general anesthesia because of the following reasons: lower operational cost, simplicity, surgical operation environment stability, quick implementation and faster recovery time. Deeper anesthesia, prolonged effective time, hemodynamic stabilization, reduced intraoperative complications and longer postoperative analgesia are aimed by using adjunct drugs. Main objective of our study is to investigate the effectiveness of magnesium as an adjunct in RIVA. Material & Methods: A set of 18-80 year old patients who were operated on upper extremity using RIVA at Istanbul University, Istanbul Medical Faculty, Department of Orthopedics between 2012 and 2013 were evaluated retrospectively for this study. Only adult subjects who are classified with ASA I and II preoperative physical condition were included. Patients were evaluated according to BMI (Body Mass Index), gender, ASA score, anesthesia success rate, hemodynamic stabilization, VAS (Visual Analogue Scale) score at 1st postoperative hour and for emergent adverse effects. Results: 40 RIVA patients were included in this study. 20 patients were anaesthetized using Magnesium (Group-M) and the other 20 patients were anaesthetized without using Magnesium (Group-K). No statistical differences were determined between the groups regarding demographic data. Comparison of hemodynamic parameters between Groupany meaningful diversity (p: 0,89). Moreover, VAS score comparisons showed definite similarities between groups (p: 0,36). Only one local anesthesia toxicity due to possible tourniquet leakage was noted in both groups (p: 1). Conclusion: It is concluded that Magnesium usage as adjuvant in RIVA showed no significant positive effect in terms of hemodynamics, postoperative analgesia and adverse effects

Anahtar Kelimeler

IVRA; magnesium; lidocaine

Kaynakça

  • Bier A. Über einen neuen Weg, Lokalanästhesie an den Gliedmans sen zu erzeugen. Arch Klin Chir. 1908;86:1007–16
  • Hannington-Kiff JG. Bier’s block revisited: intercuff block. J R Soc Med. 1990;83(3):155–8.
  • Rodolà F, Vagnoni S, Ingletti S. An update on intravenous regional anaesthesia of the arm. Eur Rev Med Pharmacol Sci. 2003;7(5):131–8.
  • Okten F, Cakar T, Leblebici KS. Lokal anestezikler. In: Guldogus F, Gurkan Y, (ed). Rejyonal Anestezi. 1st ed. Istanbul / Turkey: Nobel Tip Kitabevi; 2013. p. 79–89.
  • Coutinho EM. Calcium, Magnesium, and Local Anesthesia. J Gen Physiol. 1966; 49(4): 845–6.
  • Do S-H. Magnesium: a versatile drug for anesthesiologists. 2013;65(1):4–8. J Anesthesiol.
  • Ozcan PE, Esen F. Yogun bakim unitesinde magnezyum; olmazsa olmaz. Türk Yoğun Bakım Derneği Derg. 2011;9:30–7.
  • Miranda HF, Bustamante D, Kramer V, Pelissier T, Saavedra H, Paeile C, et al. Antinociceptive effects of Ca+2 channel blockers. European Journal of Pharmacology, 1992;217(2-3):137-41.
  • Kumar A, Sharma DK, Datta B. Addition of ketamine or dexmedetomidine to lignocaine in intravenous regional anesthesia: A randomized controlled study. J Anaesthesiol Clin Pharmacol. 2012;28(4):501-4.
  • Ivie CS, Viscomi CM, Adams DC, Friend AF, Murphy TR, Parker C. Clonidine as an adjunct to intravenous regional anesthesia: A randomized, double-blind, placebo-controlled dose ranging study. J Anaesthesiol Clin Pharmacol. 2011; 27(3): 323-7
  • Turan A, Memis D, Karamanlioglu B, Güler T, Pamukcu Z. Intravenous regional anesthesia using lidocaine and magnesium. Anesth Analg. 2005; 100(4): 1189–92.
  • Cakmak BM, Cakmak G, Akpek E, Arslan G, Sahin MS. Lidocaine, Combination at Intravenous Regional Anesthesia. BioMed Res Int. 2014, 2014:737109. doi: 10.1155/2014/737109. Properties
  • Nitroglycerine Lornoxicam, and
  • Honarmand A, Safavi M, Adineh-Mehr L. Effect of adding 8 milligrams ondansetron to lidocaine for Bier’s block on post-operative pain. Adv Biomed Res. 2013; 2: 52.
  • Omote K, Iwasaki H, Kawamata M, Satoh O, Namiki A. Effects of verapamil on spinal anesthesia with local anesthetics. Anesth Analg. 1995;80(3): 444–8.
  • Khanna P, Mohan VK, Sunder RA. Efficacy of diltiazem as an adjunct to lignocaine in intravenous regional anesthesia. Saudi J Anaesth. 2013;7(3): 305-9.
  • Dube L, Granry J-C. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review. Can J Anaesth . 2003;50(7):732–46.
  • Ashton WB, James MFM, Janicki P, Uys PC. Attenuation of the pressor response to tracheal intubation by magnesium sulphate with and without alfentanil in hypertensive proteinuric patients undergoing caesarean section. Br J Anaesth. 1991; 67(6): 741–7
  • Manners JM, Nielsen MS. Magnesium flux during open heart surgery. Anaesthesia. 1981;36(2):157– 66
  • Tramer MR, Schneider J, Marti R-A, Rifat K. Role of magnesium sulfate in postoperative analgesia. Anesthesiology. 1996;84(2):340–7.
  • Kiaee MM, Safari S, Movaseghi GR, Dolatabadi MRM, Ghorbanlo M, Etemadi M, et al. The Effect of Intravenous Magnesium Sulfate and Lidocaine in Hemodynamic Intubation in Elective Coronary Artery Bypass Grafting: A Randomized Controlled Clinical Trial. Anesthesiol http://dx.doi.org/10.5812/aapm.15905. Med. 2014;4(3)
  • Ghodraty MR, Saif AA, Kholdebarin AR, Rokhtabnak F, Pournajafian AR, Nikzad-Jamnani AR, et al. The effects of magnesium sulfate on neuromuscular blockade by cisatracurium during induction of anesthesia. J Anesth. 2012;26(6): 858– 63
  • Dogru K, Yildirim D, Ulgey A, Aksu R, Bicer C, Boyaci A. Adding magnesium to levobupivacaine for axillary brachial plexus block in arteriovenous fistule 2011;113(10):607–9. Bratisl Lek Listy.
  • Pascual-Ramírez J, Gil-Trujillo S, Alcantarilla C. Intrathecal magnesium as analgesic adjuvant for spinal anesthesia: a meta-analysis of randomized trials. Minerva Anestesiol. 2013;79(6):667–78.
  • Hung YC, Chen CY, Lirk P, Wang CF, Cheng JK, Chen CC et. al. Magnesium sulfate diminishes the effects of amide local anesthetics in rat sciatic- nerve 2007;32(4):288-95. Anesth Pain Med.
  • Sethi D, Wason R. Intravenous regional anesthesia using lidocaine and neostigmine for upper limb surgery. J Clin Anesth. 2010;22(5):324–8.
  • Santhosh MC, Rohini BP, Roopa S, Raghavendra PR. Study of 0,5% lidocaine alone and combination of 0.25% lidocaine with fentanyl and vecuronium in intravenous regional anesthesia for upper limb surgeries. Rev Bras Anestesiol. 2013;63(3):254–7.
  • Farouk S, Aly A. Quality of lidocaine analgesia with and without midazolam for intravenous regional anesthesia. J Anesth. 2010;24(6):864–8.
  • Sen H, Kulahci Y, Bicerer E, Ozkan S, Dagl G, Turan A. The analgesic effect of paracetamol when added to lidocaine for intravenous regional anesthesia. Anesth Analg. 2009;109(4):1327–30.

REJYONAL İNTRAVENÖZ ANESTEZİDE LİDOKAİN İLE LİDOKAİN VE MAGNEZYUM KOMBİNASYONUNUN KARŞILAŞTIRILMASI

Yıl 2015, Cilt: 78 Sayı: 1, 6 - 12, 26.02.2015

Gülin Haroğlu Orçan Mehmet Büget S. İpek Edipoğlu Halil Balcı Kamil Pembeci Lütfi Telci Süleyman Küçükay

https://doi.org/10.18017/iuitfd.m.13056441.2015.78/1.6-12

Öz

Amaç: Rejyonel inravenöz anestezi (RİVA), distal üst ekstremite (el, el bileği ve ön kol) operasyonlarında genel
anestezi ile kıyaslandığında daha düşük maliyetli, kolay uygulanabilir olması, ameliyat sonrası komplikasyonların daha
az olması, operasyon için elverişli bir ortam sağlaması, daha hızlı uygulanabilmesi ve hızlı derlenme sağlaması
nedeniyle operasyonlarında tercih edilen yöntem olmuştur. Adjuvan ilaçlar ile anestezi derinliğinin arttırılması ve uzun
sürmesi, hemodinaminin daha stabil olması, peroperatif oluşabilecek komplikasyonların azaltılması, postoperatif
analjezinin sürmesi amaçlanmıştır. Çalışmamızın amacı RİVA’da adjuvan ilaç olarak magnezyum kullanımının etkili
olup olmadığının değerlendirilmesidir.
Gereç ve yöntem: İstanbul Üniversitesi İstanbul Tıp Fakültesi Ortopedi Anabilim Dalında 2012-2013 tarihleri arası
dönemde opere edilmiş hastalar arasından, üst ekstremiteye RİVA uygulanmış hastalar retrospektif olarak incelendi. 18-
80 yaş aralığında ve ASA I ve II olan erişkin hastalar çalışmaya alındı. Hastaların; dosyalarından, vücut kitle indeksleri,
cinsiyet, ASA skoru, anestezi başarısı, hemodinamik stabilizasyon, postoperatif 1. saat VAS skorları ve ortaya çıkan
istenmeyen etkiler taranarak araştırıldı.
Bulgular: RİVA yapılmış, formları eksiksiz doldurulmuş, 20 adet magnezyum kullanılmış (Grup M), 20 adet
magnezyum kullanılmamış (grup K) hasta çalışmaya alındı. Gruplar arasında demografik veriler arasında istatistiki bir
fark saptanmadı (p < 0,05). Grup K ile Grup M arasındaki hemodinamik parametreler karşılaştırıldığında fark
gözlenmedi (p < 0,05). Grup M ve grup K’daki hastaların giriş VAS skorları karşılaştırıldığında fark olmadığı belirlendi
(p:0,89). Postop 1. saatteki VAS skorları açısından grup M ve grup K’daki hastalar karşılaştırıldığında benzerlik olduğu
gözlemlendi (p:0,36). Çalışmaya alınan hastalar değerlendirildiğinde, magnezyum kullanılan hasta grubunda ve kontrol
grubunda 1’er hastada muhtemel turnike kaçağı nedeniyle lokal anestezi sistemik belirtileri gözlendiği belirlendi (p:1).
Sonuç: Yaptığımız çalışmada RİVA’da adjuvan ilaç olarak magnezyum kullanımının hemodinamik açıdan, postoperatif
analjezi ve istenmeyen etkiler açısından olumlu etkisinin olmadığı saptandı.

Anahtar Kelimeler

RİVA magnezyum lidokain

Kaynakça

  • Bier A. Über einen neuen Weg, Lokalanästhesie an den Gliedmans sen zu erzeugen. Arch Klin Chir. 1908;86:1007–16
  • Hannington-Kiff JG. Bier’s block revisited: intercuff block. J R Soc Med. 1990;83(3):155–8.
  • Rodolà F, Vagnoni S, Ingletti S. An update on intravenous regional anaesthesia of the arm. Eur Rev Med Pharmacol Sci. 2003;7(5):131–8.
  • Okten F, Cakar T, Leblebici KS. Lokal anestezikler. In: Guldogus F, Gurkan Y, (ed). Rejyonal Anestezi. 1st ed. Istanbul / Turkey: Nobel Tip Kitabevi; 2013. p. 79–89.
  • Coutinho EM. Calcium, Magnesium, and Local Anesthesia. J Gen Physiol. 1966; 49(4): 845–6.
  • Do S-H. Magnesium: a versatile drug for anesthesiologists. 2013;65(1):4–8. J Anesthesiol.
  • Ozcan PE, Esen F. Yogun bakim unitesinde magnezyum; olmazsa olmaz. Türk Yoğun Bakım Derneği Derg. 2011;9:30–7.
  • Miranda HF, Bustamante D, Kramer V, Pelissier T, Saavedra H, Paeile C, et al. Antinociceptive effects of Ca+2 channel blockers. European Journal of Pharmacology, 1992;217(2-3):137-41.
  • Kumar A, Sharma DK, Datta B. Addition of ketamine or dexmedetomidine to lignocaine in intravenous regional anesthesia: A randomized controlled study. J Anaesthesiol Clin Pharmacol. 2012;28(4):501-4.
  • Ivie CS, Viscomi CM, Adams DC, Friend AF, Murphy TR, Parker C. Clonidine as an adjunct to intravenous regional anesthesia: A randomized, double-blind, placebo-controlled dose ranging study. J Anaesthesiol Clin Pharmacol. 2011; 27(3): 323-7
  • Turan A, Memis D, Karamanlioglu B, Güler T, Pamukcu Z. Intravenous regional anesthesia using lidocaine and magnesium. Anesth Analg. 2005; 100(4): 1189–92.
  • Cakmak BM, Cakmak G, Akpek E, Arslan G, Sahin MS. Lidocaine, Combination at Intravenous Regional Anesthesia. BioMed Res Int. 2014, 2014:737109. doi: 10.1155/2014/737109. Properties
  • Nitroglycerine Lornoxicam, and
  • Honarmand A, Safavi M, Adineh-Mehr L. Effect of adding 8 milligrams ondansetron to lidocaine for Bier’s block on post-operative pain. Adv Biomed Res. 2013; 2: 52.
  • Omote K, Iwasaki H, Kawamata M, Satoh O, Namiki A. Effects of verapamil on spinal anesthesia with local anesthetics. Anesth Analg. 1995;80(3): 444–8.
  • Khanna P, Mohan VK, Sunder RA. Efficacy of diltiazem as an adjunct to lignocaine in intravenous regional anesthesia. Saudi J Anaesth. 2013;7(3): 305-9.
  • Dube L, Granry J-C. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review. Can J Anaesth . 2003;50(7):732–46.
  • Ashton WB, James MFM, Janicki P, Uys PC. Attenuation of the pressor response to tracheal intubation by magnesium sulphate with and without alfentanil in hypertensive proteinuric patients undergoing caesarean section. Br J Anaesth. 1991; 67(6): 741–7
  • Manners JM, Nielsen MS. Magnesium flux during open heart surgery. Anaesthesia. 1981;36(2):157– 66
  • Tramer MR, Schneider J, Marti R-A, Rifat K. Role of magnesium sulfate in postoperative analgesia. Anesthesiology. 1996;84(2):340–7.
  • Kiaee MM, Safari S, Movaseghi GR, Dolatabadi MRM, Ghorbanlo M, Etemadi M, et al. The Effect of Intravenous Magnesium Sulfate and Lidocaine in Hemodynamic Intubation in Elective Coronary Artery Bypass Grafting: A Randomized Controlled Clinical Trial. Anesthesiol http://dx.doi.org/10.5812/aapm.15905. Med. 2014;4(3)
  • Ghodraty MR, Saif AA, Kholdebarin AR, Rokhtabnak F, Pournajafian AR, Nikzad-Jamnani AR, et al. The effects of magnesium sulfate on neuromuscular blockade by cisatracurium during induction of anesthesia. J Anesth. 2012;26(6): 858– 63
  • Dogru K, Yildirim D, Ulgey A, Aksu R, Bicer C, Boyaci A. Adding magnesium to levobupivacaine for axillary brachial plexus block in arteriovenous fistule 2011;113(10):607–9. Bratisl Lek Listy.
  • Pascual-Ramírez J, Gil-Trujillo S, Alcantarilla C. Intrathecal magnesium as analgesic adjuvant for spinal anesthesia: a meta-analysis of randomized trials. Minerva Anestesiol. 2013;79(6):667–78.
  • Hung YC, Chen CY, Lirk P, Wang CF, Cheng JK, Chen CC et. al. Magnesium sulfate diminishes the effects of amide local anesthetics in rat sciatic- nerve 2007;32(4):288-95. Anesth Pain Med.
  • Sethi D, Wason R. Intravenous regional anesthesia using lidocaine and neostigmine for upper limb surgery. J Clin Anesth. 2010;22(5):324–8.
  • Santhosh MC, Rohini BP, Roopa S, Raghavendra PR. Study of 0,5% lidocaine alone and combination of 0.25% lidocaine with fentanyl and vecuronium in intravenous regional anesthesia for upper limb surgeries. Rev Bras Anestesiol. 2013;63(3):254–7.
  • Farouk S, Aly A. Quality of lidocaine analgesia with and without midazolam for intravenous regional anesthesia. J Anesth. 2010;24(6):864–8.
  • Sen H, Kulahci Y, Bicerer E, Ozkan S, Dagl G, Turan A. The analgesic effect of paracetamol when added to lidocaine for intravenous regional anesthesia. Anesth Analg. 2009;109(4):1327–30.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Klinik Araştırma
Yazarlar

Gülin Haroğlu Orçan Bu kişi benim

Mehmet Büget

S. İpek Edipoğlu

Halil Balcı Bu kişi benim

Kamil Pembeci Bu kişi benim

Lütfi Telci

Süleyman Küçükay Bu kişi benim

Yayımlanma Tarihi 26 Şubat 2015
Gönderilme Tarihi 26 Şubat 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 78 Sayı: 1

Kaynak Göster

APA Haroğlu Orçan, G., Büget, M., Edipoğlu, S. İ., Balcı, H., vd. (2015). REJYONAL İNTRAVENÖZ ANESTEZİDE LİDOKAİN İLE LİDOKAİN VE MAGNEZYUM KOMBİNASYONUNUN KARŞILAŞTIRILMASI. Journal of Istanbul Faculty of Medicine, 78(1), 6-12. https://doi.org/10.18017/iuitfd.m.13056441.2015.78/1.6-12
AMA Haroğlu Orçan G, Büget M, Edipoğlu Sİ, Balcı H, Pembeci K, Telci L, Küçükay S. REJYONAL İNTRAVENÖZ ANESTEZİDE LİDOKAİN İLE LİDOKAİN VE MAGNEZYUM KOMBİNASYONUNUN KARŞILAŞTIRILMASI. İst Tıp Fak Derg. Mayıs 2015;78(1):6-12. doi:10.18017/iuitfd.m.13056441.2015.78/1.6-12
Chicago Haroğlu Orçan, Gülin, Mehmet Büget, S. İpek Edipoğlu, Halil Balcı, Kamil Pembeci, Lütfi Telci, ve Süleyman Küçükay. “REJYONAL İNTRAVENÖZ ANESTEZİDE LİDOKAİN İLE LİDOKAİN VE MAGNEZYUM KOMBİNASYONUNUN KARŞILAŞTIRILMASI”. Journal of Istanbul Faculty of Medicine 78, sy. 1 (Mayıs 2015): 6-12. https://doi.org/10.18017/iuitfd.m.13056441.2015.78/1.6-12.
EndNote Haroğlu Orçan G, Büget M, Edipoğlu Sİ, Balcı H, Pembeci K, Telci L, Küçükay S (01 Mayıs 2015) REJYONAL İNTRAVENÖZ ANESTEZİDE LİDOKAİN İLE LİDOKAİN VE MAGNEZYUM KOMBİNASYONUNUN KARŞILAŞTIRILMASI. Journal of Istanbul Faculty of Medicine 78 1 6–12.
IEEE G. Haroğlu Orçan, “REJYONAL İNTRAVENÖZ ANESTEZİDE LİDOKAİN İLE LİDOKAİN VE MAGNEZYUM KOMBİNASYONUNUN KARŞILAŞTIRILMASI”, İst Tıp Fak Derg, c. 78, sy. 1, ss. 6–12, 2015, doi: 10.18017/iuitfd.m.13056441.2015.78/1.6-12.
ISNAD Haroğlu Orçan, Gülin vd. “REJYONAL İNTRAVENÖZ ANESTEZİDE LİDOKAİN İLE LİDOKAİN VE MAGNEZYUM KOMBİNASYONUNUN KARŞILAŞTIRILMASI”. Journal of Istanbul Faculty of Medicine 78/1 (Mayıs 2015), 6-12. https://doi.org/10.18017/iuitfd.m.13056441.2015.78/1.6-12.
JAMA Haroğlu Orçan G, Büget M, Edipoğlu Sİ, Balcı H, Pembeci K, Telci L, Küçükay S. REJYONAL İNTRAVENÖZ ANESTEZİDE LİDOKAİN İLE LİDOKAİN VE MAGNEZYUM KOMBİNASYONUNUN KARŞILAŞTIRILMASI. İst Tıp Fak Derg. 2015;78:6–12.
MLA Haroğlu Orçan, Gülin vd. “REJYONAL İNTRAVENÖZ ANESTEZİDE LİDOKAİN İLE LİDOKAİN VE MAGNEZYUM KOMBİNASYONUNUN KARŞILAŞTIRILMASI”. Journal of Istanbul Faculty of Medicine, c. 78, sy. 1, 2015, ss. 6-12, doi:10.18017/iuitfd.m.13056441.2015.78/1.6-12.
Vancouver Haroğlu Orçan G, Büget M, Edipoğlu Sİ, Balcı H, Pembeci K, Telci L, Küçükay S. REJYONAL İNTRAVENÖZ ANESTEZİDE LİDOKAİN İLE LİDOKAİN VE MAGNEZYUM KOMBİNASYONUNUN KARŞILAŞTIRILMASI. İst Tıp Fak Derg. 2015;78(1):6-12.

Contact information and address

Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE

Email: itfdergisi@istanbul.edu.tr

Phone: +90 212 414 21 61