Granisetron’s Preemptive Effect on Hemodynamic Changes in General Anesthesia During Laparoscopic Cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy causes hemodynamic changes such as decreasing preload, compression on vena cava inferior. These effects are correlated with increased intraabdominal pressure due to pneumoperitoneum. This study aims to evaluate the effect of granisetron (1 mg) in the prevention of post-induction hypotension in adult patients with laparoscopic cholecystectomy under general anesthesia. This study aims to evaluate Methods: One hundred and forty American Society of Anesthesiologists (ASA) status I–II patients, aged 18 to 65 years, undergoing elective laparoscopic cholecystectomy surgery under general anesthesia were included. Mean blood pressure (MBP), heart rate (HR) and are measured and recorded 1 minute after induction, 1 minute before intubation, 1 minute after intubation and every 5 minutes during operation. Intubation quality was assessed by Evans score at one minute after intubation. Results: The demographic variables (gender, age, weight, height and body mass index (BMI)) were similar in both groups. The mean blood pressure was decreased in 22 patients (%31.4) in saline group (Group S) and 8 patients (%11.4) in granisetron group (Group G) compared to baseline values after 15 minutes of granisetron administration at reverse Trendelenburg position. At the same period, the heart rate was decreased in 12 patients (%17.1) in group G 18 patients (%25.7) in group S. Conclussion: Granisetron prevented hypotension after reverse Trendelenburg position and CO2 insufflation in 15th minute of granisetron administration. It can be used safely in adult patients and patients having risks of hypotension due to positions during general anesthesia.

Keywords

• Granisetron
• hypotension
• general anesthesia
• propofol
• laparoscopic cholesistectomy

Granisetron'un Laparoskopik Kolesistektomi Sırasında Genel Anestezide Hemodinamik Değişiklikler Üzerindeki Önleyici Etkisi

Öz

Giriş: Laparoskopik kolesistektomi, preload azalması ve vena kava inferior üzerine kompresyon gibi hemodinamik değişikliklere neden olur. Bu etkiler, pnömoperitoneuma bağlı olarak artan intraabdominal basınçla ilişkilidir. Bu çalışmada, genel anestezi altında laparoskopik kolesistektomi uygulanan erişkin hastalarda, granisetronun (1 mg) indüksiyon sonrası hipotansiyonun önlenmesindeki etkisi değerlendirilmiştir. Gereç ve Yöntemler: Amerikan Anesteziyoloji Derneği (ASA) sınıfı I–II olan, 18-65 yaş aralığında elektif laparoskopik kolesistektomi geçiren 140 erişkin hasta çalışmaya dahil edilmiştir. Ortalama arter basıncı (OAB) ve kalp hızı (KH), indüksiyondan 1 dakika sonra, entübasyondan 1 dakika önce, entübasyondan 1 dakika sonra ve operasyon süresince her 5 dakikada bir ölçülerek kaydedilmiştir. Entübasyon kalitesi, entübasyondan 1 dakika sonra Evans skoru ile değerlendirilmiştir. Sonuç: Demografik değişkenler (cinsiyet, yaş, kilo, boy ve beden kitle indeksi) her iki grupta benzerdi. Granisetron uygulamasından 15 dakika sonra ve reverse Trendelenburg pozisyonunda, başlangıç değerlerine kıyasla ortalama arter basıncı serum fizyolojik alan grupta (Grup S) 22 hastada (%31,4), granisetron alan grupta (Grup G) ise 8 hastada (%11,4) düşmüştür. Aynı zaman diliminde, kalp hızı Grup G’de 12 hastada (%17,1), Grup S’de ise 18 hastada (%25,7) azalmıştır. Tartışma: Granisetron, uygulamadan sonraki 15. dakikada reverse Trendelenburg pozisyonu ve CO₂ insuflasyonunu takiben gelişen hipotansiyonu önlemiştir. Genel anestezi sırasında pozisyona bağlı hipotansiyon riski olan erişkin hastalarda güvenle kullanılabilir.

Anahtar Kelimeler

• Granisetron
• hipotansiyon
• genel anestezi
• propofol
• laparoskopik kolesistektomi

Kaynakça

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