The Comparison of Spinal Ropivacaıne and Levobupivacaine for Transurethral Surgery

Yıl 2019, Cilt: 14 Sayı: 2, 80 - 84, 15.07.2019

Bora Bilal , Özgür Yağan , Mahinur Demet Albayrak Belgin Akan Tunçtürk , Nermin Göğüş

https://doi.org/10.17517/ksutfd.571916

Öz

Objective. It was aimed to compare the efficacy of levobupivacaine
and ropivacaine during transurethral resection of the prostate under spinal
anesthesia.

Material and Methods:
In this prospective, randomized, double-blind trial, 40 patients
undergoing elective transurethral resection of the prostate under spinal
anesthesia were randomized into two groups. 
0.75% levobupivacaine 7.5mg (Group I) and 0.75% ropivacaine 7.5mg (Group
II) were used intrathecally.

Results: There
were no differences the time for sensorial block to reach T10, maximum
sensorial block level, the time to reach maximum block level, motor block level
at the end of surgery between the groups. 
The two-segment regression time was 53.75 ± 10.75 minutes in Group I and
73.25 ± 15.50 minutes in Group II (p<0.000), the regression time to reach
T12 was 70.25±17.05 minutes in Group I and 88.00 ± 20.42 in Group II
(p<0.005),  the duration of the motor
block was 60.75±36.93 minutes in Group I and 92.00±26.03 minutes in Group II
(p<0.004). There was not any significant difference between groups with
regard to hemodynamic data and side effects.

Conclusions: This study showed that, low-dose levobupivacaine and
ropivacaine used in transurethral surgery have similar effects and delivers
sufficient and reliable anesthesia. Use of ropivacaine constitutes an advantage
since the motor blockage level is shorter with it. As a result, it was concluded that
low-dose ropivacaine and levobupivacaine used in transurethral surgery had
similar effects, provided adequate and reliable anesthesia, but ropivacaine was
an advantage because of the short duration of motor block.

Anahtar Kelimeler

Spinal anaesthesia, Transurethral resection of the prostate, Ropivacaine, Levobupivacaine

Transüretral Cerrahide Spinal Anestezide Ropivakain ve Levobupivakainin Karşılaştırılması

Öz

Amaç: Çalışmamızda prostatın
transüretral rezeksiyon (TUR-P) cerrahisinde spinal anestezide kullanılan
levobupivakain ve ropivakainin etkinliklerinin karşılaştırılması amaçlandı.

Gereç ve Yöntemler:
Prospektif, randomize çift kör olarak ASA I-III risk grubunda 40 hasta
çalışmaya dahil edildi. I. Grupta (n=20) intratekal aralığa % 0.75’lik levobupivakain
7.5mg, ikinci grupta % 0.75 ‘lik ropivakain 7,5 mg verilerek spinal anestezi
uygulandı.

Bulgular: Gruplar arasında
duyusal bloğun T10’a ulaşma süreleri, maksimum blok seviyesi, maksimum bloğa
ulaşma süreleri, operasyon sonu motor blok seviyesi bakımından istatistiksel
olarak anlamlı fark yoktu. İki segment regresyon süresi, grup I’de 73,25 ±
15,50 dk, Grup II’de 53,75 ± 10,75 dk, T12’ye regresyon süresi grup I’de 88,00
± 20,42 dk, grup II’de 70,25±17,05 dk, motor blok süresi ise grup I’de 92,00±26,03
dk, grup II’de 60,75±36,93 dk. bulundu. Hemodinamik
veriler ve yan etkiler bakımından istatistiksel olarak anlamlı fark saptanmadı.

Sonuç: Çalışmamızda; düşük doz levobupivakain veya ropivakain ile
yapılan spinal anestezide TUR için yeterli duyusal ve motor blok sağlandı.
Ropivakain grubunda motor blok süresi anlamlı olarak kısa bulundu. Sonuç olarak
transüretral cerrahide kullanılan düşük doz ropivakain ve levobupivakain’in
birbirine benzer etkilerinin olduğu, yeterli seviyede ve güvenilir anestezi sağladığı,
ancak motor blok süresinin kısa olması nedeniyle ropivakain kullanılmasının bir
avantaj olduğu kanısına varıldı. 

Anahtar Kelimeler

Spinal anestezi, Prostat Transüretral Rezeksiyon (TUR-P), Ropivakain, Levobupivakain

Kaynakça

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