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Transüretral Cerrahi Vakalarinda, Sürekli Spinal ve Tek Doz Spinal Anestezi Tekniklerinin Hemodinami, Duyusal ve Motor Blok Seviyesi Üzerine Etkilerinin Karşilaştirilmasi
2023
Journal:  
Acta Medica Alanya
Author:  
Abstract:

Amaç: Bu çalışmada transüretral rezeksiyon cerrahi yapılacak hastalarda: 1- Tek doz ve sürekli spinal anestezi tekniklerinin etkinliğinin 2- Hastalardaki hemodinamik değişikliklerin, duyu-motor blok düzeylerinin ve sürelerinin, anestezik ilaç dozlarının ve yan etkilerin karşılaştırılması amaçlanmıştır. Yöntem: Transüretral cerrahi planlanan 40-75 yaş arası ASA I-III grubu 40 hasta tek doz spinal anestezi (Grup 1) (n=20) ve sürekli spinal anestezi (Grup 2) (n=20) olarak rastgele iki gruba ayrıldı. Hastaların hemodinamik verileri, analjezi durumları ve motor blok seviyeleri değerlendirildi. Bulgular: Hemodinamik parametreler açısından, uygulama öncesine göre tek doz spinal anestezi grubu (grup 1) sistolik-diastolik kan basıncı ve kalp hızı ortalama değerleri sürekli spinal anestezi grubuna göre anlamlı olarak düşük bulundu (p<0,05). Duyusal ve motor blok seviyelerine bakıldığında tek doz spinal anestezi grubunda maksimum blok seviyesi T8 iken sürekli spinal anestezi grubunda T9 olarak bulundu (p<0,05). T10 ‘a ulaşma, iki segment gerileme, duyusal ve motor blok sonlanma zamanları sürekli spinal anestezi grubunda, tek doz spinal anestezi grubuna göre anlamlı olarak düşük bulundu (p<0,05). Her iki grup arası bromage skor değerleri açısından fark yoktu (p>0,05). Sürekli spinal anestezi grubunda, T10 dermatomunda analjezi sağlamak için gerekli olan lokal anestezik dozu ortalama 7,12±1,46 ml, hacmi ise 1,4±0,29 olarak bulundu. Yine intraoperatif verilen sıvı miktarı, sürekli spinal anestezi grubunda anlamlı olarak düşük bulundu (p<0,05). Sonuç: Sürekli spinal anestezi yöntemiyle, titre edilebilir ve daha az dozda lokal anestezik kullanılarak, tek doz spinal anestezi yöntemine yakın bir duyusal-motor blok seviyesi ve daha stabil bir hemodinami sağlanabilir.

Keywords:

Comparative Analysis Of The Impact Of Continuous Spinal Anesthesia and Single-dose Spinal Anesthesia Techniques On Hemodynamics, Sensory and Motor Block Levels In Transurethral Surgery Cases
2023
Journal:  
Acta Medica Alanya
Author:  
Abstract:

Aim: In this study, it was aimed to compare in patients undergoing transurethral resection surgery: 1- The effectiveness of single-dose and continuous spinal anesthesia techniques, 2- Hemodynamic changes, sensory-motor block levels and durations, anesthetic drug doses and side effects. Method: Forty American Society of Anesthesiology I–III patients in the age group of 40–75 years who were scheduled for transurethral surgery were randomly divided into two groups: single dose spinal anesthesia (Group 1) (n = 20) and continuous spinal anesthesia (Group 2) (n = 20). The patients' hemodynamic data, analgesia status and motor block levels were evaluated. Results: With regard to the hemodynamic parameters, the mean values of systolic–diastolic blood pressure and heart rate were found to be significantly lower in the single dose spinal anesthesia group (Group 1) than in the continuous spinal anesthesia group (p < 0.05). In terms of sensory and motor block levels, the maximum block level was T9 in the continuous spinal anesthesia group, while it was T8 in the single dose spinal anesthesia group (p < 0.05). Upon reaching T10, two-segment regression and sensory and motor block termination times were found to be significantly lower in the continuous spinal anesthesia group when compared to the single dose spinal anesthesia group (p < 0.05). There was no difference between the two groups in terms of Bromage score values (p > 0.05). In the continuous spinal anesthesia group, the mean dose and volume of the local anesthetic required to achieve analgesia in the T10 dermatome were found to be 7.12 ± 1.46 ml and 1.4 ± 0.29, respectively. Furthermore, the amount of fluid administered intraoperatively was found to be significantly lower in the continuous spinal anesthesia group than in the single dose group (p < 0.05). Conclusion: With the continuous spinal anesthesia method, it can be titrated and by using lower doses of local anesthetic, a level of sensory-motor blockade close to the single-dose spinal anesthesia method and a more stable hemodynamics can be achieved.

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Acta Medica Alanya

Field :   Sağlık Bilimleri

Journal Type :   Uluslararası

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Acta Medica Alanya